• 제목/요약/키워드: Intern

검색결과 73건 처리시간 0.037초

응급수술을 시행한 응급의료센터 내원 외상 환자 분석; 응급의학과 진료는 외상환자에 대한 외과의 수술과 같은 전문적인 진료를 오히려 지연시키는가? (Clinical Analysis of Trauma Surgery Patients in a Local Emergency Center; Does Emergency Physicians'Treatment Delay the Surgeons'Special Care like Emergency Operations for Trauma Victims?)

  • 이경원
    • Journal of Trauma and Injury
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    • 제20권1호
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    • pp.19-25
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    • 2007
  • Purpose: Trauma surgery is not an official medical specialty in the Republic of Korea (South Korea). Thus, a trauma victim transported to an emergency room (ER) is resuscitated and surveyed by an intern, a resident, or an emergency physician (EP) at first. Currently an operative management is decreasing because of multiple factors. Nevertheless, trauma surgery is the key for some patients. Does the EP's treatment in the ER delay the surgeon's emergency operation? Methods: A retrospective study was performed for trauma victims who underwent trauma surgery from March 2004 to February 2005 in a local emergency center of Daegu-city. We reviewed the medical records and analyzed the trauma victim's age, sex, cause of injury, method of transport, time from the trauma to the operation, EP's treatment, surgical department, mortality, and injury severity score (ISS). Results: Of the 223 trauma victims included in this study, males were predominant (83.4%). The mean age was 37.98 years of age. The main Causes of trauma were trauma NOS (not otherwise specified) and motor vehicle accidents (MVA). The main methods of transport was privately owned automobile. The mean time from trauma to operation was 617.46 min. The mean ISS was 7.67. Trauma surgery with the EP's treatment group included 40 trauma victims with higher ISS, and the time from trauma to operation was shorter than it was for the 183 trauma victims not in that group. Conclusion: The EP's treatment of high-ISS multiple-injury trauma victims can shorten the time from trauma to trauma surgery and will help the surgical department treatment. In the trauma care system of the Republic of Korea, and increased role should be encouraged for emergency physician.

물리치료사의 업무관련성 근골격계 통증, 삶의 질과 프리젠티즘의 관계 (Associations between Work-Related Musculoskeletal Pain, Quality of Life and Presenteeism in Physical Therapists)

  • 배영현;이종훈;유현주;김동언;이보라;김연희;하현근
    • 한국산업보건학회지
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    • 제22권1호
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    • pp.61-72
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    • 2012
  • Background: The purpose of this study was to analyze the associations between physical therapists' work-related musculoskeletal pain, quality of life (QoL), and presenteeism. Methods: Self-reported questionnaires were given to 402 physical therapists in Korea. Variables examined included the prevalence of pain sites related to work, pain intensity, pain pattern, pain frequency, pain duration, pain rating score (PRS), general characteristics, QoL, and presenteeism. Results: Of the 314 physical therapists who responded, 251 (79.9%) reported work -related musculoskeletal pain in at least one body part. The most affected regions included the wrist and hand (21.0%), shoulder (19.6%), and lower back (19.1%). On average patients, QoL and presenteeism differed significantly between physical therapists who reported pain and those who did not (P < 0.05). QoL showed a negative correlation with the work-related musculoskeletal pain (P < 0.01) and presenteeism (P < 0.01), while the presenteeism and work-related musculoskeletal pain showed positive one(P < 0.01). Factors influencing a physical therapist's QoL included presenteeism, Working venues (Convalescent hospital), Work status (Contra ct worker) and professional experience, while the presenteeism included QoL, work status (Intern), PRS, working venues (Convalescent hospital), Area of specialty (Pediatrics), age, sex and working hour. Conclusions: Results show that physical therapists appear to be at a higher risk for work-related musculoskeletal pain. Therefore, administrators need to use the intervention strategies to manage the presenteeism and QoL of physical therapists.

우리나라 보건지소 조직, 기능 및 관리개선에 관한 연구 (A Study on the Organization, Function and Management of Health Subcenters in Korea)

  • 정영일;강성홍
    • 보건행정학회지
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    • 제2권2호
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    • pp.57-89
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    • 1992
  • This study is aimed both to reorient the Health net-works focused to Health Subcenters in times of development of local autonomy in Korea and to collect the fundamental data such as attitude and practice of the directors of Health Subcenter. The materials are collected from 134 out of 258 sampling directors of Health Subcenters with a questionaire by mailing(respond rate 51.9%). The major findings of this fundamental data are as follows. 1. Current average number of outpatients cared by a director of Health Subcenter is found to be 21.6. 2. The directors of Health Subcenter have little deducted hours for Public Health Programme. 3. Number of the Preventive Health Programme worked by a director of Health Subcenter is from 0 to 3. The most major group worked only 1 programme marked at 69.4%. 4. The directors of Health Subcenter express approval opinin marked at 80.2% that their qualification to appoint has to finish intern course. 5. The average diagnosis allowance a month is approximately twenty hundred thousand won. 6. Most of Health Subcenter(market at 94%) adopted a self-supporting account system. 7. The most complaining subject of directors of Health Subcenter is their working environment. The second complaining subject is governmental officier's interference. 8. The average number of outpatients cared by a director of Health Subcenter is found to be certain differentials by their marriage and the duration of employment. Some proposals of development on Health Subcenter based on the result of this research is as follows : 1. The reorganization on Health Subcenter under line of National Health Center Net-work 2. The psychological reorientation of directors of Health Sucenter and officers. 3. Autonomy management of Health Subcenter. 4. Reorientation of status on directors of Health Subcenter.

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A vibration based acoustic wave propagation technique for assessment of crack and corrosion induced damage in concrete structures

  • Kundu, Rahul Dev;Sasmal, Saptarshi
    • Structural Engineering and Mechanics
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    • 제78권5호
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    • pp.599-610
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    • 2021
  • Early detection of small concrete crack or reinforcement corrosion is necessary for Structural Health Monitoring (SHM). Global vibration based methods are advantageous over local methods because of simple equipment installation and cost efficiency. Among vibration based techniques, FRF based methods are preferred over modal based methods. In this study, a new coupled method using frequency response function (FRF) and proper orthogonal modes (POM) is proposed by using the dynamic characteristic of a damaged beam. For the numerical simulation, wave finite element (WFE), coupled with traditional finite element (FE) method is used for effectively incorporating the damage related information and faster computation. As reported in literature, hybrid combination of wave function based wave finite element method and shape function based finite element method can addresses the mid frequency modelling difficulty as it utilises the advantages of both the methods. It also reduces the dynamic matrix dimension. The algorithms are implemented on a three-dimensional reinforced concrete beam. Damage is modelled and studied for two scenarios, i.e., crack in concrete and rebar corrosion. Single and multiple damage locations with different damage length are also considered. The proposed methodology is found to be very sensitive to both single- and multiple- damage while being computationally efficient at the same time. It is observed that the detection of damage due to corrosion is more challenging than that of concrete crack. The similarity index obtained from the damage parameters shows that it can be a very effective indicator for appropriately indicating initiation of damage in concrete structure in the form of spread corrosion or invisible crack.

전공의 의료커뮤니케이션 능력과 진료수행 자기효능감, 공감능력과의 상관관계 (Associations of Communication Skills, Self-Efficacy on Clinical Performance and Empathy in Trainee Doctors)

  • 김도형;김민정;이해영;김현석;김영미;이상신
    • 정신신체의학
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    • 제29권1호
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    • pp.49-57
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    • 2021
  • 연구목적 전공의 공통역량으로서 의료커뮤니케이션의 중요성을 환기시키기 위하여 전공의를 대상으로 의료커뮤니케이션 능력을 조사하고 의료커뮤니케이션 능력, 진료수행 자기효능감 그리고 공감능력의 관련성을 분석하고자 하였다. 방 법 일 대학병원 소속 총 106명 전공의를 대상으로 자기평가 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감 척도, 한국판 의사 공감 척도를 조사하였다. 성별, 나이, 전공과목(인턴, 내과계, 외과계), 연차(인턴, 1~2년차, 3~4년차)에 따른 의료커뮤니케이션 능력의 차이를 조사하였다. 상관분석으로 의료커뮤니케이션 능력, 수정된 진료수행 자기효능감, 공감능력의 상관계수를 구하였고 구조방정식 모형을 이용하여 의료커뮤니케이션 능력에 영향을 미치는 각 변수의 효과를 검증하였다. 결 과 인턴 31명(31.6%), 내과계 레지던트 45명(45.9%), 외과계 레지던트 22명(22.4%)으로 총 98명이 참가하였다. 성별, 나이, 전공과목, 연차에 따른 자기평가 의료커뮤니케이션 능력 점수는 통계적으로 유의한 차이가 없었다. 의료커뮤니케이션 능력은 수정된 진료수행 자기효능감(r=0.782, p<0.001) 및 공감능력(r=0.210, p=0.038)과 유의한 정적 상관관계가 있었다. 공감능력은 진료수행 자기효능감에 직접적으로 유의한 영향을 미쳤으며(β=0.30, p<0.01), 진료수행 자기효능감은 의료커뮤니케이션 능력에 직접적으로 유의한 영향을 보였다(β=0.80, p<0.001). 공감능력은 진료수행 자기효능감을 매개하여(β=0.26, p<0.05) 간접적으로 의료커뮤니케이션 능력에 영향을 미치고 있었다. 결 론 전공의 의료커뮤니케이션 능력은 성공적 진료를 위해 필요한 진료수행 자기효능감과 직접적 연관성이 있었으므로 전공의 공통교육과정의 하나로서 중요한 위치를 차치한다고 할 수 있다. 그리고 현재의 의료커뮤니케이션 모델은 공감 능력과는 구별해서 이해될 필요가 있음이 시사된다.

캄보디아 농업투자 환경에 관한 연구 (Research on the Circumstance for Agricultural Investment of Cambodia)

  • 이규성;배동진;김성남;강영신
    • 한국국제농업개발학회지
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    • 제23권5호
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    • pp.475-484
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    • 2011
  • 최근 글로벌기업들의 신흥국 시장 쟁탈전이 격화되고 중국의 곡물수출이 금지되고 있는 상황에서 새로운 시장으로 지리적으로 아세안의 중심에 있는 캄보디아가 주목받고 있다. 캄보디아는 최근 몇 년 동안 정부의 적극적인 개혁정책으로 고도의 성장을 이루었고, 개방적인 시장경제체제를 유지하며 해외투자자본 유치에 적극적으로 힘쓰고 있다. 특히 농업은 캄보디아의 근본적인 가난과 빈곤을 해결해줄 가장 중요한 산업으로 정부 차원에서 많은 지원이 이루어지고 있다. 따라서 본 연구를 통해서 대캄보디아 투자에 관심이 많은 한국투자자들에게 유익한 정보를 제공하고자 수행한 결과는 다음과 같다. 1. 캄보디아는 농업에 적합한 기후와 자연환경, 저렴한 인건비와 큰 잠재력을 가진 매력적인 투자처로서 각광을 받고 있고 우리나라 농산업체들도 많이 진출하고 있지만 대상국의 정치적, 경제적, 사회적 여건, 법제도, 양국간의 협력관계 등 철저한 사전조사가 선행되어야 할 것이다. 2. 캄보디아는 열악한 인프라와 관개시설의 미비, 만연한 부정부패, 사회문화적 차이로 인한 인력 운용 등의 문제점들을 해소하기 위해서는 농업 인프라 조성에 KOICA와 연계한 지원이 필요하고, 기술적으로는 KOPIA같은 해외농업개발을 위한 전문 기관과 연계한 인력 양성이 필수적이다. 3. 캄보디아는 현재 외국의 투자자들이 원활히 투자할 수 있도록 투자관련 기관을 총리실 직속으로 두는 등 법과 제도를 정비해 나가고 있다. 그러나 법과 제도의 운영이 법에 따라 시행되지 못하고 있는 점 등을 감안하여, 정부차원 뿐만 아니라 민간기업과 힘을 합쳐 투자 전에 철저한 조사와 분석이 필요할 것이다. 4. 한국의 해외식량기지 건설은 정부와 기업체 그리고 우리 국민들의 관심과 지원이 필요하다. 이제는 농업을 단순히 하나의 상품을 생산하는 여러 산업 중 하나가 아니라 국가의 전략적 산업의 하나로 바라볼 때이다.

원주기독병원 응급실로 내원한 치과 응급환자에 관한 임상적 연구 (THE CHARACTERISTICS ON THE DENTAL EMERGENCY PATIENTS OF WONJU CHRISTIAN HOSPITAL FOR LAST 10 YEARS)

  • 문원규;정영수;이의웅;권호근;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제30권1호
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    • pp.34-42
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    • 2004
  • The appropriate care to the dental emergency patients is much important in the aspect of community dental service. To attain such a purpose, the sacred duty of the training of oral and maxillofacial surgeons is required. So, a retrospective study on the characteristics of dental injuries and diseases in emergency care unit will be very meaningful. This study was carried by reviewing the charts and radiographic films of 3,394 patients, treated for dental emergency at Wonju Christian Hospital, Republic of Korea, from January 1, 1993 to December 31, 2002. All patients were classified to 6 groups including trauma, toothache, infection, hemorrhage, TMJ disorder and the others. The clinical characteristics of diseases and treatment modalities according to each group were analyzed. The trauma (73.9%) was the most frequent cause in dental emergency patients, and acute toothache, odontogenic infection, oral hemorrhage, and TMJ disorder were next in order. Gender prediction was male (68%), there were many patients on May and December in the monthly frequency, and the most frequent age group was from 0 to 9 years. In the trauma group, male (68.6%) was predominant, and soft tissue injuries and primary closures were the most frequent type of injury and treatment. In jaw fractures, traffic accidents were the most cause and the weakest site was mandibular symphysis area, and mandibular angle, condyle, and body area were next in order. In the acute toothache group, the cause was dental pulpitis mostly and treatment for that was drug administration mainly. Buccal space abscess in infection group had the largest incidence (24.5%), and common treatments were incision and drainage and medications. In the hemorrhage group, a major cause was postoperative bleeding (60.3%) and hemostasis was obtained by pressure dressing, curettage and suture. For the TMJ disorder group, the peak incidence (63.8%) was shown in the post-traumatic myofascial pain dysfunction syndrome and its primary care was medication such as analgesics and sedatives. In the other group, the various specific symptoms were complained due to acute sialadenitis, trigeminal neuralgia, acute stomatitis, chemical burn, terminal stage neuritis of head and neck cancer, and foreign body aspiration. In conclusion, for the rapid and proper care of the emergency dental diseases, well-trained education should be presented to the intern and resident course of oral and maxillofacial surgery. And it is demanded that oral and maxillofacial surgeons must be prepared in knowledge and skill for such emergency care.

한국 중소기업수출지원정책의 효율화 방안 (A Study on the Efficiency of the Export Support Policy for the SME in Korea)

  • 최재한
    • 한국콘텐츠학회논문지
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    • 제18권3호
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    • pp.114-123
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    • 2018
  • 한국의 수출지원정책은 1997년 IMF 외환위기를 계기로 중소기업 중심으로 전환한 이후 중소기업수출액이 2011년 최초로 1,000억 달러를 초과하는 양적 성장을 거두었으나 이후 정체 수준을 보여 왔다. 이와 같은 정체의 배경에는 수출지원정책이 수출경쟁력 제고에 크게 기여하지 못한 측면도 존재하는 것으로 판단된다. 따라서 중소수출기업의 수출기반확충과 수출경쟁력 제고를 위하여 2010년 이후의 주요 선행연구를 중심으로 지원정책의 문제점을 분석하고 문제점 개선을 위한 효율화 방안을 도출하였다. 연구 결과 수출지원정책의 효율화를 위해 첫째, 수출지원기관 간 기능조정과 통합, 수출단계별 지원주체의 조정, 중소기업청과 지방자치단체의 역할조정 등에 대한 검토가 필요하다. 둘째, 기업 맞춤형 지원시스템의 구축이 필요하다. 셋째, 지원기관의 인력확보 및 전문성 제고를 위해서는 무역회사 퇴직 인력 또는 청년인턴제도의 검토가 필요하다. 넷째, 일정규모 이상의 지원사업에 대하여는 외부평가의 비중을 높이고 정량평가와 정성평가 모두가 가능한 균형 잡힌 지표의 개발이 필요한 것으로 나타났다.

이비인후과 영역에서 일반의와 전문의에 의한 외래처방전의 비교 평가 (Comparative Evaluation of Drug Use for Outpatients Prescribed by General Practitioner and Specialized Practitioner in ENT Area)

  • 민현성;송태범;이명구;장제관;이종길;임성실
    • 약학회지
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    • 제54권4호
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    • pp.258-269
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    • 2010
  • As people are easy to access the National Health Insurance, medical health service has been increased. It contributed to extend human's average life expectancy and to get better health care. But also increased unnecessary health service or inappropriate drug use. Therefore, DUR (Drug Use Review) is needed to induce appropriate drug use. The purpose of this study is to evaluate outpatient prescriptions by General Practitioner (GP) and Specialized Practitioner, especially indication for ENT referral including common cold which is the frequent indications that have patient see doctor. This study was reviewed retrospectively prescriptions for ENT referral collected at the A pharmacy for ENT Clinic in Cheong-Ju, B pharmacy for GP Clinic in BoEun from Feb 2nd, 2009 to Feb 28th, 2009. Each pharmacy located closed to the each enrolled clinic. The numbers of collected prescriptions were each A pharmacy (n=2501), B pharmacy (n=1343). This study was classified Drug Related Problems (DRPs) those prescriptions had as total 6 groups according to following 6 categories; 1) Unnecessary Drug, 2) Wrong Drug, 3) Low Dose, 4) Overdose, 5) Wrong Instruction, 6) Wrong Combination. In results, Specialized Practitioner's prescriptions had more DRPs than General Practitioner's prescriptions (ENT 155.34% vs GP 130.01%). In detail, Specialized Practitioner's prescriptions had more DRPs in Low Dose (ENT 16.95% vs GP 4.77%), Overdose (ENT 6.72% vs G.P 5.51%), Wrong Instruction (ENT 7.91% vs GP 5.81%), Wrong Combination (ENT 29.31% vs GP 25.09%). These DRPs would be caused from lack of consideration for dosage and drug interaction. General Practitioner's prescriptions had more DRPs in Unnecessary Drug (ENT 70.37% vs GP 78.85%), Wrong drug (ENT 4.12% vs GP 9.98%). These DRPs would be associated with drug selection. This study was assumed that Specialized Practitioner is better prescriber than General Practitioner because Specialized Practitioner complete additional intern and residency training. But, Specialized Practitioner is not always better prescriber than General Practitioner. Furthermore, prescriptions of both Specialized Practitioner and General Practitioner had many problems. In conclusion, It could be cut down the excessive medical expense and expected more efficient medical care by reducing DRPs, thus contributing to the improvement of national health. In order to pharmacist must have good professional ability of pharmacotherapy to help the physician for the drug selection.

핵테러리즘 위협에 대한 핵안보정상회의 성과, 한계 및 과제 (The Nuclear Security Summit Achievements, Limitations, and Tasks against Nuclear Terrorism Threat)

  • 윤태영
    • 융합보안논문지
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    • 제17권3호
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    • pp.73-81
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    • 2017
  • 2009년 4월 미국 오바마 대통령의 프라하 연설을 계기로 국제사회는 핵안보 증진과 핵테러리즘 저지를 위해 2010년부터 2016년까지 4차례의 핵안보정상회의를 개최하였다. 핵안보정상회의는 테러리스트들이 핵무기 또는 핵 분열성 물질의 획득 노력을 저지하기 위한 중대한 진전을 이루었으나 여전히 한계와 문제점을 남겼다. 이를 해결하기 위한 향후 국제 사회의 과제는 첫째, 양자간 협력과 다자간 핵안보 레짐 강화를 위한 공동의 노력을 재개하고, 참가국은 자국의 핵물질 방호와 핵시설 보안을 위한 공약 이행을 위해 노력해야한다. 둘째, 4차 핵안보정상회의에서 채택된 5개 행동계획에 따라 유엔, 국제원자력기구, 국제형사경찰기구(인터폴), 세계핵테러방지구상, 글로벌파트너십은 지속적인 핵안보 증진을 위해 임무를 수행해야한다. 셋째, 참가국들은 핵안보정상회의에서 다루지 못했던 군수용 핵물질의 관리와 방호에 대한 논의를 시작해야한다. 넷째, 핵안보의 국제법적 기반인 개정 핵물질방호협약과 핵테러억제협약의 이행을 강화하고, 핵시설에 대한 사이버 공격 대비 및 핵물질의 도난 불법거래 사보타주 저지를 위해 노력해야한다.