• 제목/요약/키워드: Primary Health Clinic

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KAAACI Evidence-Based Clinical Practice Guidelines for Chronic Cough in Adults and Children in Korea

  • Song, Dae Jin;Song, Woo-Jung;Kwon, Jae-Woo;Kim, Gun-Woo;Kim, Mi-Ae;Kim, Mi-Yeong;Kim, Min-Hye;Kim, Sang-Ha;Kim, Sang-Heon;Kim, Sang Hyuck;Kim, Sun-Tae;Kim, Sae-Hoon;Kim, Ja Kyoung;Kim, Joo-Hee;Kim, Hyun Jung;Kim, Hyo-Bin;Park, Kyung-Hee;Yoon, Jae Kyun;Lee, Byung-Jae;Lee, Seung-Eun;Lee, Young Mok;Lee, Yong Ju;Lim, Kyung-Hwan;Jeon, You Hoon;Jo, Eun-Jung;Jee, Young-Koo;Jin, Hyun Jung;Choi, Sun Hee;Hur, Gyu Young;Cho, Sang-Heon;Kim, Sang-Hoon;Lim, Dae Hyun
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.591-613
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    • 2018
  • Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics. Meanwhile, in referral clinics, a considerable proportion of adult patients with chronic cough are unexplained or refractory to conventional treatment. The present clinical practice guidelines aim to address major clinical questions regarding empirical treatment, practical diagnostic tools for non-specific chronic cough, and available therapeutic options for chronic wet cough in children and unexplained chronic cough in adults in Korea.

간호교육 철학정립 및 교육과정 개발을 위한 기초조사 (A Preliminary Study on Setting Philosophy and Curriculum Development in Nursing Education)

  • 정연강;김윤회;양광희;한경자;한상임
    • 대한간호학회지
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    • 제18권2호
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    • pp.162-188
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    • 1988
  • The purpose of this study is to guide the direction of the Korean nursing education to analysize ⑴ the philosophy and objectives ⑵ curriculum, and ⑶ educational environment. This analysis is based on the data from 50 nursing schools (14 4-year colleges and 35 3-year colleges) The survey was conducted from Dec. 1986 through Jan. 1987 by mail. 1) Educational philosophy and objectives 10 4-year colleges and 8 3-year college program have curricular philosoph. Most popular curricular philosophies are human beings, health, nursing, nursology, nursing education, nurses role in the present and in the future. 10 nursing schools mentioned that human being is the subject to interact with : environment physically, mentally and socially. 2 schools mentioned that health is the state of functioning well physically, mentally and socially. 13 schools mentioned that the nursing is the dynamic act to maintain and to promote the highest possible level of health. 4 schools mentioned that the nursology is an applied science. 4 schools mentioned that nursing education is the process to induce the behavioural changes based on the individual ability. There is different opinion about the nurses' role between 4-year college and 3-year college. In the responses from 4-year colleges they focus on the leadership in effective changes, self-regulating and self-determining responsibilities, applying the new technology, continuing education, and participation in research to further nursing knowledge. In the responses from 3-year colleges, they focus on the education in college, primary health care nursing, direct care provider and public health education. Among 50 respondents 40 schools have educational goals which can be divided into two categories. One is to establish the moral and the other is to develop the professionalism. 2) Curriculm The analsis of curriculum is only based on the data from the 4-year colleges because the most of 3-year colleges follow the curriculum guideline set by the Ministry of Education. a) Comparison of the credits in cultural subject and in nursing major. The average required credit for graduation is 154.6 and the median credit is the range of 140-149. The average credit of cultural subjects is 43.4. In detail, the average number of credit of required course and elective courses are 24.1 and 19.3 respectively. The average credit for major subject is 111.2. In detail, the average credit for required courses and electives course are 100.9 and 10.4 respectively. In 5 colleges, students are offered even on elective course b) Comparison of the credit by class. The average earned credits are as follows : 41.1 in freshman, 400 in sophormore 38.3 in junior and 32.4 in senior. Cultural subjects are studied in early phases. c) Comparison of the compulsory and elective cultural subject by institute. The range of credit is 7-43 in compulsory cultural subjects and there are lot of differences among institutions. While all respondents require liberal arts as compulsary subjects, few respondents lists social science, natural science and behavioral science as required subjects. Social science-related subjects are frequently chosen as cultural subjects d) Distribution of creditsin cultural subjects by institute. The liberal art subjects are taught in 20 institute. English and physical education courses are taught in all instituions. The social science subjects are taught in 15 colleges and the basic Psycology and the Basic sociology are the most popular subjects. The natural science subjects are taught in 7 colleges and Biology and Chemistry are the most popular subjects among them. e) Distribution of credits in major basic courses by institute. Most of the institutes select Anatomy, Microbiology, Physiology, biochemistry and Pathology as basic major courses. f) Comparison of the required and elective courses for nursing major by institutions. Subjects and credit ranges in major are varing by institute. More than half of the respondents select the following subjects as required major subjects. (1) Adults Health Nursing and Practice (19.5 credits) (2) Mother and Child Care and Practice (8.9 credits) (3) Community Health Care and Practice (8.5 credits) (4) Psychiatric Nursing Care and Practice (8.1 credits) (5) Nursing Management and Practice (3.9 credits) (6) Fundamental of Nursing, Nursing Research and Health Assessment and Practice. Three institutions select Introduction to nursing, Rehabilitation Nursing, School Nursing, Public Health Nursing, Nursing English, Communication, Human Development as electives in nursing major. 3) Educational environment a) Nursing institution There are forty-three 3-year colleges and seventeen 4-year colleges and 81.4% of which are private b) Number of students and faculty 19.2% of the students are in 4-year colleges and 80.8% of the students are in 3-year colleges. In 4-year colleges, the number of nursing faculty members is in the other of assistant professor, instructor and professor. In 3-year colleges, the orderiis lecturer, associate professor, full time instructor and assistant professor. In 4-year colleges, 18.8 students are allocated per nursing faculty and in 3-year colleges, 33.1 students are allocated per nursing faculty. c) Clinical practices 66.7% of the 4-year colleges practice over 1201 hours in clinic and 28.5% of 3-year colleges practice over 1201 hours in clinic. In 4-year colleges, 11.5 students are allocated per nursing faculty and in 3-year colleges,17 students are allocated per nursing faculty The survey shows no difference in the procedure between 4-year colleges and 3-year colleges but 3-year colleges choose the more variety practicing site such as special hospital and community health clinic. d) Audiovisual facilities The survey shows a lot of difference in audiovisual facilities among institution and 3-year colleges are less equipped than 4-year colleges.

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National HPV Immunisation Programme: Knowledge and Acceptance of Mothers Attending an Obstetrics Clinic at a Teaching Hospital, Kuala Lumpur

  • Ezat, Sharifa Wan Puteh;Hod, Rozita;Mustafa, Jamsiah;Mohd Dali, Ahmad Zailani Hatta;Sulaiman, Aqmar Suraya;Azman, Azlin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.2991-2999
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    • 2013
  • Background: Introduction of the HPV vaccine is a forefront primary prevention method in reducing the incidence of carcinogenic human papillomavirus (HPV) and cervical cancer. The Malaysia government has implemented the National HPV immunisation programme since 2010, supplying HPV vaccine free to targeted 13 year olds. This study aimed to explore the level of knowledge among mothers on cervical cancer, HPV, HPV vaccine and National HPV (NHPV) immunisation programme since its' implementation. It also assessed acceptance of mothers towards HPV vaccine being administered to their daughter, son or themselves. Materials and Methods: A cross sectional study was conducted on 155 respondents using self-administered questionnaires; conducted in December 2012 at the Obstetrics and Gynaecology Clinic in a teaching hospital in Kuala Lumpur. Respondents were selected using a multistage sampling technique. Results: A response rate of 100% was obtained. Overall, 51.0% of mothers had good knowledge, with 55% having good knowledge of cervical cancer, 54.2% for both HPV and the National HPV immunisation programme and 51.0% for the HPV vaccine. Regression analyses showed that ethnicity was associated with knowledge on cervical cancer (p=0.003) while education was associated with knowledge on HPV (p=0.049). Three factors are associated with knowledge of the National HPV immunisation programme; ethnicity (p=0.017), mothers' education (p=0.0005) and number of children (p=0.020). The acceptance of HPV vaccine to be administered among daughter was the highest at 87.1%, followed by for mothers themselves at 73.5%, and the least is for sons 62.6%. Conclusions: This study found that the overall level of knowledge was moderate. Adequate information on cervical cancer, HPV, HPV vaccination and the National HPV immunisation programme should be provided to mothers in order to increase acceptance of the HPV vaccine which can reduce the disease burden in the future.

영유아 발달선열검사를 위한 체크리스트 개발 및 타당도 검정 (Development & Validation of a Checklist for Infant and Child Developmental Screening)

  • 주현옥;이내영;박인숙;이선옥;김소희
    • Child Health Nursing Research
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    • 제15권1호
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    • pp.34-41
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    • 2009
  • Purpose: In this study, a Checklist for Infant and Child Developmental Screening (CICDS) was designed for use by primary pediatric health care providers to identify infants and children with developmental delays. Method: Each Item of the CICDS was constructed referring to existing tools. In 5 public health centers of B city, 500 infants and children were selected at the age of 2, 4, 6, 12, & 18 months and assessed between October and December 2006, CICDS and the Korea Denver II were compared to assesses the validity of the CICDS. Results: The CICDS consisted of 30 items in 4 areas; Personal-social, Fine motor-adaptive, Language, Gross motor. The results of the CICDS correlated significantly with the result of Korea Denver II at each month of age. (r=0.19; p<.01). Of the 500 infants and children, 148 were "suspect" for development delays (sensitivity of 96%, specificity 73%). On the CICDS, 74.6% of children received same result as Denver II. In discriminant analysis, 89.9% of children were identified correctly by CICDS (p<.01). Conclusion: CICDS could be a screening procedures to quickly and reliably identify infants with developmental delays. It also provides a mean of recording measurements of development characteristics.

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Development of a Risk Index for Prediction of Abnormal Pap Test Results in Serbia

  • Vukovic, Dejana;Antic, Ljiljana;Vasiljevic, Mladenko;Antic, Dragan;Matejic, Bojana
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권8호
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    • pp.3527-3531
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    • 2015
  • Background: Serbia is one of the countries with highest incidence and mortality rates for cervical cancer in Central and South Eastern Europe. Introducing a risk index could provide a powerful means for targeting groups at high likelihood of having an abnormal cervical smear and increase efficiency of screening. The aim of the present study was to create and assess validity ofa index for prediction of an abnormal Pap test result. Materials and Methods: The study population was drawn from patients attending Departments for Women's Health in two primary health care centers in Serbia. Out of 525 respondents 350 were randomly selected and data obtained from them were used as the index creation dataset. Data obtained from the remaining 175 were used as an index validation data set. Results: Age at first intercourse under 18, more than 4 sexual partners, history of STD and multiparity were attributed statistical weights 16, 15, 14 and 13, respectively. The distribution of index scores in index-creation data set showed that most respondents had a score 0 (54.9%). In the index-creation dataset mean index score was 10.3 (SD-13.8), and in the validation dataset the mean was 9.1 (SD=13.2). Conclusions: The advantage of such scoring system is that it is simple, consisting of only four elements, so it could be applied to identify women with high risk for cervical cancer that would be referred for further examination.

일개 보건진료소 사업 지역의 사고조사 (A Study of the Accidents of the Residents in a Rural Area)

  • 강복수;이경수;김석범;김창윤;이옥금
    • Journal of Yeungnam Medical Science
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    • 제8권2호
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    • pp.174-184
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    • 1991
  • 농촌지역 사고의 발생정도를 파악하고 이와 관련된 인적, 환경요인을 알고자 1988년 1월 1일 부터 1988년 12월 31일 까지 1년 동안 경상북도 상주군 중동면 신암리 전 주민 1,360명을 대상으로 시행된 연구의 결과를 요약하면 다음과 같다. 대상자 1,360명 중 85건의 각종 사고가 발생하여 1,000명당 연간 발생률은 62.5였다. 연령별 발생률을 보면, 남자의 경우가 30-39세 군에서 1,000명당 연간 발생률 255.8로 가장 높았고, 여자의 경우는 60-69세가 1,000명당 연간 발생률 92.1로 가장 높았다. 성별 발생건수는 남자가 59건, 여자가 26건으로 남자에서 유의하게 높았으며, 1,000명당 연간 발생률도 남자가 86.5, 여자가 38.3으로 남자가 2배 이상 높았다. 사고를 월별, 계절별로 살펴보면 2월, 5월과 7월에 가장 많았고, 계절별로 보면 봄과 여름이 가장 많았다. 요일별로 보면 금요일에 24.7%로 가장 많이 발생하였고 그 다음이 월요일과 토요일로 각각 20.0% 발생하였다. 시간대 별로 나누어 보면 오전 9시에서 12시 사이에 전체손상의 42.2%가 발생하여 가장 많았고, 오후 9시와 오전 8시 사이에는 전체손상의 5% 미만이 발생하였다. 사고 발생시 이용한 의료기관은 보건진료소가 44건으로 51.8%를 차지하였고, 의원이 33건으로 38.8%를 차지하였다. 의료기관 이용일수는 일주일 이내에 완치된 경우가 54건으로 63.5%를 차지하였고, 한달 이상 치료한 경우도 9.4%에 이르렀다. 사고가 일어난 장소는 방과 마루, 부엌과 같은 가옥내 구조물에서 일어난 것이 23.5%, 창고나 운동장 등에서 일어난 것이 23.5% 그리고 길에서 일어난 손상이 22.4%, 논이나 밭에서 일어난 것이 20.0%를 차지하였다. 사고의 원인은 교통사고와 창상 또는 자상이 각각 17건(20.0%)으로 가장 많았다. 손상의 형태로는 개방창이 37건으로 43.5%를 차지하였고, 골절과 표면성 손상이 각각 12.9%, 다음이 중독으로 12.8%를 차지하였다. 사고의 원인이 된 도구는 농기구에 의한 것이 20건으로 가장 많았다. 손상의 부위는 손과 다리 부분이 각각 18.8%와 20.0%로 나타났고 다음이 안면부 손상이었다.

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아토피피부염에 대한 Lactobacillus 혼합배양액의 임상 증례 (The Case Study of Lactobacillus mixture culture fluid on Atopic dermatitis)

  • 조을화;김태근;홍수정;정도연;황성연;안성훈
    • 대한한의학회지
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    • 제36권3호
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    • pp.135-143
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    • 2015
  • Objectives: Recently lactic acid formulation was known as the adjuvant therapy on atopic dermatitis(AD) symptoms because of little side effects. In this study, it was studied that Lactobacillus mixed culture appliment was effective on not on AD symptoms. Methods: The case-photos 30-40 times of AD symptoms from case were observed with literatures. The case-photos were acquired with environmental AD dermatitis experience program which is conducted in SUNCHANG RESERCH INSTITUTE OF HEALTH AND LONGEVITY from 2014.01 to 2014.08. Experience applicants were limited the oral administration and chemical external administration. Results: Lactobacillus mixed culture appliment was effective because of the mitigation or disappearance of AD primary symptoms like pruritus, erythema, edema, effusion, dry skin, scaly, scab etc. AD symptom degree was dependent on lactobacillus mixed culture appliment times, and classified as Reaction Period (RAP), Reduction Period (RDP), Efection Period (EP), Reproduction Period (RPP) on a single mixed culture appliment time. And AD symptoms which were appeared in RPP were classified as Rebound Period (RBP), Effection Period (EP), Subclinical Period (SCP). Conclusions: Lactobacillus mixed culture appliment is considered to be useful for AD symptoms and is estimated to be effective by different mechanism with oral administration or steroid ointment application. Lactobacillus mixed culture appliment is expected to induce a synergistic effects on AD symptom reliefs with the other oral administration.

Significance of the tethered maxillary frenulum: a questionnaire-based observational cohort study

  • Naimer, Sody A.;Israel, Ariel;Gabbay, Aviezer
    • Clinical and Experimental Pediatrics
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    • 제64권3호
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    • pp.130-135
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    • 2021
  • Background: The clinical significance of lip-tie, or a tethered maxillary frenulum, remains under debate. Clinicians and parents are often perplexed when deciding whether procedures available to relieve a seemingly tight or severe maxillary frenulum are needed. Purpose: No previous studies have assessed the consequences of not subjecting a tethered maxillary frenulum in newborns to surgical intervention. This study aimed to contribute the first prospective trial on this topic with a relatively extended follow-up of these newborn infants. Methods: This prospective observational questionnaire-based cohort trial was performed in a community setting and aimed to determine whether lip-tie is associated with an increased likelihood of eventual feeding or oral disorders. Results: The convenience sample comprised of 61 consecutively arriving infants with concomitant tethered frenula who were treated at the clinic for various reasons. This cohort was compared with a random sample of 66 age-matched children for a mean follow-up period of 6.42 years. Infants undergoing oropharyngeal procedures were excluded. Awareness of a deviation in oral structures was reported by 18% of the study group versus 0% of the controls. Mothers participating in the study group (24.6%) less frequently recalled painful nipples or discomfort during breastfeeding than those in the control group (47.0%) (P<0.01). There were no intergroup differences in other types of feeding difficulty, dental hygiene, pronunciation, or speech development. Conclusion: Our findings suggest that a tethered labial frenulum is not associated with an increase in breastfeeding disturbances or oral disorders. These data encourage clinicians to question the need to intervene in cases of tethered maxillary frenula.

Relationship between metformin use and mortality in tuberculosis patients with diabetes: a nationwide cohort study

  • Eunki Chung;Dawoon Jeong;Jeongha Mok;Doosoo Jeon;Hee-Yeon Kang;Heejin Kim;Heesun Kim;Hongjo Choi;Young Ae Kang
    • The Korean journal of internal medicine
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    • 제39권2호
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    • pp.306-317
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    • 2024
  • Background/Aims: To determine whether metformin, which is considered a host-directed therapy for tuberculosis (TB), is effective in improving the prognosis of patients with TB and diabetes mellitus (DM), who have higher mortality than those without DM. Methods: This cohort study included patients who were registered as having TB in the National Tuberculosis Surveillance System. The medical and death records of matched patients were obtained from the National Health Information Database and Statistics Korea, respectively, and data from 2011 to 2017 were collected retrospectively. We classified patients according to metformin use among participants who used diabetes drugs for more than 28 days. The primary outcome was all-cause mortality during TB treatment. Double propensity score adjustment was applied to reduce the effects of confounding and multivariable Cox proportional hazard models were used to estimate adjusted hazard ratio (aHR) with 95% confidence interval (CI). Results: The all-cause mortality rate during TB treatment was lower (9.5% vs. 12.4%, p < 0.01) in the metformin user group. The hazard of death due to all causes after double propensity score adjustment was also lower in the metformin user group (aHR 0.76, 95% CI 0.67-0.86, p < 0.01). There was no significant difference in mortality between metformin users and non-users for TB-related deaths (p = 0.22); however, there was a significant difference in the non-TB-related deaths (p < 0.01). Conclusions: Metformin use in patients with TB-DM co-prevalence is associated with reduced all-cause mortality, suggesting the potential for metformin adjuvant therapy in these patients.

QLF-D를 이용한 장애 아동 보호자의 구강위생관리 교육 : 증례보고 (PARENTS EDUCATION OF ORAL HYGIENE USING QLF-D IN PATIENTS FOR SPECIAL HEALTH CARE NEEDS)

  • 임소영;이고은;최병재;이제호
    • 대한장애인치과학회지
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    • 제13권2호
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    • pp.99-103
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    • 2017
  • 본 증례는 Pallister-Killian 증후군 및 뇌성마비, 외상성 뇌손상이 있는 환자의 보호자에게 구강위생 관리 교육 및 동기부여를 시행하기 위한 방법 중 QLF-D를 사용한 경우이다. 치과치료에 대한 접근성이나 협조도에 어려움이 있는 장애 아동에서 치아 우식의 조기탐지 및 회복에 대한 객관적인 진단 장비, 보호자 교육 및 동기부여에 대한 효과적인 시각적 교육 자료로서 QLF-D가 유용하게 사용될 수 있다. 더 나아가 구강 건강 증진을 통한 장애 아동의 삶을 질 개선을 기대할 수 있다.