Cohidon, Christine;Imhof, Fabienne;Bovy, Laure;Birrer, Priska;Cornuz, Jacques;Senn, Nicolas
Journal of Preventive Medicine and Public Health
/
v.52
no.5
/
pp.323-332
/
2019
Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.
The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.
Kim, Ha-Na;Baik, Byeong-Ju;Kim, Jae-Gon;Kwon, Byoung-Woo;Yang, Yeon-Mi
Journal of the korean academy of Pediatric Dentistry
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v.33
no.2
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pp.317-322
/
2006
Dental caries in children has declined over the past few decades. However, Certain populations of children experience high levels of dental disease. To perform the highest quality dental care for the pediatric patient, the practitioner may need to use pharmacological means to obtain a quiescent, cooperative patient. Furthermore, complex treatment can impose high demands on the very young, making use of general anesthesia the preferred approach for some patients. General anesthesia is widely used to provide comprehensive dental treatment for children in USA and Europe and Scandinavia etc. Parental and patient satisfaction following completion of dental care under general anesthesia is reportedly high. Dental general anesthesia has disadvantage that it is expansive and carries a small but significant risk of mortality. However, It has the advantage of permitting treatment at a single visit, allowing immediate relief of pain and requiring little or no cooperation from the child. Rampant caries was the major indication for use of general anesthesia in the youngest age group or medically compromised patients. This study describe the characteristics of patient receiving comprehensive dental treatment under general anesthesia at the pediatric dentistry of Chonbuk National University Hospital in Jeonju, Korea in the 4year period between December 2001 and April 2005.
The Journal of Korean Academy of Sensory Integration
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v.6
no.1
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pp.13-23
/
2008
Objective : The purpose of this study is to investigate awareness of rehabilitation practitioners working at community wellness centers regarding the sensory integration (SI) therapy. Methods : 121 rehabilitation practitioners working at community wellness centers, located in Seoul Gyeonggi, Daegu Gyeongbuk and Busan Ulsan, participated in a questionnaire survey to examine their awareness of SI therapy. The questionnaire constructed based on four elements of the information about SI therapy; SI therapy's purpose, target population and technical process, and the qualification of SI therapist. Correlations between general characteristics and the four awareness elements of SI information were explored. The level of recognition on SI therapy were examined in various perspective such as 'have heard', 'means of the recognition', 'easiness of getting information', 'recognition of necessity of SI therapy', 'willing to participate in professional education course' and 'opinions for improving recognition'. Result : There is significant difference in awareness of the all four elements of SI informations depends on several general characteristics; practitioner's clinical field, location of the center, whether SI service has been provided or not at the center, whether the practitioner carry out SI therapy, and the practitioner's clinical experience in SI therapy. Specially, the recognition of occupational therapists is relatively high compared other rehabilitation practitioners. In terms of level of recognition, most rehabilitation practitioners(96.7%) are well-aware of necessity of sensory integration therapy. 79.4% of the practitioners manifest somewhat of difficulty in getting information related SI therapy. 93.4% of the practitioners are willing to participate in professional education course for SI therapy. Opinion for improving recognition with the most number of people(21) chosen is 'educational revitalization'. Conclusion : Many rehabilitation practitioners working at community wellness centers recognize the necessity of understand SI therapy, but there is uneasiness to get relative and valid information. There are difference awareness of the SI therapy Revitalization of education for SI therapy may provide an opportunity to improve level recognition of rehabilitation practitioners. It is suggested that organ related rehabilitation, there is a need for public relations.
Park, Ji-Won;Suh, Yeon-Ok;Lee, Jung-In;Kim, Jeong-Wha
The Korean Journal of Rehabilitation Nursing
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v.12
no.1
/
pp.30-38
/
2009
Purpose: The purpose of this study was to compare the rehabilitation nursing services what nurses recognize to be important and what they do in practice of the industrial workers. Method: The subjects were 150 nurses who were working at the industrial hospital. The questionnaire was made up with 43 items about the perception on importance and performance of rehabilitation services. Result: The highest services in the perception on importance and performance subscale were physical and therapeutic services. The highest difference between perception on importance and performance was the social and occupational services. The perception on importance of rehabilitation services had positive correlation with performance. The group take care of general patients had a higher level of perception on importance than the other group, and level of performance had significant difference with age and position. Conclusion: We need to develop the strategy for promoting the performance of services that recognize it will be important services, but not to do. Further study on system for promoting the nurse practitioner who responsible for rehabilitation nursing.
The International Standard Banking Practice for the Examination of Documents under Documentary Letters of Credit (ISBP) is the product by the ICC Banking Commission, October 2002. The ISBP is a practical complement to UCP 500, ICC's universally used rules on documentary credits. It explains, in explicit detail, how the rules are to be applied on a day-to-day basis. It fills a needed gap between the general principles announced in the rules and the daily work of the documentary credit practitioner. By using the ISBP, document checkers can bring their practices in line with those followed by their colleagues worldwide. The result should be a significant reduction in the number of documents refused for discrepancies on first presentation. We are convinced that the benefits of the ISBP will not only be of high importance for users of UCP 500, but also that the practices in the ISBP will survive a UCP revision, or will even be included in the next version of the rule (so call "UCP 600"). Though the above-mentioned benefits of the ISBP, there are several troublesome topics that will probably have to wait for a new UCP revision. It will be a challenge for the drafters of a future UCP to find solutions that will further clarify these points.
Total spinal anesthesia is a serious life threatening complication of spinal and epidural anesthesia. We report an accidental total spinal anesthesia developed during a thoracic epidural block in a practitioner's pain clinic. A 69-year-old female with post-herpetic neuralgia was treated by a thoracic epidural block. A thoracic tapping for the epidural block was performed in the right lateral position at a level between $T_{5-6}$, using a 23 gauge Tuohy needle. After the epidural space was identified, a mixed solution of 10 ml of 0.3% lidocaine and 20 mg of triamcinolone was injected into the epidural space. After removal of the syringe, fluid was dripping through the needle. The patient subsequently complained of dyspnea and dizziness, and she became unconscious. She was intubated immediately and cardiopulmonary resuscitation was performed because there was no pulse palpable. The patient recovered an hour after transfer to a general hospital and was discharged without any further complication 19 days later.
Many therapeutic modalities including continuous positive airway pressure, surgery, and oral appliances are used to treat patients with sleep-disordered breathing. However, there are no definitive treatment modalities for individual patients due to various causes of sleep-disordered breathing. Clinicians should have select best options for individual patients and it is quite challenging process. Oral appliances attracted clinical attention for its convenience and safety. Several designs of oral appliances are introduces such as soft palate lifter, tongue retaining device, and various appliances which aimed to mandibular advancement. Among these oral appliances, mandibular advancement devices (MADs) are considered the most excellent based on their effectiveness and patient tolerance. Although MADs are not guarantee dramatic outcome and less consistent than continuous positive airway pressure, they offer several advantages over continuous positive airway pressure and surgical methods, including non-invasiveness, silence, portability, and tolerability, simplicity. Therefore, general dental practitioner who had passed sleep dental curriculum or coursework can treat the patients with sleep problems. This article reviews the history, clinical indications, suggested mechanism of actions, various positive effects and several side effects, factors predicting a favorable outcome, determining amounts of mandibular advancement, compliance and long-term efficacy of MADs use.
The involvement of health-care professionals in tobacco-control activities is essential to prevent smoking-related morbidity and mortality. The purposes of this predictive correlational study were to examine tobacco-control activities and to identify the predictors of such activities of community health practitioners (CHPs). Of the 1,813 members of the Korean Association of CHP, 1,247 participated in this study. A mailed survey was conducted to collect data. The majority of CHPs supported tobacco-control policies and recognized tobacco-control activities as an important role for them. Only $44.3\%$ of CHPs were confident in their knowledge and skills regarding tobacco-control activities, and only $30.8\%$ had received professional tobacco-control education. While the majority of the CHPs 'asked, advised, and assessed' their clients, only a small number 'assisted or arranged'. The tobacco-control activities of CHPs were predicted by their attitude toward it, age, experience of tobacco-control education, educational level, and general perception of the risk of smoking; these variables accounted $13.5\%$ of variance in the tobacco-control activities of CHPs. These findings provide the basis for developing a continuing education program for CHPs. CHPs should be encouraged to integrate tobacco-control activities into their routine practice, and CHP education programs should be adjusted to increase the time spent on the tobacco-control intervention techniques.
Purpose: The study examined the psychometric properties of the Korean Geriatric Depression Scale Informant-15 (KGDSI-15), an instrument measuring geriatric depression through their primary caregivers. Methods: The participants were 370 Korean older adults $\geqq$65-years-of-age registered in a visiting health center in S city. The Korean version of Geriatric Depression Scale-Short Form (GDSSF-K) was used for comparison. Internal consistency measured tool reliability and Pearson correlation coefficient measured validity. One-way ANOVA was used to determine the clinical usability of the instrument: depression levels were classified as normal, mild depression, and severe using GDSSF-K, and the depression scores of these three groups were comparatively measured by KGDSI-15. Results: The Cronbach's alpha coefficient was .831. The correlation coefficient with GDSSF-K was r=.616 (p<.001). KGDSI-15 results showed the depression level of older adults with severe depression was highest followed by those with mild depression and normal. The group differences were also statistically significant, which indicated the clinical usability of the instrument. Conclusion: KGDSI-15 is suggested to be reliable and valid to measure the geriatric depression through the primary caregivers of older adult.
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