• 한국산업보건학회지
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• 제29권2호
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• pp.236-250
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• 2019

Objectives: The purpose of this study was to investigate the effect of intensive rehabilitation programs on pain, range of motion (ROM), lumbar muscle strength, core muscle endurance, disability, and depression in patients with traumatic low back injuries and to compare the efficacy of this therapy with that of conventional rehabilitation therapy. Methods: The study was performed with a retrospective medical chart review of patients with traumatic low back injury referred to the rehabilitation center at the Daegu Hospital of the Korean Workers Compensation and Welfare Service. Forty-four patients were allocated to either the conventional rehabilitation group (CRG; n = 22) or the intensive rehabilitation group (IRG; n = 22). The CRG group patients, who received 30-min therapist-supervised physical therapy and modality therapy five times per week for four weeks, were compared with the IRG group patients, who received 60-min therapist-supervised physical therapy, 30-min therapist-patient 1:1 matching rehabilitation therapy, and modality therapy five times per week for four weeks. Outcome measures were a numerical rating scale, ROM, lumbar muscle strength, lumbar core muscle endurance, thickness of lumbar deep focal core muscle (transverse abdominis and lumbar multifidus), Oswestry disability index (ODI), and depression (Korean version patient health questionnaire-9). Results: There were statistically significant improvements after treatment in all outcome measures in both groups (p < 0.05). In the intergroup comparison, NRS scores on the activity and thickness of lumbar deep focal core muscles increased significantly more in the IRG than in the CRG (p < 0.05). There were no statistically significant intergroup differences in NRS scores on resting, ROM except left lateral bending, lumbar muscle strength, core muscle endurance, ODI, and depression. Conclusions: We could confirm the superior effectiveness of an intensive rehabilitation program compared to conventional rehabilitation therapy in patients with traumatic low back injuries.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.184-193
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• 2024

Background/Aims: We aimed to clarify the clinical characteristics of psoriatic arthritis (PsA) in Korean patients focusing on PsA with axial involvement. Methods: A retrospective medical chart review was performed to identify PsA patients at a single tertiary center. Cases of AS patients with psoriasis were recruited from a prospective AS registry of the same center. Demographics, laboratory findings, and radiologic characteristics were assessed. Results: A total of 69 PsA patients were identified. In PsA patients, spondylitis (46.4%) was the most common form. Compared to AS patients with psoriasis, PsA patients with radiographic axial involvement were older (50.9 vs. 32.4 years; p < 0.001) and showed greater peripheral disease activity (peripheral arthritis 78.1 vs. 12.5%, p < 0.001; enthesitis 50.0 vs. 6.3%, p = 0.003). AS patients with psoriasis presented a higher rate of HLA-B^*27 positivity (81.3 vs. 17.2%; p < 0.001) and a more frequent history of inflammatory back pain (100.0 vs. 75.0%; p = 0.039) than PsA patients with radiographic axial involvement. Significant proportions of PsA patients with radiographic axial involvement had cervical spine involvement (10/18, 55.6%) and spondylitis without sacroiliitis (10/23, 43.5%). Conclusions: We demonstrate that axial involvement is common in Korean PsA patients, and its characteristics can be distinct from those of AS.

• 여성건강간호학회지
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• 제6권2호
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• pp.234-257
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• 2000

At present in the medical care, the study and effort for producing health service to consider efficiency, effectiveness, and quality are urgently called for because of the difficulty in the keen competition according to the inter- nationalization and opening, the operation in the medical institution service testing system, the change in the medical policy of KDRGs, and the lack of the health care cost increasing rate. As an alternative, the case management for the new management system is introduced in the U.S., and the Critical Pathway that is the method designing the contents of activity and its result has been developed and applied in order to anticipate and manage the patient-outcome for the realization of the cost-effective case-management. Thus, this study intended to analyze the effectiveness to obtain by developing the Critical Pathway presented as the method to improve the quality-betterment and cost effectiveness through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. As a study method, this author formed a conceptual framework through considering five Critical Pathway used in the current U.S. and three Critical Pathway presented in the literature to develop the Critical Pathway for the hysterectomy patient, and made out the preliminary Critical Pathway through reviewing the old chart. This author made the verified the validity of the expert group about the developed Critical Pathway, and to confirm the possibility of practice application, completed and settled the final Critical Pathway after using the Critical Pathway to the hysterectomy patient from March 1st to 15th, 1997. Finally, to analyze the application-effect of the developed Critical Pathway, this author offered health care service applying the Critical Pathway to the hysterectomy patient from April 15th to August 31th, 1997. The guide for the Critical Pathway was carried out in advance by outpatient setting nurse for outpatient setting visit before the operation, and after hospitalization the primary nurse monitored the execution degree on the every duty. After discharge this author surveyed the complication through phone visiting, and one month after discharge surveyed the patient's reaction about the offered service when outpatient setting visit and analyzed the result. The source for health care cost was obtained by the statistics about the hospital charge which was offered by the General Business Department. The results were as follows. 1. It was decided that the vertical line of the Critical Pathway was made up of eight items such as monitoring/assessment, treatment, line/drains, activity, medication, lab test, diet, patient teaching, and the horizontal line of the Critical Pathway was made up of from hospitalization to discharge. 2. After the analysis of service contents through reviewing the old chart, it was decided that the horizontal line of the preliminary Critical Pathway was made up of from hopitalization to fourth postoperative day, and the vertical line of it was divided into eight items which were the contents to occur with the time frame of the horizontal line. 3. After the verifying the validity of the expert group about the preliminary Critical Pathway, the horizontal line was amended from hopitalization to third postoperative day, and taking their consensus, some contents of the horizontal line was amended and deleted. 4. From March 1st to 15th, 1997, to confirm the clinical suitability, this author offered eight hysterectomy patients the medical service through the Critical Pathway. The result was that three of them could be discharged at the expected discharge day, and the others later than that day. Supplementing the preliminary Critical Pathway through analyzing the cause of that delay- case, this author developed the final Critical Pathway. 5. There were no significant differences between the experimental and the control group in the incidence of complication(P > 0.05). 6. The 92.4% of experimental group was satisfied with the Critical Pathway service. 7. The length of hospital stay of the experimental group offered with the Critical Pathway service was 4.6 days and there was a significant difference that it was 1.3 days shorter than that of the control group(t=-29.514, P=0.000). 8. There wsa a significant difference that the mean medical charge per one patient of the experimental group offered the Critical Pathway service was cheaper \124,150 than that of the control group(t=-9.826, P=0.000). 9. The result that the author assumed and analyzed hospital income with the rate of turning bed was assumed that the increase of hospital income was \63,245,072 for that study, and the income increase was expected with \68,704,864 for a year. The result that this author applied the Critical Pathway to the hysterectomy patient have no differences in the incidence of complication, high satisfaction with that service, and the length of hospital stay decreased in the experimental group, and the mean hospital charge per one patient decreased, but hospital income increased. Suggestions for further study and nursing practice are as follows. 1. The study to apply the Critical Pathway for a year, verify the validity, and measure the effect repeatedly is needed. 2. To apply and manage the Critical Pathway effectively, the study to computerize it is needed. 3. The study to develop hospital-based Critical Pathway about other diseases or procedure, and measure the effect is needed.

• 한국건설관리학회논문집
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• 제14권5호
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• pp.175-187
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• 2013

건설프로젝트에서는 다양한 참여자들이 제한된 공간에서 각자의 작업공간을 차지하며 작업을 수행한다. 작업공간에 대한 부적절한 계획은 건설프로젝트의 생산성 감소, 작업 위험 증가 및 품질 저하 등의 문제로 이어지기 때문에 작업공간은 건설프로젝트에서 고려하여야 할 중요한 요소 중 하나이다. 그러나 기존의 건설프로젝트 공사 계획 수립을 위한 방법들은 건설프로젝트에서의 작업공간을 고려하지 못하는 한계가 있었다. 따라서 본 연구에서는 체계적이지 못한 작업공간 계획으로 인하여 발생하는 작업공간 간섭 문제를 예방하기 위하여 4D BIM(Building Information Model) 기반의 작업공간 계획 프로세스를 제안한다. 제안된 프로세스는 각 작업공간의 특성과 공사수행계획을 반영하여 각 액티비티의 작업공간 점유상태를 표현하고 이를 바탕으로 발생 가능한 작업공간 간섭을 발견한다. 또한 각 액티비티와 작업공간의 특성 그리고 공사수행계획 등을 고려하여 발견된 작업공간 간섭에 대한 해결책을 도출한다. 본 연구의 결과를 바탕으로, 프로젝트 관리자는 본 공사 수행 이전에 공사에 필요한 작업공간을 미리 계획함으로써 서로 다른 액티비티 작업공간 사이의 간섭을 예방하고 건설프로젝트에서의 불필요한 손실을 예방할 수 있다.

• 한국간호교육학회지
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• 제4권2호
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• pp.249-263
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• 1998

The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

• Tuberculosis and Respiratory Diseases
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• 제48권1호
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• pp.54-66
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• 2000

연구배경: 설문지를 이용한 삶의 질 평가를 통해 진폐증 및 만성 호흡기 환자의 삶의 질 및 생활 만족도를 향상시키기 위한 효과적인 치료 및 관리 방법을 찾는데 기초 자료로 쓰고자 삶의 질 설문지의 신뢰도와 타당도를 검증 하였다. 방 법: 3차 의료기관에 요양되어 입원중인 진폐증 환자 25명과 진폐 정밀검사를 받기 위해 1주일간 입원한 진폐증 유병자 38명등 총 63명을 대상으로 1999년 4월에서 8월 사이에 COOP charts, CRQ, PRQ 등 3종의 설문지를 이용해 조사하였고 그 결과를 다른 임상 지표와 비교하였다. 결 과: 설문지 문항의 내적 일치도를 보는 크론바하 계수는 CRQ에서 각 영역별로 0.63-0.89였고 PRQ는 0.77-0.81로 외국의 설문지를 번역해서 사용한 CRQ와 독자 개발한 PRQ 모두 내적 일치도에서 만족할 만한 신뢰도를 나타내었으며 기존에 사용되어 온 COOP charts의 점수와 CRQ. PRQ 간에는 유의한 상관관계를 보였다. CRQ의 호흡곤란 및 정서 항목과 PRQ의 호흡증상 및 정서상태는 같은 개념을 서로 다른 두 가지 방법으로 측정한 것인데 이들간의 상관 관계가 다른 개념들과의 상관 관계보다 높지는 않았다. CRQ의 호흡곤란 항목의 접수는 폐기능검사 성적과 유의한 상관관계를 나타냈으며 CRQ의 정서 항목은 동맥혈 가스분석의 산소분압 및 산소포화도와 유의한 연관성을 보였다. 한편 PRQ에서는 호흡증상과 사회활동 향목이 폐기능 검사 성적과 유의한 연관을 보여주었다. 산업재해보상보험법상 요양 유무에 따라 비교한 결과 요양군이 비요양군에 비해 임상적 지표가 더 불량했으며, CRQ의 호흡곤란 항목과 PRQ의 호흡 증상 및 사회활동 항목에서 각각 요양군이 비요양군에 비해 유의하게 낮은 접수를 보였다. 임상적으로 불안정한 환자와 안정한 환자군으로 구분하여 비교한 결과 폐기능검사 소견상 노력성 폐활량(FVC)과 최고기류속도(PEF)만이 임상적으로 불안정한 군에서 유의하게 낮았으며, 설문 결과에서 CRQ는 양군간에 유의한 차이를 찾을 수 없었으나, PRQ의 호흡증상 및 사회활동 영역 그리고 COOP charts에서 불안정군의 점수가 안정군에 비해 유의하게 낮았다. 결 론: 번역한 CRQ와 새로 개발한 PRQ가 모두 진폐증 환자의 삶의 질 측정에 사용될 수 있음을 보여주며 특히 PRQ는 임상지표만 가지고 구분할 수 없는 환자의 기능적 상태 및 주관적인 생활 만족도를 알아보는데 활용될 수 있음을 알 수 있었다. 진폐증 환자를 비롯한 만성 호흡기 환자에게 CRQ와 PRQ를 활용할 수 있도록 향후 지속적인 연구를 통해 설문지 검사의 신뢰도와 타당도를 검정하는 것이 필요하다.

• 대한공업교육학회지
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• 제38권1호
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• pp.163-194
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• 2013

이 연구의 목적은 실제의 공업계열 특성화 고등학교 현장에서 적용할 수 있는 사례로서, 주제 중심의 통합 교육 프로그램을 개발하는 데에 있다. 연구의 목적을 달성하기 위해 체제적 교육과정 개발 모형인 ADDIE 모형과 Frazee와 Rudnitski(1995) 및 이창훈(2007)의 교육 프로그램 개발 모형을 분석한 후, 재구성하여 공업계열 특성화 고등학교의 주제 중심 통합 교육 프로그램의 개발 모형을 구안하였다. 이 연구에서는 위에서 요약한 내용을 토대로 개발된 연구 결과에 해당되는 공업계열 특성화 고등학교 전기 전자 통신 분야의 주제 중심 통합형 교육프로그램은 다음과 같은 특징을 갖는다. 첫째, 연구자가 개발한 주제 중심 통합형 교육 프로그램은 공업계열 특성화 고등학교의 전기 전자 통신 분야에 적용할 수 있고, 주제 중심으로 접근한 최초의 교육 프로그램의 사례라고 볼 수 있다. 둘째, 이 교육 프로그램은 공업계열 특성화 고등학교의 전기 전자 통신 분야의 3학년 학생들을 위해 자기부상열차를 만들어 보는 활동과제를 포함한 것으로, 학생들로 하여금 수업에 흥미를 가지고 적극적으로 수업에 임하는 태도를 기를 수 있게 하는 교육 프로그램이다. 셋째, 주제 중심 통합형 교육 프로그램은 학생용 학습자료와 교사용 자료 및 교수-학습 지도안으로 구성되어 있다. 학생용 학습자료는 자기부상열차의 개요, 자기부상열차의 기본 원리, 자기부상열차의 심화 원리, 자기부상열차의 활동 과제의 네 단원으로, 각 단원은 학습목표, 도입 및 소개, 학습내용(심화학습, 읽을거리), 배운 내용 확인하기 등으로 구성되어 있다. 또한, 교사용 자료는 교육 프로그램의 개요, 목표, 시간 계획 & 수업흐름도, 자기부상열차를 주제로 한 교육 프로그램의 관련 내용, 선행학습, 교육 프로그램의 내용 구조, 흐름도, 학습 활동, 평가(자기평가지, 동료평가지) 등의 내용을 포함한다.

• Journal of Preventive Medicine and Public Health
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• 제32권4호
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• pp.526-537
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• 1999

Objectives : It is known that the prevalence of diabetes mellitus(DM) appears to be rapidly increasing in recent times in Korea, presumably due to a westernized diet and change of life style followed by rapid economic growth. Based on the Seoul male cohort which was constructed in 1993, this study was conducted to estimate the annual incidence rates of DM through 4 years' follow up and to determine which factors are associated with DM risk in Korean middle-aged men. Methods : Among 14,533 men recruited at baseline, 559 were excluded because they reported a history of diabetes or were found to be diabetes at 1992 routine health examination. During 4 years' follow-up, 237 incident DM cases were ascertained through chart reviews and telephone contacts for those who have ever visited hospitals or clinics under suspicion of DM during 1993-1996 and the biennial routine health examinations in 1994 and 1996. Results : In this study the annual incidence of DM among the study population was estimated to be 0.5 per 100. This study showed that fasting glucose level at initial baseline examination was a powerful predictor of risk for diabetes several years later(fasting blood glucose of $\geq$ 110 mg/dl compared with $\leq$ 80 mg/dl, Hazard Ratio[HR]:15.6, 95% Confidence interval[CI]=9.1-26.6) after considering potential covariates such as age, family history, smoking and alcohol history, body mass index, physical activity, total energy intake, and total fiber intake. Adjusted hazard ratios of family history of diabetes was 1.95(95% CI=1.38-2.75); of obesity as measured by BMI(BMI $\geq$ 25.3 compared with $\leq$ 21.3) was 7.19(95% CI=3,75-13.8); of weight change during middle life(>10kg compared with $\leq$ 5) was 1.77(95% CI=1.16-2.69); of smoking(current vs none) was 1.93(95% CI=1.06-3.51); and fat intake(upper fertile compared with lower fertile) was 1.88(95% CI=1.01-3.49), while fiber intake was associated with the reduced risk(HR=0.36, 95% CI=0.19-0.67). Conclusion : The factors identified in this study indicate that the greatest reduction in risk of diabetes might be achieved through population-based efforts that promote fiber intake and reduce obesity, smoking, and fat intake.

• 한국농공학회지
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• 제30권2호
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• pp.55-66
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• 1988

This study was conducted to investigate the various engineering properties and correlationshops among the soil constants of alluvial clayey deposits distributed in the bay of Asan and their results are summarized as follows : 1. Grain size distribution of soil was consisted of 12 % of clay, 46-73 % of silt, 2-23 % of sand, and as for the consistency characteristics, 26-36 % of liquid limit, 18-21 % of plastic limit and 6-16 % of plastic index, and so the soil belonging to as a lower plastic nonorganic clay, it's specific gravity was 2,66-2.70, and the location on the plastic chart was approximately above the A-line. Z The natural moisture content and unit weight were 30-43 % and 1.76-1.87 g I cm$_3$, respectively, and according to increment of natural moisture content, the unit weight was decreased, and the initial void ratio and degree of saturation were shown of 0,87-1119 and 92- 100 %, most of saturated. 3. Cone resistance value which was shown 2.4 - 6.5 kg / $cm^2$ was a little lower and it was increased with the depth of layer and shown the formular $q_c=0.7_z+1.32$. 4. Unconfined compression strength was about 0.18-0.43kg /$cm^2$, cu, 0.1-0.22kg / $\psi$, $2-6^{\circ}$ under uu-test condition of triaxial, and CCU, 0.08-0.3 kg/cm , $\psi$, $12-18^{\circ}$ under the condition of cu-test. 5. Pre-consolidation load of characteristics of consolidation was 0.4-0.8 kg / $cm^2$, compression index, about 0.17-0.33. 6. Liquid limit and plastic index were incresased with the increment of clay content but most of alluvial clay was appeared as a normal through non-activity clay soil shown more natural moisture content than liquid limit, and their relationship as follows : LL=0.38( cy+54.8), PI=0.836(LL -17.8), PI =0.468(LL -0.48) 7. The initial void ratio presented correlationship of positive among clay content, natural moisture content and liquid limit, and that of reverse with unit weight, and their results as follws : $e_o=0.024(w_n+0.2)$, $e_o=e_o=0.0003c_y+0.0005 LL+0.0151 W_n+\frac{3.58}{r-t}-1.52$ 8. It was shown that the compression index has correlationship of postive among the clay content, liquid limit, plastic index, natural moisture content and initial void ratio, and their relationships as follows ; $c_c=0.44(e_o-0.47)$, $c_c=0.001$

• 정보교육학회논문지
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• 제17권1호
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• pp.83-91
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• 2013

교육과학기술부는 2011년 융합형인재교육의 일환으로 STEAM교육을 발표하였다. 가장 중요한 문제는 "어떻게 STEAM교육의 목표를 달성하는가?"이다. 그래서 본 논문에서는 상황제시를 위한 초등학교 5학년 과학의 광합성 단원의 내용과 "심해탐사로봇"이라는 창의적 주제를 가지고 로봇을 활용한 STEAM교육을 실시하였다. 학생들은 13차시의 로봇 기초교육과정을 이수한 후, 10차시의 주제중심 로봇활용교육을 실시하였다. 로봇기초교육과정에서는 로봇을 제어할 때, 정규 수학 또는 과학과목에서 배운 내용을 적용할 수 있도록 구성되었으며, 로봇활용교육과정에서는 산소센서를 이용한 광합성 이해, 브레인스토밍, 아이디어 도출, 로봇 설계, 로봇 제작, 시연 및 발표의 과정으로 구성되었다. 이 두 개의 과정에는 STEAM의 모든 요소가 포함되었다. 모든 수업이 끝난 후, 학부모와 학생들의 교사면담을 통해서 창의성, 학습태도, 학교생활의 많은 부분에서 긍정적인 답변을 얻을 수 있었다. 특히 학교생활과 학습태도가 좋지 않은 학생들이 로봇경연 대회에서 우수한 성적을 거둠으로써, 학습의 자신감과 성취감을 가질 수 있었다. 통계적인 수치를 기술하지는 않았지만 이 수업으로 인하여 STEAM교육을 위한 로봇활용교육이 창의 인성, 직업탐색등에 매우 큰 효과가 있음을 알 수 있었다.