• The Korean Journal of Pain
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• 제29권3호
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• pp.153-157
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• 2016

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

• 한국콘텐츠학회논문지
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• 제17권8호
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• pp.454-462
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• 2017

본 연구는 노인 고독사 현상에 대한 이해를 목적으로 미디어 자료를 사용하여 고독사 사례를 살펴보고자 하였다. 질적 연구방법으로 사례분석 방법을 적용하였다. 고독사 사례는 2007년부터 2017년 초까지 보도된 미디어 자료를 사용하였다. 자료 수집은 인터넷 검색 엔진을 사용하여 수행하였으며, 총 47사례가 최종 분석에 사용되었다. 60대 21사례, 70대 17사례, 80대 이상 9사례를 분석에 사용하였다. 성별은 남성 22사례, 여성 17사례, 성별미상 사례 8사례로 나타났다. 분석 결과, 고독사 사례에서 나타난 주요 위험요인으로는 빈곤과 경제적 곤경, 만성질환, 정신건강 문제, 사회적 고립, 가족 및 이웃과의 관계 절연, 실업, 1인 가구, 독신 혹은 이혼, 그리고 대도시 거주 등으로 파악되었다. 연구 결과를 바탕으로 향후 예방 전략에 대한 논의를 제기하였다.

• 대한간호학회지
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• 제46권2호
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• pp.305-314
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• 2016

Purpose: The purpose of this study was to determine quality of life (QOL) related factors in Alcoholics Anonymous (AA) members based on PRECEDE Model. Methods: A cross sectional survey was conducted with participants (N=203) from AA meeting in 11 alcohol counsel centers all over South Korea. Data were collected using a specially designed questionnaire based on the PRECEDE model and including QOL, epidemiological factors (including depression and perceived health status), behavioral factors (continuous abstinence and physical health status and practice), predisposing factors (abstinence self-efficacy and self-esteem), reinforcing factors (social capital and family functioning), and enabling factors. Data were analyzed using t-test, one way ANOVA, Tukey HSD test and hierarchical multiple regression analysis with SPSS (ver. 21.0). Results: Of the educational diagnostic variables, self-esteem (${\beta}=.23$), family functioning (${\beta}=.12$), abstinence self-efficacy (${\beta}=.12$) and social capital (${\beta}=.11$) were strong influential factors in AA members' QOL. In addition, epidemiological diagnostic variables such as depression (${\beta}=-.44$) and perceived health status (${\beta}=.35$) were the main factors in QOL. Also, physical health status and practice (${\beta}=.106$), one of behavioral diagnostic variables was a beneficial factor in QOL. Hierarchical multiple regression analysis showed the determinant variables accounted for 44.0% of the variation in QOL (F=25.76, p<.001). Conclusion: The finding of the study can be used as a framework for planning interventions in order to promote the quality of life of AA members. It is necessary to develop nursing intervention strategies for strengthening educational and epidemiological diagnostic variables in order to improve AA members' QOL.

• 대한한방내과학회지
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• 제22권2호
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• pp.239-243
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• 2001

Alcoholism is a chronic behavior disorder that disturbs the health, social, and economical functions by intaking alcohol repeatedly. Alcoholism includes some habituation, dependency, and addiction. It may be clinically silent or severe enough to lead to the rapid development of hepatic, renal and gastrointestinal failure. Alcoholism can also cause death. In this case, we administrated saenggangunbitang and sungjoocheonggantang to a patient suffering from alcohoism and its withdrawal symptoms. After administration of saenggangunbitang-sungjoocheonggantang medication, clinical symptoms, including liver function with diabetes mellitus and splenomegaly improved. saenggangunbitang-sungjoocheonggantang showed desirable effect on alcoholism symptoms.

• 한국응급구조학회지
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• 제13권3호
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• pp.91-105
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• 2009

Purpose : The purpose of this study was to describe the current status of 119 EMT to violence experiences in Korea. Method : The number of 119 EMT in this study 2522. Self-administering questionnaire data were collected from April 27 to March 8 in 2009. Collected data were analyzed using SPSS 14.0 program. Real number, percentage, mean and standard deviation were calculated. Pearson correlation coefficient was analyzed. Result : 119 EMTs experienced 95.32%-verbal insults, 61.54%-violence aggression, 60.51%- potential violence, 38.70%-physical assault. Within 30 days from the most recent period of violence experienced verbal insults and violence aggression-51.07%, potential violence and physical assault-48.41%. The patients(50.59%) and the patients and patient's carers(38.26%) proved to be violent offender. The main reason of violent act was drug or alcohol addiction(56.15%). Recent exposure to violence was 34.82% by 7 point reward of stress level. 5-point scale showed the average of experiences of violence. Response average of emotional reactions was 2.66 points and that of physical reaction was 2.18 points. Social reaction was 2.06 points. Conclusion : This study was based on the violence experience of 119 EMT. It is necessary to prevent the violence from emergency scene. So we proposed the preventive measure against violence as well as critical incident stress debriefing(CISD). Policy for CISD and stress management will be implemented in the near future in Korea.

• 한국중재학회지:중재연구
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• 제31권1호
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• pp.83-105
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• 2021

If aggrieving consumers or employees cannot prove both substantive and procedural unconscionability, many U.S. state courts will enforce arbitration agreements. Additionally, U.S. courts weigh a variety of factors to determine whether an arbitration agreement is substantively unconscionable. For example, U.S. courts have considered one or a combination of the following factors: (1) the fairness of contractual terms; (2) the severity of contractual terms' deviation from prevailing standards, customs, or practices within a particular industry; (3) the reasonableness of goods-and-services contract prices; (4) the commercial reasonableness of the contract terms; (5) the purpose and effect of the terms and (6) "the allocation of risks between the parties." Further, procedural unconscionability characterized by surprise or lack of knowledge focuses on terms that are deceptively hidden in a mass of contract language, the object of another concealment, or imposed in the circumstances involving haste or high-pressure tactics so that they are not likely to be read or understood. This unconscionability doctrine can be applied to a situation where an alcoholic dementia-afflicted older adult is admitted to a nursing home. At that time, because she had alcoholic dementia, which precluded her reading, comprehending, writing, negotiating, or signing of any legal document, her son, who did not understand the adhesion contract, signed the standardized residential contract and the arbitration agreement.

• 산업융합연구
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• 제21권2호
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• pp.79-84
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• 2023

본 연구는 청소년층에서 성인층으로 진입하는 청년층의 성별에 따른 남용약물에 대한 사용실태와 인식을 살펴 보기 위해 분석 가능한 설문지 1051부를 토대로 분석하였다. 설문에 참여한 청년들의 성별을 보면 남자 686명, 여자 365명이었으며, 성별에 따라 남용되는 약물의 종류와 마약류 및 남용약물에 대한 폐해 인식에 대해 분석하였다. 연구결과 술, 담배, 식욕억제제, 진정수면제, 아편계열 진통제 사용 경험이 성별에 따라 통계적으로 유의하였으며, 마약류 및 남용약물에 대한 폐해 인식 중 위험성과 유발문제인식, 위험성에 대한 공감에 대해서도 유의한 결과를 보였다. 마약류 및 약물남용 문제를 개선하기 위한 바람직한 방안은 여성은 257명(68.2%)가 홍보(계몽) 활동을 원하는 것으로 나타났으며, 마약류 및 약물남용 예방을 위한 효과적인 교육에 대해서 남성은 379명(54.2%)이 인터넷 온라인교육으로 나타났다. 남용약물에 의한 청년층의 약물 중독이 증가하고 있는 현실에서 약물사용에 대한 올바른 교육과 홍보가 필요하다고 사료된다.

• 한국학교보건학회지
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• 제21권2호
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• pp.119-134
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• 2008

Purpose: The purpose of this study is to understand a variety of intervention studies to prevent smoking by adolescents in U.S. and find out implications for Korea. Methods: This study reviewed articles found in the internet and analysed the data of US DHHS and CDC. Results: The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs of U.S. The main components of SHPPS are health education and physical education, health services, mental health and social services, school policies, and school environments. The CDC guidelines for school health programs to prevent tobacco use and addiction are composed of policy, instruction, curriculum, training, family involvement, tobacco-use cessation efforts, and evaluation. School-based interventions to prevent smoking can be classified into the categories of information-giving curricula, social competence curricula, social influence approaches, combined methods draw on social competence and social influence approaches and multi-modal programmes and Youth Empowerment study. The key programs for adolescent smoking prevention are ALERT Project, HSPP, TNT Project, MPP, NC YES. Conclusions: As smoking is often the first step of unhealthy behaviour such as alcohol drinking, illegal drugs, and violence, smoking prevention programmes for adolescents in U.S. have been comprehensive school-based health programs. In smoking prevention programs for adolescents, CDC plays a critical role by supporting survey, research, policy, and funds. The effectiveness of the programs was high when it was based on school and involved parents, community, and mass media. As the effect of each programme is not expected to last for a long time, consistent repetition of these interventions is essential. Current smoking prevention programs for adolescents are exploring the empowerment approach focused on the active involvement of participants rather than traditional approaches using order and discipline.

• Asian Pacific Journal of Cancer Prevention
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• 제15권10호
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• pp.4349-4352
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• 2014

Background: Pancreatic cancer has a high mortality rate because it is usually diagnosed late. Since little is known about this cancer in Iran, with the aim of improving this knowledge deficiency, we evaluated clinical, laboratory biomarkers, imaging findings and treatment modalities in Iranian patients with pancreatic adenocarcinoma. Materials and Methods: 131 cases of pancreatic adenocarcinoma in 2010-2013 were obtained from the Taleghani Hospital Record Department. Cases confirmed by histopathology from CT-guided biopsy, EUS-FNA and surgery examination were included. We excluded those with incomplete medical records. Results: The study included 131 subjects between 24 and 97 years of age and a mean age of $63{\pm}13.4$ years. Eighty (61.1%) were male and 51 (38.9%) female. Previous history included diabetes mellitus in 36 (27.5%), alcohol drinking in 5 (3.9%), smoker in 28 (21.4%) and opium addiction in 13 (10%). The common presenting history included weight loss in 79 (60.3%), abdominal pain in 77 (58.8%), fever in 11 (8.4%), nausea in 30 (22.9%), jaundice in 72 (55%), pruritus in 52 (39.7) and anemia in 33 (25.2%). CA19-9 levels with cut offs of 50, 100 and 200 U/ml were increased in 81%, 72% and 66% of patients, respectively. Tumor staging was: stage I, 3 (2.3%); stage II, 10 (7.6%); stage III, 58 (44.3%); and stage IV, 60 (45.8%). From 45 patients, 17 received ERCP inserted metallic stents and 22 plastic stents, the remaining 6 failed that PTC was done. Whipple surgery and chemotherapy were conducted for 10 and 29 patients, respectively. Conclusions: This disease affected older people and there was a male preponderance. The commonest risk factors were diabetes mellitus, smoking and cholelithiasis. The majority of patients presented with loss of appetite, loss of weight, jaundice, abdominal pain and discomfort. Almost all presented at late stages of the disease so that curative surgery was impossible. Also chemotherapy was only performed in a few patients as a neoadjuant treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권1호
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• pp.67-81
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• 1998

청소년 품행 장애의 발달에 생물사회심리학적인 다양한 요인이 관여하나 부모의 정신병리와 함께 부모의 양육태도가 중요요인으로 작용한다. 본 연구는 청소년 품행장애와 부모양쪽의 양육행동척도와의 연관관계를 정상군과 비교 조사함으로 부모의 양육행동척도중 품행장애에 유의한 영향을 줄수 있는 요인을 조사 연구하기 위한 것이다. 1996년 5월부터 1996년 12월까지 국립서울정신병원과 계요병원에 입원한 청소년 환자중에서 DSM-IV에 의거해 품행장애의 진단을 받은 52명의 환자를 연구대상으로 하였고 한 남녀공학 중고등학교 학생 152명을 정상집단인 대조군으로 하여 부모의 양육행동의 차이점을 조사하였다. 조사 설문지는 한국형 부모의 양육행동척도를 이용하여 부모의 양육행동척도 하위 요인들에 대한 집단간의 차이, 부모간의 차이, 성별차이에 따른 비교분석을 하였으며 통계방법은 다원변량 분석을 이용 검증하였다. 부모의 양육행동 하위요건에서 어머니의 양육행동 하위 요인들에 대해서는 환자, 정상 양집단간의 유의한 차이가 없었으나 아버지의 양육행동 하위 요인중 과보호에서 집단간에 유의한 차이를 보였다(F 1.194=7.91, p<0.01). 전체집단에서 부모간의 차이는 애정(F 1.195=17.21, p<0.001), 과보호(F 1.195=9.57, p<0.01),일관성 있는 규제(F 1.195=4.77, p<0.05) 변인에서 유의한 차이가 나타났다. 정상집단은 애정(F 1.143=14.22, p<0.001), 과보호(F 1.143=14.07, p<0.001), 일관성있는 규제(F 1.143=6.32, p<0.05) 변인에서 유의한 차이를 보였다. 전체 집단의 자녀의 성별차이를 보면 어머니는 남자자녀쪽의 합리적 지도(F 1.194=5.51, p<0.05)변인에서 유의한 차이를 보였고 아버지는 성별간에 유의한 차이를 보이지 않았다. 정상집단의 자녀의 성별차이는 어머니는 남자자녀쪽의 합리적 지도(F 1.142=6.88, p<0.001) 변인에서 유의한 차이를 보였으며 아버지는 성별간에 유의한 차이가 없었다. 환자집단의 자녀의 성별차이를 보면 아버지, 어머니 양쪽 다 유의 한 차이를 보이지 않았다. 어머니의 양육 행동척도에서 환자집단과 정상집단간에 차이를 보이지 않았으나 아버지의 양육행동척도에서는 과보호 요인에서 집단간 차이를 보이므로서 환자집단의 아버지가 정상집단보다 과보호를 더하고 있는 것으로 나타나 아버지의 양육행동이 문제행동에 더 큰 영향을 줄수 있음을 시사하였다.