• 임상간호연구
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• 제28권3호
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• pp.299-307
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• 2022

Purpose: The purpose of this study was to understand the effects of infection control fatigue and social support on burnout among nurses during the Coronavirus Disease 2019 (COVID-19) pandemic. Methods: This study is a descriptive survey study designed to confirm the effects of nurses' infection control fatigue and social support on burnout among nurses during the COVID-19 pandemic. The collected data were analyzed using frequency, percentage, mean, standard devia analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffe test, Pearson's correlation coefficient, and stepwise multiple regression analysis using SPSS Statistics 26.0. Results: An analysis of the correlations between fatigue from infection control, social support, and burnout showed a positive correlation between burnout and fatigue from infection control (r=.39, p<.001), and a negative correlation between burnout and social support (r=-.29, p<.001). Conflict and lack of support due to uncertain circumstances (β=.51, p<.001), support from supervisor's (β=-.22, p<.001), and experience of infection management education during the previous 1year (β=-.15, p=.007) were identified as the factors that influenced burnout among nurses, and explained 39.0% of the variance in burnout. Conclusion: The results of this study demonstrate that fatigue from infection control and social support influence burnout levels among nurses, which suggests the need to establish a new kind of work culture. Additionally, the findings call for the development and implementation of interventional programs that can reduce fatigue from infection control and increase social support for nurses.

• 대한한의학원전학회지
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• 제35권4호
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• pp.41-61
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• 2022

Objectives : This paper aims to examine the clinical meaning of treating with sweet medicinals where acupuncture fails, through studying the verse, "In case of both Yin and Yang deficiency, treat with sweet medicinals" in the Huangdineijing. Methods : Related contents in the chapters 「邪氣藏府病形」, 「根結」, 「終始」, 「經脈」, 「九鍼論」 of the Lingshu were analyzed threefold. The circumstances of the application of the "In case of both Yin and Yang deficiency, treat with sweet medicinals" principle to the late Han East Asian medicine as written in the Shanghanzabinglun were examined, and its meaning was explored. Results : The 'Yin Yang' in the verse could be substituted with the Five Zhang and Six Fu, Blood and Qi, Form and Qi, Form and Jing, Form and Zhi, etc. In patients with deficiency in Qi, Blood, Yin and Yang, we can observe external symptoms such as narrow pulse pattern, symptoms in the throat or below the throat, thirst, and coarse voice. To apply sweet medicinals is to supplement the Jing from food, Spleen and Stomach, Middle Qi and Earth Qi which produces and maintains Qi, Blood, Yin and Yang. Therefore, it is essential in treating disease patterns with deficiency in both Qi, Blood, Yin and Yang, and cannot be substituted with other means of treatment such as acupuncture, moxibustion, and other manipulative therapies. Conclusions : Sweet medicinals were applied in disease patterns with throat thirst and narrow pulse patterns which could not be managed with general acupuncture or moxibustion in the time of the Huangdineijing's publication, as it holds the Earth virtue which could harmoniously supplement the body's Qi, Blood, Yin, and Yang. Later its application broadened, treating various conditions accompanying Qi, Blood, Yin, Yang deficiency, which expanded potential of medicine and contributed to the generalization of drug treatment.

• Clinical and Experimental Pediatrics
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• 제65권4호
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• pp.201-208
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• 2022

Background: According to the National Family Health Survey-4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery. Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among them. Methods: This was a hospital-based analytical cross-sectional study of 108 new mothers. After obtaining Institutional Review Board approval and informed consent, we interviewed the new mothers on the day of discharge. Multivariate logistic regression was performed using IBM SPSS Statistics ver. 24. Results: The median breastfeeding initiation time was 90 minutes (interquartile range, 30-180 minutes). Overall, 43.5% of the mothers practiced EIBF, 77.4% practiced exclusive breastfeeding, and 43.5% were rooming in at discharge. Reasons for breastfeeding delays included extended recovery time from spinal anesthesia, maternal lassitude, and uncomfortable breastfeeding position due to post-cesarean pain. In the multivariate analysis, a birth weight less than 2,500 g (adjusted odds ratio [aOR], 4.33; 95% confidence interval [CI], 1.12-16.82; P=0.03), cesarean section delivery (aOR, 4.68; 95% CI, 1.57-13.92; P=0.005), and mother's poor knowledge of breastfeeding (aOR, 4.61; 95% CI, 1.44-14.72; P=0.010) were more likely to delay the initiation of breastfeeding. Conclusion: EIBF was practiced by less than half of the new mothers as determined by the cesarean section, baby's birth weight, and mothers' awareness of breastfeeding. Thus, it is vital to improve breastfeeding and nutritional counseling among mothers during the antenatal period and improve healthcare professionals' training to facilitate EIBF, even in circumstances such as cesarean section.

• 중환자간호학회지
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• 제17권1호
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• pp.44-56
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• 2024

Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

• International Journal of Computer Science & Network Security
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• 제24권3호
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• pp.59-70
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• 2024

Background: The COVID-19 pandemic (the form of coronaviruses) developed at the end of 2019 and spread rapidly to almost every corner of the world. It has infected around 25,334,339 of the world population by the end of September 1, 2020 [1] . It has been spreading ever since, and the peak specific to every country has been rising and falling and does not seem to be over yet. Currently, the conventional RT-PCR testing is required to detect COVID-19, but the alternative method for data archiving purposes is certainly another choice for public departments to make. Researchers are trying to use medical images such as X-ray and Computed Tomography (CT) to easily diagnose the virus with the aid of Artificial Intelligence (AI)-based software. Method: This review paper provides an investigation of a newly emerging machine-learning method used to detect COVID-19 from X-ray images instead of using other methods of tests performed by medical experts. The facilities of computer vision enable us to develop an automated model that has clinical abilities of early detection of the disease. We have explored the researchers' focus on the modalities, images of datasets for use by the machine learning methods, and output metrics used to test the research in this field. Finally, the paper concludes by referring to the key problems posed by identifying COVID-19 using machine learning and future work studies. Result: This review's findings can be useful for public and private sectors to utilize the X-ray images and deployment of resources before the pandemic can reach its peaks, enabling the healthcare system with cushion time to bear the impact of the unfavorable circumstances of the pandemic is sure to cause

• 대한영상의학회지
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• 제81권3호
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• pp.577-582
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• 2020

대한영상의학회와 대한흉부영상의학회는 COVID-19 에서의 영상검사의 사용에 대하여 다양한 상황에서의 권고안을 마련하였다. 실제 현장의 상황을 파악하고, 흉부영상의학 전문의들의 의견을 수렴하였으며, 국외 학회의 권고안과 수집 가능한 문헌을 바탕으로 현 상황에서의 가장 합리적인 안을 제시하는 것이며 상황과 근거의 변화에 따라 유연하게 즉시 수정되어야 한다.

• 대한임상독성학회지
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• 제10권1호
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• pp.22-32
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• 2012

Purpose: The purpose of this study was to examine the occurrence of toxic exposure cases in Korean emergency centers using a toxic exposure surveillance system-based report form and to provide guidelines for the prevention and treatment of toxic exposures. Methods: We retrospectively reviewed the medical records of toxic exposure patients who had visited emergency centers from January 2009 to December 2009. Epidemiology data points for the toxic exposure cases included age, gender, type of exposure, number and kind of substances involved, reason and route of poison exposure, management of the patients in the emergency departments, and the clinical outcome. Results: A total of 3,501 patients from 12 emergency departments were enrolled in the study. 50.0% of the total exposure patients were male and 63.0% of the total cases were fatal. Acute intoxication occurred in 91.3% of the total patients and suicidal intent was the most common (43.3%) reason for exposure. The most common route of exposure was ingestion (75.9%). Of the total cases, pesticides were involved in 26.3%, sedatives/hypnotics/antipsychotics were involved in 22.0%, and bites and envenomations were involved in 15.7%. Conclusion: We provided a database of patients who were admitted to emergency departments after poisoning incidents. We recommend that toxicology professionals develop a classification scheme for toxicants which is adequate for Korean domestic circumstances and initiate a toxic surveillance system for all types of exposures. With support of a psychiatric surveillance system for suicidal patients and establishment of social mediation for pesticide poisoning, major reductions in poison exposures can be achieved.

• 대한지역사회작업치료학회지
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• 제8권3호
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• pp.49-57
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• 2018

목적 : 본 연구는 작업치료사의 인권감수성 수준에 대하여 알아보고 특성에 따른 인권감수성의 차이를 비교하여 향후 작업치료사를 대상으로 인권 교육 프로그램 개발에 기초 자료를 제공하고 인권옹호자로서의 역할을 강조하고자 하였다 연구방법 : 본 연구의 대상자는 편의표집에 의해 선정된 작업치료사로 인권감수성을 측정할 수 있는 5개의 사례 이루어진 30개의 질문과 대상자의 일반적 특성을 알아보는 7가지 질문으로 구성된 설문을 온라인으로 배포, 수집하여 총 165부를 분석하였다. 결과 : 작업치료사의 인권감수성 평균은 $33.52{\pm}14.96$점이었고 하위 영역에 따른 인권감수성 평균은 상황지각 $20.44{\pm}2.32$, 결과지각 $19.85{\pm}2.32$, 책임지각 $19.14{\pm}2.21$ 순으로 나타났다. 사례 중 노인의 행복추구권($12.72{\pm}1.56$)에 대한 인권감수성이 가장 높았으며 장애인의 신체의 자유권($11.04{\pm}2.23$)이 가장 낮은 수준이었다. 작업치료사의 일반적 특성에 따른 인권감수성 중 연령, 교육정도, 근무기관과 임상경력에서 인권감수성의 차이를 보였다. 결론 : 작업치료사의 인권감수성은 연령과 임상경력에 따라 증가하는 것으로 나타났으며 다양한 인권관련 상황에 노출될수록 인권감수성이 증가함을 보였다. 또한 상황지각에 대한 점수가 가장 높은 것은 클라이언트-중심의 중재를 위한 공감능력이 중요하기 때문이다. 따라서 본 연구를 통해 인권교육의 필요성과 교육 대상자의 특성을 고려한 교육의 다양성이 필요함을 알 수 있었다.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제26권1호
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• pp.1-10
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• 2024

Objective: Endovascular coil embolization is the primary treatment modality for intracranial aneurysms. However, its long-term durability remains of concern, with a considerable proportion of cases requiring aneurysm reopening and retreatment. Therefore, establishing optimal follow-up imaging protocols is necessary to ensure a durable occlusion. This study aimed to develop guidelines for follow-up imaging strategies after endovascular treatment of intracranial aneurysms. Methods: A committee comprising members of the Korean Neuroendovascular Society and other relevant societies was formed. A literature review and analyses of the major published guidelines were conducted to gather evidence. A panel of 40 experts convened to achieve a consensus on the recommendations using the modified Delphi method. Results: The panel members reached the following consensus: 1. Schedule the initial follow-up imaging within 3-6 months of treatment. 2. Noninvasive imaging modalities, such as three-dimensional time-of-flight magnetic resonance angiography (MRA) or contrast-enhanced MRA, are alternatives to digital subtraction angiography (DSA) during the first follow-up. 3. Schedule mid-term follow-up imaging at 1, 2, 4, and 6 years after the initial treatment. 4. If noninvasive imaging reveals unstable changes in the treated aneurysms, DSA should be considered. 5. Consider late-term follow-up imaging every 3-5 years for lifelong monitoring of patients with unstable changes or at high risk of recurrence. Conclusions: The guidelines aim to provide physicians with the information to make informed decisions and provide patients with high-quality care. However, owing to a lack of specific recommendations and scientific data, these guidelines are based on expert consensus and should be considered in conjunction with individual patient characteristics and circumstances.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제7권1호
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• pp.16-23
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• 2004

목 적: 대부분의 소아과 의사들이 장중첩증의 진단이 지연되었을 경우의 문제점과 심각성을 알고 있음에도 불구하고 진단이 늦어져 수술, 심지어는 사망에 이르는 경우가 종종 발생한다. 따라서 저자들은 다른 진단명으로 입원하였다가 나중에 장중첩증으로 진단된 사례들을 조사하여 진단이 늦어지게 된 이유와 경과를 알아봄으로써 다시 한 번 의학적, 사회적 측면에서의 조기 진단의 중요성을 일깨우고자 하였다. 방 법: 저자들은 1990년 1월부터 2003년 12월까지 만 14년 간 경상대학교병원 응급실과 소아과에 장중첩증으로 내원하였던 환아들의 의무기록을 토대로 초기 진단이 장중첩증이 아니었던 경우의 14례의 증상과 첫 진단명, 진단되기까지의 경과 및 치료 결과를 조사하였다. 결 과: 1) 최종 진단이 장중첩증인 환아 중 입원 시 장중첩증을 의심하지 못했던 경우는 14례였으며 남자 8례(57.1%), 여자 6례(42.9%)였다. 2) 연령 분포는 대부분 2세 이하로 1세 이하가 10례(71.4%)였고 한 예가 10세에서 발생하였는데 그 환아는 Peutz-Jegher 증후군으로 대장 용종이 선두로 작용하였었다. 3) 내원 당시 주 증상은 구토, 경련, 설사, 기면, 보챔, 혈변, 종괴, 복부 팽만과 그 외 불쾌한 소변 냄새, 빈맥이 있었다. 입원 당시 진단명은 급성 위장관염, 세균성 이질과 독성 뇌증의증, 경련성 질환, 요로 감염, 패혈증, 복부 종괴, 장폐쇄 의심의 순으로 나타났다. 이들 중 입원 후 혈변이나 보챔 등의 증상이 있어 장중첩증을 의심하여 진단된 경우는 8례(57.1%)였으며 나머지 6례(42.9%)는 복부 팽만이나 종괴 등의 다른 이유로 복부 초음파나 전산화 촬영을 하던 중 발견되었다. 4) 입원 후 진단까지의 시간은 9례(64.3%)가 24시간이내에 진단이 되었고, 4례(28.6%)는 2~3일 사이에, 1례(7.1%)가 6일째에 진단이 되었으나 6일 째에 진단되었던 요로 감염 예는 5일 째 보채기 시작하여 6일째 신 초음파 중 발견이 되었다. 5) 장중첩증의 유형은 회장-결장형이 10례(71.4%)로 가장 많았고 그 외 회장-회장-결장형, 결장-결장형의 순으로 나타났다. 6) 전체 14례 중 9례가 수술을 하였는데 24시간 이내에 진단된 9례는 6례(66.7%), 2~3일 사이 진단되었던 4례는 3례(75%)에서 수술을 하였었다. 입원 5일 째 보채기 시작하여 6일 째 진단되었던 요로 감염의 경우는 바륨 정복술로 정복되었다. 결 론: 호발 연령에서 발생하지 않았거나 2차성 원인에 의해 발생한 경우, 첫 진단에 연연하여 증상이 설명되지 않거나 새로운 증상이 나타났는데도 장중첩증을 의심하지 못한 경우 진단이 늦어지고 결과적으로 수술을 시행하게 될 확률이 높아짐을 알 수 있었다. 따라서 장중첩증 진단 지연과 그에 따르는 치료 후유증, 합병증 및 2차적으로 발생 할 수 있는 법적 문제를 피하기 위해서는 편견에서 벗어나 항상 가능성이 있을 수 있음을 염두에 두고 환자를 대하는 것이 가장 중요하다 하겠다.