• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.180-189
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic. Methods: This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients' in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type. Results: The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4). Conclusions: This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

• 한국산학기술학회논문지
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• 제12권12호
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• pp.5797-5804
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• 2011

최근 의학교육은 의과대학에서 의학전문대학원으로의 체제변화와 의사국가고시 실기시험 도입에 따른 변화에 대처해야하는 과제를 안고 있다. 따라서 의학전문대학원 학생들의 특성을 고려하고 국가고시 실기시험을 대비한 임상수행능력향상을 위한 교육이 필요하다. 본 연구는 의대생들의 스트레스, 자아탄력성, 자기효능감에 따른 임상수행능력과의 관계를 알아보기 위한 서술적 상관관계 연구로 D시에 소재한 일 의학전문대학원생 97명을 대상으로 2011년 8월19부터 20일까지 설문조사를 실시하였다. 연구결과는 스트레스는 자아탄력성과는 부적상관관계를 나타냈었고 자기 효능감의 하부영역인 자신감과는 정적상관관계를 보였다. 자아탄력성은 임상실기수행능력의 하부영역인 CPX와는 정적상관관계를 나타내었다. 자기효능감의 하부영역인 과제난이도 선호는 OSCE와 부적상관관계를 나타내었고, 임상실기수행능력의 하부영역인 OSCE와 CPX는 정적상관관계를 나타내었다. 따라서 학생들의 스트레스 감소는 자아탄력성을 향상시킬 수 있으며 궁극적으로 임상실기수행능력을 향상시킬 수 있다고 본다. 이상의 결과로 볼 때, 임상실기수행능력 향상을 위해서는 학생 개인의 특성을 파악하여 자아탄력성 향상을 위한 교육프로그램을 개발하고 교육과정에 반영하여야 할 것이다.

• 문화기술의 융합
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• 제10권3호
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• pp.703-711
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• 2024

본 연구는 SBAR 기반 시뮬레이션실습이 간호대학생의 보고자신감, 의사소통능력, 간호역량 및 디브리핑 만족도에 미치는 효과를 검증하고자 시도되었다. 본 연구는 일지역의 일 대학 간호학과에 재학 중인 3학년 학생을 대상으로 시뮬레이션실습 교과목을 수강한 학생 46명을 대상으로 하였다. 자료는 시뮬레이션실습 전·후 자가 보고식 설문지를 이용하였으며, 2023년 10월 30일부터 12월 22일까지 수집하였으며, 단일군 전·후 실험설계연구이다. 자료분석은 SPSS/WIN version 26.0 프로그램을 사용하여 빈도분석, 기술통계, Shapiro-Wilk test, Paired t-test를 이용하여 분석하였다. 연구결과, 보고자심감은 교육 실시 전 평균 5.79±1.47점에서 교육 후 평균 7.13±1.56점이었고, 의사소통능력은 교육 전 평균 3.62±0.44점에서 교육 후 평균 4.34±0.67점이었으며, 간호역량은 교육전 평균 2.64±0.39점에서 교육 후 평균 3.26±0.51점이었고, 디브리핑 만족도는 교육 전 평균 3.57±0.51점에서 교육 후 평균 4.18±0.58점이었다. SBAR 기반 시뮬레이션실습 교육 전·후 보고자심감(t=2.84, p=.006), 의사소통능력(t=-3.28, p=.001), 간호역량(t=-8.16, p<.001), 디브리핑 만족도(t=2.72, p<.001)는 통계적으로 유의한 차이를 보였다. 본 연구결과를 토대로 간호대학생들에게 SBAR를 활용한 의사소통 교육은 저학년 교육과정부터 체계적으로 이루어지면서, 간호역량 향상을 위해 시뮬레이션 실습교육 뿐만 아니라 다양한 실습 상황에서도 SBAR 의사소통을 활용한 보고 교육 강화 및 확대가 필요할 것으로 생각된다.

• 대한방사선기술학회지:방사선기술과학
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• 제38권4호
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• pp.403-410
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• 2015

본 연구는 다중채널코일과 병렬영상기법 이용 시 관행적으로 사용하고 있는 두영역측정법을 사용한 신호대잡음비 측정의 문제점을 알아보고자 하였다. 두영역측정법 사용 시 3가지 전제 조건에 만족하는 단일채널구상코일을 이용한 기준 SNR을 산출한 후, 다중채널코일과 병렬영상기법 이용 시 공신력 있는 기관에서 권고하는 방법과 전제 조건을 고려하지 않고 사용되어 문제가 되는 두영역측정법을 사용하여 SNR을 산출한 후 비교하였다. 다중채널코일과 병렬영상기법 이용 한 두영역측정법이 가장 높은 상대표준편차를 보여 낮은 정밀도를 나타내었고, ROI 위치에 따른 SNR 차이도 매우 높아 공간적으로 잡음의 분포가 균일하지 않음을 알 수 있었다. Blend-Altman plot 통한 95% 신뢰구간 간격도 가장 넓어 기준이 되는 단일채널구상코일을 이용한 두영역측정법 대비 일치도가 낮음을 알 수 있었다. 본 연구는 동일한 영상획득조건에서 자기공명영상장치 성능평가 시험의 표준이 되는 AAPM 방법과, 신호 영역 내에서 잡음 레벨을 정확히 결정할 수 있는 NEMA 방법, 그리고 자기공명영상장치의 제조사가 권고하는 방법을 직접적으로 비교함으로써, 연구자들이 간과할 수 있는 전제조건을 만족하지 않는 다중채널코일과 병렬영상기법 이용 시, 두영역측정법을 사용한 신호대잡음비의 부정확한 문제점을 정량적으로 증명하였다는데 큰 의의가 있다.

• Journal of Positioning, Navigation, and Timing
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• 제3권1호
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• pp.17-23
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• 2014

Satellite Based Augmentation Systems (SBAS) provide ionospheric corrections at geographically five degree-spaced Ionospheric Grid Points (IGPs) and confidence bounds, called Grid Ionospheric Vertical Errors (GIVEs), on the error of those corrections. Since the ionosphere is one of the largest error sources which may threaten the safety of a single frequency Global Navigation Satellite System (GNSS) user, the ionospheric correction and integrity bound algorithm is essential for the development of SBAS. The current single frequency based SBAS, already deployed or being developed, implement the ionospheric correction and error bounding algorithm of the Wide Area Augmentation System (WAAS) developed for use in the United States. However, the ionospheric condition is different for each region and it could greatly degrade the performance of SBAS if its regional characteristics are not properly treated. Therefore, this paper discusses key factors that should be taken into consideration in the development of the ionospheric correction and integrity bound algorithm optimized for the Korean SBAS. The main elements of the conventional GIVE monitor algorithm are firstly reviewed. Then, this paper suggests several areas which should be investigated to improve the availability of the Korean SBAS by decreasing the GIVE value.

• 한국소음진동공학회논문집
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• 제15권8호
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• pp.988-995
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• 2005

Vibration has been severly increased at the branch pipe of main steam header since the commercial operation of nuclear power plant. Intense broad band disturbance flow at the discontinuous region such as elbow, valve, and header generates the acoustical pulsation which is propagated through the piping system. The pulsation becomes the source of low frequency vibration at piping system. If it coincide with natural frequency of the pipe system, excessive vibration is made. High level vibration due to the pressure pulsation related to high dynamic stress, and ultimately, to failure probability affects fatally the reliability and confidence of plant piping system. This paper discusses vibration effect for the branch pipe system due to acoustical pulsations by broad band disturbance flow at the large main steam header in 700 MW nuclear power plant. The exciting sources and response of the piping system are investigated by using on-site measurements and analytical approaches. It is identified that excessive vibration is caused by acoustical pulsations of 1.3 Hz, 4.4 Hz and 6.6 Hz transmitted from main steam balance header, which are coincided with fundamental natural frequencies of the piping structure. The energy absorbing restraints with additional stiffness and damping factor were installed to reduce excessive vibration.

• 한국소음진동공학회:학술대회논문집
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• 한국소음진동공학회 2005년도 춘계학술대회논문집
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• pp.780-785
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• 2005

Vibration has been severly increased at the branch pipe of main steam header since the commercial operation of a nuclear power plant. Intense broad band disturbance flow at the discontinuous region such as elbow, valve or heather generates the acoustical pulsation which is propagated through the piping system. The pulsation becomes the source of low frequency vibration at piping system. If it coincide with natural frequency of the pipe system, excessive vibration is made. High level vibration due to the pressure pulsation related to high dynamic stress, and ultimately, to failure probability affects fatally the reliability and confidence of plant piping system. This paper discusses vibration effect for the branch pipe system due to acoustical pulsations by broad band disturbance flow at the large main steam header in 7nn nuclear power plant. The exciting sources and response or the piping system are investigated by using on site measurements and analytical approaches. It is identified that excessive vibration is caused by acoustical pulsations of 1.3Hz, 4.4Hz and 6.6Hz transferred from main steam header, which are coincided with fundamental natural frequencies of the piping structure. The energy absorbing restraints with additional stiffness were installed to reduce excessive vibration.

• BMB Reports
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• 제43권10호
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• pp.698-703
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• 2010

In this study, we characterized two blocks of minisatellites in the 5' upstream region of the BORIS gene (BORIS-MS1, -MS2). BORIS-MS2 was found to be polymorphic; therefore, this locus could be useful as a marker for DNA fingerprinting. We assessed the association between BORIS-MS2 and breast cancer by a case-control study with 428 controls and 793 breast cancers cases. Rare alleles in the younger group (age, <40) were associated with a statistically significant increased risk of breast cancer (odds ratio, 4.84; 95% confidence interval, 1.06-22.22; and P = 0.026). A statistically significant association between the short rare alleles and cancer was identified in the younger group (8.02; 1.01-63.83; P = 0.021). Kaplan-Meier estimates showed that poor prognosis was associated with patients who contained the rare alleles. Our data suggest that the short rare alleles of BORIS-MS2 could be used to identify the risk for breast cancer in young patients.

• 품질경영학회지
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• 제41권4호
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• pp.649-657
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• 2013

Purpose: In this study, the actual situation of domestic firms vulnerable to industrial security competence will be discussed. And accordingly be discussed for effective response measures. Methods: Using a structured questionnaire by mail, fax, e-mail and fill method was used respondents. By the end of '10 R&D Center, which holds 15,247 companies(population) among the 95% level of confidence, tolerance ${\pm}3%$ p-level corporate type, sector, region extraction method stratified multi-level companies were investigated through the final 1529. Results: The average level of industrial security capabilities 43.8%(out of 100) is very weak, so urgent and positive response measures also need to be investigated sought. Conclusion: we propose the effective management framework and improvement plans to prevent illegal industrial leakage are to be made.

• 한국도로학회논문집
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• 제16권5호
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• pp.133-142
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• 2014

PURPOSES : The objective was to develop the advanced method which could not explain each observation's specific characteristic in the present negative binomial method that results in under-estimation of the standard error(t-value inflation) and affects the confidence of whole derived results. METHODS : This study dealt with traffic accidents occurring within interchange segment on highway main line with RPNB(Random Parameter Negative Binomial) method that enables to take account of heterogeneity. RESULTS : As a result, AADT and lighting installation type on the road were revealed to have random parameter and in terms of other geometric variables, all were derived as fixed parameter(same effect on every segment). Also, marginal effects were adapted to analyze the relative effects on traffic accidents. CONCLUSIONS : This study proves that RPNB method which considers each observation's specific characteristics is better fitted to the accident data with geometrics. Thus, it is recommended that RPNB model or other methods which could consider the heterogeneity needs to be adapted in accident analysis.