• 제목/요약/키워드: EBP

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일개 상급종합병원 간호사의 근거기반실무(Evidence-Based Practice) 촉진요인에 대한 인식 (Nurses' Perceptions regarding Evidence-Based Practice Facilitators in a Tertiary Hospital)

  • 조명숙;송미라;차선경
    • 기본간호학회지
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    • 제18권3호
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    • pp.300-309
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    • 2011
  • Purpose: The purpose of this study was to investigate facilitators of evidence-based practice (EBP) in Clinical Nurses. Method: The instruments used in study were the EBP facilitator scale developed by Nagy et al. and a questionnaire on EBP-related characteristics. Data were collected from 230 nurses at a tertiary hospital and analyzed by descriptive statistics. Results: Compared to previous studies, this study showed that nurses had more experience related to research courses and clinical research. However, the proportion of nurses who reviewed relevant articles still remained low. The respondents had positive perceptions of organizational supports for EBP and belief in the value of EBP, whereas they had negative perceptions of skills in locating and evaluating research reports, knowledge of research terms and statistics, and time to devote to EBP. Conclusion: The findings of the study provide important basic data to develop and implement an EBP programs. In future, EBP programs should cover the nurses' skills to search and review research literature as well as their knowledge of research terms and statistics. Furthermore, nurses will require help to ensure that there is adequate time to devote to EBP.

발생단계별 해마신경세포에서 eIF4E 및 eIF4EBP1의 표현 (Developmental Expression of Eukaryotic Initiation Factor 4E (eIF4E) and eIF4E-binding Protein 1 (eIF4EBP1) in Rat Hippocampal Neurons)

  • 박재완;문일수
    • 생명과학회지
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    • 제23권7호
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    • pp.941-946
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    • 2013
  • 신경세포의 가지돌기 내 단백질합성은 필요한 단백질을 실시간으로 제공할 수 있는 이점을 제공한다. 본 연구에서는 단백질합성인자 eIF4E와 그 억제 단백질인 eIF4EBP1의 발생단계별 표현을 배양한 해마신경세포를 면역 염색하여 조사하였다. eIF4E는 가지돌기에 점박이 모양으로 표현되었으며, 핵에는 표현되지 않았다. 그러나 eIF4EBP1는 가지돌기 뿐 아니라 발생초기(DIV 0.5)부터 핵에서 표현되었으며 성숙한 세포에서 핵에 더욱 뚜렷이 표현되었다. eIF4E 혹은 eIF4EBP1의 PSD95과의 colocalization은 $39.1{\pm}9.6%$$70.5{\pm}5.2%$ (DIV 7), $57.7{\pm}8.2%$$36.0{\pm}3.1%$ (DIV 10), $29.9{\pm}2.9%$$40.2{\pm}11.7%$ (DIV 20)이었다. eIF4E와 eIF4EBP1의 colocalizatin은 $18.5{\pm}2.6%$ (DIV 7), $11.1{\pm}3.9%$ (DIV 10), $38.6{\pm}5.6%$ (DIV 20)이었다. 이 결과는 eIF4E 및 eIF4EBP1의 많은 부분이 연접후에 위치하며, 발생초기에는 eIF4E가 활동적인 형태로 존재하지만, 성숙 신경세포에서는 eIF4EBP1과 결합하여 비활성적인 형태로 존재함을 의미한다.

절수시 Mongolian Gerbil 콩팥에서 TonEBP와 Urea transporter의 발현 변화 (Renal Expression of TonEBP and Urea Transporter in the Water-deprived Mongolian Gerbil(Meriones unguiculatus))

  • 박용덕;김성중;정주영
    • Applied Microscopy
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    • 제37권4호
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    • pp.271-280
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    • 2007
  • Tonicity responsive enhancer binding protein(TonEBP)는 콩팥에서 osmolyte의 세포내 축적을 촉매해 주는 전사조절인자로 높은 삼투농도에서 세포를 보호하는데 중요한 역할을 수행한다. 고장성환경은 TonEBP의 양적 증가와 핵 내 분포의 증가를 통해 TonEBP의 활성을 자극한다. 또한 TonEBP는 콩팥 수질내 요소축적에 중요한 역할을 하는 UT-A의 전사를 조절하는 것으로도 알려져 있다. 따라서 본 연구에서는 콩팥수질내 TonEBP와 UT-A의 기능과 상관관계를 밝히는 연구의 일환으로 다른 동물보다 급수가 제한된 환경에서 더 오래 살아남을 수 있는 수분대사능력을 가지고 있는 Mongolian gerbil을 이용하여, 절수로 인한 고장성환경의 유발에서 TonEBP와 UT-A에 대한 발현 변화를 관찰하고자 하였다. 절수에 따른 TonEBP와 UT-A의 발현 양상을 연구하기 위해, 먼저 Mongoian gerbil 각 5마리씩 3그룹으로 나누어 절수 실험을 실시하였고, 면역조직화학법을 실시하여 다음과 같은 결과를 얻었다. 정상대조군에서 TonEBP의 면역반응성은 속수질 세포들의 핵 내에 주로 분포하였으며, 절수 7일군에서 면역조직화학검사 결과, 속수질집합관에서의 염색성은 대조군에 비해 증가하였고, 특히 바깥수질 부위에 속수질에서 요세관의 가는 부분에서의 증가가 두드러졌다. 절수 14일군에서 염색성이 대조군보다 오히려 감소하였으며, 콩팥의 조직학적 손상이 관찰되었다. UT-A의 경우 바깥수질 속줄무늬층의 짧은-헨레고리가는내림부분과 정상군에서는 미약한 양성반응을 나타낸 속수질 초기부분의 긴-헨레고리가는내림부분에서 강한 발현 양상을 나타내었고, 속수질의 초기에서 중간부위의 속수질집합관도 강한 발현 양상을 확인할 수 있었다. 그러나 속수질 말단부위의 속수질집합관은 콩팥유두 끝으로 갈수록 발현량이 감소하는 것을 확인할 수 있었다. 이상의 결과는 Mongolian gerbil을 이용한 절수모델에서 증가된 콩팥수질의 Tonicity에 의해 TonEBP의 발현이 증가하고 이에 따라 UT-A의 발현도 동반하여 증가하는 것을 확인하였고, 또한 이렇게 증가된 TonEBP는 UT의 전사를 조절하여 UT를 증가시켜 오줌농축기전을 향상시키는 것으로 생각된다. 이는 속수질 세포의 스트레스에 대한 세포방어기전으로 생각된다. 그러나 절수가 계속되면 이런 적응반응에 한계를 지나쳐 오히려 TonEBP와 UT-A의 발현이 감소함을 확인 할 수 있었다.

범이론적 모형에 기반한 근거기반실무 활성화 프로그램의 개발 (Development of a Program to Facilitate Evidence-Based Practice Based on the Transtheoretical Model)

  • 조명숙;조용애;송미라;김미경;차선경
    • 성인간호학회지
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    • 제25권2호
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    • pp.136-147
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    • 2013
  • Purpose: This study developed a program to facilitate evidence-based practice (EBP) in one nursing organization, and identifies the effects of the program on the nurses' EBP facilitators. Methods: The program was based on the Transtheoretical Model of stages of organizational change, a literature review, the cases of hospitals overseas, and a prior study. To identify the effects of the program, a one-group pretest-posttest study was conducted with 45 nurses who participated in the EBP implementation. Results: The program consisted of EBP educational sessions, consultations with academic nursing faculty and clinical EBP mentors, and support from the administration and relevant departments. After the EBP program, there was a statistically significant difference in belief in the value of EBP between the pretest and the posttest (t=2.31, p=.026). However, no significant differences were found between the pretest and the posttest for organizational support to develop EBP (t=0.62, p=.537), skills in locating and evaluating research reports (s=-1.00, p=.987), knowledge of research language and skills (s=-1.00, p=.986), and time to devote to EBP (s=-23.00, p=.711). Conclusion: The findings provide important data that can be used to develop and implement strategies for enhancing EBP in clinical settings in Korea.

상급종합병원 간호사의 근거기반실무에 대한 지식과 태도 및 수행 (Registered Nurses' Knowledge, Attitudes, and Practice about Evidence-Based Practice at General Hospitals in Korea)

  • 임경춘;박광옥;권정순;정재심;최명애;김주현;이경숙
    • 임상간호연구
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    • 제17권3호
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    • pp.375-387
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    • 2011
  • Purpose: Evidence-based practice (EBP) has emerged as a marker for healthcare quality and a global issue in nursing care. This study was conducted to identify Korean registered nurses' knowledge, attitudes, and practice about EBP in Korea. Methods: With a cross-sectional design, the EBP questionnaire (EBPQ) was administered to a convenience sample of nurses (N=453) recruited from 44 general hospitals. To increase the response rate, the directors of nursing were individually contacted by the researchers. The final response rate was 95.7%. Results: The majority of participants were females (99.3%), staff nurses (57.8%), and with bachelors degree (40.6%). Most of them (314, 73.4%) had ever heard about EBP. The overall mean score for the EBPQ was $4.72{\pm}0.69$ out of maximum score of 7. The mean score for the knowledge of EBP, attitudes towards EBP, and practice/use of EBP were $4.61{\pm}0.75$, $4.85{\pm}0.94$, and $4.90{\pm}0.88$, respectively. Educational level, age, and exposure to EBP were statistically significant predictors of Korean nurses' EBP perception. Conclusion: The findings showed that nurses with higher education are more likely to use and value the best available evidence for practice. This study suggests needs not only for further exploration but also for developing educational plans provided by each institute to assist nurses with the process of EBP and the associated skills.

Silibnin의 지방세포분화 억제 및 세포사멸 유도 효과 (Silibinin Inhibits Adipogenesis and Induces Apoptosis in 3T3-L1 Adipocytes)

  • 이슬기;권택규;남주옥
    • 한국미생물·생명공학회지
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    • 제45권1호
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    • pp.27-34
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    • 2017
  • CCAAT/enhancer-binding protein beta, delta ($C/EBP{\beta}$, ${\delta}$)는 지방세포분화 과정의 초기에 필수적으로 요구되며 지방생성 주요 조절인자인 proliferator-activated receptor gamma ($PPAR{\gamma}$) and CCAAT/enhancer-binding protein-alpha ($C/EBP{\alpha}$)의 발현을 유도한다. 본 연구에서는 silibinin의 지방세포 분화 억제 효과 및 이러한 효과가 지방세포 분화초기에 $C/EBP{\beta}$$C/EBP{\delta}$의 발현 조절을 통해 일어난 다는 것을 확인하였다. Silibinin은 지방세포 내 지질축적을 억제하고 세포분화 과정 동안 관여하는 다양한 유전자의 mRNA 발현을 억제하였다. 또한 lipoprotein lipase (LPL), fatty acid binding protein 4 (AP2) 및 adiponectin과 같은 지방세포 분화 관련 유전자의 발현을 억제시켰다. 따라서, Silibinin의 지방세포 분화 억제효과는 $C/EBP{\beta}$$C/EBP{\delta}$의 발현억제에 의한 것으로 보인다. 더불어, Silibinin은 capspase-3 활성을 통해 분화하는 세포에 특이적으로 세포사멸을 유도하는 것을 확인하였다.

간호사의 근거중심실무역량에 대한 영향요인 (Factors Influencing Competency in Evidence-based Practice among Clinical Nurses)

  • 김연숙;김지미;박미미
    • 간호행정학회지
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    • 제21권2호
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    • pp.143-153
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    • 2015
  • Purpose: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. Methods: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. Results: The overall mean score for competency in EBP was $3.03{\pm}0.53$. Factors influencing competency in EBP were education (${\beta}=0.23$, p<.001), attendance at lectures on EBP (${\beta}=0.18$, p<.001), intellectual eagerness & healthy skepticism (${\beta}=0.27$, p<.001) among CTD, and hierarchy-oriented OC (${\beta}=0.14$, p=.005), which explained about 35% of the total variance. Conclusion: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

Role of CCAAT/ Enhancer Binding Protein ${\beta}$ Activation in the Induction of Glutathione S-Transferase A2 by Toluene

  • Choi, Dal-Woong;Sohn, Jong-Ryeul;Moon, Kyung-Whan;Byeon, Sang-Hoon;Kim, Hi-Chol;Kim, Young-Whan
    • 한국환경보건학회:학술대회논문집
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    • 한국환경보건학회 2005년도 국제학술대회
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    • pp.341-344
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    • 2005
  • The expression of the glutathione S-transferase (GST), whose induction accounts for antioxidant defense system, is regulated by activation of CCAAT/enhancer binding protein ${\beta}$ ($C/EBP{\beta}$), Sick house syndrome (SHS) presents healthy damage owing to the indoor environment of a building. Toluene has been implicated in one of the important causes of SHS. The present study investigated the effects of toluene treatment on the induction of GSTA2 gene and its mechanism. H411E cells treated with toluene, and GSTA2 expression was determined by immunoblot analysis. The translocation of $C/EBP{\beta}$ was assessed by immunocytochemical assays. $C/EBP{\beta}$ DNA binding activity was determined by electrophoretic mobility shift assays. The role of the C/EBP binding site in the induction of the GSTA2 gene was assessed by luciferase reporter-gene activity. Toluene induced GSTA2 protein expression. In toluene-treated cells, $C/EBP{\beta}$ translocated to the nucleus and bound to the consensus sequence of C/EBP (TTGCGCAA). Toluene treatment increased luciferase reporter-gene activity in cells transfected with the C/EBP-containing regulatory region of the GSTA2 gene. Oxidative stress is believed to play an important role in the induction of GSTA2 gene by toluene This study shows that toluene-induced GSTA2 gene expression is dependent upon nuclear translocation and binding of $C/EBP{\beta}$ to the C/EBP response element in the GSTA2 gene promoter.

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다층퍼셉트론의 오류역전파 학습과 계층별 학습의 비교 분석 (Comparative Analysis on Error Back Propagation Learning and Layer By Layer Learning in Multi Layer Perceptrons)

  • 곽영태
    • 한국정보통신학회논문지
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    • 제7권5호
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    • pp.1044-1051
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    • 2003
  • 본 논문은 MLP의 학습 방법으로 사용되는 EBP학습, Cross Entropy함수, 계층별 학습을 소개하고, 필기체 숫자인식 문제를 대상으로 각 학습 방법의 장단점을 비교한다. 실험 결과, EBP학습은 학습 초기에 학습 속도가 다른 학습 방법에 비해 느리지만, 일반화 성능이 좋다. 또한, EBP학습의 단점을 보안한 Cross Entropy 함수는 학습 속도가 EBP학습보다 빠르다. 그러나, 출력층의 오차 신호가 목표 벡터에 대해 선형적으로 학습하기 때문에, 일반화 성능이 EBP학습보다 낮다. 그리고, 계층별 학습은 학습 초기에, 학습 속도가 가장 빠르다. 그러나, 일정한 시간 후, 더 이상 학습이 진행되지 않기 때문에, 일반화 성능이 가장 낮은 결과를 얻었다. 따라서, 본 논문은 MLP를 응용하고자 할 때, 학습 방법의 선택 기준을 제시한다.

신경계물리치료에서의 근거중심실기(1) -임상의사결정과정에 EBP 적용하기- (Evidence-Based Practice in Neurological Physical Therapy (1) -Applying EBP to Clinical Decision Making-)

  • 이문규;임재헌;김태윤
    • PNF and Movement
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    • 제14권3호
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    • pp.157-176
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    • 2016
  • Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.