• 대한장애인치과학회지
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• 제11권2호
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• pp.76-80
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• 2015

장애인의 보건 수준이 높아지면서 치료보다는 예방의 관점에서의 구강 관리가 중요해지고 있다. 본 증례에서 소개된 다섯 명의 지적 장애를 지닌 환자들을 triazolam을 이용하여 경구 투여하여 치료하였다. Triazolam을 이용한 진정법은 장애인의 정기적인 구강 관리의 한 대안으로 고려해볼 수 있겠다.

• Clinical and Experimental Pediatrics
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• 제64권3호
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• pp.130-135
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• 2021

Background: The clinical significance of lip-tie, or a tethered maxillary frenulum, remains under debate. Clinicians and parents are often perplexed when deciding whether procedures available to relieve a seemingly tight or severe maxillary frenulum are needed. Purpose: No previous studies have assessed the consequences of not subjecting a tethered maxillary frenulum in newborns to surgical intervention. This study aimed to contribute the first prospective trial on this topic with a relatively extended follow-up of these newborn infants. Methods: This prospective observational questionnaire-based cohort trial was performed in a community setting and aimed to determine whether lip-tie is associated with an increased likelihood of eventual feeding or oral disorders. Results: The convenience sample comprised of 61 consecutively arriving infants with concomitant tethered frenula who were treated at the clinic for various reasons. This cohort was compared with a random sample of 66 age-matched children for a mean follow-up period of 6.42 years. Infants undergoing oropharyngeal procedures were excluded. Awareness of a deviation in oral structures was reported by 18% of the study group versus 0% of the controls. Mothers participating in the study group (24.6%) less frequently recalled painful nipples or discomfort during breastfeeding than those in the control group (47.0%) (P<0.01). There were no intergroup differences in other types of feeding difficulty, dental hygiene, pronunciation, or speech development. Conclusion: Our findings suggest that a tethered labial frenulum is not associated with an increase in breastfeeding disturbances or oral disorders. These data encourage clinicians to question the need to intervene in cases of tethered maxillary frenula.

• 대한보건연구
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• 제44권4호
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• pp.1-13
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• 2018

연구목적: 이 연구는 문제음주자 관점에서 조기개입 프로그램의 효과를 조명함으로써 탐색적 이해를 보여주는데 있다. 연구방법: 이 연구는 질적 기술 연구 설계가 사용되었다. 프로그램에 참여한 13명의 문제음주자와 개별 면담을 통해 연구자료를 수집하였으며, 질적 내용 분석으로 분석하였다. 연구결과: 조기개입 프로그램에 참여한 문제음주자는 알코올 정보, 알코올의 효과에 대한 기대, 자기효능감과 행동 변화 측면에서 4개의 주제 및 9개의 하위주제가 도출되었다. 이들은 직장 내에서 운영된 조기개입 프로그램에 참여하였기 때문에 개인별로 동기 수준에 차이가 있었으나, 프로그램의 필요성은 대체로 수용하였다. 프로그램 진행자를 신뢰하는 참여자일수록 음주행동 변화를 긍정적으로 생각하였다. 결론: 조기개입 프로그램에 참여한 문제음주자는 충분한 정보를 습득함으로써 음주 폐해에 대한 인식과 변화 동기의 증진 및 행위기술인 자기효능감의 획득을 통하여 문제음주 행동 변화에 유용한 접근임을 보여주었다. 이러한 결과는 직장 등 다양한 일차건강관리 현장에서 알코올중독 예방을 위한 조기개입을 적용하기 위한 기초자료로 활용될 수 있을 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권1호
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• pp.42-44
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• 2019

Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

• Korean Journal of Radiology
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• 제22권4호
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• pp.634-651
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• 2021

Dynamic X-ray (DXR) is a functional imaging technique that uses sequential images obtained by a flat-panel detector (FPD). This article aims to describe the mechanism of DXR and the analysis methods used as well as review the clinical evidence for its use. DXR analyzes dynamic changes on the basis of X-ray translucency and can be used for analysis of diaphragmatic kinetics, ventilation, and lung perfusion. It offers many advantages such as a high temporal resolution and flexibility in body positioning. Many clinical studies have reported the feasibility of DXR and its characteristic findings in pulmonary diseases. DXR may serve as an alternative to pulmonary function tests in patients requiring contact inhibition, including patients with suspected or confirmed coronavirus disease 2019 or other infectious diseases. Thus, DXR has a great potential to play an important role in the clinical setting. Further investigations are needed to utilize DXR more effectively and to establish it as a valuable diagnostic tool.

• 대한간호학회지
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• 제13권3호
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• pp.1-33
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• 1983

The role and function of nursing care nowadays, tend to acquire sophisicated technology because specialization has expended due to increase of the medical population and the improvement of national health standards. To implement nursing care independently as a professional nurse, the apprehension of specific knowledge and skill should be acquired during basic nursing education. So it is important for nursing education not only to include theory and actual techniques, but also to strengthen the practical training in the actual clinical setting. This study was carried out with the following objectives; 1. To survey the detailed content and frequency of actual nursing students display during their clinical training. 2. To investigate the detailed content and frequency of actual nursing behavior which students display in each clinical a area. 3. To identify the motive for selection of nursing as their major and to determine the degree of self confidence, extent of knowledge and recognition of nursing responsibility. 4. To observe the relationship between actual nursing behavior and each of the following; 1) Motive for selecting nursing as a major 2) Self confidence 3) Knowledge of nursing care 4) Recognition of nursing responsibility The conclusions of this study were as follows; 1. Among the detailed nursing behavior which junior nursing college students carry out in clinical training; taking respiration's showed the highest frequency, and taking body temperatures, blood pressures, and pulses and making beds were next in frequency in this order. 2. In detailed nursing behaviors according to clinical area; taking vital signs showed the highest frequency in the emergency room, pediatric ward, orthopedic ward, general surgical ward and internal medicine ward. However, in the operating room, assisting with endotracheal tube insertion and sterile techniques were showen to have the highest frequencies. In nursery, umbilical cord care and the measurement of body weight were the highest in frequency In neurosurgical ward, the measurement of vital signs, changing position and tracheostomy care were the highest in frequency. In obstetric and gynecological ward and in the delivery room, checking duration, intensity and frequency of contractions was the highest in frequency. 3. In regard to the motive for majoring in nursing, the aptitude and interest of the student had the highest percentage(32.86%), and self-confidence in nursing activities (M=3.36), knowledge in nursing activities.(M=3. 09), and the recognition of the nursing activity (M= 3.76) wire in the middle range. 4. When the detailed nursing behaviors were compared with motive, self confidence, knowledge and recognition, it was found that when the nursing behavior was difficult and regarding much endeavor although the motive was high, the frequency of the nursing behavior was rather low. But in the cases in which there was much self confidence and a high level of skill was required, nursing behavior was carried more frequently. When there was muck self confidence and skill was not required, the frequency of nursing behavior was rather low. In the cases of a high level of knowledge, the frequency of nursing behavior was low and when recognition for nursing behavior was given the frequency of nursing behavior was low.

• Journal of Hospice and Palliative Care
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• 제22권4호
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• pp.145-155
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• 2019

목적: 호스피스 완화의료에의 접근성 향상을 위해 요양병원을 호스피스 전문기관으로 지정하는 개정안이 최근 시행되었다. 호스피스 전문기관의 양적 증대도 중요하지만, 이러한 개정에 따른 서비스의 질적 저하 역시 충분히 고려되어야 한다. 이러한 관점에서 본 연구는 1,001명의 암환자, 1,006명의 가족 간병인, 928명의 의사 및 1,005명의 일반인이 해당 개정안이 가진 이점과 비용에 대해 어떻게 인식하고 있는지 확인하였다. 방법: 2016년 7월부터 10월까지 다기관 단면조사를 시행하였다. 연구 참여자들은 전문가 인터뷰 및 선행연구에서 추출된 본 개정안의 이점과 비용에 대해 각각 얼마나 동의 혹은 동의하지 않는지 응답하였다. 분석에는 카이제곱 분석, 단변량 및 다변량 로지스틱 회귀분석을 활용하였다. 결과: 참조집단인 일반인 집단과 비교했을 때, 의사 집단은 요양병원이 양질의 호스피스 완화의료 서비스를 제공하기 위한 시설 및 인력이 충분하지 않다는 점에 더 동의하였으나, 요양병원에서 과한 진료비를 청구할 것이라는 점에는 더 동의하지 않았다. 가족 간병인의 경우 일반인에 비해 요양병원에서 서비스를 제공한다면 접근성이 좋아질 것이라는 점에 더 동의했으나, 호스피스 정신이 훼손될 수 있음과 가족들이 환자 돌봄에 신경 쓰지 않을 것을 더 우려하였다. 일반인과 비교했을 때, 암환자 역시 마찬가지로 호스피스 정신이 훼손될 수 있음을 더 우려하였으며, 서비스의 질이 좋아질 것이라는 점에 대해서는 더 동의하지 않았다. 결론: 본 연구를 통해 호스피스 완화의료의 잠재적인 서비스 이용자 및 제공자가 해당 개정의 이점뿐만 아니라 비용 역시 인식하고 있음을 확인하였다. 본 연구 결과 및 유럽 국가들의 사례를 통해 개정안이 실제로 현장에서 실행되기 전에 호스피스 전문기관으로서 요양병원이 새롭게 갖추어야 할 요건 및 방향성에 대해 제언하였다.

• 대한간호학회지
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• 제30권1호
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• pp.84-97
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• 2000

The Necessity and Purpose of the Study Recently the number of patients with chronic diseases and the aged patients is increasing steadily. Furthermore, due to the expansion of health insurance system, the number of patients hospitalized in the general hospital is increasing at a surprising speed. However, hospitals urge the early discharge of the patients for the efficiencies of hospital administration, and therefore, the number of patients who must be taken care of in their home is also increasing. Homecare nursing is one of the health care service for the patients at home who require continual attention and care, and now increasing attentions are given to it as one of the professional nursing fields. However, it was almost impossible to find a study on the actual experiences of the homecare nurses written by their own language in Korea, that it also posed a great difficulty in understanding their diverse experience. Considering these situation, this study will help understanding of them, and provide the fundamental data on their experiences for making policies to develop homecare nursing. Methods of Research Phenomenological research method was employed to analyze the lived experiences of homecare nurses fundamentally. Data collection Data were collected from August 1998 to December 1998 from ten homecare nurses who worked for patients under the homecare nursing setting as model cases designated by Seoul Nurses Association and who agreed to the purpose of this study after listening to and understanding the explanation completely. The in-depth interview was carried at the time which was convenient both for the researcher and participants for one or two hours, and recovered with the approval participants. The first interview covered diverse and broad areas like the situation of homecare nursing, and their feelings and thoughts over it, and in the second and third interviews, more specific questions are asked. Data Analysis For the phenomenological analysis, contents analysis was employed. The data collected from the participants were analyzed into the following procedures according to Van Manen 's phenomenological analysis. 1) Reserve the preconception of the researcher by restricting it inside parenthesis. 2) Make a thorough observation of the lived experiences by insight process. 3) Analyze the contents (Find out the repetitive factors) 4) Interpret the essence found. 5) State the meaning of the interpretation. Results and discussion 1. Fear and expectation for the first visit. (unfamiliarity, awkwardness, anxiety, shivering) 2. Mingle with the family (feeling friendly with the family, becoming like a family member) 3. Being proud of her own know-how (learning the know-how, organizing alternatives, building up confidence) 4. Pity for the poor. (criticizing the current government, feeling ashamed, feeling anger) 5. Difficulty of constructing cooperative system with physicians (strenuousness, frustration) 6. Helplessness due to the lack of support system (difficulty to get supplies, annoyance, embarrassment by institutional restraints) 7. Anxiousness for heavy traffic and parking (annoyance, hastiness) 8. Ethical conflicts (pity for the patients and family, skepticism about lengthening life maintenance) 9. Burden for the possible accident (pressure, anxiety, conflict, physical exhaustion) 10. Establishment of identity as a professional (fulfillment, worth, joy) 11. Being distressed at other's ignorance

• Child Health Nursing Research
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• 제7권1호
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• pp.85-95
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• 2001

The purpose of this study was to reveal what influences the divergent methodological researches have brought the nursing practice in during the past 3 decades. The nursing record sheets ie, the nursing discourses were analyzed to know the knowledges that were recorded, accepted and communicated in nursing practice at pediatric intensive care units, and unclosed the philosophical and methodological position of that knowledges. The texts were 13 sheets, 3 kinds of nursing record(7 24hours flow charts, 4 nursing information record sheets and 2 transfer record sheets) used at 4 hospitals. The unit of analysis was 'word'. First, all words of the sheets were listed up, clustered into categories based on their contents. And then, the larger conceptual themes were drawn to elucidate the effect of the knowledge/power and the philosophical and methodological position of that knowledges. To enhanced the validity of the analysis, the data were analyzed by two researchers. The 'words' were classified into 3 categories; 'general information', 'assessment' and 'inter-vention'. The conceptual themes of the texts were 'the gaze for quantification and objectification' and 'technical/assimilated caring'. This themes reflected the logic positivistic and biomedical view that had dominated at clinical practice. Nursing has endeavored to resist the logic-positivistic knowledge/power and to established the nursing knowledge/power based on multiple philosophies and methodologies, especially phenomenological-interpretative. But the results of this study revealed that such efforts in nursing theory and research couldn't influenced the knowledge of practice. Logic positivism was yet so strong and the biomedical model yet dominated in the clinical practice. It identified that the borrowed theory and the knowledge from the received view gave nursing the power. But they were modalities that reinforced the dominant, medical power. Nursing has investigate the other positions (feminism, Habermas' critical social theory and Foucault's discourse theory). This positions suggest different assumptions but share the common concepts; equality, emancipation and freedom. The important point is how make these concepts the practical for nursing knowledge/power in practice. We must recognize that the praxis at clinical setting take place at the field unlike theoretical praxis. The change of clinical practice is the social, economic and political change.

• 한국전자통신학회논문지
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• 제15권1호
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• pp.107-114
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• 2020

본 논문에서는 하둡 플랫폼에서 비용 효율적 빅데이터 분석을 수행하기 위한 클러스터 규모의 설정 방안을 연구한다. 의료기관의 경우 진료기록의 병원 외부 저장이 가능해짐에 따라 클라우드 기반 빅데이터 분석 요구가 증가하고 있다. 본 논문에서는 대중적으로 많이 사용되고 있는 클라우드 서비스인 아마존 EMR 프레임워크를 분석하고, 비용 효율적으로 하둡을 운용하기 위해 클러스터의 규모를 산정하기 위한 모델을 제시한다. 그리고, 다양한 조건에서의 실험을 통해 맵리듀스의 실행에 영향을 미치는 요인을 분석한다. 이를 통해 비용 대비 처리시간이 가장 효율적인 클러스터를 설정함으로써 빅데이터 분석시 효율성을 증대시킬 수 있다.