• 한국콘텐츠학회논문지
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• 제19권2호
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• pp.231-247
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• 2019

본 연구는 노인의 사회경제적 박탈, 특히 사회경제적 박탈의 하위변수들이 삶의 만족도에 미치는 영향에서 우울이 매개하는지를 살펴보는 것을 목적으로 한다. 이를 위해 한국복지패널 12차년도(2017년) 자료를 사용하였다. 분석은 Baron과 Kenny(1986)의 매개효과 분석방법을 활용하였고, 우울의 매개효과에 대한 검증을 위해 Sobel Test를 실시하였다. 본 연구의 결과, 첫째 노인의 사회경제적 박탈 하위변수인 주거박탈, 식생활박탈, 사회보장박탈, 사회적박탈, 건강의료박탈, 직업경제박탈이 삶의 만족도에 유의하게 영향을 미치는 것으로 나타났다. 둘째, 노인의 사회경제적 박탈의 하위변수인 주거박탈, 식생활박탈, 사회적박탈, 직업경제박탈, 건강의료박탈이 삶의 만족도에 미치는 영향에서 우울이 부분매개효과가 있는 것으로 나타났다. 이는 사회경제적 박탈의 하위변수인 주거박탈, 식생활박탈, 사회적박탈, 직업경제박탈, 건강의료박탈을 경험할수록 우울이 증가하고 삶의 만족도는 낮아지게 되는 것을 확인하였다. 따라서 노인의 삶의 만족을 향상시키기 위해서는 사회경제적 박탈 유형 및 우울의 개인적 특성을 반영한 정책과 서비스가 제공되어야 하며, 이때 소득중심의 빈곤개념에서 벗어나 일상생활에서 경험하는 다차원적 결핍을 파악할 수 있는 기준선이 마련되어야함을 제시하였다.

• 재활치료과학
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• 제10권2호
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• pp.7-22
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• 2021

목적 : 본 연구의 목적은 뇌졸중 환자의 인지기능 회복에 대한 경두개 직류자극(tDCS)의 효과를 살펴본 연구를 분석하기 위함이다. 연구방법 : 2009년부터 2019년까지 국내외 학술지에 게재된 논문들을 NDSL, RISS, PubMed, CINAHL을 통해 검색하였다. 선정기준과 배제기준을 통해 총 11개의 실험연구 논문이 선정되었다. 이를 질적평가를 시행하고, 이 중 7편의 논문에서 9개의 결과값에 대해 메타분석을 실시하였다. 결과 : 메타 분석을 실시한 결과 효과크기는 attention 0.725, memory 0.796으로 모두 '보통 효과크기'를 보였다. 두 영역 모두 통계적으로 유의한 변화가 있던 것으로 분석되었다(p<0.05) 결론 : 본 연구 결과를 통하여 인지기능이 제한된 뇌졸중 환자에게 tDCS는 효과가 있음을 알 수 있었다. 또한, tDCS 적용법이 연구 간 서로 상이함을 알게 되었으며 이에 따라 정형화된 tDCS 프로토콜과 전문가 양성이 필요할 것으로 보인다.

• Safety and Health at Work
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• 제13권3호
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• pp.263-268
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• 2022

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

• 융합정보논문지
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• 제11권4호
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• pp.83-101
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• 2021

본 연구는 우리나라 중소기업들에게 4차 산업혁명 대응과 스마트 기업으로의 변화를 위해서는 어떠한 기술들을 우선적으로 적용하여야 하는가에 대한 내용을 AHP를 활용하여 규명하는 것이다. 이를 위하여 4차 산업혁명 관련 기술들을 종합하고, 김대훈 외(2019)의 분류기준을 준용하지만 전문가들의 의견을 추가로 수렴하여 관련 기술들을 분류하였다. 인공지능(AI), Big Data, Cloud Computing을 디지털 기반기술로, 모바일, 사물인터넷(IoT), Block Chain을 초연결 기술로, 무인운송(자율주행), 로봇(Robot), 3D 프린팅, 드론을 융합기술로, 스마트 제조 및 물류, 스마트 헬스케어, 스마트 교통, 스마트 금융을 스마트 산업기술로 구분하였다. AHP 분석과 종합가중치를 계산하는 방식으로 기술적용 우선순위를 확인한 결과 제조기업은 모바일, 인공지능(AI), Big Data, 로봇(Robot)의 순위가 높으며, 서비스기업은 Big Data, 로봇(Robot), 인공지능(AI), 스마트 헬스케어의 순위가 높고 전체기업에서는 Big Data, 인공지능(AI), 로봇(Robot), 모바일의 순서이다. 본 연구를 통해 4차 산업혁명 대응과 스마트 기업으로의 변화를 위해서는 어떠한 기술들을 우선적으로 적용하여야 하는가를 명확하게 규명하였다.

• 한국산업보건학회지
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• 제33권2호
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• pp.115-125
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• 2023

Objectives: This study was conducted to measure the level of radon in the air at a highway tunnel construction site in a gneiss area using the New Austrian Tunneling Method (NATM) and to evaluate exposure levels by occupation. Methods: Radon concentrations in the air were measured using E-PERM at points 300 m, 600 m, and 900 m from the tunnel entrance during the excavation and waterproofing work inside the tunnel. In addition, radon concentrations were measured during external excavation to compare with the inside of the tunnel. Personal exposure levels for major occupations including tunnel workers, construction equipment operators, waterproofers, shotcrete workers, and safety and health managers who participated in the construction were estimated using radon concentration measured in the work process area and working hours by occupation. Results: As a result of a total of 77 radon measurements, the geometric mean (GM) concentration was 71.1 Bq/m³, and the maximum concentration was 127.3 Bq/m³, which was below the indoor air quality criteria. Radon concentration by process decreased in the order of the tunnel excavation process (GM= Bq/m³, GSD=1.2), waterproofing process (GM=73.35 Bq/m³, GSD=1.2), and outside excavating process (GM=45.28 Bq/m³, GSD=1.2). Processes inside the tunnel were significantly higher than outside excavating processes (p<0.05). There was no statistically significant difference in radon concentration measured inside by distance from the tunnel entrance, but the innermost point of the tunnel, 900 m (GM=79.24 Bq/m³, GSD=1.27), measured the highest. Conclusions: The occupation with the highest individual exposure to radon was tunnel worker (64.16 Bq/m³), followed by construction equipment driver (64.04 Bq/m³) and waterproofer (63.13 Bq/m³).

• 한국빅데이터학회지
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• 제8권1호
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• pp.111-129
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• 2023

디지털 혁신의 확산에 따라 의료 분야에서도 인공지능을 기반으로 한 혁신의료기술의 채택이 활발해지고 있다. 이에 따라 인공지능 기반 소프트웨어형 의료기기인 SaMD(Software as a Medical Device)의 출시 및 도입도 촉진되고 있지만, 의료기관의 SaMD 도입 요인에 대한 연구는 미흡한 편이다. 본 연구의 목적은 '인공지능 기반 SaMD' 도입에 대한 의료기관의 의사결정에 영향을 미치는 중요한 요인들을 찾고, 이들 요인의 가중치와 우선순위를 분석하는 것이다. 이를 위해 의료계의 기술수용 모델, 의료 인공지능 및 SaMD 등에 관한 문헌연구 결과를 바탕으로 델파이 조사를 실시하였으며, HOTE(Human, Organization, Technology and Environment) 프레임워크와 HABIO(Holistic Approach {Business, Information, Organizational}) 프레임워크를 결합하여 연구 모형을 개발하였다. 5가지 주기준과 22개의 하부기준으로 구성된 연구 모형을 바탕으로 국내 의료기관과 SaMD 공급자의 전문가들을 대상으로 AHP(Analytic Hierarchy Process) 분석을 실시하여 SaMD 도입 요인을 실증적으로 분석하였다. 본 연구의 결과, 인공지능 기반의 SaMD 도입을 결정하는 주기준의 우선순위는 기술적 요인, 경제적 요인, 인적 요인, 조직적 요인, 환경적 요인의 순으로 나타났고, 하부기준의 우선순위는 신뢰성, 진료원가 절감, 의료진의 수용도, 안전성, 최고 경영자의 지원, 보안성, 인허가 및 규제 수준의 순이었다. 특히, 신뢰성, 안전성, 보안성 등의 기술적 요인이 SaMD 도입에 있어서 가장 중요한 것으로 나타났다. 또한, 각 집단별 가중치와 우선순위를 비교·분석한 결과, SaMD 도입 요인의 가중치와 우선순위는 기관의 유형, 의료기관의 유형 및 의료기관 보직의 유형에 따라 매우 다른 것으로 나타났다.

• 한국산학기술학회논문지
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• 제18권11호
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• pp.433-444
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• 2017

본 연구는 심혈관 질환을 공통적으로 동반하는 폐기능 장애와 대사증후군 관계에 대한 연구이다. 이들 질환이 상호 관련성이 있다는 가정 하에 폐기능 장애와 대사증후군간의 상호 관련성 여부를 확인하여 올바른 질환 관리를 위한 초석을 마련하고자 하였다. 자료는 국민건강 영양조사 자료중 2008년부터 2013년까지 6년간 자료를 통합한 53,829건에서, 폐기능 검사를 시행한 만 40세 이상으로 모든 혼란 변수를 통제한 정제된 자료 8,137명(남자, 3,951명, 여자 4,186명)의 자료를 사용하였다. 폐기능 장애는 GOLD(Global Initiative for Chronic Obstructive Lung Disease)기준에 따라 폐쇄성, 제한성으로 구분하였고, 대사증후군은 개정된 NCEP-ATPIII(National Cholesterol Education Program-Expert Panel-Adult Treatment Panel III)기준을 사용하였다. 연관성 분석은 로지스틱 회귀분석을, 유병률은 교차 분석을 시행하였다. 연구 결과, 연관성 분석에서 폐쇄성 폐질환은 대사증후군과 직접적인 관련성을 보이지 않았으며 제한성 폐질환은 대사증후군과 직접적인 관련성을 보였다. 유병률 분석에서는 폐쇄성 폐질환과 제한성 폐질환 모두 대조군보다 높은 대사증후군 유병률을 보였다. 그러나 제한성 폐질환의 대사증후군 유병률이 폐쇄성 폐질환의 대사증후군 유병률보다 더 높았다. 결론적으로 폐쇄성이 아니라 제한성 폐질환이 대사증후군과 유의한 연관성을 보였고 대사증후군 유병률도 더 높았다.

• 한국임상약학회지
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• 제24권1호
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• pp.39-44
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• 2014

Purpose: To investigate adverse drug reactions (ADR) and causative drugs in the elderly 65 years of age or older, using Korean spontaneous reporting adverse events reporting database from June 2009 to December 2010. Methods: We estimated the association between ADRs and implicated medications by calculating a proportional reporting ratio (PRR), reporting odds ratio (ROR), and information component (IC). We reexamined the most frequently implicated medications and ADRs, and the seriousness of ADRs. Then, we assessed reports and concordant rate of ADRs due to medications designated as "high-risk" in elderly by 2012 healthcare effectiveness data and information set (HEDIS) or "potentially inappropriate" by 2012 American Geriatrics Society updated Beers criteria for potentially inappropriate medications (PIMs). Results: Among 15,484 elderly reports, data-mining analysis by PRR, ROR and IC showed that 421 drug-ADR pairs were detected as signals (3,189). The most frequently reported ADR and causative drug were urticaria (470) and contrast media agents (647), respectively. One hundred eighty nine ADR cases were graded as serious. Twenty-two kinds of high-risk medications were shown to be implicated in only 0.9% of ADRs. Only thirty-nine cases were consistent with 2012 Beers criteria or HEDIS. Conclusion: These results suggest that management of the other medications including contrast media agents as well as close monitoring of PIMs are necessary for reducing ADRs in the elderly.

• 모자간호학회지
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• 제4권1호
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• pp.3-11
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• 1994

Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

• 한국임상약학회지
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• 제30권1호
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• pp.44-50
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• 2020

Background: Drug-drug interactions (DDIs) in patients using oral anticancer treatment are more common than in those using injectable anticancer agents. In addition, DDIs related to anticancer treatment are known to cause clinically significant outcomes, such as treatment failure and severe toxicity. To prevent these negative outcomes, significant DDIs are monitored and managed using the information provided in drug databases. We aimed to evaluate the consistency of information on clinically significant DDIs for tyrosine kinase inhibitors (TKIs) between representative drug databases. Methods: We selected clinically significant DDIs involving medications that are co-prescribed with TKIs and met the following criteria: the severity level of DDIs was equal or greater than "D" in Lexicomp^® or "major" in Micromedex^®. We then analyzed the consistency of the severity classification and evidence level between the drug databases. Spearman's correlation coefficient was used to identify the relationship between DDI information in the drug databases. Results: In total, 627 DDI pairs were identified as clinically significant; information on these was provided by Lexicomp^® and Micromedex^® for 571 and 438 pairs, respectively, and both drug databases provided information on 382 DDI pairs. There was no correlation between the severity and evidence level of DDIs provided in the two databases; Spearman's correlation coefficient for Lexicomp^® and Micromedex^® was -0.009 (p=0.861) and -0.064 (p=0.209), respectively. Conclusion: To judge the significance of DDIs, healthcare providers should consider that the information on DDIs may be different between drug information databases; hence, clinical factors must be considered concurrently.