• 대한소아치과학회지
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• 제34권1호
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• pp.43-52
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• 2007

현재 우리나라는 치과의사 전문의제도가 도입되고 저출산 고령화 사회로의 급속한 이행 등 여러 이유로 소아치과 전문의 수급에 관한 연구가 절실한 실정이다. 본 연구는 소아치과 전문의 수요추계에 적합한 모형을 모색할 목적으로 의료인력 수급에 관한 타 분야의 기존 연구들을 고찰하여 다음과 같은 결과를 얻었다. 1. 소아치과 전문의의 수요추계는 의료수요에 근거한 방법을 적용하는 것이 적절할 것으로 사료되었다. 2. 추계 모형에 필요한 독립변수로는 크게 유병율, 수진율, 의뢰율 출산율, 생산성, 연간 진료일수 등이 있었으나, 이러한 변수들에 대입하기 위한 기초자료가 부족한 것으로 나타나, 이를 보완할 설문조사와 전문가 의견조사가 필요할 것으로 판단되었다. 3. 독립변수는 각 특성에 적합한 회귀모형을 설정하여 추계하고, 가중치를 주어 추계 모형에 반영해야 할 것으로 판단되었다. 향후 추계 모형에 대입하기 위한 독립변수의 생성과 추계연구, 전문가의 검증과정이 추가로 필요하며 이를 토대로 소아치과 전문의 수요를 추계하여야 할 것으로 사료된다.

• 근관절건강학회지
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• 제4권1호
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• pp.26-47
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• 1997

The purpose of this study is to explore the treatment pattern of treatment of patients with arthritis. The grounded theory approach methodology was used in this study. The purposive sampling was conducted. 16 subjects who experienced RA, lived in middle sized city in Korea, and all women The results of this study were as follows : 1. The process of treatment was composed of the stage of symptom experience and the stage of sick role experience. The naming of the symptom was conducted in the stage of symptom experience through, the doctor shopping. The sick role experience was patterned by the choice of the treatment mode. 2. The treatment modes were roughly devided by western medicine and oriental or ethnic medicine. Several factors which affected the choice of the treatment mode were patient's economic state, educational level, religion, the acknowledgement of the cause of illness, duration of illness, lay referral system, the relationship of medical staff, and the acculturation of medical professionalism. The key component of the decision of the treatment was the level of the acculturation of medical professionalism. To enhance the acculturation of medical professionalism, we have to provide the information of cause and the prognosis of the disease to the patients and the variety of communication channel between medical staff and patients, and we should understand the medical culture according to the ages, gender, locations in Korea.

• 지역사회간호학회지
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• 제12권3호
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• pp.647-660
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• 2001

Forming health care management model in small-scale enterprises was the purpose of this study. For the purpose, we tried to investigate the characteristics of small-scale enterprises and analyzed the pattern of their health care management. The results are as follow: 1. The strength of health managing agency and technical supporting program lies in team approach by specialized manpower. However, if the liaison between each part of the organization is not smooth, the overall management will be very difficult. 2. Small scale enterprises are characterized by their short life after the establishment, use of rental building, lack of welfare facilities, weakness in sanitary management and aggregation of factories of similar type of industry. Because of these characteristics, it is very difficult to solve problem basically, such as improvement of working environment. Therefore, it is important to focus on health education and community based approach. 3. Many workers in small-scale factories are in middle and old age. They have health problems mainly related to personal habits. Implementation of an appropriate health promotion program is needed. 4. The number of workplaces, which should be managed by health managing agent. is increasing rapidly. But the number of health managing agent is limited. In the aspect of the requirement of manpower and equipment, training personal agent is more urgent than founding institutional agent. 5. The uniform method of health management hampers the choice of employer and workers. The types of provision of health management should be diversified. 6. For an efficient management, a frequent visit of personal agent and the following referral to a specialist should be done. The specialists in charge of secondary management are from the field of occupational medicine, occupational hygiene, ergonomics, etc. 7. The health management of small-scale facilities should have six components. They are community-based approach, multi-disciplinary cooperative system, program based on the need of recipient, forming partnership of employer and worker, change of lifestyle, and evidence-based program.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.130-136
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• 2007

Objectives : Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. Methods : A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval between symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. Results : Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. Conclusions : The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

• Child Health Nursing Research
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• 제29권4호
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• pp.271-279
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• 2023

Purpose: Adolescent self-harm is a public health problem. Research suggests a link between adverse childhood experiences (ACEs) and self-destructive behaviors. Few studies, however, have examined the effects of ACEs on self-harm among Asian adolescents. This study explored the association between lifetime ACEs and a history of self-harm among Korean children and adolescents in elementary, middle, and high schools. Methods: A cross-sectional, retrospective medical record review was conducted on a dataset of a national psychiatrist advisory service for school counselors who participated in the Wee Doctor Service from January 1 to December 31, 2020. The data were analyzed using multiple logistic regression to predict self-harm. Results: Student cases (n=171) were referred to psychiatrists by school counselors for remote consultation. Multiple logistic regression analyses revealed that the odds of self-harm were higher among high school students (adjusted odds ratio [aOR]=4.97; 95% confidence interval [CI]=1.94-12.76), those with two or more ACEs (aOR=3.27; 95% CI=1.43-7.47), and those with depression (aOR=3.06; 95% CI=1.32-7.10). Conclusion: The study's findings provide compelling evidence that exposure to ACEs can increase vulnerability to self-harm among Korean students. Students with a history of ACEs and depression, as well as high school students, require increased attention during counseling. School counselors can benefit from incorporating screening assessment tools that include questions related to ACEs and depression. Establishing a systematic referral system to connect students with experts can enhance the likelihood of identifying self-harm tendencies and offering the essential support to prevent self-harm.

• 대한간호학회지
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• 제30권6호
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• 한국임상약학회지
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• 제26권4호
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• pp.306-311
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• 2016

Objective: This study was performed to compare the changes in the blood concentrations of tacrolimus when either itraconazole or voriconazole is together with tacrolimus to prevent or treat invasive aspergillus pneumonia (IAP) in patients with lung transplants. Therefore we can compare the degree of drug-drug interactions between tacrolimus and itraconazole against tacrolimus and voriconazole. Methods: Patients who were admitted and had lung transplants in a territory referral hospital from September 2012 to May 2015 were analyzed retrospectively. The effects of itraconazole and voriconazole on the plasma concentrations of tacrolimus were analyzed. Results: Mean tacrolimus concentrations was $10.49{\pm}2.35ng/mL$ vs. $10.95{\pm}2.98ng/mL$ (p=0.722), and mean concentration of tacrolimus over the dose of tacrolimus per day was $8.510{\pm}5.890(ng/mL)/(mg/d)$ vs. $15.45{\pm}28.47(ng/mL)/(mg/d)$ (p=0.947) in itraconazole vs. voriconazole group each. The ratio of the number of the results out of target tacrolimus concentrations to the total number of tacrolimus concentration results was $18.0{\pm}13.3%$ vs. $24.4{\pm}18.5%$ (p=0.185). Conclusion: There were no significant differences between itraconzaole and voriconazole to have influences on mean concentrations of tacrolimus over tacrolimus dose per weight per day. However voriconazole tended to raise tacrolimus plasma concentrations more than itraconazole. Safer and more effective drug management to prevent and treat fungal infections should be done by therapeutic drug monitoring not only of tacrolimus but of itraconazole and voriconazole in lung transplant patients.

• 가정∙방문간호학회지
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• 제10권1호
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 지역사회간호학회지
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• 제6권1호
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• pp.34-54
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• 1995

Occupational health services in Korea have been operated as dual types: one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative. health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area: 154 places (39.4%) managed by designated. health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation due to the characterstics of each variable and analyzed for impacting factors with relation to the using multiple regression analysis using SPSS PC program, especially using t -test method in order to compare each type of health care management. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. The common sickness management is the most accomplished item in health care area of occupational health care services, while the preventive care and control for the workers who have serious health problems are insufficient in workers health care area. 3. An insufficient accomplishment of overall health education has been shown because it is difficult to perform health education due to almost no chance of the direct introduction at workplaces. Therefore a strong support system for making and supplying the media is necessary in order to activate indirect health education by means of media. 4. Because health care managers and the agencies managers where take the workplaces for this study are almost nurses who have been comparatively high work site rounding rate about an environmental management at the workplaces, that non-profession can also do it, the activities about the professional area not enough. Therefore, an appropriate referral system should be established in order to complement professional area. 5. Two factors which have an effect on the coverage rate of occupational health care services are : one is those from the workplaces such as type of services, the number of workers, the number of harzadous factors and safety & health committee, the other from health care organization about whether there is its own manager or not.

• 지능정보연구
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• 제27권2호
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• pp.1-15
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• 2021

추천시스템은 사용자의 기호를 파악하여 물품 구매 결정을 도와주는 역할을 할 뿐만 아니라, 비즈니스 전략의 관점에서도 중요한 역할을 하기에 많은 기업과 기관에서 관심을 갖고 있다. 최근에는 다양한 추천시스템 연구 중에서도 NLP와 딥러닝 등을 결합한 하이브리드 추천시스템 연구가 증가하고 있다. NLP를 이용한 감성분석은 사용자 리뷰 데이터가 증가함에 따라 2000년대 중반부터 활용되기 시작하였지만, 기계학습 기반 텍스트 분류를 통해서는 텍스트의 특성을 완전히 고려하기 어렵기 때문에 리뷰의 정보를 식별하기 어려운 단점을 갖고 있다. 본 연구에서는 기계학습의 단점을 보완하기 위하여 BERT 기반 감성분석을 활용한 추천시스템을 제안하고자 한다. 비교 모형은 Naive-CF(collaborative filtering), SVD(singular value decomposition)-CF, MF(matrix factorization)-CF, BPR-MF(Bayesian personalized ranking matrix factorization)-CF, LSTM, CNN-LSTM, GRU(Gated Recurrent Units)를 기반으로 하는 추천 모형이며, 실제 데이터에 대한 분석 결과, BERT를 기반으로 하는 추천시스템의 성과가 가장 우수한 것으로 나타났다.