• 한국안전학회지
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• 제33권1호
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• pp.148-161
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• 2018

A traffic fatality by young people marked average annual decrease of 4.5% since 2011. Meanwhile, a traffic fatality by senior over 65 years old marked average annual increase of 7.9% for the last five years which means that the annual increase of traffic fatality by senior will be a serious problem. This study started questioning that senior drivers over 65 years old did not retain the same causal factor of fatal traffic accidents and thus extensively analyzed a risk of it by age group quantitatively, dividing the senior driver group into the early, middle and latter stages. Depending on the aging level, the risk of traffic fatality showed a wide difference in seven different types of traffic accidents generally, and happened to increase with latter and middle parts of the senior driver more than the early part. Therefore, this study proposes four policy suggestions: 1) The senior driver need to be offered customized driving educations and the improvement of road environment is also recommended. 2) Political assistance is needed to support and guide a safety related technology installation for the new or existing car. 3) Renewal of driving license and an aptitude test(physical examination, cognitive test) for drivers over 75 years old should take in a less than 3 years and an additional road test is needed as occasion demands. 4) Like the United States and Europe, development and extension of customized treatment guidebook for medical teams who examine senior drivers is needed and establishment of education and administration system that a supervisor of driving license renewal can impose safety restriction and American anonymity reporting system is considered to institutionalize in the medium to longer term.

• 대한토목학회논문집
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• 제13권5호
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• pp.209-222
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• 1993

본 고는 폐기물 매립지반의 지반개량을 위하여 1992년 3월 16일부터 1992년 10월 25일까지 수행된 동다짐공사 결과에 대한 연구사례이며, 개량대상지역은 대전시 갑천변에 위치하는 폐기물 매립부지로 1983년부터 1989년까지 주로 도시생활 쓰레기, 연탄재, 구조물 해체 잔해물 및 일부 산업폐기물로 매립되어 형성된 지역이다. 동다짐 공사는 2개 지점에서 시험동다짐을 시행하여 그 결과를 기준으로 수행되었으며, 개량효과 분석 및 품질관리를 위하여 각종 현장확인 시험 및 지반거동 계측을 수행하였다. 또한 동다짐시 인접된 구조물에 미치는 영향을 분석하기 위하여 진동측정을 시행하였다. 제반 현장시험 및 계측자료 분석결과 전체적으로 지반의 강도증가 및 압축효과가 양호한 것으로 확인되어 본 지역의 폐기물 매립지반에 대한 동다짐공법 적용은 효과적인 것으로 나타났으며, 향후 본 지역과 유사한 폐기물 매립지반에 대한 동다짐공법 적용시 참고가 될 수 있을 것으로 기대된다.

• Archives of Plastic Surgery
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• 제44권4호
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• pp.293-300
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• 2017

Background Simulation training is becoming an increasingly important component of skills acquisition in surgical specialties, including Plastic Surgery. Non-living simulation models have an established place in Plastic Surgical microsurgery training, and support the principles of replacement, reduction and refinement of animal use. A more sophisticated version of the basic chicken thigh microsurgery model has been developed to include dissection of a type 1-muscle flap and is described and validated here. Methods A step-by-step dissection guide on how to perform the chicken thigh adductor profundus free muscle flap is demonstrated. Forty trainees performed the novel simulation muscle flap on the last day of a 5-day microsurgery course. Pre- and post-course microvascular anastomosis assessment, along with micro dissection and end product (anastomosis lapse index) assessment, demonstrated skills acquisition. Results The average time to dissect the flap by novice trainees was $82{\pm}24$ minutes, by core trainees $90{\pm}24$ minutes, and by higher trainees $64{\pm}21$ minutes (P=0.013). There was a statistically significant difference in the time to complete the anastomosis between the three levels of training (P=0.001) and there was a significant decrease in the time taken to perform the anastomosis following course completion (P<0.001). Anastomosis lapse index scores improved for all cohorts with post-test average anastomosis lapse index score of $3{\pm}1.4$ (P<0.001). Conclusions The novel chicken thigh adductor profundus free muscle flap model demonstrates face and construct validity for the introduction of the principles of free tissue transfer. The low cost, constant, and reproducible anatomy makes this simulation model a recommended addition to any microsurgical training curriculum.

• 한국병원경영학회지
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• 제25권3호
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• 환경생물
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• 제34권3호
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• pp.183-192
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• 2016

지금까지 개발된 나노물질 중 은나노물질은 일상 생활제품에 가장 많이 활용된 나노물질 중 하나로 알려져 있고 다양한 경로를 통해 환경에 유입되어 환경 및 인체에 부정적인 영향을 미칠 수 있는 것으로 알려져 있다. 화학물질과 달리 나노물질은 물리화학적 특성에 따라 동일 나노물질이더라도 그 유해성이 다르다고 알려져 있지만 기존 연구들은 다양한 특성을 동일 시험조건에서 평가하기 보다는 하나의 특성에 대해 독성을 보고하는 수준에 그치고 있다. 따라서 기존 연구들의 서로 다른 시험생물, 시험조건, 나노물질 특성 등을 고려할 때 나노물질의 물리화학적 특성에 따른 독성의 체계적인 비교평가가 어려운 한계가 존재한다. 본 연구는 은나노물질의 다양한 물리화학적 특징에 따라 수생생물에 미치는 독성영향을 평가하고자 한다. 대표적인 3종 (어류, 물벼룩, 조류)의 수생생물에 대한 은나노물질의 입자상 크기 (50, 100, 150 nm), 형태 (입자형, 선형), 코팅물질 종류 (PVP, citrate)에 따라 생태독성평가를 진행하였다. 연구결과, 나노 물질의 크기가 작을수록 그리고 입자상 형태보다 선형에서 독성이 비교적 높게 나타났다. 특히 선형 은나노의 경우, 길이에 비례하여 그리고 입자에 비해 비교적 높은 독성을 나타냈다. 반면, 은나노의 코팅물질 종류는 대상 수생생물에 따라 독성의 영향이 다르게 평가되었다. 본 연구는 은나노물질의 다양한 물리화학적 특성에 기인한 독성을 동일한 시험 조건, 시험생물에서 체계적으로 비교 평가하였다는 점에서 의의가 있으며 본 연구결과는 은나노물질의 환경 및 인체 위해성평가 자료로서 활용될 수 있을 뿐 아니라 보다 안전한 은나노물질 소재개발을 위한 과학적 자료로서 활용될 수 있을 것으로 사료된다.

• 대한간호학회지
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• 제26권2호
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• pp.428-442
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• 1996

Stomatitis is a common toxicity associated with the administration of certain cancer chemotherapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to establish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subsect were divided into three groups : control group : not gargling experimental group A : normal saline gargling (4 times a day) experimental group B : nystatine solution gargling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times(once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X/sup²test. The results are as follows : 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B.（X/sup²＝0.002 P＝0.001）. The grade of stomatitis(mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A F＝1.96 P＝0.0024）. In incidence of tongue change, control group, experimental group B were significantly higher than experimental group B（F＝6.84 P＝0.0039）. In control group and experimental group A. oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

• 대한지역사회영양학회지
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• 제22권3호
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• pp.207-217
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• 2017

Objectives: The aim of this study was to examine self-management status, nutritional knowledge, barrier factors in dietary management and needs of nutritional management program for women with Gestational Diabetes Mellitus (GDM). Methods: A total of 100 women with GDM were recruited from secondary and tertiary hospitals in Seoul. The questionnaire composed of general characteristics, status of self-management, dietary habits, nutrition knowledge, barrier factors in dietary management, needs for nutrition information contents and nutritional management programs. Data were collected by a self-administered questionnaire. All data were statistically analyzed using student's t-test and chi-square test using SAS 9.3. Results: About 35% of the subjects reported that they practiced medical nutrition and exercise therapy for GDM control. The main sources of nutrition information were 'internet (50.0%)' and 'expert advice (45.0%)'. More than 70% of the subjects experienced nutrition education. The mean score of nutrition knowledge was 7.5 point out of 10, and only about half of the subjects were reported to be correctly aware of some questions such as 'the cause of ketosis', 'the goal of nutrition management for GDM', 'the importance of sugar restriction on breakfast'. The major obstructive factors in dietary management were 'eating more than planned when dining out', 'finding the appropriate menu when dining out'. The preferred nutrition information contents in developing management program were 'nutritional information of food', 'recommended food by major nutrients', 'the relationship between blood glucose and food', 'tips on menu selection at eating out'. The subjects reported that they need management program such as 'example of menu by calorie prescription', 'recommended weight gain guide', 'meal recording and dietary assessment', 'expert recommendation', 'sharing know-how'. Conclusions: Based on the results of this study, it is necessary to develop a program that provide personalized information by identifying the individual characteristics of the subjects and expert feedback function through various information and nutrition information contents that can be used in real life.

• 한국간호교육학회지
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• 제3권2호
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• pp.193-206
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• 1997

Because the oral mucositis is often inevitable in acute leukemia patients during chemotherapy, the efforts must be made to keep these leukemia patients from oral mucositis. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. This quasi-experimental study was performed to compare the prohpylatic value of these oral care protocols. Thirty-nine subjects were assigned to one of three groups. The first group performed bivon-normal saline gargling protocol, the second group performed chlorhexidine gargling protocol, and the last contrast group kept traditonal gargling protocol. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count (ANC) reached $1,000/mm^3$. It continued about 2-4 weeks. The data was analyzed by ANCOVA and Kruskal-Wallis one way ANOVA, chi-sqare, survival analysis. The results were as follows : The contrast group showed significantly highest mean score of the OAG and Beck's perception of oral discomfort among three groups from second week to third week. However chie-test and survial analysis showed that the incidence of severe mucositis were not significantly different among three groups. Conclusively we recommend that nurses who care acute leukmia patients use bivon-normal saline gargling protocol be careful to occur severe mucositis during chemotherapy.

• 대한간호학회지
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• 제47권1호
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• The Journal of Korean Physical Therapy
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• 제12권1호
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• pp.73-78
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• 2000

The Sit-and-Reach Test (SRT) is commonly nea to assess flexibility of the spine and length of the hamstring muscle, The purpose of this study was to describe hamstring muscle length as reflected by use of the SRT, the Hip Joint Angle (HJA) and Sack length(from C7 to S2) in children, to examine the correlation between Back length, SRT and HJA measurements and to examine gender differences. The 162 subjects were participated without known musculoskeletal and neurological impairments of their spine or lower exeremities. In the Long-silting position, the Back length, SRT and HJA measurements were obtained. A mean Back length value of 46.2cm, a mean SRT value of 29.4cm and a mean HJA of 77,0 degrees were obtained including all subjects. There was a strong correlation between the SRT and HJA measurements (r=.66). There were a difference between boys and girls in Back(p=.0019) and HJA measurements (p=.015). The results of this study suggest that measurements for the SRT and HJA were correlated than Back. The HJA measurements guide treatment more effectively than do Back length and SRT measurements.