• 중환자간호학회지
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• 제6권1호
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• pp.1-10
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• 2013

Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.

• 간호행정학회지
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• 제17권4호
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• pp.443-450
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• 2011

Purpose: This study was a descriptive correlation study to increase understanding of, and relationships among critical thinking disposition, clinical decision making and job satisfaction of cancer center nurses. Method: The participants in this study were 150 nurses working in one cancer center located in Gyeonggi Province. The statistic program, SPSS WIN17.0 was used for data analysis and data were analyzed using t-test, ANOVA, and Pearson correlation. Results: The critical thinking disposition of the participants showed statistically significant differences according to areas of practice (F=4.426, p=.005), and current position (F=9.346, p=.000). For clinical decision making of the participants, statistically significant differences were found according to current position (F=10.667, p=.000). Furthermore, for job satisfaction, there were statistically significant differences according to income (F=6.779, p=.002), length of career (F=2.701, p=.033) and current position (F=5.423, p=.005). There were significant positive correlations for critical thinking disposition with clinical decision making, and with job satisfaction. Conclusions: The results of the study indicate that to improve clinical decision making and job satisfaction of cancer center nurses, it is necessary to increase critical thinking disposition. To make this change, appropriate programs are needed to increase critical thinking and clinical decision making of general cancer center nurses.

• Tuberculosis and Respiratory Diseases
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• 제44권5호
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• pp.1105-1113
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• 1997

배 경 : 급성호흡부전증후군에서 배측 폐는 복측 폐에 비해 이환 정도가 심하여 기계호흡시 PEEP 사용에도 폐포 모집이 어려운 것이 알려져 있고 이러한 상태에서 prone position은 이환이 심한 배측 폐의 국소 환기를 향상시키고 동맥혈산소분압의 호전을 가져온다는 보고들이 있으나 아직 prone position 의 호흡생리학적 효과나 혈류역학적 효과가 완전히 정립되지 않았다. 방 법 : 급성폐손상 점수 평균 2.5 이상인 ARDS 환자 23명(남 : 여 =11 : 12, 연령 $62.1{\pm}20.8$세)을 대상으로 먼저 supine position에서 호흡 지표로 동맥혈가스분석, 총호흡기계 정적 탄성과 혈류역학적 지표로 평균 동맥압, 분당 심박수 등을 얻은 뒤 prone position으로 전환하였다. Prone position 5분에 동일한 혈류역학적 지표, 0.5 및 2시간에 호흡 지표를 얻었으며, 2시간까지의 $PaO_2/FIO_2$ 비가 supine position에 비해 20mmHg 이상 증가한 경우를 양성 호흡반응, prone 5분의 평균동맥압이 supine position에 비해 10mmHg이상 증가한 경우를 양성 혈류역학적반응으로 각각 정의하였다. 결과 : 1. 양성 호흡반응 대상 ARDS 환자 중 65%(15/23)가 양성 호흡반응을 보였고 양성 반응자는 비반응자에 비해 연령, 남녀비, ARDS 유발 원인, supine position에서의 $PaO_2/FIO_2$비, Cst, rs 등은 차이가 없었으나 평균동맥압이 더 높고($91.1{\pm}13.1mmHg$ vs. $76.0{\pm}18.7mmHg$, p=0.035), 생존율이 높은 경향을 보였다(9/15 vs. 2/8, p=0.074). 양성 호흡반응자의 supine, prone 0.5 및 2시간의 $PaO_2$는 각각 $69.8{\pm}17.6mmHg$, $83.2{\pm}22.6mmHg$, $96.8{\pm}22.7mmHg$(p<0.001), $PaO_2/FIO_2$비는 각각 $108.1{\pm}40.5mmHg$, $137.3{\pm}60.0mmHg$, $157.7{\pm}50.0mmHg$로 증가하였다(p=0.001). 2. 양성 혈류역학적반응 Prone position시 평균 동맥압이 10mmHg이상 증가한 경우는 22%(5/23)이었고 이 중 2명은 양성 호흡반응이 없는 환자였다. 양성 혈류역학적반응을 보인 환자와 보이지 않은 환자 사이에 기저 평균동맥압($77.1{\pm}11.1mmHg$, $89.8{\pm}16.6mmHg$, p=0.099)이나 supine position 에서의 PEEP 사용 수준 ($7.8{\pm}3.2cm$ $H_2O$, $8.6{\pm}3.5cm$ $H_2O$, p=0.188) 등은 유의한 차이가 없었다. 결 론 : ARDS 환자에서 prone position은 폐산소화지표를 호전시키거나 평균동맥압을 상승시키며 양성 호흡반응 여부는 ARDS 발생 후 조기에 결정되는 것으로 추정되었다.

• 시큐리티연구
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• 제57호
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• pp.9-26
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• 2018

현 정부의 공공부문 '비정규직의 정규직화'라는 정책기조 변화를 반영하기 위해 현재 국가중요시설에서 시설방호 직무를 수행하고 있는 경비업체 소속 특수경비원의 정규직 전환이 진행되고 있다. 특히 국가중요시설로 지정되어 있는 주요 정부청사의 방호인력 구성은 방호직렬 공무원으로 구성된 방호관, 경비업체 소속의 특수경비원, 청원경찰, 경찰로 구성된 청사경비대 등 다양한 형태의 방호인력에 의해 방호직무가 수행되고 있다. 정규직 전환을 위해 국가중요시설에서 방호직무를 수행하고 있는 특수경비원의 직접고용을 위한 방식으로 특수경비원을 직접 고용하는 형태, 공단 설립을 통해 직접 고용하는 형태, 방호관(공무원)으로 신규 채용하는 형태, 자체경비원으로 직접 고용하는 형태, 청원경찰로 직접 고용하는 형태 등의 다양한 전환 방식이 논의되고 있다. 비정규직의 정규직화 정책기조 반영을 위해, 국가중요시설에서 방호직무를 수행하고 있는 경비업체 소속 특수경비원을 직접고용으로 전환하는 방식은 개별 국가중요시설의 방호 환경, 방호인력운영 특성 등 여러 사정을 고려하여 신중하게 진행할 필요가 있다. 특히, 특수경비원의 정규직화 진행과정에서는 전환대상자인 특수경비원, 이해관계자들의 다양한 의견수렴이 반드시 선행될 필요가 있다.

• Journal of Advanced Marine Engineering and Technology
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• 제38권10호
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• pp.1263-1268
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• 2014

In this study, the variations of swirl center according to evaluating position have been investigated in a steady flow bench of SI engine. For the experiments, two engine heads with different intake valve angles ($11^{\circ}$ and $26^{\circ}$) were tested in the flow bench by varying the evaluating position (1.75~6.0B) and valve lift (2~10 mm). Particle image velocimetry was used to measure the velocity field inside the engine cylinder. The swirl center position is found with a critical point theory and the intensity of turbulence is calculated from PIV velocity data. The results show that the center of swirl is located closer to the center of cylinder and turbulence intensity is lower, when the intake valve angle is the smaller. It is conventional to evaluate the swirl ratio at 1.75B position in the steady flow bench of SI engine. At this position, however, the distance of swirl center from the cylinder center scatters significantly for the variation of valve lift, and the turbulence intensity is much stronger regardless of the valve angle. Thus, to estimate the flow at the end of compression stroke in a real engine from the data in the steady flow experiments, the evaluation position should be moved further downstream more than 4.5B.

• 중환자간호학회지
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• 제11권1호
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• pp.79-88
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• 2018

Purpose : This study was performed to evaluate the effects of a prolonged a $30^{\circ}$ side-lying position on comfort and skin condition by applying the trunk maintenance repositioning method, which can keep the $30^{\circ}$ side-lying position effective for preventing pressure ulcers. Method : Fifty-four healthy nurses working at a general hospital in Seoul were randomly assigned to an experimental group (n=27) or a control group (n=27) and assumed a position of lying on their right or left side for two hours. The trunk maintenance repositioning method was applied to the experimental group using the pillow made by the researcher, while the original repositioning method was applied to the control group using the regular pillow from the subject hospital. Participants' posture angles, comfort, and skin condition were measured at the time of the intervention, as well as at one and two hours after the intervention. Results : There was no statistically significant difference in position angle, comfort, skin condition change, or sacrum and greater trochanter pressure change between the two groups over time. Conclusion : It is necessary to review the method and frequency of change of position in each hospital. In addition, a proper position changing pillow should be developed in consideration of patients' various body shapes.

• 대한기계학회논문집A
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• 제27권9호
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• pp.1597-1606
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• 2003

Static analysis using hybrid finite element(FE) method has been applied to characterize the influence of position, runout and thickness errors of the sun, ring and planet on the bearing forces and critical tooth stress. Some guidelines for tolerance control to manage critical stress and bearing forces are deduced from the results. Carrier indexing error planet assembly and planet tooth thickness error are most critical to reduce planet bearing force and maximize load sharing as well as to reduce critical stresses. Sun and carrier bearing forces due to errors increase several times more than those of normal condition.

• Journal of Mechanical Science and Technology
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• 제18권4호
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• pp.606-621
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• 2004

A dynamic analysis using a hybrid finite element method was performed to characterize the effects of a number of manufacturing errors on bearing forces and critical tooth stress in the elements of a planetary gear system. Some tolerance control guidelines for managing bearing forces and critical stress are deduced from the results. The carrier indexing error for the planet assembly and planet runout error are the most critical factors in reducing the planet bearing force and maximizing load sharing, as well as in reducing the critical stress.

• Journal of Preventive Medicine and Public Health
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• 제43권2호
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• pp.138-150
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• 2010

Objectives: There are at least three conceptual models for the effects of the childhood social environment on adult health: the critical period model, the social mobility model, and the cumulative risk model. However, few studies have investigated all three different models within the same setting. This study aims to examine the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility over the life course on the health in adulthood based both on the critical period model and the social mobility model. Methods: This study was conducted on 9583 adults aged between 25 and 64 years old and they were the respondents to the Korea Welfare Panel Study (2006). A multivariate logistic regression analysis was carried out, using the critical period model and the social mobility model out of the life course approaches, to look into the impact of childhood and adulthood socioeconomic positions and intergenerational social mobility on the health status in adulthood. Results: Household income and occupation out of the adulthood socioeconomic position indicators had an independent influence on the adulthood health status. The childhood socioeconomic position indicators, except for the place of childhood residence, affected the adulthood health status even after adjustment for the adulthood socioeconomic position. The effect of intergenerational social mobility was also statistically significant even after adjusting for the adulthood socioeconomic position, but it became insignificant when the childhood socioeconomic position was additionally adjusted for. Conclusions: Adulthood health is indeed affected by both the childhood and adulthood socioeconomic positions as well as intergenerational social mobility. This result shows that a life course approach needs to be adopted when dealing with health issues.

• Steel and Composite Structures
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• 제33권5호
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• pp.653-661
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• 2019

In this paper aeroelastic behavior of 3-phase nano-composite beam-plate with double delaminations is investigated. It is tried to study the effect of carbon nano-tubes (CNTs) on critical flutter pressure of reinforced damaged nano-composite structures. In this case, the CNTs are appending to the polymer matrix uniformly. The Eshelby-Mori-Tanaka model is used to obtain the effective material properties of 3-phase nano-composite beam-plate. To investigate the aeroelastic behavior of delaminated beam-plate subjected to supersonic flow, it is assumed that the damaged segments are forced to vibrate together. The boundary conditions and auxiliary conditions at edges of delaminated segments are used to predict critical flutter pressure. The influence of CNTs and different delamination parameters such as delamination length, axial position and its position through thickness are investigated on critical flutter pressure.