• Journal of Trauma and Injury
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• 제22권2호
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• pp.142-147
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• 2009

Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn' be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn' be found on CXR to be verified, which helped us to could accurately evaluate patients.

• 한국융합학회논문지
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• 제12권5호
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• pp.217-225
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• 2021

본 연구는 중독경향성을 중심으로 유아의 스마트기기 사용 문제행동과 관련된 국내연구 동향을 분석하였다. 연구동향 주요 결과는 다음과 같다. 첫째, 연도별 발행 논문 수는 총 79편이고, 다양한 학술지에 중독경향성 연구물이 게재된 데 비해 연구자의 전공은 교육과 복지계열 학과에 편중되었다. 둘째, 연구주제는 총 81개로, 실태(현황), 척도개발, 관련변인, 개입, 인과관계였다. 연구주제 비중은 관련변인 연구주제가 60편(74.1%)으로 가장 많았다. 셋째, 연구대상은 유아, 양육자, 교사로 구분되었고, 양육자 대상의 주된 연구대상은 어머니였다. 넷째, 연구방법은 양적연구가 73편(92.4%), 질적연구 2편, 문헌연구 1편, 혼합연구 2편, 기타 1편이었다. 다섯째, 영향요인 분석결과는 위험요인과 보호 요인으로 분류되고, 이는 구체적으로 개인요인, 가정요인, 사회·환경요인으로 구분되었다. 이를 바탕으로 논의와 실천적 제언을 덧붙였다.

• 산업융합연구
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• 제21권2호
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• pp.25-32
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• 2023

뇌손상 환자는 초기 재활 단계에서 가장 흔한 소화장애로 변비가 발생하며 예후에 영향을 미친다. 본 연구의 목적은 경관영양하는 뇌손상 환자의 재활 치료 입원, 전동 직후부터 배변 습관을 사정하고 복부 마사지와 하지 관절 운동을 적용하여 효과를 알아보고자 한다. 연구 설계는 뇌손상 환자에게 배변 간호 중재(복부 마사지와 하지 관절 운동)를 적용하여 그 효과를 알아보기 위한 비 동등성 대조군 시차 연구이다. 연구결과, 배변 횟수는 실험군의 배변 횟수가 통계적으로 유의하게 높았으며 (p=.030), 좌약 사용은 대조군이 실험군보다 사용 횟수가 통계적으로 유의하게 높았다(p=.004). 변비 완화 시점은 실험군은 1.73일, 대조군은 4.61일로 두 군간 변비 완화 시점에 차이가 있는 것으로 나타났다(p<.001). 뇌손상 환자에게 재활 초기부터 배변을 완화시키고 변비를 예방을 위한 간호 중재는 복부 마사지와 하지관절 운동이 효과적임을 입증하였다.

• Journal of Korean Neurosurgical Society
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• 제66권4호
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• pp.446-455
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• 2023

Objective : Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution. Methods : Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA, and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated. Results : A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p<0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p<0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p<0.001). There was no TXA-related adverse event. Conclusion : The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.

• 한국인구학
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• 제18권2호
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• pp.51-69
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• 1995

이 연구는 한국사회에서 사회복지 정책을 어떻게 전개해 나가야 할 것인지에 관한 관심 속에서 선진복지국가인 스웨덴의 사회복지제도가 어떻게 발전해 나갔는지를 인구변천에 초점을 맞추어 살펴보고 있다. 먼저 스웨덴과 한국의 인구발전과정을 인구변천모형에 따라 분석하고, 인구변천 단계에 따라 사회복지가 어떻게 발전해 나왔는지를 주로 사회복지 법규를 통해 규명하고 있다. 다음 각 단계별 법규와 사회보장비 지출을 검토하여 스웨덴의 복지발달과정의 이념을 규명한 후, 한국의 사회복지정책이 어떤 방향을 나가야 할지를 제시하고 있다. 연구결과 스웨덴에 비해 한국의 사회보장비지출은 절대 부족상태이며, 스웨덴이 보편주의적 서비스를 강조하는데 비해 한국은 특수집단에 대한 서비스를 강조하고 있음이 부각되었다. 또 한국은 특수한 역사적, 문화적 요인에 의해 보훈계통의 비용이 지불되고 있다. 이 연구의 정책적 함의는 한국사회도 앞으로 소극적인 복지정책보다는 스웨덴에서 처럼 보편주의, 생산주의 및 가정복지를 바탕으로 한 복지민주주의 정책에 대한 적극적인 자세가 필요함을 제시하고 있다.

• 한국의료질향상학회지
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• 제7권1호
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• 대한구순구개열학회지
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• 제2권1_2호
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• pp.29-41
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• 1999

구순구개열은 악안면의 선천기형중 발생빈도가 가장 높은 것으로 알려져 있으며,출생시부터 성장이 완료되는 시기까지 일관된 치료계획에 의한 종합적인 진료체계가 필수적이다. 구순구개열이 존재할 경우 구개부의 조기 봉합후의 반흔조직 형성으로 인한 치열궁의 협착 또는 중안모의 함몰 경향과 함께 상악 측절치의 선천적 결손 또는 기형치, 전치의 회전과 경사 등이 수반되므로 교정치료에 의한 기능적, 심미적인 치열의 회복이 필요하게 된다. 구순구개열 환자의 교정치료에 있어서 상악치열의 정상적인 배열과 구치부 반대교합의 치료를 위해 상악골 확대가 종종 필요하며, 이를 위하여 Hyrax appliance, Quad-helix 및 Fan-type expansion screw, Jointed fan type expander 등 다양한 장치가 활용될 수 있다. 심하지 않은 구순구개열 환자의 교정치료에서 상악골 확대를 위한 장치의 선택은 환자의 치열궁 형태, 연령, 구치부와 전치부의 치열궁 폭경 등 다양한 요인이 고려되어야 하며, 치료 후 악궁형태의 보정에 특별한 주의를 기울여야 할 것이다.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.304-314
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• 2020

본 연구는 이성 교제의 경험이 있는 여대생을 대상으로 이성 교제 관련 특성, 자아존중감, 성적 자율성이 이성 교제의 집착 행동에 미치는 영향을 파악하기 위한 목적으로 수행된 서술적 조사연구이다. 자료수집은 2012년 11월 25일부터 12월 20일까지 편의 표집의 방법으로 구조화된 설문지를 이용하여, 자가 보고식으로 조사되었으며, 총 167부의 설문지가 최종분석에 사용되었다. 자료 분석방법은 t-test, ANOVA, scheffe test, Pearson의 상관 계수와 다중 선형 회귀 분석방법을 사용하였다. 연구결과, 여대생의 이성 교제 시 집착 행동은 이별 경험의 횟수에 따라 유의한 차이가 있는 것으로 나타났으며(F=4.16, p=.003), 이성 교제의 집착 행동은 자아존중감(r=-.31, p<.001) 및 성적 자율성(r=-.21, p=.006)과 유의한 음의 상관관계가 있는 것으로 나타났다. 자아존중감과 이별 경험의 횟수는 여대생의 이성 교제에서의 집착 행동에 유의한 영향을 주는 요인으로, 약 20%의 설명력을 갖는 것으로 파악되었다(F=8.03, p<.001). 그러므로 이성 교제 시 집착 행동 관련 문제를 해결하기 위한 전략으로, 이성과의 이별횟수가 많은 여대생의 경우, 자아존중감과 성적 자율성을 강화하기 위한 인지적, 교육적 중재가 필요하며, 집착 행동의 위험요인을 가지고 있는 여대생을 선별하여, 사례별 문제해결 기반 상담을 제공하는 것이 심리적 건강향상에 도움이 될 것이다.

• 여성건강간호학회지
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• 제6권4호
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• pp.549-565
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• 2000

Comprehensive review of the literature was conducted to determine 1) selected risk factors and its impact that affect pregnancy outcome such as smoking, alcohol consumption, and substance abuse 2) these factors can facilitate future strategies for health promotion and prevention for both pregnant women and fetus. Review of literature were extracted from searching MEDLINE(1966 - Oct. 2000). CINAHL (1982 - Oct. 2000) and the domestic literature. The following factors were identified: 1. The effects of risk behaviors on pregnancy. ${\cdot}$Maternal smoking was associated with the occurrence of premature or LBW delivery, fetal growth retardation, extremities defects, heart defects and sudden infant death syndrome. ${\cdot}$Maternal alcohol consumption was associated with spontaneous abortion, premature or LBW delivery, morphologic/neurologic problems, especially fetal alcohol syndrome. ${\cdot}$Heroin was associated with withdrawal after birth in which were born to heroine addicts for gestational age and lung maturation in animal studies. ${\cdot}$Cocaine was associated with spontaneous abortion, abruptio placenta and a poor response to environmental stimuli. ${\cdot}$So far, the effects of caffeine on pregnancy was controversial, but severe caffeine consumption was associated with premature or LBW delivery, spontaneous abortion, still birth and dystocia. 2. Intervention methods and its effects identified were as follows ${\cdot}$Conducted intervention for smoking, alcohol and drug consumption were single or combined. ${\cdot}$Intervention methods were counseling, phone contact, mailing, use of educational videotape, booklet, support person and alternatives such as nicotine patch. ${\cdot}$The interventions increased the rates of smoking cessation during pregnancy and awareness of the risk of drug consumption, and decreased amount of alcohol consumption. ${\cdot}$The intervention outcome found positive effect on birth weight and length. 3. Our recommendations were as follows ${\cdot}$The personal and social cognition should be enhanced through education and the mass media. ${\cdot}$It's necessary to educate and give information of preconceptional care, planned pregnancy and early prenatal care for optimal pregnancy outcome. ${\cdot}$It's necessary to develop comprehensive assessment tool which is reliable and valid on smoking, alcohol consumption and substance abuse to identify supportive or interventional program.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.851-856
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• 2016

Background: Breast cancer is a major health problem among women around the world. Recent developments in screening and treatment have greatly improved the prognosis of patients with breast cancer in developed countries. However, in developing countries breast cancer mortality remains high.Breast cancer awareness is a first and important step in reducing breast cancer mortality. The development of a validated instrument to measure breast cancer awareness is crucial for the understanding and implementation of suitable health education programs to facilitate early deletion and minimize mortality. Objective: The objective of this study was to develop an instrument for the assessment of breast cancer awareness in Thai women. Materials and Methods: This methodological study was conducted in two stages: (1) literature searches and semi-structured interviews were conducted to generate items of the breast cancer awareness scale (B-CAS) which were subsequently examined for content and face validity, and (2) an exploration of the factor structure of the resulting instrument and an examination of its reliability. Data were collected using a self-administered questionnaire in Thai women aged 20-64 in August, 2015. Results: A total of 219 women (response rate 97.4 %) participated in this validation study. The B-CAS contains five domains with 53 items on breast cancer awareness: 1) knowledge of risk factors, 2) knowledge of signs and symptoms, 3) attitude to breast cancer prevention, 4) barriers of breast screening, and 5) health behavior related to breast cancer awareness. Items with a content validity index < 0.80 were excluded, and factor structure for the remaining items reflected the hypothesized five factor model. The scales based on all retained items was shown to have strongly internal consistency reliability (Cronbach's ${\alpha}=0.86$). Conclusions: The B-CAS provides good psychometric properties to assess breast cancer awareness in women. It can be used to examine breast cancer awareness in Thai women and it could lead to the development and evaluation of suitable educational interventions for raising breast cancer awareness. Future research should focus on further validating the B-CAS including an assessment of construct and criterion-based validity.