• 대한간호학회지
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• 제26권4호
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• 대한간호학회지
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• 제20권2호
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• 한국구조물진단유지관리공학회 논문집
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• 제16권3호
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• pp.31-40
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• 2012

궤도틀림은 열차의 주행안전 및 승차감에 미치는 영향이 크고, 소음 진동의 주요원인으로 작용한다. 따라서 현장에서 발생하는 궤도의 틀림을 체계적으로 분석함으로써 이를 저감할 수 있도록 차량운행 조건과 선로선형 및 궤도구조를 설계하는 것은 중요한 과제이다. 현재 국내에서 EM-120에 의해 검측된 틀림 데이터는 매우 불규칙적인 형태를 나타내며 데이터 분석 시 다양한 문제점을 가지고 있다. 본 연구에서는 궤도의 효율적인 유지관리를 위해 검측된 틀림데이터의 효율적인 처리 기법을 개발하고, 정제된 데이터를 이용해 선로를 구성하고 있는 이음매, 도상, 노반, 체결구 등의 요소를 고려하여 레일 궤도 틀림의 진전 정도를 정량화 하였다. 또한 축적된 검측 데이터로부터 궤도의 건전도를 평가할 수 있는 방법을 정립하고 잔존수명을 예측하여 효율적 유지관리를 실현하기 위하여 검측 데이터의 확률론적 수명 산정 기법 개발 및 데이터를 이용한 구간 특성에 따른 궤도틀림 표준편차의 틀림 진전 정도에 대한 통계 및 확률적 분석을 수행하였다.

• 한국환경보건학회지
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• 제49권4호
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• pp.183-189
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• 2023

Background: The indoor air quality of classrooms, in which the capacity per unit area is high and students spend time together, must be managed for safety and comfort. It is necessary to develop an eco-friendly indoor air quality reduction method rather than biased management that relies solely on air purifiers. Objectives: In this study, plants and air purifiers were installed in middle school classrooms to evaluate the indoor PM_2.5 reduction. Methods: Four middle school classrooms were selected as test beds. Air quality was monitored in real-time every one minute using IoT equipment installed in the classrooms, corridors, and rooftops. After measuring the background concentration, plants and air purifiers were installed in the classroom and the PM_2.5 reduction effect was analyzed through continuous monitoring. Results: After installing the plants and air purifiers, the average PM_2.5 concentration was 33.7 ㎍/m³ in the classrooms without plants and air purifiers, 25.6 ㎍/m³ in classrooms with plants only, and 21.7 ㎍/m³ in classrooms with air purifiers only. In the classroom where plants and air purifiers were installed together, it was 20.0 ㎍/m³. The reduction rates before and after installation were 4.5% for classrooms with plants only, 16.5% for classrooms with air purifiers only, and 27.6% for classrooms with both plants and air purifiers. The I/O ratio, which compares the concentration of PM_2.5 in classrooms with corridors and outside air, also showed the lowest in the order of plants and air purifiers, air purifiers, and plant-only classrooms. Conclusions: The PM_2.5 reduction effect of using plants was confirmed, and it is expected to be used as basic data for the development of environmentally-friendly indoor air quality improvement methods.

• 한국조경학회지
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• 제46권1호
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• pp.115-126
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• 2018

여성, 아이, 노인, 장애인 등 보행약자를 위한 보행친화가로를 조성하기 위하여, 차량 중심에서 보행자 중심으로 바뀌고 있는 도시환경변화의 패러다임을 반영시켜야 하며, 이를 통해 도시 가로의 보행환경의 질을 높이고, 보편적 이동권을 확보하여 사회통합을 유도해야 한다. 본 연구는 세종특별자치시 행정중심복합도시 1지구에 위치한 상업 주거지역 주변의 가로공간을 대상으로 보행도로 현황을 분석하고 파악하여, 보행환경을 향상시킬 수 있는 보행증진방안을 제안하고자 수행하였다. 연구 대상지의 물리적 환경을 파악하기 위해 위성지도와 수치지도를 사용하였으며, 조사 지역의 기본자료에 대해서 정리하고, 가로 현황과 보행 환경에 대하여 현장 조사를 결과를 바탕으로 사용자에 대하여 의식과 만족도를 평가하기 위해 설문 조사를 진행하였다. 총 315부의 설문지가 분석되었으며, 조사 대상지 4곳의 보행서비스 수준은 모두 최상급인 A급이었으며, 녹지 시설의 배치도 비교적 충분한 것으로 파악되었다. 연구 분석 결과, 요인분석을 통해 영향력 있는 요인들은 높은 순서에 따라 디자인>편리성>가로수 및 휴게시설>안전성>안전 보호시설>교통 및 안내시설>연속성>노면 기본상태>쾌적성 이다. 주거지역: 교통 및 안내 시설>노면 기본 상태>쾌적성>편리성>연속성>디자인>조명 및 범죄 방지시설>안전성>가로수 및 휴게시설로 나타났다.

• 한국의류산업학회지
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• 제17권4호
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• pp.657-665
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• 2015

This study evaluated the thermoregulatory properties of functional thermal underwear ('heating underwear') in markets using a thermal manikin and human wear trials. One ordinary thermal underwear (ORD) and two functional thermal underwear (HEAT1 and HEAT2; manufactured goods, HEAT1: moisture absorbing heat release mechanism, HEAT2: heat storage, release mechanism) were chosen. Thermo-physiological and subjective responses were evaluated at an air temperature of $5.0{\pm}0.5^{\circ}C$ and air humidity of $30{\pm}5%RH$ with five male subjects ($21.6{\pm}1.3yr$ in age, $178.0{\pm}5.9cm$ in height, $68.2{\pm}5.9kg$ in body mass). Experimental conditions consisted of four ensembles that included winter clothes (Control: no underwear, ORD, HEAT1, HEAT2). Water-vapor resistance was greater in fabric of HEAT1 than others. The results were: 1) Total thermal insulation (IT) using a thermal manikin were not greater for HEAT1 (0.860clo) and HEAT 2 (0.873clo) than for ORD (0.886clo). 2) There were no significant differences in rectal temperature, mean skin temperature, heart rate and total body mass loss between the four conditions. Microclimate clothing temperature on the back was greater for ORD than for HEAT1 and HEAT2. Subjects felt more comfortable with HEAT1 than for others at rest. HEAT2 was higher in microclimate humidity when compared to other conditions. The results suggest that thermoregulatory properties of 'heating underwear' in market did not differ from those of ordinary thermal underwear in terms of total thermal insulation and thermoregulatory responses in a cold environment.

• KIEAE Journal
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• 제15권2호
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• pp.19-26
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• 2015

Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the findings of study in an effort to design environments that augment care by improving patient safety and being therapeutic. On SPSS (Statistical Package for Social Science) t-test is applied to simulate two independent variables of PDR (Pre Design-Research) and POE (Post- Occupancy Evaluation). PDR is conducted on relatively new hospital Hallym University Dongtan Sacred Heart Hospital to analyse visibility from researchers' point of view, here the ICU is arranged in I-Shape. POE is applied on Dongguk University Ilsan Hospital to simulate walking on LogWare where two NS are designed based on L- Shape and Seoul St. Mary's Hospital, The Catholic University of Korea where five NS are functional for ICU Intensive Care Unit, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), Critical Care Unit (CCU), Korean Oriental Medical Care Unit which are mostly arranged in U-Shape, and walking pattern is recognized to be in a zigzag path. Method: T-Test is applied on two dependent communication variables: walkability and visibility, with confidence interval of 95%. This study systematically analyses the Nurse Station (NS) typo-morphology, and simulates nurse horizontal circulation, by computing round route visits to patient's bed, then estimating minimum round route on LogWare stop sequence software. The visual connectivity is measured on depth map graphs. Hence the aim is to reduce staff stress and fatigue for better patients care by minimizing staff horizontal travel time and to facilitate nurse walk path and support space distribution by increasing effectiveness in delivering care. Result: Applying visibility graph and isovist field on space syntax on I- Shape, L- Shape and U- Shape ICU (SICU, MICU and CCU) configuration, I-shape facilitated 20% more patients in linear view as they stir to rise from their beds from nurse station compared to U-shape. In conclusion, it was proved that U-Shape supply minimum walking and maximum visibility; and L shape provides just visibility as the nurse is at pivot. I shape provides panoramic view from the Nurse Station but very rigorous walking.

• 대한치과보철학회지
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• 제32권2호
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• pp.268-280
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• 1994

Tissue conditioners have been used for treatment of denture stomatitis caused by wearing of dentures. Early studies pointed out Candide albicans (C. albicans) as main etiologic factor, and antifugal agents were added for control of the species. But there is a little information about broad comparison on the effect of tissue conditioners and antifungal agents added. The purpose of the present study was to compare the inhibiting effect of four tissue conditioners and one temporary soft liner on the growth of C. albicans for treatment of denture stomatitis using gel diffusion method by measuring diameter of the zone of growth inhibition. Three antifungal agents were added to each material for evaluation of the effect of added agents. Finally, observation was made to evaluate the effect of the loss of antifungal elements by aging of the specimen. The results of this study were obtained as follows : 1. Tempo had remarkable antifungal effect showing the zone of growth inhibition as 2.35 mm at 1st day, and was most effective on End: 4th and 7th day from incubation (p<0.05). But Coecomfort, Dura conditioner, Visco-gel, Coe-soft had little antifungal effect from the 1st day of incubation. 2. Nystatin was most effective showing 9.60-12.04 mm of zone of inhibition at the 1st day from incubation. The antifungal properties were reduced to amphotericin B, chlorhexidine and materials without agent (p<0.05), and the effect was diminished by time. 3. As pretreatment with amphotericin B, nystatin, chlorhexidine, Tempo was very effective at the 1st day from incubation showing zone of inhibition as 3.65, 12.04, 4.78 mm with addition of each agent. Dura conditioner had strongest antifungal effect at the next day as 2.86, 5.33, 1.29 mm of zone of inhibition, and yielding results of Coe-comfort, Tempo, Coe-soft was shown at 4th and 7th day from incubation (p<0.05). Taken all together, tissue conditioners have little antifungal effect except Tempo. Formation of the zone of growth inhibition was due to agents amphotericin B, nystatin, chlorhexidine and nystatin was most effective. Conclusively, it is advisable to select material which is effective on the growth of C. albican and consider addition of antifungal agents for treatment of denture stomatitis.

• 한국항공우주학회지
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• 제43권6호
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• pp.557-567
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• 2015

헬리콥터 진동의 주요 가진원 중 가장 결정적인 요인은 주로터이며 이러한 로터 유발진동은 승무원과 승객의 안락함을 보장하기 위해 회전익 항공기에서 해결해야할 과제 중 하나이다. 종래의 헬리콥터에서는 수동형 진동저감장치가 주로 사용되어 왔고 수리온 항공기에도 여러 가지 형태의 수동형 진동저감장치가 적용되어 있다. 최근 국외 항공기 제조업체에서는 수동형 진동저감장치 대비 작은 중량으로 우수한 진동저감 성능을 발휘할 수 있는 능동진동제어시스템(AVCS)의 적용을 확대하고 있는 추세이다. AVCS는 중량 절감외에도 항공기 형상, 비행 상태 변화 시에도 만족할만한 성능을 유지할 수 있는 장점이 있다. 이러한 AVCS를 수리온에 적용 시 어느 정도의 성능을 발휘하는지 확인하기 위한 성능시연 프로그램을 수행하였고, 최적의 센서와 작동기 조합을 찾기 위한 최적화 과정을 수행하였다. 지상 및 비행시험을 통해 계측된 데이터를 이용하여 최적의 센서 및 작동기 조합을 도출하고 비행시험 결과와 비교하였다.

• 대한방사선치료학회지
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• 제18권1호
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• pp.43-51
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• 2006

목 적: 본원에서는 자체 제작한 double tilt angle 방식의 board를 이용하여 비교적 table set-up에 어려움을 가진 다양한 형태의 환자를 대상으로 치료에 적용하여 유용성을 평가해 보았다. 대상 및 방법: Double tilt angle board(DTAB) 제작은 Breast board를 이용해 누운 상태에서 몸전체에 각도를 주도록 하고, 상업용 두부고정용구(Head tilt board)와 동일 방식의 Head tilt board를 10 mm 두께의 아크릴을 이용해 축소 제작하여 환자 경부에 한 번 더 각도를 줄 수 있게 이중 tilt 방식으로, 일자형과 U-자형 Aqua-plast 모두 사용할 수 있는 구조이며, 일정 간격의 Hole & Holder를 제작해 환자의 신장에 제한 없이 사용할 수 있게 하였다. 이러한 자체 제작한 보드를 SVC 환자 3명, Pacemaker 환자 2명 및 8명의 기관절제술을 시행한 환자와 같이 호흡의 불안정, 목과 가슴의 심한 압박감과 통증으로 인해 Table에 제대로 눕지 못하여(Set-up이 어려워) 치료를 시행하기 어려웠던 13명의 환자들을 대상으로 모의 치료하고 치료 시 10회의 반복적인 L-gram 촬영의 오차범위로 재현성을 평가해 보았다. 결 과: SVC 환자 1명, Pacemaker 환자 2명 및 4명의 기관절제술을 시행한 환자와 같은 호흡불안정한 총 13명의 환자를 대상으로 Simulation 해본 결과 SVC($40{\sim}56$), Pacemaker($30{\sim}68$), 기관 절제술($25{\sim}45$) 각각의 적정한 tilt angle을 이용한 환자 Set-up이 가능하였고 L-gram을 이용한 오차범위 측정결과에서도 5 mm 이내의 범위를 나타냄으로써 일반적인 원발성 종양환자와 동일한 치료 결과를 보였다. 결 론: 치료목적에 부합하는 새로운 double tilt 형태의 Board를 제작하여 불안정한 호흡과 기도유지의 어려움으로 인해 Table에 눕지 못하는 다양한 환자들을 대상으로 사용한 결과 용이한 환자 Set-up이 가능해져 목적하는 치료 계획과 치료를 시행할 수 있었다는 데 큰 의의를 두며, 앞으로 이러한 적응증을 가진 환자의 치료에 있어서 오는 시간적, 심리적인 부담감을 최소화할 것이며, 구형의 Board만을 재활용해 제작함으로써 커다란 비용절감의 경제적 효과를 보았다.