• 지역사회간호학회지
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• 제10권1호
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• 대한치과교정학회지
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• 제41권3호
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• pp.174-183
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• 2011

치근 흡수는 백악질과 상아질의 부분적인 상실로 특징되어지는 상황이며, 치근의 길이 감소를 야기하고 치아의 기능에 심각한 영향을 줄 수 있다. 일반적인 병리적인 치근 흡수와 구별하여 교정치료와 관계된 치근 흡수를 orthodontically induced root resorption (OIRR)이라고 부른다. 이번 연구의 목적은 한국인을 대상으로 하여 교정 치료 후에 나타나는 치근 흡수와 관련된 환자 요인과 교정치료 요인을 찾고, 그 양상에 대해 알아보는 것이다. 판별될 요소들은 발치 치료 여부, 성별, 나이, 치근첨의 변위량과 방향, 총 치료 기간, 치아 길이, 치근의 형태였다. 이번 연구는 단국대학교 치과대학병원 교정과에서 2007년 11월부터 2008년 12월 사이에 포괄적인 교정치료가 종결된 환자의 상악 중절치를 대상으로 하였다. 선정된 대상자 수는 137명이었다. 각각의 기록은 치근단 사진과 측모 두부 방사선사진으로 구성되어졌다. 전체 대상치아에 대한 평균 치근 흡수량은 1.63 mm였으며 표준편차는 1.58 mm였다. 이변량적인 비교에서 발치 치료군에서는 $2.10{\pm}1.64mm$, 비발치 치료군에서는 $1.18{\pm}1.39mm$로 나타났다. 발치 치료 군에서 흡수량이 0.92 mm 컸으며, 통계적으로 유의한 차이를 나타냈다. 초기 치아의 길이가 길수록 흡수량이 컸으며, 4 mm 이상의 심한 치근 흡수를 보이는 그룹에서 blunt, pointed, eroded 형태의 비정상적인 치근 형태의 비율이 높았다. OIRR에 영향을 줄 수 있는 요소로 발치 여부, 초기 치아의 길이, 치근의 형태가 있었다.

• Child Health Nursing Research
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• 제20권2호
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• pp.96-104
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• 2014

목적 아동을 돌보는 간호사에게 중요한 역량인 아동성장발달에 대한 이해를 위하여 영화를 활용한 영화간호교육 수업설계를 개발하고 간호학생을 대상으로 개발된 수업설계를 적용하고 그 결과를 분석함으로써 보다 효과적인 영화간호교육 전략의 기초자료로 삼고자 하였다. 방법 Kolb의 경험학습모델을 기반으로 영화간호교육의 수업설계를 개발하고 일 대학 간호학과 1학년 대상의 '인간성장발달' 과목에 적용하여 대상자의 학습유형, 영화간호교육의 만족도, 영화간호교육의 장단점 등을 조사하였다. 설문조사에 응한 75명의 자료는 SPSS 통계프로그램을 활용하여 연구목적에 맞게 기술통계와 다변량분산분석, 케이스 백분율 등으로 분석되었다. 결과 아동성장발달 이해를 위한 영화간호교육은 구체적 경험, 반성적 관찰, 추상적 개념화, 그리고 능동적 실험의 4단계로 구성되며 영화감상, 강의, 토론과 작문 등의 수업방법을 포함하였다. 개발된 영화간호교육적용 결과 비교적 높은 만족도를 보였으며 학습유형별, 차시별 학습내용에 대한 영화간호교육 만족도는 통계적으로 유의한 차이가 없었다. 그리고 수업이 재미있고 흥미롭다고 답하거나 영화감상에 시간이 많이 소요된다고 영화간호교육의 장단점을 보고하였다. 결론 경험학습을 도모할 수 있는 영화간호교육의 효과를 극대화하기 위하여 적절한 상업영화의 발굴, 다양한 모듈의 개발, 그리고 영화간호교육의 효과를 명확하게 검증하고 학습성과를 체계적으로 평가할 수 있는 평가방법이 개발되어야 할 것이다.

• 대한한의진단학회지
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• 제14권1호
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• pp.79-95
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• 2010

Background and Purpose : By preventing diseases caused by exogenous evil, disorder of internal organs, and seven modes of emotions and adapting to mother nature when the mind is unsettled, and keeping the body and mind relaxed diseases can be avoided, but there can be unpredicted situations caused accidentally by stroke. Currently the general prescription is regulating the flow of vital energy including drugs eliminating blood stasis. Even though the stroke is resulted from diseases caused by exogenous evil, by observing the patient's physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart to clear the upper body and invigorate the functions of the spleen and stomach and purge with drugs of warm nature is a closer approach than simply prescribing vital energy regulating drugs with eliminating blood stasis to the main purpose of treatment. Methods : 1) The subject of the study are 2 cases of patients who have visited the private hospital of the person who is announcing the results of the study. These patients have been given a diagnosis of edema or cystoma caused by bursitis in the knee joint through perception or medical examination and were waiting for operational application. 2) Sources related to stroke from Dong Eui Bo Gwam(東醫寶鑑) were used as the general standard of Korean Traditional Medicine, and to promote the understanding the original text and the translation has been given. 3) By observing the whole body such as the patient's usual physical appearance, essence of life, vital energy, and mental faculties which are believed to be the functions of the heart, or partly using the "Yin is even and well while Yang is firm" theory of "Plain Questions" as the background to present the results of the clinical study. Results and Conclusion : Generally the prescriptions from the first volume of Dong Eui Bo Gwam(東醫寶鑑) are mostly drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating blood circulation. Also prescriptions for bone fracture or fracture of bones and sinews are mostly to eradicate blood stasis with drastic drugs or coaptation drugs added to drugs eliminating stagnated blood including extravasated blood and the blood moving sluggishly in circulation or congested in a viscus, alleviating pain, invigorating vital energy, possessing warm properties for the Xue system.

• Clinical and Experimental Pediatrics
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• 제51권10호
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• pp.1077-1084
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• 2008

목 적: 세균성 수막염은 소아에서 심각한 감염 질환이지만 우리나라에서 그 빈도와 원인균, 사망률, 나이별 분포에 대한 연구가 많지 않다. 본 연구에서는 서울의 한 대학 병원에서 세균성 수막염의 연령별, 원인균 별 빈도와 임상 양상에 대해 알아보았다. 방법: 1993년 9월부터 최근 2006년 8월까지 13년간 이화여자대학교 목동 병원에 세균성 수막염으로 입원한 신생아에서 18세까지의 소아를 대상으로 하여 연령별 원인균 및 발생 빈도와 역학을 후향적으로 분석하였다. 세균성 수막염의 정의는 첫째로 뇌척수액에서 세균이 분리 배양되었거나, 둘째로 뇌척수액에서 세균은 배양되지 않았지만 뇌막 자극 증상이 있고 뇌척수액에 백혈구수의 증가가 있으며 혈액에서 세균이 배양되어 배양된 세균이 수막염의 원인으로 추정되는 경우로 하였다. 결과: 총 81례 중 GBS가 30례(37.0%)로 가장 흔한 원인균이었고 이어서 H. influenzae가 22례(27.2%), S. pneumoniae가 12례(14.8%), E. coli가 3례(3.7%), N. meningitidis가 1례(1.2%), 기타균이 13례(16.0%)이었다. 신생아와 2개월 이하의 수막염에서 GBS가 가장 흔한 균이었다. 3개월에서 5세에서는 H. influenzae가 가장 흔한 균이었으며 5세 이상에서는 S. pneumoniae가 가장 흔했다. 31례에서 합병증이 있었으며 사망률은 과거에 비해 감소하였다. 결론: 신생아에서 세균성 수막염의 원인으로 GBS가 가장 많았다. Hib 백신의 도입 이후 H. influenzae에 의한 수막염의 빈도가 감소하는 추세였다. 단백결합 폐구균 백신의 효과에 대한 연구가 필요하며 GBS에 대한 예방전략을 세워야 한다.

• 대한한의진단학회지
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• 제15권2호
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• pp.175-190
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• 2011

Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1747-1753
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• 2013

Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.

• 대한소아치과학회지
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• 제28권3호
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• pp.363-368
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• 2001

광중합형 복합레진은 일부 성분들이 강한 광학-전자기선에 노출됨으로써 경화된다. 최초의 제품들은 자외선을 이용하여 중합되었다. 초기의 이러한 제품들은 작업시간의 조절가능 기포 형성 감소, 색 안정성 향상으로 각광받았지만, 자외선의 위해 성과 얕은 중합깊이를 극복하지 못해 결국 가시광선 중합형으로 대체되었다. 가시광선 중합형 복합레진의 중합완성도는 단량체(monomer)에서 복합체(polymer)로의 변환율에 의해 결정된다. 결국 수복물의 성공여부는 조사된 가시광선의 중합능력과 밀접한 연관성을 갖는다. 이번 조사의 목적은 현재 임상(치과 병 의원)에서 사용되고 있는 광중합기의 광도를 여러 연구를 통하여 그 신뢰성이 입증된 digital radiometer를 이용해 평가하고, 3가지 기본부품의 결함을 검증해서 임상가들에게 유익한 정보를 주기 위함이다. 조사 결과, 조사 대상 광중합기 중 17.8%가 적절한 중합에 부적절한 상태에 있으며, 46.6%가 광 조사시간을 연장할 필요가 있는 것으로 드러나, 광조사기의 절반 이상이 수복물의 성공적인 중합을 위해서는, 중합시간의 연장을 필요로 하거나, 기계적 결함으로 점검을 필요로 하는 상태에 있었다. 이번 조사로, 현재 치과 병, 의원에서 사용중인 광조사기의 부품성능과 그 관리에 문제가 있음을 알 수 있다. 이러한 결과는, 최근에 이루어진 외국의 조사에서와 유사하였다. 광조사기를 이용한 수복치료의 성공과, 구입당시 수준의 적절한 품질(quality)을 유지하기 위해서는, 광조사기 관리와 부품 교체에 대한 임상가들의 이해가 필요할 것으로 보인다.

• 농촌의학ㆍ지역보건
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• 제19권1호
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• pp.31-39
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• 1994

We carried out this study by analyzing the annual reports, surveyed by medical college student(Ewha Woman's University) through the medical records of new patients of Su-Dong Myon Health Subcenter from 1982 to 1992, and the specific survey data of 247 in Su-Dong Myon area which consists of 5,454 population and 1,651 household(43.6% farm household), in December, 1993. Results were as follows: 1) The number of population in Su-Dong Myon is 5,265 in 1982, 4,905 in 1984, 4,885 in 1986, 4,820 in 1988, 4,663 in 1990, 5,454 in 1992. 2) Since 1982, the annual utilization rate of a rural health subcenter showed decreasing tendency: such as 609(the highest rate) per 1,000 inhabitants in 1982, 485 in 1984, 525 in 1985, 281 in 1988, 316 in 1990 and 197 in 1992. The utilization rate by sex was decreasing chronologically in male, and age-specific utilization rate showed rapidly decreasing tendency since 1982 : 1,037 per 1,000 inhabitants in 1982, 877 in 1984, 1,084 in 1986, 519 in 1988, 538 in 1990 and 333 in 1992, in age group of 0-14, but not changing tendency in age-groups of 65 and over. 3) The monthly utilization rate of a rural health subcenter showed increasing tendency in March, July and August from 1982 to 1987, and in March and May from 1988 to 1992. 4) The patient rate of medical insurance showed increasing tendency since 1983: 17.0% per 100 patients(the lowest rate) in 1983, 21.3% in 1985, 20.4% in 1987, 70,0% in 1989 and 77.8% in 1991. However, the patient rate of Medicaid showed no specific change. 5) The utilization rate by the remedial measures for primary health care showed 30.8% of the answered in private special clinic, the highest rate, and 30.0% in drug stores, 25.5% in health subcenter, 10.5% in hospital and 1.2% in oriental clinic. In favorite physicians for primary health care, specialist was the highest rate, 48.6% of the answered, and general practitioner, 39.7% and home doctor, 8.9% in next order. And 70.8% of the answered experienced to visit the health subcenter more than once. 6) Disfavorite reasons of health subcenter were insufficient equipment(42.1%, the highest), and the next order, short cure time per day(25.1%), "be not cured"(12.2%), "be not(6.9%) and unkindness(3.6%), And the major obstacles in utilizing the medical facilities for primary health care were farm works(41.7%, the highest), distance(27.1%) and medical cost(11.4%).

• 한국산학기술학회논문지
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• 제17권10호
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• pp.119-130
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• 2016

본 연구는 의사로부터 고혈압으로 진단받은 사람들을 대상으로 개인 건강행태 및 지역 보건의료수준이 고혈압의사진단에 미치는 영향을 파악하고자 실시하였다. 연구는 2010년도 지역사회건강조사대상 만 19세 이상 성인 229,229명을 대상으로 개인특성에 따른 고혈압 의사진단의 차이 비교는 카이제곱 검정을 사용하였으며, 개인 및 지역수준 변수를 고려한 고혈압 의사진단의 관련지표의 지역 간 변이 파악은 다수준 로지스틱회귀분석를 실시하였다. 연구결과 개인건강행태수준에서 연령수준이 높을수록, 최종학력이 높을수록, 기초생활수급이 무일 때, 체질량지수가 높을수록, 일회음주량이 많을수록 고혈압 의사진단 경험률이 높았다. 또한 보건의료기관을 이용한 사람이, 한 달 동안 혈압측정횟수가 높을수록, 주관적 스트레스 수준이 높을수록, 우울감 경험이 있을 때 고혈압 의사진단 경험률이 높았다. 반면에 고용형태가 임금근로자인 경우, 고용주 및 자영업자에서, 걷기일수가 많을수록, 현재 흡연여부 경험이 적을수록, 민간의료보험에 가입한 사람에서 고혈압 의사진단 경험률이 낮았다. 건강행태 및 지역의 보건의료수준에 따라, 고혈압의사진단에 미치는 영향이 크다는 것을 알 수 있었으며, 추후 많은 연구에서 지역수준을 고려한 다수준 분석이 필요할 것으로 사료된다.