• 가정간호학회지
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• 제29권1호
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• pp.31-39
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• 2022

Purpose: This study investigated the effects of evidence-based practice competency, self-leadership, and organizational commitment on professional self-concept of nurses in regional trauma centers. Methods: The 98 research participants were nurses with clinical experience of a year or more. Descriptive statistics, t-tests, Mann-Whitney U test, ANOVA, and Pearson's correlation coefficients were computed, and multiple regression analysis was conducted. Results: Professional self-concept showed statistically significant differences according to marital status, religion, and educational background, and was positively correlated with and affected by evidence-based practice competency, self-leadership, and organizational commitment. Conclusion: Trauma nursing education programs should include evidence-based practice competency and self-leadership and organizational support should be provided to improve the professional self-concept of nurses in regional trauma centers.

• Archives of Plastic Surgery
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• 제49권2호
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• pp.215-220
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• 2022

Background In Japan, there is a large regional disparity in plastic surgery availability. In order for plastic surgery to be widely available for all citizens, it is essential for at least one plastic surgery facility to be located in each secondary medical zone. Methods Using the Japan Society of Plastic and Reconstructive Surgery homepage and some databases, we extracted data on secondary medical zones that do not have a plastic surgery facility. The national and regional coverage rates were calculated. The coverage rate for each group divided by the degree of population concentration was also calculated. Results We found that 147 of 344 secondary medical zones did not have a plastic surgery facility, and the area coverage rate was found to be 57.27% nationwide. The coverage rate in terms of population was 87.07% (correlation coefficient of area and population coverage = 0.983). The area coverage rates in Hokkaido-Tohoku, Kanto, Chubu, Kansai, Chugoku-Shikoku, and Kyushu-Okinawa districts were 47.46, 72.15, 76.47, 62.79, 52.08, and 32.81%, respectively. The corresponding population coverage rates were 79.92, 91.62, 94.27, 90.59, 80.68, and 69.54%, respectively. The area coverage rates in metropolitan areas, provincial cities, and rural areas were 98.08, 75.90, and 15.87%, respectively. In contrast, the area coverage rate of dermatology was 62.79% and that of orthopaedics was 97.09%. Conclusion Unfortunately, it is estimated that more than 40% of secondary medical zones are underserved by plastic surgery, and 13% of the population is not able to fully benefit from this specialty in Japan.

• 한국지역지리학회지
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• 제11권5호
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• pp.405-425
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• 2005

대중관광에서 신관광으로의 전환은 문화관광의 다기한 발전과 밀접하게 연결되어 있다. 본 연구에서는 문화관광지의 생성 개발 및 진화 발전 단계를 도출하여 '문화관광개발의 개념적 모형'을 구축하고자 한다. 또 관광, 문화예술 활동, 문화제품 생산 간에 유기적인 시스템이 존재하고 있음을 개념적으로 밝히고 있다. 연구 결과 문화관광지는 '장소 이미지 형성', '상징적 공간 구축', '문화적 활동의 영역적 시스템 형성' 등 세 단계를 거치면서 진화 발전한다. 또 각단계별로 존재하는 몇 가지 지배적인 구성요소를 도출함으로써 문화관광지의 발전 매커니즘을 보다 구체적으로 이해할 수 있게 되었다. 이 연구는 통합적, 영역적 관점에서 관광현상을 분석함으로써, 관광부문과 지역 사회경제 각 부문간 관계를 이해하고, 활력 있는 시스템적 관계로 전환하는 방법론 개발에 기여한다. 이 연구는 장소성, 장소이미지, 활동공간, 영역적 시스템 및 네트워크 등 인문지리학적 이론과 개념에 크게 의존하고 있다.

• The Korean Journal of Pain
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• 제27권4호
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• pp.339-344
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• 2014

Background: The diagnostic criteria of complex regional pain syndrome (CRPS) have mainly focused on dichotomous (yes/no) categorization, which makes it difficult to compare the inter-patient's condition and to evaluate the intra-patient's subtle severity over the course of time. To overcome this limitation, many efforts have been made to create laboratory methods or scoring systems to reflect the severity of CRPS; measurement of the skin temperature asymmetry is one of the former, and the CRPS severity score (CSS) is one of the latter. However, there has been no study on the correlations among the CSS, temperature asymmetry and subjective pain score. The purpose of this study was to evaluate whether there is any correlation between the CSS, skin temperature asymmetry and subjective pain score. Methods: Patients affected with CRPS in a unilateral limb were included in this study. After making a diagnosis of CRPS according to the Budapest criteria, the CSS and skin temperature difference between the affected and unaffected limb (${\Delta}T$) was measured in each patient. Finally, we conducted a correlation analysis among the CSS, ${\Delta}T$ and visual analogue scale (VAS) score of the patients. Results: A total of 42 patients were included in this study. There was no significant correlation between the ${\Delta}T$ and VAS score (Spearman's rho = 0.066, P = 0.677). Also, the CSS and VAS score showed no significant correlation (Spearman's rho = 0.163, P = 0.303). Conclusions: The ${\Delta}T$ and CSS do not seem to reflect the degree of subjective pain in CRPS patients.

• 한국농촌건축학회논문집
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• 제21권4호
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• pp.61-68
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• 2019

This research aimed to propose an organizational system that implements a planning agreement in local small and medium sized city, Korea. To conduct this research, three successful cases were deduced using integration systems to investigate purpose and background of the planning agreement. Articles, reports, media, and participation in meetings and workshops related on this topic are used for collecting data and interview of regional activists and experts, and public officials were carried out. Among them, the case of Yeongju city that used the new integration system instead of pre-adminstration system was examined in detail. There are three local governments; Yeongwol-gun, Jeungpyeong-gun, and Yeongju city which have successfully fulfilled projects from various departments of central adminstration not projects of planning agreement. The similarity noticed between those three cases is to continue various projects from several departments of central adminstration for numerous years and contribute to regional revitalization. A successful factor was to establish organizational system and manage it for the integration plan and performance for appropriate regional and administrative characteristics. In particular, in the case of Yeongju city, organization for urban architectural management composed of civilian experts were formed, authorized status on administrative organization was established, and the function and role were identified. It is helpful to other local governments to carry out the projects of planning agreement as the case of Yeongju city is now a new method.

• The Korean Journal of Pain
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• 제33권2호
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• pp.131-137
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• 2020

Background: Among various diseases that accompany pain, complex regional pain syndrome (CRPS) is one of the most frustrating for patients and physicians. Recently, many studies have shown functional and anatomical abnormalities in the brains of patients with CRPS. The calcium-related signaling pathway is important in various physiologic processes via calmodulin (CaM) and calcium-calmodulin kinase 2 (CaMK2). To investigate the cerebral mechanism of CRPS, we measured changes in CaM and CaMK2 expression in the cerebrum in CRPS animal models. Methods: The chronic post-ischemia pain model was employed for CRPS model generation. After generation of the animal models, the animals were categorized into three groups based on changes in the withdrawal threshold for the affected limb: CRPS-positive (P), CRPS-negative (N), and control (C) groups. Western blot analysis was performed to measure CaM and CaMK2 expression in the rat cerebrum. Results: Animals with a decreased withdrawal threshold (group P) showed a significant increment in cerebral CaM and CaMK2 expression (P = 0.013 and P = 0.021, respectively). However, groups N and C showed no difference in CaM and CaMK2 expression. Conclusions: The calcium-mediated cerebral process occurs after peripheral injury in CRPS, and there can be a relationship between the cerebrum and the pathogenesis of CRPS.

• 보건행정학회지
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• 제25권4호
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• pp.285-294
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• 2015

Background: Suicide is one of important health problems in Korea. Previous studies showed factors associated with suicide in individual levels. However, suicide was influenced by society that individuals belong to, so it was required to analyze suicide in local levels. The purpose of this study was to analyze the regional disparities of suicide mortality by gender and the association between local characteristics and suicide mortality. Methods: This study included 229 city county district administrative districts in Korea. Age- and sex-standardized suicide mortality and age-standardized suicide mortality (male/female) were used as dependent variables. City county district types, socio-demographics (number of divorces per 1,000 population, number of marriages per 1,000 population, and single households), financial variable (financial independence), welfare variable (welfare budget), and health behavior/status (perceived health status scores and EuroQol-5 dimension [EQ-5D]) were used to represent the local characteristics. We used hot-spot analysis to identify the spatial patterns of suicide mortality and negative binomial regression analysis to examine factors affecting suicide mortality. Results: There were differences in distribution of suicide mortality and hot-spot regions of suicide mortality by gender. Negative binomial regression analysis provided that city county district types (city), number of divorces per 1,000 population, financial independence, and EQ-5D had significant influences on the age- and sex-standardized suicide mortality per 100,000. Factor influencing suicide mortality was the number of divorces per 1,000 population in both male and female. Conclusion: Study results provided evidences that suicide mortality among regions was differed by gender. Health policy makers will need to consider gender and local characteristics when making policies for suicides.

• 보건행정학회지
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• 제23권2호
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• pp.176-187
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• 2013

Background: In 2006 Emergency Medical Services Index (EMSI), which summarizes the performance of regional emergency medical services system, was developed. This study assesses the performance of the EMSI to help determine whether EMSI can be used as evaluation tool. Methods: To build a composite score of the EMSI from predefined 24 indicators, 3 normalized values were calculated for each indicator, the normalized values of each indicator were weighted using 4 weighting methods, and the weighted values were aggregated into the final composite score using 2 aggregation schemes. The performance of EMSI was evaluated using 3 criteria: discrimination, construct validity, and sensitivity. Discrimination was the proportion of regions that did not include the overall median rank in the 5th to 95th percentiles rank interval, which was calculated from Monte Carlo simulation. Construct validity was a correlation among the alternative EMSIs. Sensitivity of EMSIs was evaluated by total shift of quartile membership and changes of 5th to 95th percentile intervals. Results: The total discrimination performance of the EMSI was 50.0%. Correlation coefficients between EMSIs using standardized values and those using rescaled values ranged from 0.621 to 0.997. Variation of the quartile membership of regions ranged from 0.0% to 75.0%. The total change in the 5th to 95th percentile intervals ranged from -19 to +17 places. Conclusion: The results suggested that the EMSI could be used as a tool for evaluating quality of regional EMS system and for identifying the areas for quality improvement.

• 한국항공운항학회지
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• 제10권1호
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• pp.69-82
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• 2002

최근 항공자유화의 주요 변화는 미국 중심의 양자간 항공자유화와 소지역적 다자간 협정 체제의 성립이다. 소지역적 다자간 항공운송협력은 서로 마음이 맞는 국가들간에 기존의 양자간 항공 협정 체제에 근거하는 것이며 각국은 항공운송산업의 발전을 도모하기 위하여 시장접근 및 운수권에 대한 규제와 제한을 완화하고 역내의 자유로운 항공교통을 실현하기 위해 노력하고 있다. 본 연구에서는 지역적 항공운송협력의 배경과 실태를 살펴보고 항공자유화의 추진 결과 경제적으로 얻을 수 있는 효과를 예상하고자 아시아에 위치하면서 미국과 항공자유화 협정을 체결한 싱가포르를 대상으로 항공자유화 정책의 경제적 효과를 산업연관분석을 통하여 연구를 행하였다.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.1-13
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• 2016

Background: The purpose of this study was to investigate longitudinal changes of the utilization of operational and surgical medical care inside and outside a metropolitan area over 10 years, analyzing the residential areas of patients and the locations of medical facilities for major cardiovascular surgery. Methods: Data analysis was conducted by classifying the addresses of patients and the locations of medical care facilities of metropolitan cities and provinces, using data from the National Health Insurance Corporation from January 2003 to December 2013. Results: There is serious concentration of major heart surgery to medical facilities in Seoul; this problem has not improved over time. There were differences in percentages of surgical procedures performed in the metropolitan areas according to major diseases. In the case of Busan and Daegu provinces, at least 50% of the patients underwent surgery in medical facilities in the city, but there are other regions where the percentage is less than 50%. In the case of provinces, the percentage of surgical procedures performed in medical facilities in Seoul or nearby metropolitan cities is very high. Conclusion: Policies to strengthen the regional capabilities of heart surgery and to secure human resources are required to mitigate the concentration of patients in the capital area. Many regional multi-centers must be designated to minimize unnecessary competition among regional university hospitals and activate a win-win partnership model for medical services.