• 보건행정학회지
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• 제29권3호
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• pp.248-261
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• 2019

Establishing a healthcare delivery system is key to building a cost-effective healthcare system that can prevent the waste of healthcare resources and increase efficiency. Recently, the rapid increase in the national medical expenditures due to the aging of the population and the increase in chronic diseases has raised the question about the sustainability of the healthcare system including the health insurance system. This is why we need to reform the medical delivery system, including the function setting of medical institutions. Accordingly, gradual and practical efforts based on the recognition of reality are needed for solving the problems and improving the medical delivery system. The first effort is to secure policy measures to establish functions and roles of medical institutions which are the basis of the healthcare delivery system, and a systematic medical use system for appropriate medical use. This approach can be achieved through a reasonable health insurance schemes. Without reasonable reform efforts, it will be difficult for Korea's health care system to develop into a system that can provide cost-effective and high-quality medical services that the people want.

• 대한의사협회지
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• 제61권11호
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• pp.662-669
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• 2018

The cutaneous melanoma has been regarded as rare disease entity in Korea for long time but it shows a silent growth recently. Furthermore the management of cutaneous melanoma including staging system, surgical principle, sentinel lymph node biopsy and subsequent complete node dissection and, most importantly, immunotherapy and target therapy against cutaneous melanoma recently. The incidence of cutaneous melanoma is steadily increasing in Korea but its increase is rapid recent 2 decades to 4.3 times and should be greater soon according to the steeper increase of life expectancy. New staging system proposed by American Joint Committee on Cancer (2017) includes changes in individual TNM category and stage groups, particularly from a prognostic viewpoint. Dermoscopy has been successfully introduced in the differential diagnosis of pigmented skin lesion focusing on cutaneous melanoma by non-invasive simple diagnostic tool. Sentinel lymph node biopsy was a issue of long debate whether survival benefit is real or not. Temporary conclusion about this question is reached after two large scale studies and immediate complete node dissection should be performed in a certain situations. Most important change is drug therapy focusing on immunotherapy and target therapy. Braf- and MEK-inhibitor, immune checkpoint inhibitor and PD-1 blocker has been proved to be effective as a sole or combination regimen against advanced and/or high-risk adjuvant setting of cutaneous melanoma. In conclusion, these remarkable changes will be reviewed shortly here.

• 임상간호연구
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• 제29권1호
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• pp.75-84
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• 2023

Purpose: This study developed a protocol for nursing care after death for adult patients in hospitals. Methods: This was a methodological study to develop a care after death protocol. The preliminary protocol was developed based on a literature review, guidelines, and practice recommendations from groups of experts and clinical nurses. Content validity was evaluated by a group of experts (n=6) and nurses (n=30) in two hospitals. Results: The preliminary protocol recommendations were modified by validation and the open-question analysis results. The final protocol comprised three general recommendations and 43 recommendations in five steps that are verification and notification of a death, personal care of the body, viewing the patient, patient transfer, and documentation and self-care. Conclusion: This study result provides nurses with a consensus information on patient care after death and family support in a hospital setting. This nursing protocol is expected to improve the quality of care after death for adult patients and their families, and can be used for developing educational and emotional support for nurses to accomplish their important role.

• 한국농촌건축학회논문집
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• 제26권2호
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• pp.9-16
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• 2024

In order to achieve carbon neutrality in the architectural field by 2050, this study analyzed the energy impact proportional to CO2 emissions of each technique, such as design methods, the properties of building structures, prefabrication methods, passive houses, and active facilities. In addition, the results were presented quantitatively in terms of carbon reduction, and corresponding housing cases were analyzed. The research method is limited to residential buildings at the Passive House energy level, and carbon reduction techniques and elements in architecture are examined through various literature and materials, and empirical cases are analyzed to determine the specific possibility of realizing carbon reduction in architecture. We want to secure it. Based on these analysis results, it was possible to suggest that it is possible to explore various approaches to carbon reduction in future residential construction. By combining the most efficient techniques according to the energy reduction level or goal setting of the building in question, we expect the possibility of achieving the goal of carbon reduction in the residential sector more realistically.

• 한국지능시스템학회논문지
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• 제16권1호
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• pp.43-48
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• 2006

인터넷에서 가장 활발하게 사용되고 있는 웹은 특성상 구성주의 학습원리를 실현하는데 적절한 환경을 제공하고 있으며, 교육 시스템의 변화를 가져오고 있다. WBI(Web Based Instruction)는 웹을 매체로 활용하여 원거리에 있는 학습자를 교육시키는 형태로서 교수자와 학습자간 상호작용을 가능하게 하고, 다양한 형태의 학습 자료를 제공하며, 시간과 장소의 제약을 극복할 수 있는 장점이 있다. 본 논문은 문제은행 방식의 모의시험을 제공하는 웹 기반 학습 시스템의 설계 및 구현을 통하여 학습자 중심의 능동적인 학습활동이 이루어 질 수 있는 학습 환경을 구축하고 그 효과를 분석하는데 목적이 있다. 본 논문의 워드프로세서 자격증 시험을 위한 웹 기반 자기 주도적 학습 시스템은 교수자가 매번 새로운 문제를 출제하는 것이 아니라 문제은행에 저장되어 있는 문제를 검색하여 재 사용할 수 있고, 단원별로 원하는 문제 수를 지정하여 시험지를 출제한 수 있도록 구현하여 진정한 의미의 문제은행이라 할 수 있다. 학습자 웹 기반 학습을 하는 과정에 평가를 한 수 있도록 하였으며 즉각적인 피드백의 제공으로 학습자가 자기 주도적인 학습을 하는데 도움을 주었다. 또한, 시험 응시 후 단원별로 유사문제 검색을 할 수 있는 기회를 제공하였고, 학습자 문제은행 초기화면에서 키워드 검색으로 문제를 검색할 수 있게 함으로써 학습 효율을 더욱 증대시켰다.

• 한국병원경영학회지
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• 제7권4호
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• pp.172-192
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• 2002

The purpose of this study is to ascertain whether the effect of introduction of OCS(Order Communication System) to the hospital is satisfied or not comparing the anticipated effect with the actual effect. For this purpose, a domestic hospital which has introduced and has been operating OCS for several years was chosen. Based on the internal data of S Hospital prepared before introducing OCS, researcher has analyzed the basic direction, design standard and status of operation after the introduction of OCS, etc. After analyzing the status of operations of several departments using OCS and interviewing with the chiefs of pertinent departments, a survey form was designed. Actual survey and interviews were conducted by the researcher for weeks to know whether doctors, nurses, medical technicians and clerks of the patient management dept. were satisfied with OCS and to find if they have any recommendations to improve OCS. Based on the analysis of survey, the effect of OCS was evaluated whether it has satisfied the anticipated effectiveness. For the question if they feel convenient in using OCS, doctors, nursing staffs in charge of ward and the staffs of billing dept. has answered that they were all satisfied(100%). The answers for the same question were relatively high in the case of nurses in charge of outpatient and staffs of radiography. Of course, there have been some nurses and staffs who complained for the inconvenience. However, overall satisfaction was high on the average. Some common problems occurred after the introduction of OCS were frequent errors due to instability of OCS system, paralysis of function of hardware on data back-up system and redundant investment due to erroneous choice of DB program in setting DB. It was also pointed out that lack of computer education and low participation of medical staffs has resulted in failure of developing effective software. As a result, it has lowered the efficiency of OCS. For example, some works have to be done by hands even after OCS. Based on the result of this research, recommendations to maximize the effect of OCS were presented as follows. First, strong leadership of CEO and active cooperation of doctors are mandatory. Second, all the process of hospital work should be analyzed and be redesigned in more efficient ways. Third, OCS should be designed to be user-based system which can be used efficiently by all staffs of the hospital. Forth, prior to the operation of OCS, proper tests of the program and trainings of the pertinent staff are required. Fifth, prior to the selection of hardware, BMT(Bench Marking Test) should be conducted. Sixth, before introducing OCS, staffs in charge of OCS should visit many hospitals operating the OCS system and take their cases into account.

• 한국조사연구학회지:조사연구
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• 제10권3호
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• pp.85-106
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• 2009

본 연구는 한국과 일본에서 나타나는 인터넷 이용행태의 기본적인 특성과 전반적인 인식이 온라인에서의 관계망의 형성과 유지에 어떤 영향을 주고 받는지를 구체적으로 살펴보았다. 이를 위해 한국과 일본의 이용자들의 온라인 관계망의 현황과 개인적 성향, 인터넷 이용패턴, 그리고 인터넷에 대한 인식 등을 설문조사를 통해 알아보았다. 연구결과를 요약하면, 온라인 관계망의 크기와 활용에 있어서 한국의 이용자들이 보다 적극적인 것으로 나타났으며, 양국 모두 자주 만나기 어려운 사적인 관계의 대상들과 관계하는 비율이 높은 것을 알 수 있었다. 또한 한국의 이용자들은 개인적 성향이나 인터넷 관련 행태 및 인식이 전반적으로 만남의 방식에 영향을 미치지 않았던 데 비해 일본의 이용자들은 관계지향적인 인터넷 이용 패턴과 인터넷의 유용성에 대한 인식이 온라인에서의 접촉 양상에 영향을 미치는 것으로 나타났다. 온라인 관계망의 크기와 관련하여 양국 모두에 공통적으로 나타난 것은 인터넷을 정보지향적으로 이용할수록 등록된 대화상대가 증가한다는 점이었다. 이는 인터넷에서의 관계형성에 있어 약한 유대에 기반한 관계가 효율적이고, 이러한 관계를 통해 얻을 수 있는 혜택이 정보적 혜택이라는 기존의 이론과 잘 부합하는 결과라고 할 것이다. 아울러 일본의 경우 온라인에서의 관계형성 전반에 있어 온라인 공간에 대한 위험인식 정도, 즉 신뢰의 여부가 크게 영향을 미치는 것으로 분석되었다.

• 약학회지
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• 제58권6호
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• pp.378-386
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• 2014

Topical agents including of steroids are easily exposed to Korean patients in community setting. Those topical agents must be use cautiously because can cause adverse drug reaction unlike other oral medication. We evaluate the using pattern topical agents of Korean in community setting. We performed a questionnaire survey in three different pharmacies (general community pharmacy, dermatology clinic oriented pharmacy, general hospital oriented pharmacy) and in three university town. The survey asked necessity of topical agents, the number of applications per day, application period, site, and exist of steroids ingredient, etc. Total 330 people was participated in the survey from May 1st to July 31st, 2014. We analysed the survey by the frequency of each question and cross-analysis of the compliance between general public and pharmacy groups. In results, Korean people used topical agents for sudden skin diseases (66.9%), was gotten by dermatologist's prescription (89.1%), and did not know their diagnosis (39.2%). The people applied topical agents on face (22.3%), less one half FTU (finger tip unit) per application (61.9%), less than one week (62.9%). Though they was received drug education from pharmacist (52.2%), did not heard about adverse effects (78.4%). And compliance of applied times in pharmacy group was higher than in-non-pharmacy group (56% vs 38%, p=0.002). The highest compliance between 3 pharmacy subgroup was general community pharmacy (76.3% vs 61.6%, 61.2%, p=0.039). Compliance of applied duration was no difference between groups. Majority of respondents did not know diversity of ingredients, potency, application area of topical steroids, and replied to feel some vague reluctance and to think so dangerous about topical steroids. In conclusion, Korean people in community use topical agents well but still some exposed to risk from topical agents.

• 간호행정학회지
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• 제6권1호
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• pp.97-107
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• 2000

In human societies, there are various organizations which are unique and have different roles. Among them, hospital organization are much more complex than other organizations because of their multitude of professional groups each with its own goals. To achieve its purposes, hospital should manage each professional group effectively. Hospital nursing organizations are the core positions in hospitals for patient care. Therefore nursing organizations have have efficient nurse managers to lead nurses for their own purposes. First- line nurse managers have special tasks for patients and nurses, which include to motivating, managing communicating with the people. So they should have high self-efficacy, which is the belief that one can successfully perform the behaviors in question. Self-Efficacy of first line nurse managers that asked them for leading their staff, and their tasks, is essential to bring about self-realization of staff nurses through motivation and job satisfaction, taking advantage of sound surrounding which is able to operate her staff nurses in order to function efficiently. But there were few studies on the topic in a hospital setting. This study was designed to measure first-line nurse managers' self-efficacy. The subjects for this Study were 167 first-line nurse managers randomly selected from 18 university hospitals in Korea. The Self-Efficacy was measured using 'The general self-efficacy scale' developed by Sherer and Maddux(1982). The data were collected through questionnaires and analysed using SAS program, frequencies, percentages and Pearson' correlation coefficients. The results of this study were as follows : 1. The average of first- line nurse managers' self- efficacy was 66.7. 2. The correlation between first-line nurse managers' self- efficacy and general characteristics(age, education, career) was not significant. From the above findings, this study can suggest the following : 1. Repeat studies are needed in various hospital settings. 2. First-line nurse managers must be trained with special programs for each nursing organizations' purposes.

• 셀메드
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• 제6권3호
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.