• Title/Summary/Keyword: 연구보고지침

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ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

A practical analysis approach to the functional requirements standards for electronic records management system (기록관리시스템 기능요건 표준의 실무적 해석)

  • Yim, Jin-Hee
    • The Korean Journal of Archival Studies
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    • no.18
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    • pp.139-178
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    • 2008
  • The functional requirements standards for electronic records management systems which have been published recently describe the specifications very precisely including not only core functions of records management but also the function of system management and optional modules. The fact that these functional requirements standards seem to be similar to each other in terms of the content of functions described in the standards is linked to the global standardization trends in the practical area of electronic records. In addition, these functional requirements standards which have been built upon with collaboration of archivists from many national archives, IT specialists, consultants and records management applications vendors result in not only obtaining high quality but also establishing the condition that the standards could be the certificate criteria easily. Though there might be a lot of different ways and approaches to benchmark the functional requirements standards developed from advanced electronic records management practice, this paper is showing the possibility and meaningful business cases of gaining useful practical ideas learned from imaging electronic records management practices related to the functional requirements standards. The business cases are explored central functions of records management and the intellectual control of the records such as classification scheme or disposal schedules. The first example is related to the classification scheme. Should the records classification be fixed at same number of level? Should a record item be filed only at the last node of classification scheme? The second example addresses a precise disposition schedule which is able to impose the event-driven chronological retention period to records and which could be operated using a inheritance concept between the parent nodes and child nodes in classification scheme. The third example shows the usage of the function which holds or freeze and release the records required to keep as evidence to comply with compliance like e-Discovery or the risk management of organizations under the premise that the records management should be the basis for the legal compliance. The last case shows some cases for bulk batch operation required if the records manager can use the ERMS as their useful tool. It is needed that the records managers are able to understand and interpret the specifications of functional requirements standards for ERMS in the practical view point, and to review the standards and extract required specifications for upgrading their own ERMS. The National Archives of Korea should provide various stakeholders with a sound basis for them to implement effective and efficient electronic records management practices through expanding the usage scope of the functional requirements standard for ERMS and making the common understanding about its implications.

Climate-Smart Agriculture (CSA)-Based Assessment of a Rice Cultivation System in Gimje, Korea (한국 김제의 벼 경작 시스템의 기후스마트농업 (Climate-Smart Agriculture) 기반의 평가)

  • Talucder, Mohammad Samiul Ahsan;Kim, Joon;Shim, Kyo-Moon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.23 no.4
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    • pp.235-250
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    • 2021
  • The overarching question of this study is how a typical rice cultivation system in Gimje, Korea was keeping up with the triple-win challenge of climate-smart agriculture (CSA). To answer this question, we have employed (1) quantitative data from direct measurement of energy, water, carbon and information flows in and out of a rice cultivation system and (2) appropriate metrics to assess production, efficiency, GHG fluxes, and resilience. The study site was one of the Korean Network of Flux measurement (KoFlux) sites (i.e., GRK) located at Gimje, Korea, managed by National Academy of Agricultural Science, Rural Development Administration. Fluxes of energy, water, carbon dioxide (CO2) and methane (CH4) were directly measured using eddy-covariance technique during the growing seasons of 2011, 2012 and 2014. The production indicators include gross primary productivity (GPP), grain yield, light use efficiency (LUE), water use efficiency (WUE), and carbon uptake efficiency (CUE). The GHG mitigation was assessed with indicators such as fluxes of carbon dioxide (FCO2), methane (FCH4), and nitrous oxide (FN2O). Resilience was assessed in terms of self-organization (S), using information-theoretic approach. Overall, the results demonstrated that the rice cultivation system at GRK was climate-smart in 2011 in a relative sense but failed to maintain in the following years. Resilience was high and changed little for three year. However, the apparent competing goals or trade-offs between productivity and GHG mitigation were found within individual years as well as between the years, causing difficulties in achieving the triple-win scenario. The pursuit of CSA requires for stakeholders to prioritize their goals (i.e., governance) and to practice opportune interventions (i.e., management) based on the feedback from real-time assessment of the CSA indicators (i.e., monitoring) - i.e., a purpose-driven visioneering.

Non-carbapenem Drugs for Patients with Bacteremia caused by Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: Piperacillin-Tazobactam (Extended-Spectrum β-Lactamase 생성 장내세균속균종 균혈증 환자들의 치료에서 비카바페넴 항생제의 단일 기관 치료 결과: Piperacillin-Tazobactam을 중점으로)

  • Hyunjoo Oh;Seunghee Lee;Misun Kim;Sang Taek Heo;Jeong Rae Yoo
    • The Korean Journal of Medicine
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    • v.99 no.3
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    • pp.149-157
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    • 2024
  • Background/Aims: Carbapenems are recommended for treating bacteremia caused by extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae (ESBL-E). However, this has resulted in a significant rise in the utilization of carbapenems in cases of ESBL-E infection. We evaluated the clinical outcomes of patients with ESBL-E bacteremia treated with non-carbapenem antimicrobials. Methods: We conducted a retrospective case-control study of a cohort of patients with documented ESBL-E bacteremia from January 2021 to December 2021. The patients were divided into two groups according to whether they received non-carbapenem or carbapenem therapy. The rates of treatment failure, 30-day mortality and microbiologic failure, and the durations of hospitalization and of antimicrobial therapy were compared between the two groups. Antimicrobial susceptibility testing and phenotypic identification of ESBL-E were performed using the Vitek 2 system. Results: Of 118 patients with ESBL-E bacteremia, 54 received non-carbapenem drugs (non-carbapenem group [NCG]) and 64 received carbapenems (carbapenem group [CG]). Treatment failure at 30 days occurred in 16.7% of the patients in the NCG and in 18.8% in the CG (p = 0.65). The 30-day mortality rate was 14.8% in the NCG and 17.2% in the CG (p = 0.63). Extra-urinary tract infection and prior antimicrobial therapy within 30 days were risk factors for treatment failure in patients with ESBL-E bacteremia. The clinical outcomes did not differ significantly between the two groups, challenging the prevailing preference for carbapenems in the treatment of ESBL-E bacteremia. Conclusions: Non-carbapenem antimicrobials such as piperacillin/tazobactam are recommended for patients with mild ESBL-E bacteremia in South Korea.

A Review of Archaeological Research on Silla in North Korea (북한의 신라 고고학 연구 현황과 특징)

  • Yoon, Sangdeok
    • Korean Journal of Heritage: History & Science
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    • v.53 no.2
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    • pp.270-285
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    • 2020
  • This study examines the state of archeological research on Silla and Unified Silla conducted in North Korea and identifies its characteristics. In South Korea, most research has focused on prehistoric times in North Korea, and little research has been done on Silla and Unified Silla. Noting this, we attempted to examine the history of archaeological research in North Korea to provide foundations upon which to go forward. The research was examined in terms of general archaeological themes including tombs, fortresses, the capital city, earthenware, roof tiles, ornaments, weapons, and horse harnesses, and we identified four characteristics from the examination. First, Juche ideology had a great influence on interpretation of the unification of the three kingdoms. The Juche ideology was first proposed in 1955, and at the time, it was not fully established as an ideology but rather seen as constituting opposition to toadyism. Accordingly, the unification of the three kingdoms led by Silla was seen as amounting to collusion with foreign forces and was not acknowledged. A piece of evidence shows that this change took place around 1962. Second, an inclination to testify to the 'uniqueness' of the cultures of the three kingdoms is observed. The argument is that culture in the Korean peninsula has unique characteristics that set it apart from Chinese culture, and that the cultures of the three kingdoms share much in common. This inclination was not mentioned in research until the 1950s, and it can be seen as an effort to comply with Juche ideology and prove the principle of unity as stated in the national leader's instructions in the 1960s. Third, the influence of Goguryeo on the formation of Silla culture is emphasized. Related research explains that Baekje, Silla, and Gaya adopted the 'superior' culture of Goguryeo, and could establish 'uniqueness' of culture accordingly. It is claimed that an advanced Goguryeo culture was disseminated throughout Balhae and Unified Silla, and then to Goryeo, resulting in a true unification of the ethnic culture. Fourth, researchers in North Korea presume the Silla tombs and other relics to be far older than South Korean researchers' estimate. From a standpoint of highlighting the long history of Korea, they estimate the Silla Dynasty was founded in the early or mid-first century. Accordingly, archeological evidence that demonstrates the establishment of the state is dated as far back. Such an estimate is also indispensable in justifying the explanation that the chamber tombs of Goguryeo had a direct influence on Silla. These research characteristics which arose during the 1960s continue to be basic guidelines for North Korean researchers.

Status of Meal Serving and Nutritional Quality of Foods Served for Children at Community Child Centers in Korea (지역아동센터의 배식 실태 및 배식량 측정을 통한 영양적 질 평가)

  • Kwon, Sooyoun;Yeoh, Yoonjae
    • Journal of the East Asian Society of Dietary Life
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    • v.25 no.2
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    • pp.352-362
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    • 2015
  • The purpose of this study was to examine portion sizes and nutritional quality of foods served to children at Community Child Centers (CCCs), July 2014, in Korea. A survey was administered to foodservice employees working at CCCs. Thirty-nine participants completed the self-administered questionnaire regarding CCCs foodservice practices. In the weight test, fifteen volunteers of demonstrated typical portion sizes for $5^{th}$ grade elementary school students. Nutrition knowledge scores were significantly different between foodservice employees with experience taking a foodservice class for one year (6.04 out of 10.0 points) and those without experience (4.58 points). Foodservice employees with experience taking a foodservice class scored significantly higher in performing meal serving practices, e.g., wearing a sanitary cap and apron when serving food, than those without experience. The amount of foods served for children did not meet standard serving sizes; portion sizes of rice, soup, main dish, side dish and kimchi served by foodservice employees were 87.3%, 63.2%, 56.5%, 37.1% and 81.3% of standard serving sizes, respectively. When energy and nutrient intakes from portion sizes were calculated, energy, vitamin A, thiamin, riboflavin and calcium intakes did not meet standards for nutrition control of school meals. However, protein, vitamin C and iron intakes met more than 100.0% of standards. These findings suggest that foodservice employees with experience taking a foodservice class apply their knowledge to foodservice practices. Although portion sizes can influence energy and nutrient intakes in children, the actual portion sizes served by CCCs foodservice employees were inadequate and did not meet standards for serving size and nutrition. Thus, all CCCs foodservice employees need to receive foodservice education and be provided guidelines regarding portion sizes for children.

A comparative study of pre- and post-treatment cephalometric measurements: Upper premolar extraction only vs. upper/lower premolar extraction groups (상악 편악 소구치발치와 양악 소구치발치에 의한 교정치료 전후의 측모 두부방사선계측법적 비교 연구)

  • Kim, Young-Seok;Kim, Su-Jung;Kang, Seung-Goo;Lee, Young-Jun
    • The korean journal of orthodontics
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    • v.37 no.6
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    • pp.421-431
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    • 2007
  • The objective of this study was to provide guidelines for the diagnosis and successful treatment of orthodontic treatment with upper premolar extraction only Methods: The sample group consisted of 40 patients (20 with upper premolar extraction only, 20 with both upper and lower premolar extractions) who showed an overjet of more than 7 mm and were finished successfully. Lateral cephalographs were taken before and after orthodontic treatment. Landmarks showing the position of the upper and lower incisors and the position of the upper and lower lip were determined and angular measurement of these values were obtained for statistical analysis (Mann-Whitney test). Results: At pre-treatment, the position of the lower incisor was less labially inclined and the convexity of the lower lip was smaller in the upper premolar extraction only group than in the upper/lower premolar extraction group. At post-treatment, there was no difference in all measurements except for the position of the lower incisor. A comparison of changes between pre- and post-treatment showed that the retraction of upper & lower incisors and the decrease in convexity of the lower lip were greater in the upper/lower premolar extraction group. Conclusions: Treatment by upper premolar extraction can be of benefit for patients whose lower incisor proclination and lower lip protrusion are not excessive.

A Review of the Systemic Analysis Method on Dental Sedation for Children (소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰)

  • An, Soyoun;Lee, Jewoo;Kim, Seungoh;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.331-339
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    • 2015
  • The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

The Development of National Competency Standard(NCS) Regarding Casino Operations Management (카지노운영관리 직무에 관한 국가직무능력표준(NCS) 개발)

  • Kim, Dong-Yeon;Oh, Seung-Gyun;Koo, Ja-Gil;Kim, Jinsoo
    • 대한공업교육학회지
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    • v.39 no.1
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    • pp.143-163
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    • 2014
  • This study developed a National Competency Standard(NCS) regarding the casino operations management based on the manual for developing National Competency Standard of 13 years and a revised classification system chart of the National Competency Standard. For the research method, this study developed a national competency standard of relevant jobs after going through review, consultation, modification, supplementation, and reporting procedures 10 times with development experts of the National Competency Standard, the industrial setting professionals, education and training experts, qualification(job analysis) experts, facilitators, and a working group of job verification committee based on the phased range and DACUM procedure of study. The major development results of this study are as follows. First, this study selected and defined duties based on the revised classification system chart of the National Competency Standard, then drew and developed total 8 ability units based on the applicable duties. Secondly, based on the developed ability units, total 27 ability unit factors were deduced and developed. Thirdly, a standard system by ability unit factor was developed based on the level of the national competency standard and revised classification system chart, then this study deduced and developed a supra-domain of the standard system by competency units using the standard tranquility value by these competency unit factors. Based on such development contents and guidelines for the national competency standard ability unit classification number, this study deduced and developed category numbers by relevant competency unit. Fourthly, total 27 relevant performance standard by competency units and knowledge, skill, and attitude were deduced and developed. Fifthly, this study deduced and developed a scope of application, work situation, evaluation guide, core competency, and development history in reference to the total 8 relevant competency units based on the duties.

Effect of Gastric Cancer Screening on Patients with Gastric Cancer: A Nationwide Population-based Study (위암 환자에서 국가암검진의 효과)

  • Cho, Young Suk;Lee, Sang Hoon;So, Hyun Ju;Kim, Dong Wook;Choi, Yoon Jung;Jeon, Han Ho
    • Journal of Digestive Cancer Research
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    • v.8 no.2
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    • pp.102-108
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    • 2020
  • Background: This study was performed to evaluate the effect of gastric cancer screening through analysis of screening-related data. Methods: We investigated claims data of gastric cancer from 2009 to 2015. We evaluated whether the screening was performed to prior to registration as patients with gastric cancer. The effect of gastric cancer screening was also analyzed by gender. Results: We collected total 196,293 patients with gastric cancer. 74% of them had previous experience of gastric cancer screening. In patients with screening, early gastric cancer was 33.4% and advanced gastric cancer was 17.3%. 22,548 (15.5%) patients were diagnosed with gastric cancer within 2 years after screening. In the case of patients without screening, early gastric cancer was 15.1% and advanced gastric cancer was 25.3%. In case of men, 76% of them confirmed gastric cancer through screening, and 70.2% of women confirmed the gastric cancer. In both men and women, the rate of early gastric cancer was higher among those with screening than those without screening. Conclusion: In this study, we were able to indirectly confirm the stage shift of gastric cancer screening. However, within 2 years after screening, not a few patients with gastric cancer were diagnosed. Therefore, more studies are warranted to in the future.