• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 춘계학술대회
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• pp.3-6
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• 2006

장출혈증후군은 성숙한 젖소의 치명적인 질환으로서 급성으로 진행하는 복부팽창, 쇼크, 장폐쇄, 흑변, 대변 속에 소화된 혈액응괴 또는 응괴쪼가리 등을 나타내는 것이 특정이다. 가능성이 있는 소인으로서 비유로 인한 신체적 스트레스, 곰팡이 핀 사료 및/또는 Clostridium perfringens 의 증식을 촉진하는 관리, 식이 및 환경 요인 등이 있다. 장출혈증후군의 발병기전에 대해 더 많이 밝혀질 때까지 예방대책은 위에 설명한 추정적인 요인들에 초점을 맞춰야 하며, 개개의 목장에 필요에 맞게 계획되어야 한다. 또한 이러한 의사결정 과정에 예산에 대한 세심한 분석도 해야 한다.

• 정보과학회지
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• 제32권1호
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• pp.44-52
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• 2014

• 의료법학
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• 제21권2호
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• pp.163-207
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• 2020

우리나라의 임상시험은 최근 10년간 그 규모가 성장하여 임상시험 산업의 주요 국가로 자리매김 하였다. 임상시험은 의료수준의 발전 및 치료 가능성의 확대를 위해 중요한 의미를 지니고 있다. 그러나 임상시험은 의약품 등의 안전성과 유효성을 증명하기 위한 것으로서 본질적으로 위험성을 내포하고 있으므로, 적절히 통제되어야만 임상시험대상자의 건강과 자기결정권이라는 법익을 보호할 수 있다. 이를 위해 임상시험을 수행하는 의사의 선관주의의무 이행이 특히 중요하다. 약사법과 그 하위법령은 시험자인 의사가 준수하여야 할 여러 의무를 규정하고 있다. 이 중 대상자 보호의무와 설명의무는 의사의 임상시험대상자에 대한 주된 선관주의의무를 구성한다. 이는 통상적인 의사의 진료행위에 있어서의 주의의무 및 설명의무와도 본질적으로 그 보호법익과 내용이 유사하다. 임상시험의 경우 통상적인 진료행위의 경우보다 가중된 설명의무가 요구된다. 임상시험에서의 구체적인 주의의무 기준 설정은 향후 판결과 연구를 통해 이루어져야 할 것이나. 주의의무의 기준을 막연히 높이거나 입증책임을 전환하는 등으로 임상시험을 수행하는 의사의 책임을 가중시킬 경우, 자칫 임상시험의 발전 및 환자의 새로운 치료법에 대한 접근성을 저해하고 손해의 공평·타당한 분담이라는 원칙에 위배될 우려가 있다. 이러한 의무들 외에도 임상시험에 대한 법령은 의사에 대해 여러 의무를 규정하고 있는바, 이러한 법령의 위반이 선관주의의무 위반에 해당함으로써 손해배상책임이 인정되는지의 문제는 해당 법령이 부수적으로라도 임상시험대상자의 안전과 이익을 보호하기 위한 것인지 여부, 대상자의 법익 침해의 유무와 정도, 법령위배행위의 태양 등을 종합적으로 고려하여 판단하여야 한다. 이와 같은 여러 의무의 충실한 준수가 이루어지도록 담보하고, 구체적 사안에서 임상시험대상자의 법익이 적절히 보호되었는지에 대해 사법(司法)적, 행정적 통제를 함으로써 법익 보호를 효과적으로 담보할 수 있을 것이다.

• 부모자녀건강학회지
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• 제15권1호
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• pp.20-32
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• 2012

Purpose: The purpose of this study was to identify clinical decision making pattern of pediatric nurses and analyze how it shows the differences in types of decision making pattern by nurses characters. Methods: A self-administered questionnaire was used to pediatric nurses of 4 general hospitals in Seoul from February 2004 to April 2004. The data of 251 nurses was analyzed by varimax rotation factor analysis, t-test, and ANOVA. Results: 6 decision making patterns were identified: Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, Nursing Model-oriented, Medical Knowledge-oriented, and Patient-Family-Nurse Collaborative. Individual Patient-oriented, Pattern-oriented Intuitive, Typical Nursing Knowledge-oriented, and Nursing Model-oriented decision making pattern got meaningful differences in age, marital status, total number of years in nursing practice, and number of years in pediatric nursing practice. Conclusion: We expect the result of this study can be applied for promotion of understanding the decision making of nurses that occurs in pediatric nursing practice and also can be used as foundation data for development and expansion of pediatric nursing practice.

• 한국간호교육학회지
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• 제22권3호
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• pp.304-315
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• 2016

Purpose: The purpose of this study was to explore the relationships of critical thinking disposition (CT), nursing work environment (NWE), and clinical decision making ability among nurses. Methods: A cross-sectional, descriptive study design was conducted on 192 nurses who had worked for more than six months in five general hospitals. A self-reported questionnaire was used to collect data, which included demographics, CT, NWE, and clinical decision making ability. Results: The mean score of CT was 3.5. The highest score was on the objectivity of CT and the lowest on systematicity. The mean score of NWE was 2.3. The highest score was on the collegial nurse-physician relations of NWE and the lowest on the staffing and resource adequacy. The mean score of clinical decision making ability was 3.3. In hierarchical multiple regression, affecting factors on clinical decision making ability were CT and NWE. Conclusion: The findings showed that clinical decision making ability is associated with CT and NWE. To improve clinical decision making ability, it is important to improve CT. In addition, it should be considered to improve NWE where the nurses can make a decision with their job through critical thinking.

• 가정간호학회지
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• 제21권2호
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• pp.147-155
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• 2014

Purpose: Clinical decision-making carried out by nurses is a complex process that influences the quality of care provided and various patient outcomes. This study examined the relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Method: The study had a non-experimental correlational design. Data were collected from 100 home health advanced practice nurses in 20 hospitals. Results: The mean critical thinking disposition score was $3.69{\pm}.39$ out of 5 and the mean score for clinical decision-making abilities was $3.48{\pm}.22$ out of 5. In this correlation analysis, a significant positive correlation (r=.58, p<.001) was found between critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses. Conclusion: In order to improve the clinical decision-making ability of home health advanced practice nurses, we need to improve their critical thinking disposition. In order to make this change, appropriate training program are needed to increase the critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses.

• 기본간호학회지
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• 제17권2호
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• pp.274-281
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• 2010

Purpose: The purpose of this study was to identify the correlation between level of professional autonomy and clinical decision making abilities in clinical nurses, and to provide basic information for promoting competency nurses in making independent decisions. Method: Data were collected from July 1 to July 18, 2008, and participants were 202 clinical nurses in general hospitals. Collected data were analyzed using descriptive statistics: frequency and percentage and Pearson correlation coefficients with the SPSS WIN 14.0 program. Results: The professional autonomy index for the nurses was 159.63 points. The clinical decision making ability index was 119.79 points. The most highly ranked factor in clinical decision making was search for information and unbiased assimilation of new information. There was a statistically significant difference in professional autonomy according to age, clinical experience, and type of duty. Relation between level of professional autonomy and clinical decision making showed a positive correlation. Conclusion: As a results show a significant correlation between professional autonomy and clinical decision making in clinical nurses, improvement in professional autonomy of clinical nurses, would be promoted through continuous support and training.

• 기본간호학회지
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• 제22권3호
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• pp.308-317
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• 2015

Purpose: The aim of this study was to examine the effects of case-based learning (CBL) on clinical decision making and nursing performance. Methods: This research was conducted between September, 2011 and January, 2012 as a nonequivalent comparison group design. The participants were 55 third year nursing students who were enrolled in a college of nursing in a university in Korea. The intervention was the CBL procedures which involved role-play practice videoed by camera and watched on the computer by the students. Questionnaires were used before and after the intervention to measure clinical decision-making. Nursing performance tests were done after the intervention. Results: Statistically significant group differences were observed in clinical decision-making. Nursing performance was significantly higher in the CBL group than in the control group. Conclusion: CBL focused on the solving problem process and clinical cases which are based on clinical setting allowing students to develop efficiency in clinical practice and adaptation to the clinical situation.

• 근관절건강학회지
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• 제30권1호
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• pp.48-57
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• 2023

Purpose: The purpose of this study was to examine nurses' critical thinking disposition and knowledge sharing activity and professional work environment on clinical decision-making ability. Methods: The data collection period for this study was from May 24 to May 31, 2021. The data were collected from 167 nurses who consented to participate in this study and have worked for more than one year at general hospital in Seoul. The data were analyzed using the SPSS/WIN 25.0 program. Results: A significant positive correlation was found between clinical decision-making ability and critical thinking disposition, knowledge sharing activity, and a professional work environment. Critical thinking disposition (β=.32, p<.001), knowledge sharing activitiy (β=.24, p=.002) and professional work environment (β=.20, p=.006) had a significant effect on clinical decision-making ability. These factors explained 35.5% of clinical decision-making ability (F=24.22, p<.001). Conclusion: Therefore, in order to develop the critical thinking disposition of nurses, development of systematic educational programs and strategies for practical application are needed. Through this, nurses can improve the professional decision-making ability and clinical performance ability.

• 한국정보처리학회:학술대회논문집
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• 한국정보처리학회 2019년도 춘계학술발표대회
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• pp.508-510
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• 2019

본 연구에서는 딥 러닝을 이용하여 완전 자동화된 다중 클래스 전체 심장 분할 알고리즘을 제안하였다. 제안된 방법은 recurrent convolutional block과 residual multi-dilated block을 삽입하여 기존 U-Net을 개선한 인공신경망 모델을 사용하였다. 평가는 자동화 분석 결과와 수동 평가를 비교하였다. 그 결과 96.88%의 평균 DSC, 95.60%의 정확도, 97.00%의 recall을 얻었다. 이 실험 결과는 제안된 방법이 다양한 심장 구조에서 효과적으로 구분되어 수행되었음을 알 수 있다. 본 연구에서 제안된 알고리즘이 의사와 방사선 의사가 영상을 판독하거나 임상 결정을 내리는데 보조적 역할을 할 것을 기대한다.