• Advances in pediatric surgery
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• 제12권2호
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• pp.147-154
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• 2006

One day surgery in children has been practiced for last 10 years in this institution. This study is to examine its safety and effectiveness for patients younger than 15 years old treated at the Department of Pediatric Surgery, Asan Medical Center, from September. 1996 to December, 2005. A total of 3,709 patients, 37 % of the total pediatric operations, are included in this retrospective study. The most prevalent ages were between 1 and 3 years olds (1,199 patients). Twenty patients were younger than 6 months, and they all had one day surgery safely. Operations were herniorrhaphy in 3,126 patients,followed by excisional biopsy, chemoport removal, and OK 432 injection. There were 12 cases (0.32 %) of unplanned admissions, 7 occurred within 6 months of one day surgery. Perioperative fever was the most common cause of admission in 4 cases. The related conditions of unplanned admission were bleeding in 2 cases and radical surgery in 2. One day surgery in this institution was easily accessible and safe. This is to the result of appropriate selection of patients, cooperation with anesthesiologists, adequate control of postoperative pain, and home care programs.

• Archives of Plastic Surgery
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• 제43권3호
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• pp.248-253
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• 2016

Background Financial, clinical, and psychological considerations have made same-day surgery an attractive option for a variety of procedures. This article aimed to analyse the postoperative results of same-day primary unilateral cleft nasolabial repair. Methods This study was performed from 2011 to 2014. Unilateral cleft lip patients fulfilling the inclusion criteria were preoperatively classified as mild, moderate, and severe. All patients underwent same-day surgery and were discharged after satisfying the appropriate clinical criteria, receiving thorough counselling, and the establishment of a means of communication by phone. Postoperative outcomes were assessed and stratified according to preoperative severity and the type of repair. Results A total of 423 primary unilateral cleft lip patients were included. Fisher's anatomical subunit approximation technique was the most common procedure, followed by Noordhoff's technique. The postoperative outcome was good in 89.8% of cases, fair in 9.9% of cases, and poor in 0.2% of cases. The complication rate was 1.18% (n=5), and no instances of mortality were observed. The average hospital stay was 7.5 hours, leading to a cost reduction of 19% in comparison with patients who stayed overnight for observation. Conclusions Mild unilateral cleft lip was the most common deformity for which Fisher's anatomical subunit approximation technique was performed in most of the cases, with satisfactory postoperative outcomes. Refinements in the cleft rhinoplasty techniques over the course of the study improved the results regarding cleft nasal symmetry. Single-day primary unilateral cleft cheiloplasty was found to be a cost-effective procedure that did not pose an additional risk of complications.

• 약학회지
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• 제59권4호
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• pp.190-200
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• 2015

Evaluation Project on Appropriate Prescribing (EPAP) which is analysing prescribing pattern and providing physicians feedback has begun in 2001. EPAP indicators are related to antibiotics for acute respiratory tract infections, overuse of injection, polypharmacy (no. of drugs prescribed together, no. of prescriptions with 6 or more drugs), prescribing of specific medication group (drugs for acid related disorders, NSAIDs, corticosteroids) and medication expenditure per prescription day. The aim of this study was to suggest a development plan for EPAP indicators suitable for domestic situation. A consensus group consisting of seventeen health care professionals evaluated significance of each therapeutic class for EPAP indicators expansion considering information such as magnitude of issue, prescribing indicators of foreign countries, reimbursement criteria by each therapeutic class. Based on the data and group survey, 5 classes were selected as candidates for prescribing indicators and we presented 24 indicators regarding 5 classes. The results suggested that we need to augment evaluation indicators of additional area.

• Physical Therapy Rehabilitation Science
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• 제10권4호
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• pp.463-469
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• 2021

Objective: If non-surgical treatment fails, arthroscopic rotator cuff repair (ARCR) is recommended, and ARCR considers graft augmentation in consideration of size, direction, and re-tear. It is reported to have potential benefits by improving the healing rate as it can fill the gaps that have been left behind. The purpose of this study is to investigate the effect of structural changes observed after ARCR on muscle action through magnetic resonance imaging and to investigate the effect of appropriate physical therapy required for graft augmentation in the general ARCR rehabilitation protocol. Case presentation: A 47-year-old male hospitalized for postoperative rehabilitation following ARCR participated in a 5-week physical therapy intervention. The postoperative day was 6 months, but due to shooting pain and shoulder dysfunction,and the movement of the shoulder was compensatory motion, not normal motion. Physical agents, manual therapy, and supervised exercise for 110 minutes per session were performed 3 times a week, and pain intensity, range of motion, function, and strength were evaluated. Results: As a result of the study, the patient showed positive improvement in pain intensity, range of motion, function, and strength. In addition, normal scapulohumeral rhythm movement was observed. Conclusions: According to the results of this case, appropriate physical therapy according to the compensatory motion shown in the structural changes after ARCR can positively improve the pain intensity, range of motion, function, and strength of ARCR patients.

• 응용통계연구
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• 제27권5호
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• pp.667-679
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• 2014

우리나라 노인장기요양보험에서는 수급자가 월 한도액 범위 내에서 필요한 서비스를 비용-효율적으로 이용할 수 있도록 지원하고자 표준장기요양이용계획서를 작성하여 제공하고 있다. 본 연구는 표준장기요양이용계획서의 객관성 확보와 업무 효율성 제고를 위하여 의사결정나무기법을 이용해 수급자의 건강 및 기능 상태에 맞는 최적의 급여계획을 도출하는 표준급여모형을 개발하였다. 타당도 높은 모형 개발을 위하여 국민건강보험공단의 전국 220개 장기요양운영센터로부터 장기요양인정조사와 표준장기요양이용계획서 작성 경험이 풍부한 직원(본 연구에서는 '훈련된 조사자'라고 함)을 추천받아 자료수집의 내용과 방법에 대해 교육을 실시하였고, 이들이 수급자의 건강 및 기능 상태를 평가하고 작성한 수급자 개인별 맞춤형 급여계획을 자료 분석에 활용하였다. 표준급여모형은 1단계로 시설 또는 재가 급여 권고 여부를 결정하는 모형을, 2단계로 재가급여를 권고했을 경우의 재가급여 세부 종류별 권고 여부를 결정하는 모형을 개발하였다. 본 연구에서 개발된 표준급여모형은 전산프로그램화 되어 국민건강보험공단 직원이 수급자에게 제공할 표준장기요양이용계획을 수립하는 과정에 실제로 활용되고 있어 표준장기요양이용계획서의 객관성 확보와 업무 효율화가 기대된다.

• 한국보육지원학회지
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• 제20권2호
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• pp.145-167
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• 2024

Objective: This study aimed to investigate the moderated-moderated mediating effects of children's media content selection and parental restrictive media mediation on the relationship between children's screen media time and executive function difficulties. Methods: A total of 693 parents of children aged 5~6 years participated in this study and were asked to answer all survey questions. The data were analyzed by descriptive statistics and correlation analysis using SPSS 27.0. Model 11 of PROCESS macro 4.3 was used to examine the moderated-moderated mediation model. Children's gender, age, childcare enrollment status, and household income were included in the analyses as covariates. Results: The moderated-moderated mediating effects of children's media content selection and parental restrictive media mediation were found to be significant. Specifically, bedtime mediated the relationship between screen media time and executive function difficulties only when parents did not appropriately implement restrictive mediation and children freely selected media content. Conclusion/Implications: It is recommended that parents understand the importance of implementing restrictive media mediation and selecting appropriate media contents for their child to prevent executive function difficulties in early childhood. Also, child education or day-care centers should offer education program about appropriate media use to reach more parents.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.21-28
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• 2013

Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.

• Clinical Nutrition Research
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• 제13권2호
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• pp.108-120
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• 2024

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

• 한국엔터테인먼트산업학회논문지
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• 제13권1호
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• pp.25-34
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• 2019

본 연구는 대학생을 대상으로 정신건강 자가관리를 위한 모바일 앱을 개발하기 위한 연구로, 대상자의 요구를 반영하여 개발하기 위해 사용자 중심 설계를 이용하였다. 사용자 중심설계란 대상자에게 적합하게 적용하기 위해 대상자 요구도 사정-분석-설계-개발-평가-수정 및 보완-적용하는 연구설계이다. 대학생들의 정신건강 자가관리를 위해 이들의 주요 정신건강 문제인 음주·수면·우울·스트레스 등 4가지 영역으로 구성하였다. 각 영역별 현재 상태에 대한 자가테스트 콘텐츠, 점검 결과 분석 및 알림, 현재 상태에 대한 관리 방안 제시 등이 가능하도록 설계하였다. 이를 기반으로 안드로이드 기반 정신건강 자가관리 앱을 개발하였다. 대상자가 자신의 정신건강 상태자료를 입력함으로써 각각의 결과에 대한 정상 혹은 위험 정도를 설명하고 이에 따라 대상자는 자신이 수행할 수 있는 적절한 중재법을 선택할 수 있다. 또한 4가지 영역에 대한 현재 상태를 일자별로 나타낼 수 있는 정신건강자가관리 캘린더와 현재상태를 애니메이션과 상태바를 통해 통합적으로 표현할 수 있도록 개발하였다. 본 연구는 대상자 중심으로 다가갈 수 있는 정신건강 중재로, 지속적이고 더 향상된 프로그램으로 개선할 수 있는 정신건강 자가관리 앱 개발의 기초적인 연구로서 시도하였다.

• 한국의료질향상학회지
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• 제26권2호
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• pp.66-76
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• 2020

Purpose:Hospitals provide top medical service using exceptional manpower, medical technology, and state-of-the-art equipment, thus raising the standard of customer satisfaction. In addition, their medical service is becoming higher than before. One-stop service is a good way to improve the quality of customer-centered service as a qualitative marketing strategy. This study thus aims to facilitate subsequent research and compare customer satisfaction before and after one-stop service. Methods: The study included 72 patients who received the reserved examination and one-stop service for 20 days from April 23 to May 12, 2014. The surveyed questionnaire data were analyzed using SPSS 18.00. Results: The comparison results of customer satisfaction showed that the satisfaction score was generally high in the areas of kindness of examination staff, the speedy/accuracy of work processing of examination staff, and the kindness of reservation staff. The group before one-stop service showed their dissatisfaction with repeated visits and difficulty of booking a desired day. The group after one-stop service showed dissatisfaction with the long waiting time for examination or same-day treatment. Conclusion: The one-stop service showed good results, but new uncomfortable issues for the customer were revealed as well, which may result in more work of employees. Considering the characteristics of various clinical departments, the author hopes to find an efficient operation plan through the development and improvement of an appropriate one-stop service method.