• 한국병원경영학회지
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• 제7권3호
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• pp.1-24
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• 2002

The purpose of this study was to find the factors affecting the bum out syndrome and its degree in terms of personal, organizational and clients characteristics, and then to find the ways to reduce or eliminate those factors. The 228 doctors and the nurses who worked at the emergency departments in 6 general hospitals with more than 700 beds in Seoul were surveyed from April 15, 2002 for 15 days. A structured self-recording questionnaire was used; the t-test and ANOVA was used to analyse the median difference between the occupation, and multiple regression was employed to find the factors affecting the bum-out syndrome. The summary of this research analysis is as follows : First, of several variables, the highest frequency of the burn-out was the emotional burn-out followed by lack in personal touch toward the patients, decrease in sense of personal achievement. These results indicate that the doctors and nurses in emergency departments experience higher degree of burn-out than the social workers and the nurses who work at other departments in heath care environment as other studies revealed. Second, the analysis of the total burn-out factors showed the lower self respect, younger age, heavier work load, higher dissatisfaction rate toward remuneration and not-so-smooth relationship with the patients and their relatives the higher burn out rate. These variables explained 54% of the total variables. Third, the nurses experienced more burn-out syndrome than the doctors. The degree of self-respect, work pattern, relationship with the clients, age and remuneration were the causes of the burn-out. The doctors recorded lack in personal touch toward the patients more, while the nurses more to emotional exhaustion. The limitations of this research are the subjective answers of the respondents to certain questions and differences in sample numbers of each hospital in which some reservation can be exercised in explaining statistical significance of the data, and generalizing the conclusion. Despite of its limitation, this research has its own merit as an unpreceded research in this field, and provision of the basic materials to prevent and find causes of the burn-out syndrome among the doctors and nurses in the emergency departments.

• Journal of Gastric Cancer
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• 제3권3호
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• pp.151-157
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• 2003

Purpose: In this study, we attempted to ascertain the proton magnetic resonance spectroscopy (${1}^H$ MRS) peak characteristics of human gastric tissue layers and finally to use the metabolic peaks of MRS to distinguish between normal and abnormal gastric specimens. Materials and Methods: Ex-vivo ${1}^H$ MRS examinations of thirty-five gastric specimens were performed to distinguish abnormal gastric tissues invaded by carcinoma cells from normal stomach-wall tissues. High-resolution 400-MHz (9.4-T) ${1}^H$ nuclear magnetic resonance (NMR) spectra of two gastric layers, a proper muscle layer, and a composite mucosasubmucosa layer were compared with those of clinical 64- MHz (1.5-T) MR spectra. Three-dimensional spoiled gradient recalled (SPGR) images were used to determine the size and the position of a voxel for MRS data collection. Results: For normal gastric tissue layers, the metabolite peaks of 400-MHz ${1}^H$ MRS were primarily found to be as follows: lipids at 0.9 ppm and 1.3 ppm; alanine at 1.58 ppm; N-acetyl neuraminic acid (sialic acid) at 2.03 ppm; and glutathione at 2.25 ppm in common. The broad and featureless featureless spectral peaks of the 64-MHz MRS were bunched near 0.9, 1.3, and 2.0, and 2.2 ppm in human specimens without respect to layers. In a specimen (Borrmmann type III) with a tubular adenocarcinoma, the resonance peaks were measured at 1.26, 1.36 and 3.22 ppm. All the peak intensities of the spectrum of the normal gastric tissue were reduced, but for gastric tumor tissue layers, the lactate peak split into 1.26 and 1.39 ppm, and the peak intensity of choline at 3.21 ppm was increased. Conclusion: We found that decreasing lipids, an increasing lactate peak that split into two peaks, 1.26 ppm and 1.36 ppm, and an increasing choline peak at 3.22 ppm were markers of tumor invasion into the gastric tissue layers. This study implies that MR spectroscopy can be a useful diagnostic tool for gastric cancer.

• 기독교교육논총
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• 제62권
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• pp.135-160
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• 2020

본 연구는 기독교교육상담학과와 교육상담학과의 교육과정을 면밀하게 분석하여 기독교교육상담학과와 일반교육상담학과의 교육과정에 관한 현황과 문제점을 찾아 논의하고 기독교교육상담학과의 균형 잡힌 교육과정을 제시하였다. 이를 위해 기독교교육상담학과와 일반교육상담학과의 교육목표, 교과목, 상담실습 등의 교육운영과정을 중심으로 분석하였다. 기독교교육상담학과와 일반교육상담학과는 융합전공 학과의 특징을 가지고 기독교교육, 청소년, 아동·청소년, 평생교육 등의 학과와 교육상담학과가 합쳐진 경우가 많아 그에 대한 학과기초 과목들이 상담교과목들 보다는 교과목에서 높은 비율을 차지한 것으로 분석되었다. 기독교교육상담학과와 일반교육상담학과의 실습관련 교과목을 비교하였는데 분석된 결과에 의하면, 두 학과 모두 개설된 실습관련 교과목수가 상당히 부족함을 알 수 있었다. 개설된 상담학 교과목에서 상담자의 전문성 신장을 위한 개인분석, 교육분석, 상담윤리, 상담사례 슈퍼비전의 교과목들은 아직도 부족한 것으로 분석되었다. 상담전문가를 양성하기 위해서는 임상시스템의 체계화와 상담자교육을 위한 다양한 상담분석 및 슈퍼비전의 교과목들의 확대가 시급한 실정으로 평가된다. 사회가 복잡해짐에 따라 상담의 요구와 상담전문가의 필요가 높아지는 현대사회에서, 한국의 대학들이 상담자 양성을 위한 표준화 된 지표를 중심으로 상담교육의 모델을 개발할 것을 제안한다.

• Childhood Kidney Diseases
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• 제1권1호
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• pp.60-66
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• 1997

목적 : 요로 결석은 소아에서는 비교적 드물다고 하나, 점점 증가하고 있으며, 유발요인이 있는 경우에는 보다 빨리 진단할 수 있다. 본 연구를 통하여 요로 결석 환아들의 주증상, 진단, 감염및 동반 질환 여부, 치료 등에 대하여 알아보고자 하였다. 방법 : 1986년 1월부터 1996년 6월까지 10년 5개월간 세브란스 병원에 내원한 15세 미만의 요로 결석환아 45명을 대상으로 후향적 고찰을 하였다. 결과 : 요로 결석 환아의 평균 연령은 6.5세, 남녀비는 5.4:1이었고, 가족력은 13.3%에서 나타났다. 주증상은 육안적 혈뇨가 가장 많았고, 요로 감염을 동반한 환아 46.1%,요로 기형 및 질환을 동반한 환아가 35.6%에서 나타났다. 진단 방법으로는 단순 요로 촬영, 경정맥 신우 조영술, 복부 초음파 등이 사용되었는데, 초음파만으로 진단받은 경우도 다수 있어 의의가 크다고 하겠다. 치료로는 체외 충격파 쇄석술, 경피적 신결석 적출술, 수액 요법, 이뇨제등이 사용되었다. 결론 : 소아 요로결석에 대해 관찰한 결과, 유의할 만한 질환으로 생각되며, 요로 폐색이 있는 환아에서는 시급한 치료가 요구된다. 특히 단순 방사선 촬영및 경정맥 신우 조영술에서 발견되지 않은 환아에서는 반드시 초음파를 하여 진단해야 할 것이다. 한편, 결석의 성분 분석이 이루어지지 않아 다소 아쉬운 점이 남는다.

• 대한간호학회지
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• 제30권6호
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Journal of Korean Medical Science
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• 제33권48호
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• pp.295.1-295.7
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• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• Clinical and Experimental Pediatrics
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• 제58권10호
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• pp.380-385
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• 2015

Purpose: Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. Methods: The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ${\leq}18years$ presenting with croup or epiglottitis. Results: We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were $2.2{\pm}2.0$ and $5.6{\pm}5.8years$, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P<0.05). Conclusion: Both groups had similar sex ratios, arrival times, 3 most common chief complaints, and 5 most common comorbidities. Epiglottitis patients had a lower incidence rate, higher mean age of onset, and higher hospitalization rate and experienced dyspnea, sore throat, and vomiting more often than croup patients. Our results may help in the differential diagnosis of croup and epiglottitis.

• 한국의상디자인학회지
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• 제18권4호
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• pp.47-62
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• 2016

As the occupational education in junior college is being searched to be connected to practical industrial settings at present, importance of field placement is now being heightened. Industrial field experience shall be developed as the work can be performed in the practical site based on the generally comprehensive contents through the applicable educational course rather than simply independent educational course. Furthermore, characteristics of the applicable major shall be reflected in the field placement to be connected to the industrial field experience so that image promotion of the major and other additional value of the major can be effectively operated. However, it is practical situation that most of the field placements are being operated separately from connection and characterization of the educational curriculum in spite of the variety of the industrial field experiences and works in the field sites. Thus, the author of the thesis would analyze practical cases of the industrial field experiences in the past and grasp the problems of them so that we can develop models of the industrial field experiences proper for characteristics of fashion related departments. Especially, through the study the author of the thesis has developed the practical educational model where the fashion majoring educational courses can be connected with the field placement in the school industry in which the practical environment is established as in the applicable industry. In addition, it is judged that Developed educational models can be realized for subsidiary companies with close relationship with the departments besides the school based enterprises.

• 한국병원경영학회지
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• 제21권3호
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• pp.11-21
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• 2016

The purpose of this study is to investigate the degree of difficulty and turnover of nurses working in the field and to derive clinical work activation and supply policy improvements. Data was collected from December, 2014 to January, 2015, from 23 hospitals, and participants were 3,887 nurses working in the field, Survey details : the difficulty of the clinical work of nurses working in hospitals, turnover intentions status and policy proposals for clinical research work enabled General characteristics, difficulties in clinical working, turnover intention and clinical work plan activation are frequency analysis. The difference between each of the variables in accordance with the general characteristics are one-way ANOVA analysis, Correlation analysis of the variables is also a Pearson correlation coefficients. 'difficulties in clinical working' was a statistically significant difference depending on the type of hospital, nursing class, number of beds, location, age, position, employment, gender, working form, working department, salary, career, and degree level. 'turnover intention' was a statistically significant difference depending on nursing rate, number of beds, region, age, position, sex, shifts, departments, annual income, and career. 'policy recommendation' was a statistically significant difference depending on type of hospital, nursing rate, age, position, employ, shifts, departments, annual income, degree level and career 'difficulties in clinical working' is 'turnover intention' (p<.001), 'policy recommendations' (p<.001) and had a significant positive correlation. and 'turnover intention' had a "policy recommendation" significant positive correlation with the relationship (p<.001) The most difficulties point of the nurses working in the field are the environment, such as shift, urgent and dangerous. Major policy proposals are improve treatment such as wages, and welfare.

• 융합정보논문지
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• 제11권6호
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• pp.154-161
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• 2021

본 연구는 요양병원에서 응급실로 전입된 노인의 복합만성질환 유무에 관한 특성 및 연관성을 분석하였다. 2019년 1월 1일부터 12월 31일까지의 국가응급진료정보망 자료에서 만성질환으로 응급실에 내원한 환자 중 장기요양병원에서 전입된 고령 환자들의 수는 13,608건이었다. 복합만성질환자 중 75세 이상이 79.9%이며, 복합만성질환으로 입원한 비율은 74.0%로 나타났다. 응급실 재실시간은 복합만성질환 유무에 따라 차이가 있었으며(P<0.001), 복합만성질환의 유병률은 응급실 내원환자와 응급실 경유 입원환자의 교차비(Odds ration, OR)에서 광주(OR 8.899 vs. 8.142)와 전북(OR 13.865 vs. 10.676)이 높게 나타났다. 이와 같이 본 연구는 복합만성질환의 유무에 대한 환자들의 특성들이 연령과 지역 등에 따라 서로 다르다는 것을 보여주었다.