• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• 생물정신의학
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• 제18권3호
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• pp.163-167
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• 2011

Complex regional pain syndrome (CRPS) is a disease that causes chronic spontaneous pain and hyperesthesia of one or more parts of legs and arms, which is accompanied with problems of the automatic nervous system or the motor nervous system. However, up to date, it is unclear what causes the syndrome and how to diagnose and treat it. Although several treatments including medication and sympathetic nerve block are performed against CRPS, the therapeutic effect of the treatments is limited. The electroconvulsive thera-py (ECT), of which the mechanism is not clarified, is a treatment used for treatment-resistant depression. ECT is also reported to be effective against pain. Therefore, we performed the ECT for a 24-year-old female patient who has been diagnosed as CRPS. Her pain had not been much improved by medications and interventional procedures. At admission to a psychiatric ward for ECT, she com-plained of over 8 points of pain on visual analogue scale and the constrained movement around the painful part. Eight ECTs-three times a week-were performed for three weeks in hospital and then the ECT once a week was performed after her leaving the hospital. During the ECTs, pain had been reduced and the range of movement in the constrained parts had increased. Further systematic re-search is needed to confirm the effect of electroconvulsive therapy against CRPS.

• 대한공간정보학회지
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• 제15권1호통권39호
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• pp.9-16
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• 2007

대학 입학생의 수가 급격히 감소하면서 각 대학 당국에서는 많은 입학생 유치와 학교 운영의 문제를 개선하기 위하여 다양한 방안을 모색하고 있다. 특히 대학의 입시 및 입학현황 자료는 대학당국의 입학 및 홍보정책을 결정하고, 나아가 학교생활복지를 향상하는데 있어서 중요성이 매우 높은 자료이다. 따라서 다양한 입시 및 입학 관련 현황 자료와 대학 결정 요인을 고려한 효율적인 분석이 이루어질 수 있는 입학관리시스템의 도입이 절실히 요구된다. 본 연구에서는 기본지리정보 데이터를 바탕으로 대학입시 지원자, 합격자 및 등록자의 자료에 대하여 분석할 수 있는 대학입학관리시스템을 개발하였으며, 해당 시스템을 이용하여 지역별 지원자, 지역별 합격자, 지역별 등록자, 지원자 대비 합격률 및 최근3년간 지원자 변화율을 분석할 수 있었다. 또한 대학의 입학홍보정책 및 학교운영에 요구되는 합리적이고 적합한 자료를 제공할 것으로 판단된다.

• 의학교육논단
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• 제26권1호
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• pp.5-18
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• 2024

The author recommends the creation of a nationwide career guidance program at the national level through the establishment of a long-term cohort, involving collaboration among medical schools nationwide. This cohort would be constructed for the purpose of analyzing correlations from admission to medical school to post-graduate education, facilitating the development of a career guidance program. This will aid in career development through students' self-analysis and competency building. Each medical school should operate a systematic career guidance program. Career guidance for post-graduate major selection should be included in the regular curriculum. Schools are advised to operate student counseling rooms for various career guidance services. For example, medical schools can operate 1:1 career counseling, academic counseling, career guidance surveys, psychological tests, and counseling. It is advisable to establish a mentor-professor system, connect mentor professors, and build a network of experts related to majors to provide immediate support according to students' needs. Professional mentor training should be provided to mentor professors. To provide opportunities for students to experience their career paths in advance, early clinical exposure, long-term integrated clinical practice, community-based clinical practice, participation in student research programs, career fairs, and student internship programs are recommended. In South Korea, it is necessary to systematically operate the internship system and make improvements to facilitate optical career choices. Additionally, considering the significant influence of social factors on students' career choices in South Korea, efforts should be made to identify and address the issues related to these social factors.

• 한국교육학연구
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• 제23권1호
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• pp.379-404
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• 2017

본 연구는 대학의 성인전담 단과대학의 운영방안을 구체적이고 실질적인 차원에서 모색하고자 하였다. 이를 위해 성인학습자를 위한 단과대학 추진 배경으로 성인학습자의 능력개발 요구에 대한 기회 확대, 고등평생교육제도 실행에서의 문제, 현행 평생 학습중심대학 사업의 한계 등을 분석하였다. 그리고 성인전담 단과대학 운영의 우수 사례로 미국 하버드대학과 시카고대학, 영국의 워릭대학을 선정하여 각 교육과정 구성과 운영 방법 등을 살펴보고, 이를 기초로 전문가 면담을 진행하여 성인전담 단과대학의 운영방안을 제안하였다. 그 결과 대학 조직개편의 운영철학으로 대학책무성과 정책적 효율성, 대학 특성화, 그리고 지속적이고 안정적 체제의 구축을 제시하고 다양한 입학진입트랙의 제공, 사전 준비교육과정의 제공을 통한 학습준비도의 확보, 선행학습인정 범위 및 방법, 전공과 수업방식, 학사제도 및 재정지원을 포함한 기타 성인학습자 맞춤형 서비스 등을 제안하였다.

• 한국콘텐츠학회논문지
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• 제19권11호
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• pp.132-143
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• 2019

본 연구는 교육대학의 입시 제도가 사교육과 어떤 관련성이 있는지를 알아보고, 사교육 경감을 위한 교육대학 입시 제도의 개선 방향에 대해서 탐색하고자 하였다. 이를 위해 현장에서 대학 입시를 담당하는 대구·경북 지역의 고등학교 3학년 담임교사들과 교육대학 입시를 실제적으로 경험한 D 교육대학 1학년 재학생을 대상으로 교육대학 입학 전형 요소와 사교육과의 관련성에 대한 인식을 알아보았다. 연구 결과, 교육대학 입시에서 내신 강화가 공교육을 강화하는 효과도 있지만, 내신이 중요하다는 인식이 강하게 작용하여 오히려 사교육을 강화하는 역작용이 발생할 여지가 있다는 의견이 많았다. 농촌 지역인 경상북도와 대도시인 대구 지역의 전형 요소별 인식 차이가 커서 지역 사회의 특성을 고려한 전형과 각 교육대학이 위치한 지역별 특성을 반영한 입시 제도의 도입이 필요하다. 정시 전형의 요소별 점수 반영 비율에 대해서 3학년 담임교사들은 수능 점수 반영 비율을 낮추어야 한다는 의견을 제시했으며, 이와 함께 면접 반영 비율의 상향을 주장하였다. 본 연구의 결과를 통해 사교육 감소를 위한 교육대학 입시제도의 개선 방향에 대한 시사점은 서류 평가의 공정성 확보가 요구되며, 면접의 강화와 함께 나타날 수 있는 사교육 문제의 해결을 위해서 면접의 방향 및 문항에 대한 공개가 뒤따라야 한다는 것이다.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.347-355
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• 2018

Background: Nephrotic syndrome (NS) is the most common glomerulopathy in children. Acute kidney injury (AKI) is a common complication of NS, caused by severe intravascular volume depletion, acute tubular necrosis, interstitial nephritis, or progression of NS. However, the incidence and risk factors of childhood-onset NS in Korea are unclear. Therefore, we studied the incidence, causes, and risk factors of AKI in hospitalized Korean patients with childhood-onset NS. Methods: We conducted a retrospective review of patients with childhood-onset NS who were admitted to our center from January 2015 to July 2017. Patients with decreased renal function or hereditary/secondary NS, as well as those admitted for management of other conditions unrelated to NS, were excluded. Results: During the study period, 65 patients with idiopathic, childhood-onset NS were hospitalized 90 times for management of NS or its complications. Of these 90 cases, 29 met the Kidney Disease Improving Global Outcomes criteria for AKI (32.2%). They developed AKI in association with infection (n = 12), NS aggravation (n = 11), dehydration (n = 3), and intravenous methylprednisolone administration (n = 3). Age ${\geq}9$ years at admission and combined use of cyclosporine and renin-angiotensin system inhibitors were risk factors for AKI. Conclusion: AKI occurred in one-third of the total hospitalizations related to childhood-onset NS, owing to infection, aggravation of NS, dehydration, and possibly high-dose methylprednisolone treatment. Age at admission and use of nephrotoxic agents were associated with AKI. As the AKI incidence is high, AKI should be considered during management of high-risk patients.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.75-82
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• 2010

Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.120-125
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• 2017

Purpose: The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS). Methods: Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis. Results: Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05). Conclusions: The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.

• 한국수학교육학회지시리즈E:수학교육논문집
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• 제28권2호
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• pp.195-217
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• 2014

대학수학능력시험은 고등학교 교육과정을 바탕으로 대학 교육에 필요한 수학 능력을 측정하는 시험으로, 대학입시제도가 갖고 있는 사회적 영향력으로 인해 모든 국민의 관심을 받고 있는 고부담 시험이다. 대학수학능력시험은 교육 과정의 개정에 따른 영향 뿐 아니라 공교육의 정상화, 수험생의 학습 부담 완화 등과 같은 외적 요인에 의해 여러 차례 변화되어왔다. 본 고에서는 교육과정의 개정에 따른 수학 영역의 평가 내용의 변화와 해외 대학입학 수학시험의 내용 영역에 대한 분석을 통해 향후 대학수학능력시험의 개선 방향 탐색을 위한 시사점을 도출하고자 한다.