• Tuberculosis and Respiratory Diseases
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• 제70권3호
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• pp.191-198
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• 2011

Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU), with an incidence ranging from 8% to 38%. Patients who acquire VAP have higher mortality rates and longer ICU and hospital stays. Because there are other potential causes of fever, leukocytosis, and pulmonary infiltrates, clinical diagnosis of VAP is overly sensitive. The only alternative approach to the clinical diagnosis of VAP is the Clinical Pulmonary Infection Score (CPIS). Employing quantitative cultures of respiratory secretions in the diagnosis of VAP leads to less antibiotic use and probably to lower mortality. With respect to microbiologic diagnosis, however, it is not clear that the use of invasive sampling using bronchoscopy is associated with better outcomes. Delayed administration of antibiotic therapy is associated with an increased mortality, and inadequate antibiotic therapy is also associated with higher mortality. Therefore, prompt initiation of adequate antibiotic therapy is a cornerstone of the treatment of VAP. The initial antibiotic therapy should be based on the most common organisms in each hospital and the most likely pathogens for that specific patient. When final cultures and susceptibilities are available, de-escalation to less broad spectrum antibiotics should be done. Since clinical improvement usually takes 2 to 3 days, clinical responses to the initial empirical therapy should be evaluated by day 3. A short course of antibiotic therapy appears to be equivalent to a traditional course of more than 14 days, except when treating non-fermenting gram-negative organisms. If patients receive initially adequate antibiotic therapy, efforts should be made to shorten the duration of therapy to as short as 7 days, provided that the etiologic pathogen is not a non-fermenting gram-negative organism.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권2호
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• pp.7-16
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• 2023

Purpose: Seclusion room in a psychiatric facility limit the body and space for treatment or protection, so controversy over human rights violations arises despite their necessity. The seclusion room should be created as an environment that can promote the recovery and healing of patients, not the purpose of managing patients. while ensuring the safety of medical staff. Therefore, the purpose of this study is to compare and analyze the standards of overseas guidelines for the seclusion room in psychiatric facility, and through this, it is intended to contribute to the improvement of facility standards for seclusion rooms in Korea, which are at a very insufficient level. Method: This study takes the method of comparative analysis through literature review. We analyze the facility standards of seclusion room in Korea, and compare and analyze guidelines for seclusion rooms in Australia, US, UK, and Canada. Result: As a result, the elements of the guideline for seclusion room were classified into size, space, opening, furniture and equipment, and etc. The results of comparative analysis of details are presented. Implications: Korea should also prepare guidelines for psychiatric institutions, and among them, the standards for seclusion room, which are at the center of controversy over human rights violations, should be reviewed in depth.

• International Journal of Advanced Culture Technology
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• 제11권4호
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• pp.177-192
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• 2023

A prerequisite for a lasting ceasefire is the emergence of a prevailing view in Moscow and Kyiv that the fighting has reached a hurting stalemate. In sum, they both lose more through continuing warfare than by a ceasefire. This study applies social identity dynamics of nationalism to this escalatory conflict. It generates findings that imply that China as a third-party great power intervening mediator can potentially play a pivotal role. Shifting the respective prevailing views in Moscow and Kyiv of their interaction from a zero-sum foundation requires proffering powerful economic and political third-party incentives. Effective inducement would facilitate national defense, development and prestige for Moscow as well as Kyiv. China arguably has the underutilized potential power capabilities necessary to alter the respective prevailing views of strategic relationships among the great powers within Moscow, Brussels and Washington. A prerequisite for success in striving effectively towards this strategic goal is cooperation with the Beijing despite skepticism from Washington. This study utilizes a process tracing methodological approach. It highlights that the foundations of the Russo-Ukraine war lie in the institutionalization within Euro-Atlantic integration of the Cold War assumption that the USSR was an imperialist revisionist actor. Russia is the USSR's successor state. Moscow's prevailing view is that Russian national self-determination was unjustly circumscribed in the multinational Soviet totalitarian Communist system. The Euro-Atlantic community is perceived as a neocolonial imperial threat by allying with post-1991 Ukrainian nationalism at Russia's expense. The study finds that acknowledging Eurasian regional multipolarity is necessary, if not sufficient, to coopt Beijing into a global political stabilization strategy. It functionally aims to promote international balancing to lessen potentials for horizontal as well as vertical escalation of the Russo-Ukrainian conflict.

• 벤처창업연구
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• 제15권4호
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• pp.83-96
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• 2020

시장경제의 메커니즘으로 해결이 어려웠던 다양한 사회적 문제는 정부 주도의 사회적 기업 등의 비영리단체가 해결해야한다는 고정관념을 벗어나, 최근 혁신적인 아이디어에 기반하여 사회적 문제를 해결하고 이러한 과정에서 사회적 가치와 경제적 가치를 함께 창출하는 소셜벤처에 대한 관심이 증대되고 있다. 소셜벤처의 의사결정 프로세스와 성과를 이해하기 위해서는 기존 경제적 가치에 집중하는 스타트업과 영리추구를 배제하는 비영리단체를 분석하는 방법과는 차별화된 접근이 필요하다. 그럼에도 불구하고 국내 안정적인 사업 궤도에 진입하는 데 성공한 소셜벤처는 상대적으로 부족하다. 특히 소셜벤처의 초기 창업 단계 및 죽음의 계곡을 극복해나가는 과정에 대한 직접적인 관찰과 조사는 현실적으로 쉽지 않다. 이에 본 연구에서는 청각장애인 택시기사들이 직접 운행할 수 있는 서비스를 개발하고 성공적으로 창업하여 성장하고 있는 '고요한택시'를 단일사례 연구방법으로 분석하였다. 창업 초기부터 현재까지 주요 전략적 의사결정 과정을 직접 관찰과 심층 인터뷰를 통해 수집된 다양한 맥락 정보를 분석한 결과, '몰입상승효과에 대한 방어기제'와 '사회적 및 경제적 가치 추구의 직교성'의 주요 의사결정 메커니즘을 파악하였다. 이러한 연구결과는 사회적 기업가들이 처한 높은 환경적 불확실성에 대응하기 위한 실무적 방안으로 활용될 수 있을 것이다. 본 연구는 탐색적 연구로서 단일사례 분석 방법을 적용한 연구결과의 일반화 범위는 제한적이나, 향후 다양한 관점에서 소셜벤처의 특성을 규명하는 학술적 논의를 마련하는데 의의를 가진다.