• 대한간호학회지
• /
• 제46권5호
• /
• pp.697-709
• /
• 2016

Purpose: This study was conducted to develop and test a structural model of evidence-based practice (EBP) implementation among clinical nurses. The model was based on Melnyk and Fineout-Overholt's Advancing Research and Clinical Practice through Close Collaboration model and Rogers' Diffusion of Innovations theory. Methods: Participants were 410 nurses recruited from ten different tertiary hospitals in Korea. A structured self-report questionnaire was used to assess EBP knowledge/skills, EBP beliefs, EBP attitudes, organizational culture & readiness for EBP, dimensions of a learning organization and organizational innovativeness. Collected data were analyzed using SPSS/WINdows 20.0 and AMOS 20.0 program. Results: The modified research model provided a reasonable fit to the data. Clinical nurses' EBP knowledge/skills, EBP beliefs, and the organizational culture & readiness for EBP had statistically significant positive effects on the implementation of EBP. The impact of EBP attitudes was not significant. The dimensions of the learning organization and organizational innovativeness showed statistically significant negative effects on EBP implementation. These variables explained 32.8% of the variance of EBP implementation among clinical nurses. Conclusion: The findings suggest that not only individual nurses' knowledge/skills of and beliefs about EBP but organizational EBP culture should be strengthened to promote clinical nurses' EBP implementation.

• KSBB Journal
• /
• 제18권4호
• /
• pp.329-334
• /
• 2003

Insulin-like growth factor-I (IGF-I) 유전자의 발현은 사람 및 쥐에서 두 개의 promoters (P1과 P2)로부터의 전사와 alternative RNA splicing 및 differential RNA polyadenylation과 같은 복잡한 기전들에 의하여 조절되는데 조직에 따라 성장호르몬을 포함한 여러 요소들이 관여하는 것으로 알려져 있다. 또한 사람의 IGF-I 유전자 exon 1의 upstream에 존재하는 P1에 hepatocyte nuclear factor l$\alpha$와 CAAT/enhancer-binding protein (C/EBP) isoform 들이 결합하여 조직 및 발달단계 특이한 발현에 중요한 역할을 할 것으로 제안되었지만, exon 1의 downstream sequence가 IGF-I 유전자의 조직 특이적 발현을 조절하는 지에 대하여는 연구되어 있지 않다. 연령이 다른 쥐의 간 및 뇌 조직에서 total RNA를 분리하고 solution hybridization/RNase protection 방법으로 분석하여 IGF-I 유전자의 발현이 태어난 후 간 조직에서는 점차적으로 증가하였지만 뇌조직에서는 감소하여 발달단계에 따라 조직 특이하게 발현되는 것을 확인하였다. IGF-I exon 1의 주요한 전사 개시점으로부터 아래쪽에 존재하는 C/EBP 결합부위를 포함하고 있는 cis-acting element에 해당하는 oligonucleotide들과 간 및 뇌조직에서 분리한 핵단백질들을 이용하여 DNA-결합 활성을 가진 분자량이 다른 C/EBP$\alpha$나 C/EBP$\beta$ 단백질들을 확인하였으며 southwestern 및 western immnoblotting 분석을 하여 간 조직의 핵 추출물에서는 42$^{C}$EBP$\alpha$/, 와 p38$^{C}$EBP$\alpha$/, p35$^{C}$EBP$\alpha$/, p38$^{C}$EBP$\beta$/, 그리고 p35$^{C}$EBP$\beta$/가 IGF-I exon 1 oligonucleotide와 복합체를 형성하고 뇌 조직에서는 p42$^{C}$EBP$\alpha$과 p38$^{C}$EBP$\beta$가 복합체 형성에 관여하는 것으로 나타났다. 이러한 결과들은 FRE-C/EBP isoform 복합체 형성이 IGF-I 유전자 발현의 조직 특이적 조절에 중요한 역할을 할 것으로 제안한다.할을 할 것으로 제안한다.

• PNF and Movement
• /
• 제15권2호
• /
• pp.115-124
• /
• 2017

Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed's My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.

• 한국임상보건과학회지
• /
• 제5권4호
• /
• pp.1009-1014
• /
• 2017

Purpose. This study compared the awareness of the evidence-based practice(EBP) in 100 physical and occupational therapists. Methods. A questionnaire on awareness was conducted to examine the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. A questionnaire consisted of items on the general characteristics, the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP of the subjects. Data analysis was made by IBM SPSS Statistics Ver. 20. The EBP awareness was examined by the independent t-test. Results. For the attitude toward EBP, there was a statistically significant difference in the item of 'Therapists should judge whether they apply study results to individual patient. For the educational experience of EBP, there was no statistically significant difference in all items. For the performance ability of EBP, there was a statistically significant difference in the item about the ability to understand patient's desire for treatment and treatment preference and the item about the ability to determine appropriate treatment process in cooperation with patients. Conclusions. Both two groups showed very low results in the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. Therefore, it is necessary to enhance EBP education in undergraduate programs and the clinical field.

• 간호행정학회지
• /
• 제22권5호
• /
• pp.448-460
• /
• 2016

Purpose: The study was done to verify evidence-based practice (EBP) readiness and factors contributing to EBP competency in general hospital nurses. Methods: Participants were 219 nurses working in 7 general hospitals in G-city and J Province. Data were collected from May 12 to May 28, 2015 and analyzed using one-way ANOVA, Pearson's correlation and stepwise multiple regression. Results: Mean score for EBP competency was $3.89{\pm}0.83$, for critical thinking disposition, $3.35{\pm}0.36$, for EBP attitude, $3.53{\pm}0.66$, for beliefs about value of EBP, $3.42{\pm}0.56$, for ability in research performance, $2.86{\pm}0.57$, for time to devote to EBP, $2.57{\pm}0.69$ and for organization support for EBP, $3.36{\pm}0.46$. EBP competency was significantly correlated with critical thinking disposition (r=.37, p<.001), beliefs about value of EBP (r=.43, p<.001), ability in research performance (r=.44, p<.001), and time to devote to EBP(r=.33, p<.001). Factors influencing EBP competency in general hospital nurses were research performance (${\beta}=.29$, p<.001), beliefs about value of EBP (${\beta}=.24$, p<.001), critical thinking disposition (${\beta}=.15$, p=.014), recognition of EBP (${\beta}=-.18$, p=.002), which together explained 35% of total variance. Conclusion: Findings indicate that introduction and activation of EBP in general hospitals is essential and development of systematic training programs to strengthen critical thinking disposition and EBP competency are needed.

• 재활치료과학
• /
• 제1권2호
• /
• pp.41-53
• /
• 2012

목적 : 본 연구는 한국 작업치료사들의 근거기반 치료(Evidence-Based Practice; EBP)에 대한 인식도, 임상적 의사결정에 사용하는 근거자원, EBP 실행을 방해하는 요인을 조사하고자 하였다. 연구방법 : 2009년 12월부터 3월까지 임상에 있는 작업치료사들에게 총 500부를 배부하였고, 그 중 회수된 160부(32%)를 기술통계를 통해 분석하였다. 결과 : 설문의 응답자는 남성보다 여성이 많았고, 치료경력이 5년 미만인 치료사가 전체의 90% 이상을 차지하였다. 응답자의 대부분은 EBP와 관련된 교육 경험이 없고(76%), 현재 실시하지 않는 것(55%)으로 나타났다. 또한 치료 시 활용하는 근거자원도 주관적인 판단이었다. 그러나 인식도 조사에서 EBP를 통해 작업치료사의 전문성이 향상될 수 있고(96%), 임상적인 판단에 도움을 준다고(88%) 응답하였다. 치료사의 대부분은 EBP 적용을 위해 도움을 줄 수 있는 개선책으로 근거자원 탐색을 위한 시간적인 여유 확보(90%)와 교육과정 참여가 필요(92%)였다. 이와 같은 결과는 임상 현장에서 EBP에 대한 적용 정도는 낮으나 인식도는 높은 것을 보여주어 향후 EBP에 대한 교육프로그램 활성화의 필요성을 간접적으로 제시하였다. 결론 : 한국 작업치료가 질 좋은 서비스를 제공하기 위해 적극적인 교육과정 개설과 강사 개발이 필요하고, 전국 대학의 작업치료전공 학생들이 근거기반의 교육을 받을 수 있도록 힘써야 할 것이다. 또한 작업치료사의 전문성을 향상시키기 위한 EBP가 조속히 이루어져 하고, 그에 교육프로그램과 그 효과성에 대한 연구가 끊임없이 이루어져야 할 것이다.

• 대한간호학회지
• /
• 제46권4호
• /
• pp.501-513
• /
• 2016

Purpose: The current challenges faced by nurses in providing high quality and evidence-based practice (EBP) supported care require profound changes in nursing education. To understand the changes needed to strengthen EBP education, the researchers examined EBP self-efficacy, course needs, barriers, and facilitators for academic faculty and clinical nurse preceptors to teach EBP in undergraduate nursing curricula. Methods: For this study, mixed-method approach was used with survey data collected from 73 academic faculty members from 54 universities. Further, 17 clinical nurse preceptors in three academic hospitals provided qualitative data for exploration of barriers and facilitators to teaching EBP. Data analysis used SPSS/WIN 21.0 and content analysis. Results: Quantitative data showed that although the overall level of self-efficacy among faculty was moderate, the implementation levels were relatively low. Most faculty members agreed with the need to integrate EBP courses into undergraduate nursing curricula. The qualitative data showed that the barriers to teaching EBP were lack of knowledge, skill, and initial investment for teaching EBP; hierarchical, rules-oriented nursing culture; potential learner overloads in processing EBP; limited research dissemination and application. Facilitators were identified as the importance of EBP to the profession of nursing; collaboration in schools and hospitals; and continuing education in teaching/utilizing EBP. Conclusion: The findings indicate that for successful integration of EBP ni nursing education there is a need for faculty training and integrated EBP courses.

• The Korean Journal of Physiology and Pharmacology
• /
• 제20권6호
• /
• pp.649-655
• /
• 2016

TonEBP belongs to the Rel family of transcription factors and plays important roles in inflammation as well as kidney homeostasis. Recent studies suggest that TonEBP expression is also involved in differentiation of several cell types such as myocytes, chondrocytes, and osteocytes. In this study, we investigated the roles of TonEBP during adipocyte differentiation in 3T3-L1 cells. TonEBP mRNA and protein expression was dramatically reduced during adipocyte differentiation. Sustained expression of TonEBP using an adenovirus suppressed the formation of lipid droplets as well as the expression of FABP4, a marker of differentiated adipocytes. TonEBP also inhibited the expression of $PPAR{\gamma}$, a known master regulator of adipocytes. RNAi-mediated knock down of TonEBP promoted adipocyte differentiation. However, overexpression of TonEBP did not affect adipogenesis after the initiation of differentiation. Furthermore, TonEBP expression suppressed mitotic clonal expansion and insulin signaling, which are required early for adipocyte differentiation of 3T3-L1 cells. These results suggest that TonEBP may be an important regulatory factor in the early phase of adipocyte differentiation.

• The Korean Journal of Physiology and Pharmacology
• /
• 제11권3호
• /
• pp.135-138
• /
• 2007

Hypertonicity imposes a great deal of stress to cells since it causes rise in cellular ionic strength, which can be reduced by the accumulation of compatible osmolytes. TonEBP plays a central role in the cellular accumulation of compatible osmolytes via transcriptional stimulation of membrane transporters and aldose reductase. Alternatively spliced forms of TonEBP mRNA have previously been reported and two of them showed different transcriptional activity. In the present study, isoform-specific antibodies were produced to confirm the translation of the spliced mRNA to protein. TonEBP was immunoprecipitated by using anti-TonEBP antibody and then immunoblotted using anti-TonEBP or isoform specific antibodies to find out the expression profile of TonEBP isoforms in basal or stimulated condition. From these results, we conclude that all TonEBP isoforms are expressed in mammalian cells and their expression patterns are not same in every cells.

• 한국융합학회논문지
• /
• 제9권2호
• /
• pp.13-18
• /
• 2018

본 논문은 다층을 갖는 네트워크를 가장 효율적으로 학습하는 것은 결국 최적의 가중치 벡터의 집합을 찾아가는 과정이라는 간단한 접근 방법을 기본으로 하고 있다. 일반적인 학습 문제의 단점을 극복하기 위해 제안 모델에서는 EBP와 OVSSA의 특징들을 결합한 방법을 사용한다. 즉 EBP가 지역 최소치에 빠질 수 있는 성질을 보강하기 위해 OVSSA의 확률이론으로 빠져나갈 수 있도록 제안 방법은 각각 알고리즘의 장점만을 취하여 하나의 모델을 구성한다. 제안 알고리즘에서는 EBP에서 오류를 줄이기 위한 방법들을 에너지함수로 사용하고, 이 에너지를 OVSSA로 최소화 하는 방법을 사용하였다. 두 가지의 상이한 성질을 가지는 알고리즘이 합쳐질 수 있음을 간단한 실험 결과를 통해 확인한다.