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소아청소년 양극성 장애의 임상 경과 (Clinical Course of Bipolar Disorder in Children and Adolescents)

  • 강나리;곽영숙
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제23권1호
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    • pp.3-7
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    • 2012
  • Objectives : The early onset of mood symptoms in bipolar disorder has been associated with poor outcomes in many studies. However, aspects of the clinical course of bipolar disorder in children and adolescents are controversial. The goal of this article is to review the clinical characteristics and longitudinal course of children and adolescents with bipolar disorders. Methods : Searches were conducted in MedLine, PsycINFO, KISS, and RISS using the terms phenomenology, clinical course, outcome, BPD, pediatric, children and adolescents. Twenty-one reports were selected : either original articles reporting symptoms and clinical characteristics of subjects (ages 5-18 years), or published articles in reviewed journals about bipolar disorder in children and adolescents. Results : Approximately 70% of subjects with bipolar disorder recovered from their index episode, and 50% had at least 1 syndromal recurrence, particularly depressive episodes. For 60% of the follow-up time, subjects had syndromal or subsyndromal symptoms with numerous changes in symptoms and shifts of polarity. Approximately 20% of BP-II subjects converted BP-I. Conclusion : Bipolar disorders in children and adolescents are characterized by episodic illness with subsyndromal and syndromal episodes with mainly depressive and mixed symptoms and rapid mood changes. Extensive follow-up time is needed to evaluate the continuity of bipolar disorder symptoms from childhood to adulthood.

일차진료 항생제 치료기간과 비인두 항생제 내성률에 대한 연구 고찰 (A Review of Studies on Antibiotic Course and Antibiotic Resistance in Nasopharyngeal Pathogens in Primary Care Setting)

  • 신향화;이선행;윤성중;장규태
    • 대한한방소아과학회지
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    • 제32권2호
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    • pp.64-71
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    • 2018
  • Objectives The purpose of this study is to examine the correlation of antibiotics administration duration and antimicrobial resistance by reviewing domestic and foreign literatures. Methods We searched literatures dated up to 23 February, 2018 in PubMed and Cochrane Library using terms of "Anti-Bacterial Agents", "Carrier State", "Nasopharynx", "Drug Administration Schedule", and also searched via RISS (Research Information Service System), KISS (Koreanstudies Information Service System), DBpia (DataBase Periodical Information Academic) using terms of antibiotics, resistance, and dose. Results In comparison with shortened and standard antibiotic course, longer treatment duration is associated with greater antimicrobial resistance or non-significant difference, but we cannot find literature that shortened antibiotic course increases antimicrobial resistance on human nasopharyngeal flora. Conclusions Currently, there is no evidence that completing the standard antibiotic course reduces antimicrobial resistance. It can be a strategy for reducing antibiotic use to apply Korean medicine treatment, as well as short-course antibiotic therapy or delayed antibiotic prescription. Additional well-designed trials should be conducted in domestic and foreign settings about the appropriate duration of antibiotic therapy.

일 대학병원 정신분열병 환자의 퇴원 후 경과에 미치는 치료적 요인 (The Therapeutic Factors Affecting Post-discharge Course of Schizophrenia Patients in a University Hospital)

  • 남정현;노성원;최준호;이경우
    • 생물정신의학
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    • 제13권1호
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    • pp.26-31
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    • 2006
  • Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

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영남대학교 의과대학 의예과 교육과정 개발과 편성 사례 (Curriculum Development for Preclinical Medical Education at Yeungnam University)

  • 김성용
    • 의학교육논단
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    • 제19권3호
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    • pp.138-144
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    • 2017
  • After Yeungnam University's College of Medicine was established in 1979, the curriculum for a preclinical medical education course was developed and implemented. Several modifications have since been made to the curriculum which was driven by changes in national policies and in the medical education environment. In recent years, it has become necessary to complement the weaknesses or shortcomings in the curriculum that were discovered during the basic medical education assessment process of the medical college. Since 2009, Yeungnam University has run two medical courses: a 6-year college of medicine course and a 4-year medical school course. However, as a result of changes in national policy, Yeungnam University decided to offer only the 6-year college of medicine course with an entirely new curriculum which will be implemented in 2017. The new curriculum for the preclinical medical education course consists of 36 credits of cultural essentials courses, 44 credits of major required courses, and 2 credits of major elective courses. The curriculum development requires the support of the university and/or college, the ensured independence of the curriculum development organization, and the cooperation and attention of fellow professors. Continuous efforts are needed to check, evaluate, and improve the curriculum.

간호교육 프로그램학습성과 평가를 위한 Course Embedded Assessment(CEA) 적용방안 기초연구 (A Study on application Course Embedded Assessment(CEA) for Program Outcome Assessment in Nursing Education)

  • 남성미
    • 한국산학기술학회논문지
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    • 제16권5호
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    • pp.3121-3130
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    • 2015
  • 본 연구는 간호교육 인증평가의 핵심인 프로그램학습성과 평가에 Course embedded Assessment(CEA)를 적용하기 위한 기초연구로 시행되었다. 선행연구과 미국대학 평가 사무국의 자료를 통해 CEA의 개념, 장 단점, 단계, 적용 시 주의사항 등을 고찰하였으며, 이를 근거로 간호교육 프로그램학습성과 평가체계에 적합한 CEA모형과 세부지침을 제시하였다. CEA 과정은 프로그램학습성과 설정, 학습성과의 가중치 산정, 교육과정에 연계, 루브릭 개발, 평가, 결과 및 성과달성도 분석, 교육과정개선을 위한 피드백으로 구성하였으며 선행연구에서 제시된 단점과 주의사항을 보완하여 시행 지침을 작성하였다. 본 연구를 토대로 간호교육 프로그램학습성과평가 체계를 구축한다면 학생의 성장과 성취에 대한 일관성 있는 평가와 지속적인 교육과정 개선으로 간호교육의 질적 향상에 기여할 것으로 사료된다.

Short-course Versus Long-course Preoperative Radiotherapy plus Delayed Surgery in the Treatment of Rectal Cancer: a Meta-analysis

  • Liu, Shi-Xin;Zhou, Zhi-Rui;Chen, Ling-Xiao;Yang, Yong-Jing;Hu, Zhi-De;Zhang, Tian-Song
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5755-5762
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    • 2015
  • Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

Short-course hypofractionated radiochemotherapy for unresectable locally advanced cancer of the base of tongue: palliation only? A case report and short review of the literature

  • Kalogeridi, Maria-Aggeliki;Kouloulias, Vassilios;Zygogianni, Anna;Kyrgias, George
    • Radiation Oncology Journal
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    • 제32권2호
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    • pp.99-102
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    • 2014
  • We present a case of unresectable cancer of the base of tongue treated with hypofractionated 3D conformal radiotherapy and concomitant chemotherapy. Based on the excellent tumour response in this radiotherapy regimen and international experience in short course treatments we shortly reviewed, we propose that this therapeutic approach could be considered in a curative setting for patients unsuitable for the a standard long course radiochemotherapy schedule.

노인간호학 교과과정 모형개발 (Development of Gerontological Nursing Curriculum Model)

  • 송미순;김귀분;김주희;김희경;신경림
    • 대한간호학회지
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    • 제33권3호
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    • pp.376-385
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    • 2003
  • Purpose: This study was conducted to develop gerontological curriculum model which reflects the need of Korean society. Method: Three round Delphi survey method was applied to find consensus of gerontological nursing competencies (knowledge, attitudes and skills) for graduates of nursing schools from the panel of gerontological nursing practice experts. Important concepts in gerontological nursing were delineated from literature review and discussions of gerontological nursing educators. Based on these results the gerontological nursing curriculum model was developed and course structure outlined by the researchers as a group. Result: As the result of delphi survey, 32 items of knowledge, 29 items of attitude, and 21 items of skill were identified. The curriculum model constructed around a cube with three plane- functional capacity levels, settings, and nursing practice. Specific knowledge, attitudes and skills for gerontological theory and practicum course were suggested. Competency items were assigned to theory and/or practice. Conclusion: A curriculum model for gerontological nursing has been developed by a group of gerontological nursing educators. The curriculum model should be further tested and developed with detailed theory and practicum course outline and textbooks.

스프레드시트를 기반으로 한 새로운 경영과학 강의 방식 (Spreadsheet-based Educational Method for Management Science)

  • 정기호
    • 경영과학
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    • 제19권2호
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    • pp.41-58
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    • 2002
  • New attempt has been made on Management Science (MS) education since the end of 1990s. The most distinctive feature of the new attempt is using spreadsheet program like Excel as a teaching tool for MS course. The spreadsheet program gives an excellent tool for modeling and solvina MS problems. In order to improve the pedagogical effect through using the spreadsheet program for MS course, new teaching model based on spreadsheet encompassing new course contents, effective instruction method, and examination method is needed. For this purpose, professors teaching MS should share their own teaching experiences and methods. So this paper explains remarkable functions of Excel and how to use them for the MS tools. This paper also stresses the importance of team project and case study to improve the effect of MS education through the use of Excel and presents some tips on MS education.