• 가족자원경영과 정책
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• 제15권4호
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• pp.43-64
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• 2011

This study suggests policies to rearrange the status of Health Family Support Centers, targeting hands-on workers and centering on collected problems and improvements. To attain this aim, the study rearranged the materials investigated in 2009. On this basis, the study suggests the following policies. First, Health Family Support Centers changed into Korean Institute Healthy family which could prepare a means for opinion convergence through base organizations. Thus, it is necessary to establish a Gyeonggi-do wide area Health Family Support Center. Second, space and human resource arrangement, suitable to business, are necessary, and so are stable, secure finances. Third, urban areas, agricultural villages, and fishing villages are distributed across Gyeonggi-do. Thus, the development of specialized business, suitable to Gyeonggi-do, is necessary. Consequently, this study suggests executing obligatory family education (education for engaged couples, education for parents). Fourth, case management models, unique to Health Family Support Centers, have to be developed, as well as unified services related to education, counseling, and cultural businesses. Fifth, the Health Family Support Center has to secure its own status as a hub organization of inter-regional family businesses, has to strengthen its organizational identity, and has to promote suitable business development.

• 한국치위생학회지
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• 제16권4호
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• pp.499-506
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• 2016

Objectives: The purpose of the study is to investigate the participation motivation and satisfaction of continuing education in the dental hygienists. Methods: A self-reported questionnaire was completed by 900 dental hygienists in Seoul and Gyeonggido in continuing education 2015. The questionnaire consisted of general characteristics of the subjects (7 items), continuing education requirements (6 items), and continuing education evaluation (9 items). Cronbach's alpha was 0.859 in participation motivation and 0.901 in satisfaction. Likert five point scale was used. Data were analyzed by SPSS 22.0 program. Results: The priorities of the contents were as follows; patient care and counseling(49.0%), the latest information and technology(43.9%), middle management roles(23.3%), health care management(17.6%), and lecture studies(4.4%) in order by multiple responses survey. The favorite instructors were specialized dental hygienist(52.3%). The ideal pay for education fee was 50 percent supported by the institution. The best official announcement of education was e-mail. The participation motivation of education was 4.45 points and was focused on the education completion issue. The lowest score was 2.77 of development of human relationships between participants. The choice for instructor was 3.43 and the lowest score was 2.49 of education fee. Overall satisfaction score was 3.04. Conclusions: Diversification of the continuing education is very important. It is necessary to develop and implement the education methods and to train the dental hygiene specialists for the education.

• 대한임상독성학회지
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• 제11권2호
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• pp.81-88
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• 2013

Purpose: The aim of this study is to investigate current status, indications, and complications of hyperbaric oxygen therapy. Methods: A retrospective investigation of patients who underwent hyperbaric oxygen therapy at a university medical center from September 2004 to August 2013 was conducted based on patients' medical records and results of an email survey for 99 emergency centers. Results: During the study period, a total of 233 patients underwent hyperbaric oxygen therapy. Indications for hyperbaric oxygen treatment of illness or injury were as follows: 1) 151 cases of acute carbon monoxide poisoning(65.4%), 2) flap wound management, including 42 cases(18.2%), 3) skin care transplanted, including 23 cases(10.4%), 4) Burger's disease, including 5 five cases(2.1%), respectively. Total application time$^*$ frequency was 1,088 and total time was 1,239 hours. Among 233 patients who underwent hyperbaric oxygen therapy, 32 patients(13.7%) had complications: 1) otalgia in 21 cases(9.0%), 2) mastoiditis?in six cases(2.6%), 3) hemotympanum in five cases(2.1%), respectively. There were only 8 emergency centers that currently had an operational hyperbaric oxygen chamber in 77 emergency centers(10.4%). Conclusion: Indications identified through this study showed difference from current indications worldwide. It seems necessary that physicians' perception regarding application of hyperbaric oxygen therapy for more indications be changed and improved. A hyperbaric chamber capable of providing respiratory assistance and intensive care is also needed. A good network for sharing treatment experiences and a specialized team for administration of hyperbaric oxygen therapy is also required.

• Journal of Korean Neurosurgical Society
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• 제66권3호
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• pp.228-238
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• 2023

Intraventricular hemorrhage (IVH) is a serious concern for preterm infants and can predispose such infants to brain injury and poor neurodevelopmental outcomes. IVH is particularly common in preterm infants. Although advances in obstetric management and neonatal care have led to a lower mortality rate for preterm infants with IVH, the IVH-related morbidity rate in this population remains high. Therefore, the present review investigated the pathophysiology of IVH and the evidence related to interventions for prevention. The analysis of the pathophysiology of IVH was conducted with a focus on the factors associated with cerebral hemodynamics, vulnerabilities in the structure of cerebral vessels, and host or genetic predisposing factors. The findings presented in the literature indicate that fluctuations in cerebral blood flow, the presence of hemodynamic significant patent ductus arteriosus, arterial carbon dioxide tension, and impaired cerebral venous drainage; a vulnerable or fragile capillary network; and a genetic variant associated with a mechanism underlying IVH development may lead to preterm infants developing IVH. Therefore, strategies focused on antenatal management, such as routine corticosteroid administration and magnesium sulfate use; perinatal management, such as maternal transfer to a specialized center; and postnatal management, including pharmacological agent administration and circulatory management involving prevention of extreme blood pressure, hemodynamic significant patent ductus arteriosus management, and optimization of cardiac function, can lower the likelihood of IVH development in preterm infants. Incorporating neuroprotective care bundles into routine care for such infants may also reduce the likelihood of IVH development. The findings regarding the pathogenesis of IVH further indicate that cerebrovascular status and systemic hemodynamic changes must be analyzed and monitored in preterm infants and that individualized management strategies must be developed with consideration of the risk factors for and physiological status of each preterm infant.

• Journal of Trauma and Injury
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• 제23권2호
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• pp.113-118
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• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

• 한국산학기술학회논문지
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• 제16권7호
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• pp.4641-4650
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• 2015

본 연구는 지방의료원의 고객세분화를 통하여 향후 전문화된 의료기관으로 진료전문성을 강화하여 경쟁력을 확보할 수 있는 진료전문화 전략을 제시하는데 목적이 있다. 조사기간은 2013년 1월부터 12월까지 입원한 환자 26,658명을 연구대상을 선정하였다. 분석방법은 군집분석과 의사결정나무분석을 이용하였다. 결론을 보면, 성별은 여자, 연령은 60세 이상, 질환별로는 근 골격계 및 결합조직의 질환이 충성고객으로 선정되었다. 이들은 지방의료원의 고객관리측면에서 향후 구전의 효과가 높은 고객 군으로 금전적인 소비규모가 높은 점을 고려하여 이들에게 제공된 의료서비스에 대한 모니터링과 커뮤니케이션을 통해 지속적인 관계를 유지하는 것이 중요하다. 앞으로 전문 분야의 전문의와 전문적 시설 확보 등의 적합한 조직구조와 환경을 갖추는 것이 중요하며, 지역 내 개원의, 유관기관간의 전략적 제휴 통한 진료협력 및 의뢰, 의료서비스 범위의 집중화가 필요하다.

• 문화기술의 융합
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• 제6권3호
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• pp.19-26
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• 2020

본 연구는 근대(1876-1945) 한국사회의 전염병에 대한 사회적 의미와 변화 과정 속에서 간호사의 역할에 대하여 규명함으로써 간호역사를 이해하고 간호의 새로운 방향을 제시하는 데 목적이 있다. 이를 위해 근대 사회의 전염병의 시대적 의미와 관리에 관하여 살펴 보았다. 지난 역사 속에서 전염병은 사회에 많은 문제점을 일으켰고 피해를 최소화하기 위해 많은 노력을 지속적으로 실시하였다. 전염병 관리를 위한 노력이 다른 나라에 비해 늦게 시작 되었지만 지속적인 노력 끝에 위생이라는 개념이 인식되기 시작하면서 전염병의 의미 및 간호의 의미가 다르게 해석되었다. 또한 전염병 관리를 위한 지속적인 노력 속에서 간호사의 역할과 존재감이 새롭게 조명되었다. 근대 한국사회에서 간호사의 역할이 초반에는 보조자의 역할로 인식되었다. 하지만 전문적 교육과 훈련을 통해 단순한 돌봄이 아닌 전문적 지식을 바탕으로 이루어진 전문가로써 인식이 넓혀지기 시작하였다. 본 연구는 과거와 현재 공존하면서 다양한 문제를 일으키고 있는 전염병에 대한 역사적 재탐색을 하였다는 것에 의의가 있다. 또한 간호사의 새로운 역할과 사명감을 새롭게 조명했다는 것에 의의가 있다.

• 한국식생활문화학회지
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• 제34권4호
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• pp.389-400
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• 2019

In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

• 한국학교ㆍ지역보건교육학회지
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• 제2권1호
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• pp.41-52
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• 2001

The purpose of this research is to plan the activation of university health business through the appraisal of the function and role of university health centers. To be more specific: Firstly, analyze the facility, personnel, health service of the health centers, Secondly, appraise the role and function of the health centers, and Thirdly, consider the activation plans of health centers. The research method taken was the study of surveys conducted and written research materials on 5 women's universities in Seoul. These materials where descriptively analyzed by converting the surveys, facility and usage of health center and current personnel status in to percentage. The major results of the research are as follows: Unlike as stated in each university's additional clause on the number of personnel were working. This lack of specialized personnel resulted into lack of specialized and various services. Medicine for external application were stocked well whereas only simple medicine for internal application were on shelf and were issued only with a doctor's prescription. Universities with a full-time doctor had various available equipments. One university conducting dental treatment was equipped with indirect chest camera, dental X-ray, unit, chair(dental treatment chair) and even supersonic, electrocardiogram were available. In the case of D women's university, the number of beds compared to the number of students was lower than that of the other 3 universities, to the total size of the university was smaller than that of the other 3 universities. Among health prevention and care matters, health consultation was the only matter practised by all universities. Uniquely, there was one university that hosted epidemic prevention business. There are various tests given by each university, with each showing many differences, but some universities did not even conduct these tests. Vaccinations were usually being conducted through commission. All universities provided basic treatment, therefore matters concerning treatment at health centers were being conducted well. Concerning the management of equipment and documents, all the matters were being conducted except one university where instead of a student medical record, they were using a daily record. Because these were women's universities, most of the educations were on women's health. The subjects of these educations included: sex, contraception, prevention and control of tuberculosis, obesity, mouth hygiene, alcohol, geriatric disease, mental health and first-aid. The rate of health center usage is growing. Being women's universities, the service and treatment practised were mostly concerning sex education.

• Molecules and Cells
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• 제37권6호
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• pp.441-448
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• 2014

Inflammasomes are specialized signaling platforms critical for the regulation of innate immune and inflammatory responses. Various NLR family members (i.e., NLRP1, NLRP3, and IPAF) as well as the PYHIN family member AIM2 can form inflammasome complexes. These multiprotein complexes activate inflammatory caspases (i.e., caspase-1) which in turn catalyze the maturation of select pro-inflammatory cytokines, including interleukin (IL)-$1{\beta}$ and IL-18. Activation of the NLRP3 inflammasome typically requires two initiating signals. Toll-like receptor (TLR) and NOD-like receptor (NLR) agonists activate the transcription of pro-inflammatory cytokine genes through an NF-${\kappa}B$-dependent priming signal. Following exposure to extracellular ATP, stimulation of the P2X purinoreceptor-7 ($P2X_7R$), which results in $K^+$ efflux, is required as a second signal for NLRP3 inflammasome formation. Alternative models for NLRP3 activation involve lysosomal destabilization and phagocytic NADPH oxidase and /or mitochondria-dependent reactive oxygen species (ROS) production. In this review we examine regulatory mechanisms that activate the NLRP3 inflammasome pathway. Furthermore, we discuss the potential roles of NLRP3 in metabolic and cognitive diseases, including obesity, type 2 diabetes mellitus, Alzheimer's disease, and major depressive disorder. Novel therapeutics involving inflammasome activation may result in possible clinical applications in the near future.