• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제6권1호
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• pp.109-115
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• 1995

2세 10개월된 중증 정신지체아동의 이미증 치료에서 지시따르기 훈련을 통한 장난감 놀이지도(DRO)와 이미증 제재수단으로 얼굴가리개(Facial Screening)가 사용되었다. 이 아동의 이미증은 주로 손가락 빨기, 장난감 입에 넣고 빨기, 주위의 물건에 닥치는 대로 입을 대고 빠는 형태이다 빠는 행위의 발생은 장난감 놀이지도 전에는 15분 당 평균 18.6회였으나, 놀이지도 기간에는 평균 5.4회, 얼굴가리개를 통해 빠는 행위를 제재한 치료기간에는 평균 2.3회로 감소되어, 얼굴가리개의 사용이 이 아동의 이미증 치료에 큰 효과를 보였다. 이 아동은 이미증 이외에 구토행위를 보였는데, 본 연구에서는 구토행위를 치료하지 않았으나, 놀이지도 및 이미증 치료기간 동안 구토행위가 저절로 감소된 현상을 보인 것은 기존 연구에서 밝혀진 바와 같이 한 행동의 치료가 다른 문제행동의 감소에 영향을 줄 수 있음을 증명하고 있다.

• 농촌의학ㆍ지역보건
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• 제27권1호
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• pp.155-164
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• 2002

본 연구는 일개 보건지소에 등록된 고혈압 환자의 치료율 및 관리율을 구하고 치료지속성과 관련성이 있는 변수를 파악하고 치료중단 이유를 조사하기 위하여 2000년 11월 이전에 군남면 보건지소에 등록되어 치료받고 있는 고혈압 환자 295명을 대상으로 하여, 의무기록조사와 전화설문조사를 병행하여 실시되었다. 그 결과는 다음과 같다. 1. 대상자 295명중 남자가 108명(36.6%), 여자가 187명 (62.7%)이었으며 평균연령은 남자 64.6세, 여자 66.3 세로 여성에서 더 높았다(p<0.05). 2. 대상자의 54.9%가 지속적인 치료를 받는 것으로 조사되었고, 간헐적 치료군이 19.3%, 치료중단군이 25.8%였다. 3. 성, 연령, 의료보장, 거주지 등 연구대상자의 특성중 거주지로부터 보건지소까지 이동시 소요되는 시간만이 치료지속성과 통계적으로 유의한 관련성이 있었다(p<0.01). 3. 치료중단의 이유로는 증상 또는 몸의 불편함이 없어서가 23.9%를 차지하였고 그 다음으로 타의료기관 이용(18.4%), 교통의 불편(17.9%), 약국 이용(14.9%), 거동 불가능(7.5%), 경제적인 이유(6.0%), 보건지소 서비스에 불만족(4.4%) 순이었다. 4. 전체 대상자 295명의 평균 치료혈압은 $144.9{\pm}12.9/86.9{\pm}8.6mmHg$이었고, 이들 중 평균 치료혈압 이 140/90mmHg 미만으로 적절히 조절되는 환자는 32.5%였다. 이러한 연구결과를 종합해 볼 때, 보건지소 고혈압 환자들의 낮은 치료율, 관리율을 개선하기 위해서는, 적극적인 추후관리와 고혈압에 대한 환자의 잘못된 인식을 교정해주는 효과적인 보건교육을 포함하는 보다 체계적인 고혈압 관리 사업이 요구된다고 하겠다.

• 대한간호학회지
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• 제48권3호
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• pp.266-278
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• 2018

Purpose: The aim of this study was to develop a substantive theory on self-management conducted by the adolescents with chronic kidney disease from their lived experience. Methods: Data was collected through in-depth interviews from May to December in 2015 with thirteen adolescents with chronic kidney disease. The data collected were analyzed on the basis of Strauss and Corbin's grounded theory. Results: The core of the category found in this study was "overcoming the unstable sense of self- control and integrating disease experience into their life". The causal conditions triggering the central phenomenon were "restriction in daily life" and "manifestation and aggravation of symptom". The central phenomenon in the experience of self-management within the adolescents with chronic kidney disease was "unstable sense of self control". The intervening condition for unstable self control were "micro system support" and "motivational resources". This study found that the adolescents with chronic kidney disease followed a series of strategies when they faced the central phenomenon, including; passive coping, reappraisal of illness, active coping, compliance with treatment, controlling physical activity, and adjusting school life. With these strategic approaches, the adolescents with chronic kidney disease could maintain their active lifestyles and achieve their health behaviors. The process of self-management by these adolescents passed through four phases; limited experience caused by diseases, effort for normalization, reorganizing their daily lives, and integration with daily lives and self-management. Conclusion: This Study explored the process and experience of self-management of adolescents with chronic kidney disease. These findings can be used for basis for developing substantive theory and nursing intervention strategy for adolescents with chronic kidney diseases.

• Tuberculosis and Respiratory Diseases
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• 제85권1호
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• pp.25-36
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• 2022

Background: Only a few studies directly compared the therapeutic efficacy and safety of two pressurized metered-dose inhalers (pMDIs) in asthma. We analyzed the asthma treatment outcomes, safety, and patient preferences using formoterol/beclomethasone (FORM/BDP), a pMDI with extra-fine particles, compared with formoterol/budesonide (FORM/BUD), another pMDI with non-extra-fine particles. Methods: In this randomized, double-blind, double-dummy parallel group study, 40 adult asthmatics were randomized to FORM/BDP group (n=18; active FORM/BDP and placebo FORM/BUD) or FORM/BUD group (n=22; active FORM/BUD and placebo FORM/BDP). During the two visits (baseline and end of 8-week treatment), subjects were asked to answer questionnaires including asthma control test (ACT), asthma control questionnaires (ACQ), and Quality of Life Questionnaire for Adult Korean Asthmatics (QLQAKA). Lung function, compliance with inhaler, and inhaler-handling skills were also assessed. Results: Ten subjects in the FORM/BDP group and 14 in the FORM/BUD group completed follow-up visits. ACT, ACQ, QLQAKA (a primary outcome), and adverse events did not differ between two groups. We found that the increase in forced expiratory volume in 1 second/forced vital capacity and forced expiratory flow at 25% to 75% of the pulmonary volume in the FORM/BDP group was higher than in the FORM/BUD group. Regarding preference, subjects responded that the flume velocity of FORM/BDP was higher, but more adequate than that of FORM/BUD. They also answered that FORM/BDP reached the trachea and bronchus and irritated them significantly more than FORM/BUD. Conclusion: The use of pMDI with extra-fine particles may relieve small airway obstruction more than the one with non-extra-fine particles despite no significant differences in overall treatment outcomes. Some asthmatics have a misconception about the adequacy of high flume velocity of pMDIs.

• 동의신경정신과학회지
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• 제20권3호
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• pp.1-13
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• 2009

Objectives : The glial cell, located in between the blood vessel and nerve cell, takes charge of the cell support, nutrition supply, elimination of body waste, and cell action. GagamSohabhwangwon(GGSH), a chinese traditional medicinal prescription has been used orally for the treatment of seizures, infantile, convulsion, stroke and so forth. This paper examines the effect of the GagamSohabhwangwon(GGSH) essential oil on cell activity and anti oxidation. Methods : MTT assay methods were employed to measure the cell activity based on the amount of the GagamSohabhwangwon(GGSH) essential oil by using primarily cultivated glial cell. In addition, this paper measured a viability of the glial cell after a protein active retarder control to confirm the multiplication of the cell and examined the cell extinction by the active oxygen, an extinction shielding effect with different amount of the GagamSohabhwangwon(GGSH) essential oil to observe anti oxidation. Furthermore, this paper measured a viability of the cell and phosphorylation(phosphorylation) of the protein which affects the multiplication of the glial cell. Results : When controlling the amount of the GagamSohabhwangwon(GGSH), there was a multiplication effect of the primary glial cell, the multiplication of the cell was dependent on the density of the GagamSohabhwangwon. The multiplication power of the primary glial cell was suppressed by PKA inhibiter (H89). In compliance with the active oxygen the extinction of the primary glial cell was dependent on the density of the GagamSohabhwangwon, there was a shielding effect of the cell extinction when GagamSohabhwangwon(GGSH) was preprocessed. When inducing the multiplication of the primary glial cell, phosphorylation of the Akt, BDNF, CREB, ERK and ERM were increased. Conclusions: Based on the results, GagamSohabhwangwon essential oil will have the effect which activates the nervous system cell and protects the cell through anti oxidation.

• 성인간호학회지
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• 제20권2호
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• pp.353-363
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• 2008

Purpose: This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. Methods: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. Results: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(${\chi}^2$ = 29.029, p = .000), verification of right patient, right site and right procedure(${\chi}^2$ = 40.663, p = .000), participation of surgical team(${\chi}^2$ = 68.412, p = .000), and the number of cases of performance(${\chi}^2$ = 242.900, p = .000). Conclusion: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.

• Steel and Composite Structures
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• 제37권6호
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• pp.663-678
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• 2020

This paper proposes a novel topology optimization method generating multiple materials for external linear plane crack structures based on the combination of IsoGeometric Analysis (IGA) and eXtended Finite Element Method (X-FEM). A so-called eXtended IsoGeometric Analysis (X-IGA) is derived for a mechanical description of a strong discontinuity state's continuous boundaries through the inherited special properties of X-FEM. In X-IGA, control points and patches play the same role with nodes and sub-domains in the finite element method. While being similar to X-FEM, enrichment functions are added to finite element approximation without any mesh generation. The geometry of structures based on basic functions of Non-Uniform Rational B-Splines (NURBS) provides accurate and reliable results. Moreover, the basis function to define the geometry becomes a systematic p-refinement to control the field approximation order without altering the geometry or its parameterization. The accuracy of analytical solutions of X-IGA for the crack problem, which is superior to a conventional X-FEM, guarantees the reliability of the optimal multi-material retrofitting against external cracks through using topology optimization. Topology optimization is applied to the minimal compliance design of two-dimensional plane linear cracked structures retrofitted by multiple distinct materials to prevent the propagation of the present crack pattern. The alternating active-phase algorithm with optimality criteria-based algorithms is employed to update design variables of element densities. Numerical results under different lengths, positions, and angles of given cracks verify the proposed method's efficiency and feasibility in using X-IGA compared to a conventional X-FEM.

• 정신신체의학
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• 제11권2호
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• pp.149-158
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• 2003

목 적: 고전적 정신신체질환인 내과 외래의 소화성 궤양과 고혈압 환자를 대상으로 하여 불안, 우울의 정도와 그 심리적인 특성을 관찰하고, 그러한 특성이 내과 치료에 미치는 영향과 정신과 자문 현황 등을 알아 보고자 하였다. 방 법: 1999년 3월에서 4월까지 본원 내과 외래를 방문하였던 소화기계와 심혈관계 환자에게 State Trait Anxiety Inventory(STAI), BDI, SCL-90R과 발병 원인 및 심각성, 약물 순응도, 의사와의 관계에 대한 만족도 등으로 구성된 설문을 시행하였다. 이후 병록지 검토, 전화 인터뷰를 통하여 소화성 궤양 환자 56명, 본태성 고혈압 환자 44명을 선택하였다. 대조군은 1999년 9월 한 달 동안 본원 건강 검진 센터를 방문한 환자 중 설문조사에 응한 153명 중 116명을 선택하였다. 결 과: BDI 우울군은 21점을 기준으로 소화성 궤양 환자 중 39.3%, 본태성 고혈압 27.7%, 대조군 12.1%였다. 상태특성불안척도에서 45점을 기준으로 하였을 때 상태 불안군은 소화성 궤양 환자 중 44.6%, 본태성 고혈압 54.5%, 대조군 18.1%였고, 특성 불안군은 궤양 환자에서 42.9%, 고혈압 환자에서 34.1%, 대조군이 25.8%로 나타났다. 환자들이 인식하고 있는 질환의 심각도와 불편함은 고혈압 환자들이 소화성 궤양보다 높았고, 심각성의 인식 정도는 BDI, STAI와 통계적으로 의미있는 상관관계를 나타냈다. SCL-90R 중 SOM 척도, BDI, STAI 가 높은 환자들은 의사의 설명에 대한 만족도나 약물 순응도가 낮게 나타났다. 소화성 궤양 환자의 48.2%, 본태성 고혈압 환자의 45.7%가 심리적인 요인을 가장 큰 발병 원인으로 생각하였다. 향정신성 약물이 처방된 예는 소화성 궤양에서 16.1%, 본태성 고혈압 환자에서 9.1%였으나 정신과에 자문된 경우는 각 1명씩으로 1.8%, 2.3%에 불과하였다. 결 론: 내과 외래 환자들은 입원환자와 같이 높은 수준의 불안과 우울을 보였으며, 특히 소화성 궤양 환자들은 우울에서, 본태성 고혈압 환자들은 상태 불안이 높았다. 환자들의 심리적인 특성은 약물에 대한 순응 정도와 관련이 있어 치료 결과에 영향을 주는 것으로 여겨졌다. 많은 환자들이 발병 원인으로 심리적인 요인을 들고 있었으나 정신과 자문율은 낮아서, 내과 질환의 심리적인 특성에 따른 정신의학적 접근 방법이 필요하다고 생각되었다.

• 한국시뮬레이션학회논문지
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• 제30권1호
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• pp.43-54
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• 2021

2019년 말 코로나19(중증급성 호흡기 증후군 코로나 바이러스 타입 2)가 발견된 이후로 전세계적으로 퍼져나가고 있다. 본 연구에서는 접촉자 발견 수준이 바이러스 전파에 미치는 영향을 파악하기 위해서 현재 대한민국의 코로나19 전파 상황을 반영한 에이전트 기반 시뮬레이션 모델을 소개한다. 본 연구에서는 실제적인 시뮬레이션 모델 개발을 위해 대한민국 내 관련 데이터를 수집하고 그 확률분포를 추정하였다. 감염, 격리, 회복, 사망의 전체 감염 프로세스를 도식화하였으며 사람들의 상호작용을 교통량 데이터를 기반으로 하여 모델링 하였다. 사회적 거리 두기 같은 정부 시책에 대한 사람들의 순응도를 반영하기 위해 합성 로지스틱 함수를 활용하였다. 접촉자 발견 수준에 따른 감염 양상 변화를 파악하기 위해 발견 수준을 0%에서 100%까지 변화 시켰다. 그 결과 적극적인 접촉자 추적이 바이러스 확산을 효과적으로 제한하고 제한의 효과가 접촉자 발견 수준이 증가함에 따라 기하급수적으로 증가하는 것을 확인하였다.

• 수산해양기술연구
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• 제59권4호
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• pp.362-376
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• 2023

The IUU Fishing Index is composed of 40 indicators. These indicators were grouped by state responsibilities (flag, coastal, port, and general including market) defined in the FAO IPOA-IUU (2001) and then by type into vulnerability, prevalence, and response. A total of 152 coastal nations was surveyed. Korea's total combined IUU Fishing Index was 2.49 in 2019 and 2.91 in 2021, indicating a drop in the ranking to the third worst out of 152 countries followed by China and Russia in 2021. The indicators that increased the IUU fishing risk in 2021 compared to 2019 included seven indicators of prevalence and two indicators of response while those reducing the risk included one prevalence and one response indicator. The IUU Fishing Index revealed that many fisheries observers and monitoring, control and surveillance (MCS) practitioners active in the waters of RFMOs jurisdiction where Korean distant water vessels operate have mentioned concerns about the compliance with RFMO conservation measures or fishing practices. It suggested that strengthening management intervention in the fishing sector is needed. The primary tool for management is the MCS system. Given the logistical difficulty of oversight from land, air and at-sea, there is a need to enhance MCS strategies through logbook data, at-sea observer and electronic monitoring program. It also suggested that MSC fisheries certification and fisheries improvement projects, which are widely used for improving fishing sector performance, could contribute to the eradication of IUU fishing and the promotion of sustainable distant water fisheries.