• 한국임상약학회지
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• 제9권1호
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• pp.35-43
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• 1999

Over the last 50 years, a number of antibiotic agents have been developed and clinically used in the area of infectious diseases. Due to antimicrobial resistance problems and increasing health care costs, the rational use of antibiotics has been required. As a drug of choice to treat infections caused by MRSA, vancomycin has been extensively prescribed since the late 1970's. Recently, reports of vancomycin-resistant organisms such as VRE and VRSA have been increased to draw medical concerns. The objectives of this study were to evaluate the rational use of vancomycin and the appropriateness of the Restrictional Program of Antibiotic Utilization (RPAU) which has been operated at Samsung Medical Center. A retrospective chart review was performed in 132 hospitalized patients treated with vancomycin in the surgery departments from. January to June 1998. The guidelines of ASHP and HICPAC for vancomycin were modified and used as our criteria to determine the vancomycin DUE. In one hundred out of the patients, uses of vancomycin were approved by the Department of Infectious Diseases (DID) based on the RPAU. Vancomycin was appropriately used in $62.5\%$ of the 100 patients according to the criteria of justification of use, while $60.0\%,\;60.0\%,\;79.0\%,\;and\;51.0\%$ of the patients showed appropriate according to those of lab reports such as applicable culture obtained, pretreatment SCr, WBC and serum drug concentration monitoring, respectively. Although the rest 32 patients were not approved to receive vancomycin by the DID, twenty two percent continued receiving vancomycin treatment. This might result from the fact that the RPAU was started not before the use of antibiotics but in the middle of antimicrobial therapy. Continual education should be provide to the related health professionals and the RPAU should be simultaneously modified in order to increase the rate of appropriate uses of antibiotics.

• 농업생명과학연구
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• 제44권6호
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• pp.51-59
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• 2010

이 연구는 사유림 기능평가에 적합한 산림기능 유형 및 기능 우선순위를 분석하기 위해 수행되었다. 전문가그룹과 시군산림공무원을 대상으로 설문조사를 실시하여 제안한 산림기능유형의 적정성과 산림기능의 우선순위를 평가하였다. 현행 산림기능유형에 대한 기능명칭 변경, 통합의 필요성에 대해서 전반적으로 동의하는 것으로 나타났으며, 최종적으로 4개의 산림기능(자원순환, 수자원함양, 생활환경보전, 산림보전) 구분체계를 제시하였다. 또한 산림기능 우선순위는 집단간, 권역별 우선순위에 차이가 존재하므로 전국 사유림 기능평가시 국 공유림처럼 획일적으로 기능 우선순위를 부여하는 것보다는 권역단위로 기능 우선순위를 상이하게 적용할 필요성이 있는 것으로 판단된다.

• 임상간호연구
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• 제17권2호
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

• 한국방사선학회논문지
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• 제15권5호
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• pp.649-656
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• 2021

본 연구는 태아의 자궁 내 성장제한을 평가하는 변수로 소뇌횡직경과 복부둘레비(TCD/AC ratio)의 적절성을 평가하고자 하였다. 2019년 4월부터 2021년 3월까지 부산소재 I 병원에서 정기검진으로 초음파를 실시한 784명의 임산부를 대상으로 진행하였으며 소뇌횡직경과 복부둘레 측정값을 통해 후향적으로 분석하였다. 단순회귀분석에서 임신주수에 소뇌횡직경은 97.2%, 복부둘레는 97.5%의 영향력을 보였으며(p<0.001) 정상태아의 TCD/AC ratio는 임신주수에 상관없이 13.2로 결정되었다. 또한 빈도분석을 통해 임신주수 그룹별 TCD/AC ratio의 백분위수를 산출하였으며 자궁 내 성장제한 예측의 95 백분위수는 14.2로 나타났다. 결과적으로 TCD/AC ratio는 태아의 정상적인 성장을 평가하고 IUGR을 예측하는 유용한 변수로 활용될 수 있을 것으로 사료된다.

• 한국산업보건학회지
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• 제31권3호
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• pp.266-273
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• 2021

Objective: The objective of this study was to suggest improvement methods for investigations and systems through a review of musculoskeletal risk factor investigation reports conducted in the workplace. Methods: A total of 34 reports on musculoskeletal risk factor investigations were reviewed. To confirm the appropriateness of the evaluation, reevaluation was conducted through a field investigation using other evaluation tools. In order to understand the effectiveness of the improvement plan, a survey was conducted with those in charge of tasks with ergonomic burdens. Results: As a result of performing a field survey using the work sampling method recommended by the KOSHA (Korea Occupational Safety and Health Agency) for ten tasks, eight tasks were determined to pose an ergonomic burden. When 30 tasks were evaluated with RULA (rapid entire body assessment), 90% of them were evaluated at a higher level than the results of the workplace survey. Among the improvement measures, only 36% of the field workers affirmed them, and in only 19% of the workplaces were actual improvements made. Conclusions: In order to improve the ergonomic investigation system for risk factors in the ergonomic burden task, it is necessary to secure the objectivity of the evaluation performed by the institution and enable the active participation of workers in improvement activities.

• Journal of Acupuncture Research
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• 제38권3호
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• pp.219-226
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• 2021

Background: The objective structured clinical examination (OSCE) is a widely used method to assess the clinical performance of students in clinical practice. Although OSCE has been used for undergraduate students of Korean medicine, this has not been widely reported. Methods: In 2020, the practical course for acupuncture and moxibustion medicine (acupuncture, electroacupuncture, pharmacopuncture, auricular acupuncture, and burning acupuncture) was taught using flipped learning, according to clinical practice guidelines, and assessed by the OSCE. The appropriateness of this model of education and its evaluation using OSCE were evaluated using a 5-point Likert scale, and the results were analyzed. Results: Of the respondents, 67% reported that the OSCE accurately reflected their competency, and 82% reported that online video lectures helped them to improve their clinical skills. The average adequacy score of the model was > 3.7/5, and the average adequacy score of the checklist used in the OSCE was > 4.1/5 for all 5 clinical application skills. The difference in the mean self-efficacy score between students who had taken the OSCE and those students who had not taken the OSCE, was highest in the burning acupuncture group (0.923). Conclusion: This study showed that students' satisfaction with the OSCE was high and flipped learning was an effective education model. In the future, models representing the human body or simulated patients should be used to evaluate students' skills and attitude.

• 대한방사선기술학회지:방사선기술과학
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• 제41권6호
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• pp.545-552
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• 2018

The purpose of this study was evaluated the relationship between echocardiography and cardiac computed tomography in normal adults by visual assessment, and evaluated the effective doses of cardiac computed tomography. The subjects were 100 normal patients who visited two general hospitals in Chungnam, from January 1 to May 30, 2018. We obtained images by using these modalities and evaluated the wall thickness and internal dimension of the Left Ventricle with visual assessment. To evaluate the appropriateness of the visual evaluation, two evaluators who were trained for one week were measured and the agreement between the evaluators were verified by statistical analysis. The effective doses of computed tomography were evaluated using the dose length product. As a result, there was a high correlation between the two modalities. The agreement between the two visual evaluator were also highly agreed. The mean X-ray dose of the subjects was $11.1{\pm}3.1mSv$. Although the purpose of imaging is somewhat different in the clinical setting, echocardiography could achieve the same results as radiation-invasive computed tomography. It is thought that utilization will become even larger.

• 융합보안논문지
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• 제19권2호
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• pp.21-28
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• 2019

제4차 산업혁명 시대로 불리는 초연결-초지능 사회의 출현은 안보 환경의 새로운 변화를 가져왔다. ICT(정보통신기술) 융 복합 하이테크 기술이 전 방위적으로 도입되면서 현실 공간을 움직였던 사람 중심의 동력은 코드를 중심으로 한 사이버 공간으로 대체되고 있으며, 그 의존도는 계속 높아지고 있다. 하지만 이러한 기술적 변화는 역설적으로 우리 사회를 위협하는 또 다른 안보취약점으로 작용하고 있으며, 과학기술이 가져온 기회와 도전을 동시에 직면하며 사이버 방어체계를 구축해야 하는 당위성을 가져왔다. 이에 본 연구에서는 갈수록 지능화되고 대규모로 진화하고 있는 사이버 공격에 적극적으로 대응할 수 있는 이론적 근거로 정당방위 이론을 제시하였고, 이에 대한 자주적 사이버 안보전략 수립 방향으로 첫째, 사이버 안보법 제정의 필요성 둘째, 미국 등 사이버 강대국들과의 대응공조 체계 마련 셋째, 사이버 인력을 어떻게 양성할 것인가에 대한 방안 마련을 제언하였다.

• 한국수학교육학회지시리즈C:초등수학교육
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• 제22권2호
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• pp.129-147
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• 2019

본 연구에서는 CCSSM-CA와 그에 따른 미국 초등 교과서에 제시된 분수의 연산 내용을 분석하였다. 분석 결과, 분수를 단위분수나 분모가 같은 분수의 합으로 표현하게 하여 분수 개념과 연산을 연결 짓는 특징이 있었다. 또 분수의 곱셈에서는 곱하는 한 수의 크기에 기초하여 다른 수의 곱의 결과를 비교하도록 하거나, 나눗셈에서는 단위분수가 포함된 나눗셈을 먼저 다루고, 다양한 방법으로 계산을 하도록 제시하는 특징 등이 있었다.

• Clinical and Experimental Reproductive Medicine
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• 제45권4호
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• pp.183-188
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• 2018

Objective: The purpose of this retrospective study was to evaluate the appropriateness of various follicle-stimulating hormone (FSH) starting doses in expected normal responders based on the nomogram developed by La Marca et al. Methods: A total of 117 first in vitro fertilization cycles performed from 2011 to 2017 were selected. All women were expected normal responders and used a recombinant FSH and flexible gonadotropin-releasing hormone antagonist protocol. The FSH starting dose was empirically determined (150, 225, or 300 IU). The FSH starting dose indicated by La Marca's nomogram was determined using female age and serum $anti-M{\ddot{u}}llerian$ hormone or basal FSH levels. If the administered dose was exactly the same as the proposed dose, the cycle was assigned to the concordant group (34 cycles). If not, it was assigned to the discordant group (83 cycles). Optimal ovarian response was defined as a total of 8-14 oocytes, hypo-response as < 8 oocytes, and hyper-response as > 14 oocytes. Results: Between the concordant and discordant group, ovarian response (optimal, 32.4% vs. 27.7%; hypo-response, 55.9% vs. 54.2%; and hyper-response, 11.8% vs. 18.1%) and the number of total or mature oocytes were similar. Ovarian hyperstimulation syndrome was rare in both groups (0% vs. 1.2%). The implantation rate, clinical pregnancy rate, miscarriage rate, and live birth rate were all similar. Conclusion: The use of the proposed FSH starting dose determined using La Marca's nomogram did not enhance the optimal ovarian response rate or pregnancy rate in expected normal responders. Individualization of the FSH starting dose by La Marca's nomogram appears to have no distinct advantages over empiric choice of the dose in expected normal responders.