• 보건행정학회지
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• 제33권2호
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• pp.115-117
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• 2023

The issue of increasing the number of physicians is emerging. Because the physician workforce is a critical component of the health care system, and substantial costs are involved in training personnel, a cautious approach is required. The demand to increase the number of physicians is based on the contention that there are difficulties in accessing essential health services and the need to prepare for future demands such as fostering physician-scientists. However, simply increasing the number of physicians is not an appropriate approach to address these demands, especially considering that the effects of such an increase will appear 10 years later. Moreover, it is concerned that the current argument for increasing the physician workforce is intertwined with political interests. When considering the impact on the health care system, decisions regarding the expansion of the physician workforce should be based on evidence. Additionally, rather than temporarily responding to social issues, it is expected that a governance system will be established to continuously discuss and decide on fostering medical personnel.

• 한국과학교육학회지
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• 제28권3호
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• pp.211-226
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• 2008

The purpose of this study was to investigate science teachers' understandings about scientific argumentation in the classroom. Seven structured interview protocols were developed, asking the definition of scientific inquiry, the differentiation between scientific inquiry and hands-on activity, the opportunity of student argumentation, explicit teaching strategies for scientific argumentation, the critical example of argumentation, the criteria of successful argumentation, and the barrier of developing argumentation. The results indicate that there are differences and similarities in understandings about scientific argumentation between two groups of middle school teachers and upper elementary. Basically, teachers at middle school define scientific inquiry as the opportunity of practicing reasoning skills through argumentation, while teachers at upper elementary define it as the more opportunities of practicing procedural skills through experiments rather than of developing argumentation. Teachers in both groups have implemented a teaching strategy called "Claim-Evidence Approach," for the purpose of providing students with more opportunities to develop arguments. Students' misconception, limited scientific knowledge and perception about inquiry as a cycle without the opportunity of using reasoning skills were considered as barriers for implementing authentic scientific inquiry in the classroom.

• Tuberculosis and Respiratory Diseases
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• 제81권2호
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• pp.99-105
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• 2018

Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics. As a non-pharmacologic strategy to combat the effects of AECOPD, noninvasive ventilation (NIV) is recommended as the treatment of choice as this therapy is thought to be most effective in reducing intubation risk in patients diagnosed with AECOPD with acute respiratory failure. Recently, a few adjunctive modalities, including NIV with helmet and helium-oxygen mixture, have been tried in cases of AECOPD with respiratory failure. As yet, insufficient documentation exists to permit recommendation of this therapy without qualification. Although there are too few findings, as yet, to allow for regular andr routine application of those modalities in AECOPD, there is anecdotal evidence to indicate both mechanical and physiological benefits connected with this therapy. High-flow nasal cannula oxygen therapy is another supportive strategy which serves to improve the symptoms of hypoxic respiratory failure. The therapy also produced improvement in ventilatory variables, and it may be successfully applied in cases of hypercapnic respiratory failure. Extracorporeal carbon dioxide removal has been successfully attempted in cases of adult respiratory distress syndrome, with protective hypercapnic ventilatory strategy. Nowadays, it is reported that it was also effective in reducing intubation in AECOPD with hypercapnic respiratory failure. Despite the apparent need for more supporting evidence, efforts to improve efficacy of NIV have continued unabated. It is anticipated that these efforts will, over time, serve toprogressively decrease the risk of intubation and invasive mechanical ventilation in cases of AECOPD with acute respiratory failure.

• Child Health Nursing Research
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• 제20권4호
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• pp.340-349
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• 2014

목적 본 연구의 목적은 아동의 처치관련 통증을 경감시키기 위한 관심전환중재를 적용한 국내 중재연구들을 분석, 평가하고, 추후 아동의 처치관련 통증을 경감시키기 위한 관심전환중재 연구의 발전방향을 제시하기 위한 근거자료를 제공하고자 함이다. 방법 본 연구는 통증과 관련하여 아동을 대상으로 실시된 관심전환요법의 국내 간호연구 동향을 파악하고 실무 및 연구의 발전방향을 모색하기 위한 비판적 고찰 연구이다. 결과 국내에서 실시된 관심전환을 중재로 적용한 연구는 대부분이 학령전기 및 학령기 초기 아동을 대상으로 실시한 유사실험연구 설계였으며, 시청각 자극을 통해 관심을 전환하는 방법을 가장 많이 사용하였다. 관심전환중재는 아동의 통증과 두려움 등의 행동반응 결과변수의 변화에는 분석 연구의 대부분에서 효과가 있는 것으로 그리고 생리적 반응 결과변수의 변화에는 분석 연구의 46.7%에서 효과가 있는 것으로 나타났다. 그러나 분석에 포함된 논문들의 연구설계, 시행, 보고 등에 있어서 방법론적인 엄격성이 부족하였다. 또한 각 연구들은 시행한 관심전환중재의 절차에 대한 제한된 정보만을 제시하여 다른 연구자들이 반복연구를 시행한다거나 중재를 실무로 중개하는 데 한계가 있었다. 결론 관심전환요법이 아동의 절차관련 통증과 두려움을 경감시키는 데 효과가 있는지에 대한 근거를 좀 더 확실하게 파악하기 위해서는 방법론적 엄격함이 요구된다. 추후 연구에서는 관심전환중재의 임상적 활용성을 파악하기 위해 비용과 시간 효과성 그리고 보호자와 건강관리 제공자의 만족도를 밝히기 위한 연구가 요구된다.

• Tuberculosis and Respiratory Diseases
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• 제71권4호
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• pp.278-281
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• 2011

Allergic bronchopulmonary aspergillosis (ABPA) is a complex clinical entity resulting from an allergic immune response to Aspergillus species, and most often occurs in patients with asthma. ABPA is rarely observed in the absence of asthma, which is, in fact, the principal criterion for its diagnosis. Our patient was a 53-year-old woman with no history of bronchial asthma. She presented with a 1-month history of cough, mucopurulent nasal discharge, and localized pulmonary consolidation. Peripheral blood eosinophilia and elevated serum IgE were observed. Sinus radiography showed right maxillary sinusitis. Pathologic examination of bronchoscopic biopsy specimens revealed conglomerates of fungal hyphae. Pulmonary function and bronchial provocation tests were within normal ranges. The patient was successfully treated for 3 months with itraconazole and oral prednisolone. There has been no evidence of recurrence over a 7-month follow-up. ABPA coupled with sinusitis in a nonasthmatic patient is a very rare occurrence and warrants reporting.

• 중환자간호학회지
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• 제6권2호
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• pp.78-88
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• 2013

Purpose: The purpose of this study was to identify the trends in studies published in Journal of Korean Critical Care Nursing (JKCCN) from 2008 to 2013. Methods: A total of 65 studies published between 2008 to 2013 were reviewed using criteria developed by researchers. Results: Approximately 36% of studies were conducted with patients. Intensive care unit (ICU) was the most popular site as the study setting. Among 59 research papers, 42.4% were approved by institutional review board (IRB). Quantitative studies were 78.6%, while qualitative studies were 4.6%. The research designs for the quantitative studies were survey (52.3%), quasi-experimental (16.9%), and so on. There was no randomized controlled trial. The most frequently used methods to provide nursing intervention was education. In addition, "nurse" and "ICU" were most commonly used keyword. Conclusion: Considering the low rate of IRB approval, more stringent application of research ethics is necessary to improve the quality of JKCCN. In addition, more randomized controlled trials should be encouraged to support evidence-based practice in critical care.

• 한국콘텐츠학회논문지
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• 제19권11호
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• pp.462-473
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• 2019

본 연구는 간호대학생의 비판적 사고성향과 진로준비행동 간의 관계에서 셀프리더십과 진로결정 자기효능감의 매개효과를 확인하기 위하여 시행되었다. 광주의 간호대학에 재학 중인 학생을 대상으로 하였으며 263명의 자료를 분석하였다. 수집된 자료는 SPSS 23.0 Program을 이용하여 분석하였고, 매개효과의 유의성 검증을 위해 Sobel test를 실시하였다. 연구 결과는 다음과 같다. 첫째, 비판적 사고성향은 간호대학생의 진로준비 행동에 긍정적인 영향을 미치는 것으로 나타나 비판적 사고성향이 높은 간호대학생은 진로준비행동이 높음을 알 수 있었다. 둘째, 비판적 사고성향과 진로준비행동 간의 관계에서 셀프리더십은 완전 매개효과를 갖는 것으로 나타났다. 셋째, 비판적 사고성향과 진로준비행동 간의 관계에서 진로결정 효능감은 완전매개효과를 갖는 것으로 나타났다. 이러한 연구결과는 간호대학생의 긍정적인 진로준비행동을 촉진하기 위해 비판적 사고성향을 향상시키고, 셀프리더십과 진로결정 자기효능감을 증진시키기 위한 교육프로그램들이 간호교육현장에서 필요함을 시사한다.

• Tuberculosis and Respiratory Diseases
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• 제72권1호
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• pp.72-76
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• 2012

We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.

• Tuberculosis and Respiratory Diseases
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• 제44권3호
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• pp.661-668
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• 1997

종양세포에 의한 hyperamylasemia는 드물게 보고되고 있으며 주로 폐암에 의하고 조직형은 선암으로 보고되어 있다. 이때 생성되는 아밀라제는 타액형으로 췌장질환에 의한 것과는 구별이 되며 hyperamylasemia에 의한 임상적인 증상은 없다. 저자등은 소세포성 폐암으로 진단받은 54세 남자 환자에서 아밀라제 농도가 상승되어 있음을 발견하고, 임상경과 및 검사결과 아밀라제를 분비하는 소세포성 폐암으로 진단하고 문헌 고찰과 함께 보고하는 바이다.

• Biomolecules & Therapeutics
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• 제18권4호
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• pp.363-374
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• 2010

Growing evidence suggests a prominent role for leptin in human cancer progression. The intricate pattern of leptin cross-talk with other associated signaling pathways is a critical area of research that will ultimately contribute to comprehending the role of leptin in cancer progression. This review summarizes a portion of the current understanding of leptin signaling, with a critical focus on its contribution to tumor cell invasion and metastasis. Five topics are addressed in this review: (1) Leptin receptor, (2) Leptin signaling, (3) Leptin and cancer, and (4) Leptin and tumor invasion. Due to the complex cellular effects of leptin, a more precise understanding of leptin signaling pathways must still be elucidated. Leptin is clearly a major factor for stimulating tumor progression through a complex spectrum of interplay and cross-talk among various signaling molecules. An understanding of the role of leptin in invasion and metastasis will provide valuable information for establishing strategies to modulate leptin signaling, which should be a high priority for the development of anti-cancer therapeutics.