• Journal of Dental Anesthesia and Pain Medicine
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• 제17권4호
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• pp.265-270
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• 2017

Background: Endotracheal intubation during anesthesia induction may increase airway resistance ($R_{aw}$) and decrease dynamic lung compliance ($C_{dyn}$). We hypothesized that prophylactic treatment with a transdermal ${\beta}2$-agonist tulobuterol patch (TP) would help to reduce the risk of bronchospasm after placement of the endotracheal tube. Methods: Eighty-two American Society of Anesthesiologists (ASA) category I or II adult patients showing obstructive patterns were divided randomly into a control and a TP group (n = 41 each). The night before surgery, a 2-mg TP was applied to patients in the TP group. Standard monitors were recorded, and target controlled infusion (TCI) with propofol and remifentanil was used for anesthesia induction and maintenance. Simultaneously, end-tidal carbon dioxide, $R_{aw}$, and $C_{dyn}$ were determined at 5, 10, and 15 min intervals after endotracheal intubation. Results: There was no significant difference in demographic data between the two groups. The TP group was associated with a lower $R_{aw}$ and a higher $C_{dyn}$, as compared to the control group. $R_{aw}$ was significantly lower at 10 min (P < 0.05) and 15 min (P < 0.01), and $C_{dyn}$ was significantly higher at 5 min (P < 0.05) and 15 min (P < 0.01) in the TP group. A trend towards a lower $R_{aw}$ was observed showing a statistically significant difference 5 min after endotracheal intubation (P < 0.01) in each group. Conclusions: Prophylactic treatment with TP showed a bronchodilatory effect through suppressing an increase in $R_{aw}$ and a decrease in $C_{dyn}$ after anesthesia induction without severe adverse effects.

• 한국가족복지학
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• 제54호
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• pp.155-185
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• 2016

본 연구는 장애 및 비 장애유아의 모가 인식하는 문제행동 유형, 원인, 지도방법의 차이를 알아보고, 모의 사회 인구학적 변인, 유아의 문제행동 유형, 원인이 지도방법에 미치는 영향에 대해 분석하였다. 이를 위해 서울과 경기지역에 거주하는 만 2세부터 취학 전 자녀를 둔 비 장애유아 모 100명과 장애유아 모 76명, 총 176명을 대상으로 설문조사를 실시하였다. 연구 결과는 첫째, 문제행동 유형에서 내재화 문제행동과 사회적 활동의 기피요인이 대상 간에 통계적으로 유의미한 차이를 보였다. 둘째, 문제행동의 원인에서는 유아의 행동과 특성 요인에서 대상 간 유의미한 차이가 나타났다. 셋째, 문제행동 지도방법에서는 가정에서의 지원환경 구축과 사회정서 전략요인이 통계적으로 유의미한 차이를 나타냈다. 마지막으로, 비 장애 유아는 모의 사회 인구학적 변인 중 모의 최종학력과 유아의 특성 요인이, 장애유아는 모의 사회 인구학적 변인 중 월 가계소득과 유아의 기타 요인이 문제행동을 지도하는데 영향을 미치는 것으로 분석되었다. 이와 같은 연구결과를 토대로 실천적용 방안을 제시하였다. 연구의 제한점과 후속 연구 제안을 추가적으로 논의하였다.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권7호
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• pp.707-722
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• 2019

근린의 개념은 근현대사를 거치며 우리사회에 지역사회를 조성하기 위한 원리로 활용되어 왔으며, 물리적 시설을 중심으로 하는 근린의 개념은 역할과 의의에 관해 꾸준히 논의 되어왔다. 본 연구에서 주목하는 쌈지공원은 근린시설로서 재생을 통한 환경의 개선과 이를 통한 지역 공동체의 확보에 역할을 하였으며, 수도권지역에 조성된 한평공원 및 한뼘공원 총 72개의 답사 조사를 통해 계획적 의의와 함께 설문조사를 통해 쌈지공원 주변 거주민과 이용자의 이용성 및 장소애착을 확인하였다. 본 연구를 통해 도출한 결론은 다음과 같다. 첫째, 이용자의 인구통계학적 특성에 따라 집단별로 공원에 대한 장소애착에 유의한 차이가 존재하는 것으로 확인되었다. 이는 오늘날 공급되는 주거의 주된 유형의 차이가 생태적 공간을 경험하고자 하는 차이에 영향을 미치는 것으로 볼 수 있다. 둘째, 교육수준에 따라 집단별로 공원에 대한 장소애착의 유의한 차이를 확인할 수 있다. 셋째, 이용자의 이용행태에 따라 집단별로 공원에 대한 장소애착에 차이가 존재하며 이는 이용회수, 체류시간 등에 따른 구체적 차이를 확인할 수 있다.

• 국제지역연구
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• 제22권1호
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• pp.141-159
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• 2018

본 연구는 중국 상하이 시에 거주하거나 출퇴근하는 사람들을 대상으로 하여, 스마트폰 택시앱의 가치속성에 대한 지각, 만족도 및 택시 앱 사용빈도 등의 영향요인을 탐색하는데 목적이 있다. 총 306명을 대상으로 하여 조사한 연구결과는 다음과 같다. 택시 앱 이용실태 조사 결과, 대상자들 중 가장 많은 수가 택시 앱을 이용한지 1년 이상이라고 응답하였으며, 1주일에 1~2번이용 하고 있는 것으로 나타났다. 또한 조사대상자들의 연령, 학력에 따라 택시 앱 이용실태에 차이가 있는 것으로 나타났다. 조사대상자들은 스마트폰 택시 앱의 가치속성 중 용이성 지각을 5점 척도 중 4.41점으로 가장 높게 지각하고 있으며, 반대로 위험성 지각은 3.34점으로 가장 낮게 지각하였다. 마지막으로 사회. 인구학적 특성과 택시 앱 이용 특성을 통제한 상태에서, 택시 앱 가치 지각 변수들이 택시 앱 만족도에 유의한 영향을 미쳤다. 구체적으로, 서비스 품질, 유용성, 시스템 활용성을 높게 지각할수록 만족도도 높은 것으로 나타났으며, 특히 시스템 활용성과 유용성 지각이 미치는 영향력이 높게 나타났다.

• 한국산학기술학회논문지
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• 제20권4호
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• pp.250-263
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• 2019

본 연구는 일반인들이 정신질환을 가진 사람들에 대한 인식을 개선시키기 위한 일환으로 공공 노력의 필요성을 제기하고 방안을 제시하기 위함이다. 그리고 정신질환태도에 관한 인구통계학적인 차이, 인식개선을 위한 공익광고 필요성과 매체별로 현재수준과 기대수준을 비교 분석한 후 이를 개선하기 위한 방안을 제시하였다. 이를 위해 치료를 통해 완전히 회복될 수 있는 우울증, 강박증, 공황장애를 중심을 살펴보았고 서울과 수도권에 거주하는 일반인들을 대상으로 설문조사를 실시하였다. 연구결과 응답자들의 정신질환자에 대한 태도에 대한 인식차이에서는 성별, 결혼상태, 연령대, 가족 중 정신질환 치료 경험 유무에 따라 정신질환자에 대한 태도에서 인식차이가 있음을 확인하였다. 반면 종교, 월수입, 학력에 따른 인식차이는 유의하지 않음을 확인할 수 있었다. 또한 대부분의 응답자는 인식개선을 위해 공공의 노력 즉, 대중매체를 통한 노력이 필요하다고 인식하는 것을 확인하였고 TV광고, 인터넷, 라디오, 광고탑, 운송수단의 활용을 통한 광고가 강화되어야한다고 생각하는 것을 확인할 수 있었다. 이러한 연구 결과를 통해 본 연구에서는 정신질환자의 인식 개선을 위해 대중매체를 통한 광고의 필요성을 제시하였고 이를 강화하기 위한 방안으로 사회적 차원, 조직적 차원, 개인적 차원을 중심으로 제안하였다.

• Journal of Acupuncture Research
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• 제36권1호
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• pp.12-20
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• 2019

Background: This study was conducted to verify the effectiveness and effectiveness-related factors of Korean medicine (KM) treatment for patients who have been involved in traffic accidents (TA). Methods: The medical records of 150 TA patients hospitalized in Dongguk University Bundang Oriental Medicine Hospital from September 2017 to May 2018 were reviewed. Medical records included information on patient demographic characteristics, TA situations, use of KM treatment, clinical characteristics, 4 scales [numeric rating scale (NRS), visual analogue scale (VAS), EuroQol-visual analogue scale (EQ-VAS) and neck disability index (NDI)]. Statistical analyses were performed to determine the effectiveness and effectiveness-related factors of treatment. Results: The 150 patients (almost 1:1 gender ratio) were typically in their 40's (26.67%), had rear impact to their vehicle (37.33%), were in the driver's seat (70.00%), and without head trauma and loss of consciousness (83.33%). The main symptoms were neck pain (60.66%) and lower back pain (54.00%). All 150 patients showed significant improvement after KM treatment. 4 scales significantly improved when the treatment started within 3 days from the accident and patients were hospitalized longer and took more diverse treatments. The patients experiencing a higher initial pain level (NRS 8-10, $VAS{\geq}70$) showed significant improvement of NRS and VAS scores with faster and longer inpatient treatments than the other patients. The patients with higher initial pain levels ($VAS{\geq}70$) also showed significant improvement in EQ-VAS scores. Conclusion: KM treatment was effective for TA patients in this study. Treatment initiation time, hospitalization period, treatment diversity and initial pain level are related to the degree of improvement of a patient's symptoms.

• Nutrition Research and Practice
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• 제13권3호
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• pp.230-239
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• 2019

BACKGROUND/OBJECTIVES: Little is known about the dietary patterns (DPs) of women during pregnancy. The present study aimed to identify the DPs of pregnant Malaysian women and their associations with socio-demographic, obstetric, and anthropometric characteristics. SUBJECTS AND METHODS: This prospective cohort study included 737 participants enrolled in Seremban Cohort Study between 2013 and 2015. Food consumption was assessed using a validated 126-food item semi-quantitative food frequency questionnaire (SFFQ) at four time-points, namely, pre-pregnancy and at each trimester (first, second, and third). Principal component analysis (PCA) was used to identify DPs. RESULTS: Three DPs were identified at each time point and designated DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), DP 7-9 (second trimester) and DP 10-12 (third trimester). DP 1, 4, and 7 appeared to be more prudent diets, characterized by higher intakes of nuts, seeds & legumes, green leafy vegetables, other vegetables, eggs, fruits, and milk & dairy products. DP 2, 5, 8, and 11 had greater loadings of condiments & spices, sugar, spreads & creamer, though DP 2 had additional sweet foods, DP 5 and 8 had additional oils & fats, and DP 11 had additional tea & coffee, respectively. DP 3 and 6 were characterized by high protein (poultry, meat, processed, dairy, eggs, and fish), sugars (mainly as beverages and sweet foods), and energy (bread, cereal & cereal products, rice, noodles & pasta) intakes. DP 9 had additional fruits. However, DP 12 had greater loadings of energy foods (bread, cereal & cereal products, rice, noodles & pasta), sugars (mainly as beverages, and sweet foods), and good protein sources (eggs, nuts, seeds & legumes). Malays were more likely to have lower adherence (LA) for DP 1 and 10 than non-Malays. DP 2, 8, and 11 were more prevalent among Malays than non-Malays. Women with a higher education were more likely to have LA for DP 10, and women with a greater waist circumference at first prenatal visit were more likely to show LA for DP 11. CONCLUSIONS: DPs observed in the present study were substantially different from those reported in Western populations. Information concerning associations between ethnicity, waist circumference and education with specific DPs before and throughout pregnancy could facilitate efforts to promote healthy dietary behavior and the overall health and well-being of pregnant women.

• 병원약사회지
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• 제35권4호
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• pp.391-399
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• 2018

Background : The Antimicrobial Stewardship Program promotes interdisciplinary interventions and targeted recommendations for the proper utilization of antibiotics. In particular, the aim of the program is to avoid indiscriminate use of broad-spectrum antibiotics based on the documented literature on the significant impact of unsystematic usage of antibiotics on the distribution of antibiotic-resistant microorganisms. To improve the care process for pneumonia treatment using antimicrobial agents, institution-level guidelines were established and disseminated at the Seoul National University Bundang Hospital in April 2016. In this study, we evaluated changes in the physicians'antibiotic prescribing patterns both before-and after-the implementation of the guidelines. Methods : The electronic medical records of inpatients who were prescribed with one or more antibiotics in May 2014 (Group A) and May 2016 (Group B) were reviewed. Data on demographic characteristics, clinical outcomes, and antibiotic prescriptions were collected and the prescription records were compared both before- and after- the implementation of the guidelines. Results : A total of 180 patients were included in the study: 77 patients in group A and 103 patients in group B. The baseline characteristics of the patients were not significantly different between the two groups. Community-acquired pneumonia was the most common diagnosis in both the groups and the difference was not significant (68.8% vs. 67.9%; p=0.67). The type of antibiotic prescriptions used for empirical treatment was not different between the two groups. The most commonly prescribed empirical antibiotics were cephalosporins, with no significant difference (p=0.31). One of the most inappropriately used antibiotics was piperacillin/tazobactam and the rate of prescription was similar in both the groups (p=0.68). The rates of appropriate empirical selection of antibiotics remained unaltered between the two groups (67.5% vs. 71.8%; p=0.53). Conclusions : Implementation of the guidelines only exhibited no significant effect on the antibiotic prescribing patterns of physicians for the treatment of pneumonia. To improve the adequate use of empiric antibiotics, more active interventions and closer monitoring of the feedbacks should be additionally considered and evaluated in future studies.

• Clinics in Shoulder and Elbow
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• 제24권1호
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• pp.21-26
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• 2021

Background: To evaluate the demographics, clinical and radiographic features of calcific tendinitis of the shoulder in the Korean population, specifically focusing on the incidence of coexisting rotator cuff tear. Methods: Between October 2014 and January 2015, we performed a prospective multicenter study with 506 patients from 11 training hospitals in Korea. We collected data of demographics and radiographic analysis based on simple radiographs, clinical assessments based on visual analog scale (VAS) and the American Shoulder Elbow Surgeons (ASES) score, and treatment modalities that are used currently. We also evaluated coexisting rotator cuff tear by ultrasonography (US) or magnetic resonance imaging (MRI) images. Results: There were 402 female patients (79%) with mean age of 55 years (range, 31-87 years). Mean duration of symptoms was 16 months. Mean size of calcific materials was 11.4 mm (range, 0-35 mm). Mean value of VAS and ASES scores were 6.5 (range, 1-10) and 47 (range, 8-95), respectively. Of 383 patients (76%), 59 (15%) had rotator cuff tear including 15 full-thickness tears on US or MRI. Patients with rotator cuff tears were significantly associated with older age, recurrent symptoms, menstrual disorders in females, and having undergone calcification removal surgery and rotator cuff repair (all p<0.05). Conclusions: This study reported demographic, radiographic, and clinical features of calcific tendinitis of the shoulder in Korean population, which were not different from those of Western population. Coexisting rotator cuff tear was found with 15% incidence in this large series, suggesting that further radiographic study to evaluate rotator cuff tear might be needed in some calcific tendinitis patients of older age and presenting with recurrent symptoms.

• 보건행정학회지
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• 제30권4호
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• pp.479-492
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• 2020

Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.