• 한국보육학회지
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• 제17권4호
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• pp.163-185
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• 2017

본 연구는 유아교육기관에서 정교사 2인 공동담임제의 현실적인 탐색을 통해 현장적용을 실천하는데 도움이 되고 이를 통해 전문성을 갖춘 교사체제를 정립함으로써 교사간의 협력적인 능력 창출과 운영에 대한 기초연구가 되고자 한다. 이를 위해 2017년 4월부터 7월까지 약 3개월간 경기도 소재의 K유치원에서 교사 16을 대상으로 반구조화 된 개인 및 집단면담 13회, 현장관찰 8회, 참여관찰 4회에 걸쳐 수집한 자료를 분석하였다. 자료의 분석은 질적 자료 분석 방법인 키워드 분류, 유목화, 소주제 발견 단계로 진행 되었다. 그 결과, 정교사 2인 공동담임제의 협력적 운영에 대해 '업무 수행', '어려움', '기관의 지원', '변화'로 범주화하여 기술하였다. 이러한 연구결과를 통해, 정교사 2인 공동담임제를 도입하여 전문성을 갖춘 2인 교사가 협력적 운영의 과정, 변화를 통해 교육의 질을 향상시키는 데 기반이 될 것으로 기대한다.

• Journal of Chest Surgery
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• 제53권5호
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• pp.291-296
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• 2020

Background: We report our 10-year experience with traumatic peripheral arterial injury repair at an urban level I trauma center. Methods: Between January 2007 and December 2016, 28 adult trauma patients presented with traumatic peripheral arterial injuries. Data were retrospectively collected on demographic characteristics, the mechanism of injury, the type of vascular injury, and physiological status on initial assessment. The analysis also included the Mangled Extremity Severity Score (MESS), Injury Severity Score, surgical procedures, and outcome variables including limb salvage, hospital stay, intensive care unit stay, and postoperative vascular complications. Results: Four (14.3%) patients required amputation due to failed revascularization. MESS significantly differed between patients with blunt and penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005). The amputation rate was not significantly different between patients with blunt and penetrating trauma (20% vs. 0%, respectively; p=0.295). The overall mortality rate was 3.6% (1 patient). Conclusion: Blunt trauma was associated with higher MESS than penetrating trauma, and amputation was more frequent. In particular, patients with blunt trauma had significantly higher MESS than patients with penetrating trauma (8.2±2.2 vs. 5.8±1.3, respectively; p=0.005), and amputation was performed when revascularization failed in cases of blunt trauma of the lower extremity. Therefore, particular care is needed in making treatment decisions for patients with peripheral arterial injuries caused by blunt trauma.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권5호
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• pp.318-323
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• 2017

Objectives: Mandibular angle reduction or reduction genioplasty is a routine well-known facial contouring surgery that reduces the width of the lower face resulting in an oval shaped face. During the intraoral resection of the mandibular angle or chin using an oscillating saw, unexpected peripheral nerve damage including inferior alveolar nerve (IAN) damage could occur. This study analyzed cases of damaged IANs during facial contouring surgery, and asked what the basic standard of care in these medical litigation-involved cases should be. Materials and Methods: We retrospectively reviewed a total of 28 patients with IAN damage after mandibular contouring from August 2008 to July 2015. Most of the patients did not have an antipathy to medical staff because they wanted their faces to be ovoid shaped. We summarized three representative cases according to each patient's perceptions and different operation procedures under the approvement by the Institutional Review Board of Seoul National University. Results: Most of the patients did not want to receive any further operations not due to fear of an operation but because of the changes in their facial appearance. Thus, their fear may be due to a desire for a better perfect outcome, and to avoid unsolicited patient complaints related litigation. Conclusion: This article analyzed representative IAN cutting cases that occurred during mandibular contouring esthetic surgery and evaluated a questionnaire on the standard of care for the desired patient outcomes and the specialized surgeon's position with respect to legal liability.

• 대한간호학회지
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• 제27권4호
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• pp.880-891
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• 1997

The purpose of this study was (1)to undertake a survey to identify the profile of inactive nurses, who account for 42.2% of the 130,000 RN(Registered Nurses) in Korea, (2)to identify factors related to the inactivation of these nurses, (3)to identify reasons behind the high turnover rate of nurses, and (4)to delineate measures for inactive nurses to participate in professional nursing activities so as to upgrade the quality of the health care delivery system in Korea. For these purposes, this study surveyed existing literature on the turnover of nurses and, used the nominal group technique of action research, to collect ideas from hospital/nurse administrators, inactive nurses, nurses on the job, graduate students in nursing, part-time nurses, patients, and their families to formulate strategies to mobilize inactive nurses. The findings are as follows : Frist, institutional supports should be provided to mobilize inactive nurses. To be more specific : (1) A data-base needs be created at the Korean Nurses Association to link inactive nurses with jobs available. (2) Retraining programs need be established to equip inactive nurses for new jobs. (3) Comprehensive information related to employment needs should be made available. Second, a conducive environment needs to be created to draw in inactive nurses to the job market. To be more specific : (1) A system of part-time work needs to be introduced in hospitals. (2) Nurse-specialists need to be promoted. (3) Potential jobs need to be created. (4) Working environment and terms and conditions for nurses need to be improved. (5) Competent nurses need to be secured in the health care delivery system. To achieve the goals presented above, this paper presented 55 specific strategies that may help mitigate the turnover rate of nurses and, in turn, help make the Korean Nurses Association effective in implementing its policies.

• Imaging Science in Dentistry
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• 제47권4호
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• 산업진흥연구
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• 제3권2호
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• pp.41-51
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• 2018

본 연구는 아동학대문제를 사회문제로 보고, 이는 사회 전체가 해결점을 찾아야 할 사안임을 직시하고 그 해결방안을 제시하고자 한다. 본 연구 결과는 다음과 같다. 첫째, 법적 보완이 우선되어야 한다. 이는 관련 법률에 대한 입법 및 법 개정을 통한 법적 보완으로 해결할 수 있다. 둘째, 제도적 보완이 이루어져야 한다. 피학대아동에게 학교교육보다는 신체적 심리적 치료가 절실하다. 향후 아동복지시설은 양육시설보다는 가정에서 살고 있지만 문제행동을 하는 아동을 위한 아동상담소와 전문적 치료가 필요한 아동을 위한 치료형 보호시설을 확충해야 한다. 셋째, 학대피해아동에 대한 조치가 뒤따라야 한다. 피해아동을 대상으로 하는 조치결과에는 원가정보호, 분리보호, 가정복귀, 사망이 있다.

• 한국사회복지학
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• 제69권1호
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• pp.199-222
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• 2017

본 연구는 중증뇌병변장애인 자녀를 둔 아버지가 경험하는 양육경험을 바탕으로 그동안 사각지대에 있던 중증뇌병변장애인의 생활을 살펴보고, 기존 선행연구에서 주로 다루었던 어머니의 장애자녀 양육경험 연구에서 벗어나 아버지만의 고유한 양육경험을 Giorgi 현상학 연구방법을 이용하여 분석하였다. 연구에는 중증뇌병변장애인 자녀를 둔 아버지 4명이 참여하였고, 일 대 일 심층면담을 통해 자료를 수집하였다. Giorgi(2004)의 현상학 연구방법으로 접근하여 분석한 결과는 다음과 같다. 아버지의 양육경험의 명확한 주제는 '숯 덩어리 가슴', '개똥밭에서 살아나기', '삶의 폐허', '현실에 대항하는 자세', '가족 생활양식의 구성', '업(業)으로서의 자녀', '부성 바로 세우기'였다. 분석 결과를 근거로 장애자녀를 양육하는 아버지의 경험을 통해 장애자녀의 어려움과 구조적 문제들을 논의했고, 사회복지 실천차원에서의 구체적 제언을 하였다.

• 한국임상약학회지
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• 제27권3호
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• pp.178-185
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• 2017

Objective: Because of communication difficulties, the hearing-impaired face many disadvantages throughout their lives. One of those is limited access to health care services, particularly medication service. Though they suffer from problems related to taking medication properly, there have been few studies on their actual condition of medication use in Korea. This study is to investigate any obstacles to properly taking medications and, therefore, to suggest preliminary evidence for policy measures to improve safe medication use among the hearing-impaired. Methods: Study participants consisted of hearing-impaired individuals living in Seoul. We also interviewed two sign language interpreters in order to illuminate health care state of the hearing-impaired. In-depth interview for each study participant was recorded and was translated into a written script for analysis. Results: Study participants were comprised of four women (66.6%) and two men (33.3%). There were one participants in 20's, two participants in 30's, one 40's, and two 50's. Sign language interpreters were all women. One was in her 30's and the other was in her 40's. Communication difficulties have been found to be key barrier to use medication safely. A negative image of pharmacists also hinders safe medication usage, lowering access to local pharmacy and leading discretional self-medication. This article provides pharmacists with solutions to promote adherence in this population. Conclusion: The hearing-impaired had limited access to medication-related information as well as using services in a hospital and local pharmacy due to their disability. Institutional improvement for safe medication usage among the hearing-impaired is necessary.

• 보건행정학회지
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• 제17권2호
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• pp.68-90
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• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• Child Health Nursing Research
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• 제16권3호
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• pp.211-219
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• 2010

Purpose: The study was done to measure the effects of maternal heart sound on body weight, physiologic reactions (heart rate [HR] and cortisol) and behavioral states of preterm infants. Methods: Thirty-five preterm infants were recruited from a neonatal intensive care unit at a university hospital. Institutional Review Board approval and informed consent were obtained. The infants were assigned to an experimental group (n=18) with an auditory stimulation for 7 days of life, a continuous delivery of maternal heart sound using MP3 attached inside the incubator, or to a control (n=17) without any auditory stimulation. The outcome variables, daily variations in weight, HR and behavioral states, and differences in cortisol were analyzed. Results: There were differences in variations of daily weights (F=3.431, p=.011) and in cortisol (t=3.184, p=.006) between groups, but no difference in variations of daily HR (F=0.331, p=.933) and behavioral states (F=1.842, p=.323). Conclusion: The findings support the safety of continuous maternal heart sound as no changes in HR and behavioral states occurred, and the efficacy as weight increased and cortisol decreased. This auditory simulation may lead to more efficient utilization of energy in preterm infants by consistently providing familiar sounds from intrauterine life and blocking noxious sounds from NICU environments.