1,721,005 research outputs found
(A) clinical study of endotracheal tube size, tracheal length and bronchial angle in infants
No full text의학과/석사[한글]
유소아의 기관내 튜브 삽관시에 적정크기의 튜브선택과 튜브의 고정길이에 많은 주의를 요한다. 튜브의 고정길이가 너무 깊은 경우나 기관길이가 해부학적으로 짧은 경우는 기관지삽관이 된다. 튜브의 크기가 너무 큰 경우에는 후두부종이 문제가 되며, 튜브크기가 작은 경우에는 적절한 환기가 될 수 없다.
지금까지 많은 연구에서 유소아의 적정 튜브크기와 고정길이에 대한 고찰이 있었으나 만1세 이하의 영유아에 대한 보고는 드물며 특히 한국인 영유아에 대한 보고는 없다. 그러므로 저자는 신촌 세브란스 병원에서 수술을 시행받는 146명의 만1세 이하의 영유아를 대상으로 기관삽관시 적절한 튜브크기를 알아보았으며 수술전에 촬영한 흉부 X-선사진을 이용하여 기관길이 및 좌우 기관지 각도를 측정하였다.
위에서 측정한 사항을을 기초로 다음 5가지 사항을 관찰하여 보았던 바 1)기관내 튜브크기와 연령과의 상관관계는 기관내 튜브크기( mm ) = 0.08 x나이(월령) + 3.36으로 상관계수는 0.09였다. 2) 기관내 튜브크기와 체중과의 상관관계는 기관내 튜브크기( mm )=0.13 x체중( kg )+2.89로 상관계수는 0.78이었다. 3) 기관길이와 연령과의 상관관계는 기관길이 ( cm ) = 0.15 x나이 (월령 )+ 4.0으로 상관계수는 0.68이었다. 4 )기관길이와 체중과의 상관관계는 기관길이( cm ) =0.21x체중( kg )+ 3.34로 상관계수는 0.68이었다. 5)생후 개월수에 따른 좌우 기관지 각도의 평균치는 좌측 및 우측의 차이가 대략 10도로서 개월수에 따른 유의한 차이를 볼 수 없었고 좌측 기관지 각도의 평균치는 47도, 우측 기관지 각도의 평균치는 차이가 있었다.
이상의 결과들로 다음과 같은 결론을 얻었다.
1) 1세이하 영유아의 기관내 튜브 적정크기는 나이보다 체중에서 상관관계가 높았 다.
2) 기관길이는 나이와 체중에서 상관관계가 비슷하였다.
3) 기관길이는 생후 4.2cm였으며 12개월에 5.8cm였다.
4) 1세이하 영유아의 좌우 기관지 각도는 좌측이 47도, 우측이 37도로 좌측이 10도가 더 컸고, 월령수에 따른 유의한 차이가 없었다.
[영문]
It is important to choose adequate endotracheal tube size and fixation length for children at the time of intubation. It tends to bronchial intubation because of short tracheal length, therefore careful attention should be paid to fixation.
Some studied that body weight and age are important determinant factors for adequate tube size . Others claimed that height, head circumference, size of nares, and cross sectional area of body are also important factors of endotracheal tube size. So we studied for adequate tube size and tracheal length according to
age(month) and body weight(kg). We also studied right and left bronchial angle in 146 infants.
We prepared standard tube size according to Dripps' table and one size greater or smaller than standard size. For the selection of adequate tube size, there must be no resistance of passing the tube through the cricoid cartilage and the airway pressure should be at least 15cmH^^2 0 with ambu bagging and anesthetic gases would leak above the pressure of 25cmH^^2 O. Tracheal length and right and left main bronchial angle were also measured with preoperative chest X-ray film.
Tracheal length was measured from vocal cord to carina. Right and left brochial angle were measured from the midline of trachea.
The results are as follows:
1) the relationship coeffiency between tube size and body weight(0.78) was greater than that of age(0.69).
2) the relationship coefficiency between the tracheal length and body weight (0.68) was same as that of age (0.68).
3) Tracheal length ranged from 4.2cm at birth to 5.8cm at 12 months of age.
4) There was no difference in main bronchial angle according to age(month) but left bronchial angle was 47 degree and right bronchial angle was 37 degree in average.
With the above results, we assume that body weight is the most important determinant factor for adequate tube size and the possibility of right bronchial intubation is greater in neonate compared with adult.restrictio
sj-docx-1-tej-10.1177_20417314211067004 – Supplemental material for Lightwave-reinforced stem cells with enhanced wound healing efficacy
No full textSupplemental material, sj-docx-1-tej-10.1177_20417314211067004 for Lightwave-reinforced stem cells with enhanced wound healing efficacy by Yu-Jin Kim, Hye Ran Jeon, Sung-Won Kim, Yeong Hwan Kim, Gwang-Bum Im, Jisoo Im, Soong Ho Um, Sung Min Cho, Ju-Ro Lee, Han Young Kim, Yoon Ki Joung, Dong-Ik Kim and Suk Ho Bhang in Journal of Tissue Engineering</p
EMU and the Dynamics of Italian Path-shifting Pension Reforms: Rethinking Punctuated-equilibrium Model
No full text이 글은 이탈리아의 경로변경적인 연금개혁에 대한 분석을 통해 제도변화에 대한 지배적 이론인 분절적 균형모델의 한계를 지적하고 대안적 시각을 제시한다. 이탈리아의 연금개혁 사례는 제도 변화의 다양성을 보여주며, 경직성이 강한 제도의 변화도 외적 충격이 아니라 내생적 동학에 의해 결정된다는 것을 보여주고 있다. 1990년대 이탈리아에서 역사적 유산을 벗어나는 구조적 연금개혁이 가능했던 주요 요인은 새로운 권력관계 속에서 지배적인행위자로 등장하여 당시 외적 충격과 국내 정치․제도가 제공하는 기회를 적극적으로 활용한 기술관료 정부의 역할(정책아이디어와전략)에 있다. 이들 개혁주창세력은 연금개혁과정에서 축소개혁에 대한 비토세력의 저항을 약화시키기 위한 수동적인 성격의 비난회피전략 뿐 아니라 연금체계의 합리화와 현대화를 목표로 한 적극적인 호평추구 전략을 병행했다. 그리고 이들은 사회적 협의를 제도화하고, 특히 비토세력인 노조와의 비공식적, 공식적 협상을 통해 정치적으로 실행 가능한 연금개혁안을 작성했다. 반복된 게임의 양상을 띤 협상과정에서 노정간 타협과 자원 교환기제는 사회적 합의에 의해 개혁이 이루어지는 데 결정적이었다.
연금개혁의 내용은 건전재정을 추구한 정부의 정책 아이디어, 핵심 노조원의 기득권을 방어한 노조의 이해관계가 맞물려 이루어진 타협의 산물이다. 바로 이것이 이탈리아의 연금개혁이 혁신적인 성격에도 불구하고 그 효과는 장기간에 걸쳐 점진적으로 나타나게 된 이유이다. 이 글은 제도변화의 기제를 제도결정론적 관점과 외적 충격에 의한 분절된 균형모델로 설명하는 제도주의 이론과는 달리 지배적 정책 아이디어, 주요 행위자의 이해관계와 전략적 상호작용양상이 제도변화의 동학과 다양성을 결정짓는다는 점을 강조한다.
This paper sheds light on the mechanism of path-shifting pension reforms in the 1990s in Italy with the aim of criticising mainstream arguments and suggesting an alternative analytic perspective on the dynamics of institutional changes. This paper argues that the role of Italian technocratic governments (in terms of policy idea and reform strategies) determined the success of consensual, pathshifting pension reforms. They, emerged from new balance of power, realigned the network of decision-making of pension reforms to translate their policy idea in specific policies. They used credit-claiming strategies in addition to blameavoidance strategies, by elaborating reform goals in terms of modernisation and rationalisation, as well as cost-containment, of the pension system, and promoted concertative policy-making to overcome veto powers. During the multiple-game of negotiations on pension reforms, compromises and the exchange of resources were main mechanisms of striking deals between technocratic governments and trade unions. That's why the far-reaching effect of the Italian innovative reform resulted in delay in time. Unlike neoinstitutionalist (punctuated equilibrium model) arguments, this paper suggests that the dynamics and the dimension of policy change depend on the dominant policy idea, which mirrored power relations, and the strategic interaction of main players and the preference structure, in particular, of trade unions, even in the face of strong external shocks such as the economic and monetary crisis and the overriding imperatives of qualifying for EMU
상급종합병원과 종합병원의 비교
Full text link학위논문(석사) -- 서울대학교대학원 : 행정대학원 공기업정책학과, 2022. 8. 정광호.본 연구의 목적은 의료전달체계 개선을 위해 시행된 상급종합병원 경증질환 재진 시 외래 본인부담률 인상정책이 외래 의료이용에 미친 영향을 살펴보고, 의료전달체계에 미친 영향을 평가하는 것이다. 2020년 10월부터 시행 된 경증질환 재진시 외래 본인부담률 인상(상급종합병원 60% → 100%) (보건복지부 고시 제 2020-221호)을 대상으로 2020년 1월부터 2021년 9월까지 건강보험심사평가원 청구데이터를 사용하여 정책 시행 전·후의 정책적용집단(상급종합병원) 46개 기관과 정책비적용집단(종합병원) 284개 기관을 구분하여 병원 단위로 이중차이분석(difference-in-difference method)을 실시하였다. 분석 결과에 따르면, 정책의 시행이 월별 외래 내원일수에 미친 영향은 음의 방향으로 통계적으로 유의하였다. 본 연구의 결과를 바탕으로 상급종합병원 경증질환 외래 본인부담률 인상 정책이 상급종합병원의 외래 규모를 적정수준으로 감소시켜 의료전달체계 개선에 긍정적 영향을 미쳤음을 확인하였으며, 상급종합병원의 기능과 역할 정상화에 초점을 맞추도록 정책의 설계 및 적용이 필요함을 제언한다.The purpose of this study is to investigate the effect of the policy of the increasing the outpatient co-insurance rate for revisiting a minor disease at a tertiary hospital on the use of outpatient care and evaluate the effect on the medical delivery system. Using data from the Health Insurance Review and Assessment Service from January 2020 to September 2021, to evaluate the effectiveness of increase of outpatient co-insurance rate for re-examination of mild disease (60% → 100% at tertiary hospitals) (Ministry of Health and Welfare Notice No. 2020-221), which has been in effect since October 2020. a double difference analysis was applied by dividing 46 institutions in the policy groups (tertiary general hospital) and 284 non-policy groups (general hospital). According to the analysis results, the effect of policy implementation on the number of monthly outpatient visits was statistically significant in a negative direction. Based on the results of this study, it was confirm that the policy to increase the outpatient co-insurance rate for mild disease at tertiary hospitals had a limited positive effect on the improvement of the medical delivery system by reducing the number of outpatients at tertiary hospitals. We proposed the design and application of policies focused on normalizing the functions and roles of tertiary general hospitals.제 1 장 서 론 7
제 1 절 연구의 배경 및 필요성 7
제 2 절 연구의 목적 10
제 3 절 연구의 내용 및 방법 11
제 2 장 이론적 배경과 선행연구 검토 12
제 1 절 이론적 배경 12
제 2 절 선행연구 검토 25
제 3 절 선행연구와 차별점 31
제 3 장 연구의 설계 및 분석방법 32
제 1 절 연구대상정책 32
제 2 절 연구가설 33
제 3 절 분석방법 및 분석틀 33
제 4 절 자료원과 분석대상 36
제 4 장 분석결과 43
제 1 절 분석대상의 일반적 특성 43
제 2 절 주요변수 통계결과 50
제 3 절 정책시행 전후 분석결과 56
제 4 절 지역별 분석결과 65
제 5 장 논의와 결론 76
제 1 절 연구결과 고찰 및 정책적함의 76
제 2 절 연구의 한계 및 제언 83
참고문헌 86
Abstract 104석
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No full text��������� ��������������������� ��������� ��������������� ��������������� ������ ������������. ��� ��������������� ��������� ��������������������� ������ ��������� ������������ ������������ ��������� ������ ��������� ��������� ��������� ������. ��������� ��������������� ������������ ��������� ��������������� ������ ��������� ��������������������� ��������������� ��������� ������������ ��������� ��������� ��������� ������������ ��������� ������������. ��������� ��� ��������������� ��������� ��������� ������������ PLS ��������������� ������ ������������������ ��������� ������������ ��������� ��������������� ��������� ���������������. ��� ������, ������ ��������� ��� ��������������������� ��������� ��������� ������ ��� ��������������� ��������� ���������������. ��������� ��������������������� ��������������� ������������ ��������� ��������������������� ������������ ��������������� ��������������� ��������� ������ ������������. ��������� ��������������������� ��������� ��������� ������ ��� ��������� ������ ������ ��������������� ��������� ��������� ������.Uncertainty in large-scale tourism development is the main reason of the delay on the project. The purpose of this study is to identify the status and effect of this large-scale tourism development project. Huge amount of funds has to be invested prior to the development of this project and with high uncertainty of successful development, the procedure is the most important factor of this project. Therefore, under the basis of these assumptions, we operated a PLS regression analysis to see any factors that has influence during the procedure of the project. The result of the PLS regression analysis resulted that among all of the factors, the participation and role of regional community is the highest priority. In order to lead large-scale tourism development to success is to listen to the ideas of various project-related personnels and form a public - private partnership for evaluation of the project
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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