• Proceedings of The Korean Society of Health Promotion Conference
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• 2004.10a
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• pp.17-58
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• 2004

뉴저지주 보건교육/건강 증진정책을 논하기전에 건강증진과 보건 교육사의 뜻을 먼저 기술하기로 한다. 건강증진이란 일상 사회생활과 행동과학의 응용에서 시작하며 교육의 효율적 작전 및 기술, 질병 역학 조사, 개인 및 가족단위 건강 위해 행위 절감, 사회연관 구축망 조성, 그리고 적게는 이웃, 더 나아가 조직체계 및 지역 사회의 네트웍 실시등을 실시한다. 보건교육 및 건강증진 전문가란 ' 전국 보건교육 인증 위원회(NCHEC) ' 에서 채택된 다음 7개 활동 영역에서 개인적, 그룹, 각주단위, 그리고 범 국가적 조직에서 종사하는자로 한다. 개인 및 지역사회 보건 교육 필요성 분석- 계회, 실행, 효율성 평가, 사업 진행 조정, 자문, 컴뮤니케이션 등의 활동범위를 들 수 있다. 공인 보건 교육사(CHES)란 대학 및 대학원에서 보건 교육학 소정의 필수 과목을 이수하고 학.석사 소지자로서 ' 전국 보건 교육 인증 위원회 ' 에서 그 자격을 인정 받고 공인 자격 시험에 합격한자로 한다. 합격자는 자기 성명뒤에 CHES란 칭호를 부치며 매 5년마다 75단위이상 인정된 전문 직업 보수 교육을 받아야 한다. 보건 교육사 고용 분야는 연방, 주, 지방 정부의 보건 교육사(10-15%) 및 건강 증진 전문가로 종사하며; 이들은 지역 사회 조직화, 프로그람 기획, 공공사업 마켓팅, 메디아, 컴뮤니케이션 자질을 갓추어야 하며; 상해 예방, 학교 보건, 지역 사회 영양 실태 향상, 그 외 모든 건강 증진과 질병 예방에 일익을 담당 하여; 의사, 간호사, 약사, 영양사,환경 위생사드의 전문분야종사자들괴 한팀이 되어 지역 사회 보건 사업에 기여한다. 쥬저지 보건 교육사들은 주법령 8조 '||'&'||' 보건행정 표준 시행령 ' 에 따라 포괄적 보건교육/건강증진 프로그램을 개발하여 총체적으로 조절 관장한다. 특희 ' 미국 학술원 의료 연구원 ' 에서 제정한 ' 10대 필수 공중 보건 사업 ' 에 기준을 두고; 1) 개인 및 지역사회 필수 보건 여건 분석 평가, 2) 보건 교육 이론에 따른 사업 계획 설정, 3) 교육 전략과 보건문제 발굴에 따라 일반 대중 대상 보건 교육 실행 (프로그람 기획, 연수 교육, 미디어 캠페인, 공중보건 향상책 옹호), 4) 사업 진행 과정 정리, 그 결과에 대한 영향력과 결과 평가, 5) 프로그램진행, 인사 및 예산관리 참여, 6) 근무향상을 위한 보수교육 프로그램 개발, 7) 보건 의료 업무 종사자 상호 협조성 향상 훈련, 8) 지역 사회자원 밭굴, 9) 적절한 고객 의뢰 체제 시행, 10) 위기 관리 컴뮤니케이션 체제 개발실시, 11) 일반 대중에게 공중 보건 향상 고취, 12) 각종 협력 지원금 신청서 작성 제출, 13) 문화/인종적으로 적절한 시청각 교재 발굴, 15) 질적 및 양적 보건교육/건겅증진책 연구 실시, 16) 비 보험 가담자, 저 보험자, 빈곤자, 이민자 색출 선도, 17) 관활 구역내 상재하는 각 건강증진 프로그램 밝혀 내서 불필요한 중복 회피등이다. 그 외에도 보건 교육사들은 사회 복지 단체인 미국 암 협회, 미국 심장 협회,미국 폐장 협회 등 각종 사회 복지 비영리단체 와 자선 사업 단체들과 긴밀희 협조하거나 그 단체 임직원으로서 건강 증진 사업에 종사한다. 병원 및 의료기관에선 임직원 보수 교육, 환자의 질병 예방및 건강증진 교육, 그리고 의료 사업장내 건장 증진업무에 종사한다. 건강 유지 의료 기관(HMO)에선 예방주사, 정기검진 촉진등을 통한 입원일수 절감, 응급실 사용도 절감등으로 의료비 감축, 삶의질 향상상에 종사한다. 사업장 보건 교육사는 스트레스 관리, 금연 및 흡연 중단선도, 체중 절감, 종업원 건강증진 생활화참여 유치, 컴뮤니케이션 개발, 마켓팅, 질병 예방등에 그 전문 직업적 노하우를 사업체 건강 증진 프로그램 개발에 접목한다. 뉴저지 2010년대 건강 증진책은 5대 목표 설정하여 현재 시행하고 있다. 특이한점은 2001년 9.11사태 이후 연방정부와 주정부의 상당한 예산 지원을 그랜트 지원금 형식으로 받아 연방, 주정부, 지방 정부, 의료 기관등에서 일사 불란하게 생물/화학/방사성 테러에 대비하는데 보건 교육사들은 시민 인지도 향상과 위기관리 컴뮤니케이션 영역에서 활약한다. 총체적인 보건 교육/건강 증진책은 다음 천년간 뉴저지 건강증진 백서와 미연방 정부 건강증진 2010에 준하여 설립한 뉴저지 건강 증진 2010 에 의한다. 그 모델을 보면; 1) 생활 습관 향상으로 위해 행위 절제; 적절한 영양 섭취 와 과체중화 차단 불필요한 투약 절제와 그 관리 흡연 탐익 절감, 금연, 흡연관련 신체/정신적 피해 관리/치료 습관성 약물 중독 조기발견 예방 낙상 예방 폭력, 의도적/비의도적 상해 예방 2) 심장질환, 암, 뇌졸중, 당뇨, 폐염, 인프루엔자등 주사망원인 질병 조기 발견 예방 책 마련; 독감.폐렴 예방 주사 실시 3) 보건 교육 대상과 표적 설정 특히 보건사업 참여 동반자 발굴하여 그 동참과 책임분담 책려; 주. 지방 정부기관, 의료 종사자, 의료 보험 업자, 대학 등 교육 기관, 연구 기관, 교육자, 지방 보건소, 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구., 지역 사회 비 영리단체, 종교 단체 및 교역자 등의 참여 촉구.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.55
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• pp.209-240
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• 2012

Since the age of Lord Mansfield, who laid the foundation of the modern English insurance contract law in the second part of the 18th century, English insurance law has developed a unique rule of warranty. Lord Mansfield adopted very different approach and afforded such a strict legal character to insurance warranty, because the promise, given by the insured, played an important role for the insurer to assess the scope of the risk insured at that time. It is still important that the insured keep his promises strictly to the insurer under the insurance contract, but legal environments have changed dramatically since the times of Lord Mansfield. English Law Commission proposed some proposals for reforming the warranty regime to reflect the changes of legal environment in CP 2007. This article is, therefore, designed to examine the proposals and consider their legal and practical implications. The proposals of Law Commission is summarized as following. First, in CP 2007, Law Commission made two principal proposals for reform of the law on warranty. The first is that the insurer should not be entitled to rely on a breach of warranty unless the insured has been provided with a witten statement of what they have undertaken under warranty. The second is that the insurer should not be entitled to reject a claim on the ground that the insured has breached a warranty unless there was a causal connection between the breach and the loss. Secondly, for consumer insurance, the rule requiring a causal connection would be mandatory, whereas for business insurance, it would be possible for the parties to agree on the effect a breach of warranty should have, provided they use clear language to express their intentions. Thirdly, where the insured contracted on the insurer's written standard terms of business, some statutory controls would be afforded to the contract to ensure that the cover was not substantially different from what the insured reasonably expected. Finally, Law Commission propose that a breach of warranty give the insurer the right to terminate the contract, rather than automatically discharging it from liability, but (unless otherwise agreed) only if the breach has sufficiently serious consequences to justify termination under the general law of contract. Having evaluated the proposals of the Law Commission and considered their legal and practical implications, it is quite clear that the proposed rule interfere with freedom of contract and create legal uncertainty. But change can not made without any victims, so Law Commission's attempt to change severe and injust aspects of the warranty regime would be very welcomed and respected.

• Journal of Yeungnam Medical Science
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• v.2 no.1
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• pp.191-202
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• 1985

As the result of a significant improvement in the economic situation and development of scientific techniques in Korea during the last 20 years, the life expectancy of the Korean people has lengthened considerably and as a result the number of old aged people has markedly increased. Such an increase of the number of aged people brought about many problems. Authors would like to take a medical look at the "Problem of old aged people" presently facing us in Korea. Currently the number of people over 65 has increased rapidly and is 1,620,000, 4% of total population. But it is still much lower than 8.9% in Japan, 10.7% in U.S.A., and 14.9% in the United Kingdom. Over 25% of these aged people were found to have at least more than one disease which requires medical care. Diseases occur in the circulatory system, 30.9%, respiratory system, 17.1%, digestive system 8.6%, mental disorders, 8.4%, malignant neoplasms, 7.0%. About 51% of the aged over 65 are under medical security benefit, mostly with partial coverage plan. Their clinic visit rate was very low (2.0% in 1981), which might be due to financial reasons. Since diseases affecting the aged progress chronically, early detection and long term care are utter most important. However there is almost no special facility, long term care center or geriatric specialist. For proper management of medical problems in the growing population of the Korean eldery expansion of medical security coverage, greater number of specialized facilities, education of geriatric special manpower and efficient operating system should be established.

• Health Policy and Management
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• v.27 no.4
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• pp.336-346
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• 2017

Background: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. Methods: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. Results: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. Conclusion: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.

• Health Policy and Management
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• v.22 no.4
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• pp.467-496
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• 2012

Public participation in the decision making for scarce health resources is important because health policy requires trust based consensus, which can be achieved by public's understanding and involvement of related policies. In the past, opportunities for interaction between health policy decision makers and lay public were rare in Korea. As political impulses towards public participation in health policy have increased, a few of deliberation methods were attempted. However, there is little research, reporting such cases with a critical examination of relevant theories and previous studies. We first critically review the literature on public participation within theories of democracy, governance, and empowerment. Next, we report a case of a citizen council experiment, which was held to examine public's preferences among different benefit options regarding new drugs and medical technologies. Specifically, in an one-day long citizen council with a total of 28 lay public, twelve questions of whether a drug or a technology should be included in the benefit package of health insurance were asked. Pre- and post-surveys investigated participants' perception of public engagement in health policy. Although it was experimental, the citizen council ensured that lay public could be careful enough to rationally compare the costs and benefits of different options and collectively make decisions. Further, results from pre- and post-survey showed a strong willingness of members to be involved in health care decision making. In the conclusion, we emphasize that better theories and methods need to be developed for more cases of citizen participation in health care policy and management.

• Journal of Legislation Research
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• no.53
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• pp.593-631
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• 2017

Like the technological competition of each country around commercialization of Autonomous Vehicles(the rest is 'AV'), legalizations are also in a competition. However, in the midst of this competition, the Ethik-Kommission Automatisiertes und vernetztes Fahren of Germany has recently introduced 20 guidelines. This guideline is expected to serve as a milestone for future AV legislations. In this paper, I have formulated a new legislative proposal that will incorporate the main content presented by the Ethik-Kommission. The structure is largely divided into general rules of purpose and definition, chapter on types of AV and safety standards, registration and inspection, maintenance, licenses for AV, driver's obligations, insurance and accident responsibilities, roads and facilities, traffic system, and chapter on penalties. The commercialization of AV in Korea seems to be in a distant future, and it is possible to pretend that it is not necessary to prepare legal systems. But considering our reality, leading legislation may be necessary. In this paper, I have prepared individual legislative proposals based on the essential matters based on the criminal responsibility in case of AV car accidents. To assure the safety of AV, AV and mode of operation were defined for more clear interpretation and application of law, and basic safety standards for AV were presented. In addition, the obligation of insurance and the liability for damages were defined, and the possibility of immunity from the criminal responsibility was examined. Furthermore, I have examined the penalties for penalties such as hacking in order to secure the effectiveness of the Act. Based on these discussions, I have attempted the 'Autonomous Vehicles Act', which aims to provide a basis for new discussions to be held on the basis of various academic fields related to the operation of AV and related industries in the future. Although there may be a sense of unurgency in time, the automobile industry needs time to prepare for the regulation of the AV ahead of time. And a process of public debate is also needed for the ecosystem of healthy AV industry.

• The Korean Journal of Air & Space Law and Policy
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• v.30 no.1
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• pp.207-244
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• 2015

Aviation safety is the stage in which the risk of harm to persons or of property damage is reduced to, and maintained at or below, an acceptable level through a continuing process of hazard identification and risk management. Many accidents and incidents have been taking place since 2014, while there had been relatively safer skies before 2014. International civil aviation community has been exerting great efforts to deal with these emerging issues, thus enhancing and ensuring safety throughout the world over the years. The Preamble of the Chicago Convention emphasizes safety and order of international air transport, and so many Articles in the Convention are related to the safety. Furthermore, most of the Annexes to the Convention are International Standards and Recommended Practices pertaining to the safety. In particular, Annex 19, which was promulgated in Nov. 2013, dealing with safety management system. ICAO, as law-making body, has Air Navigation Commission, Council, Assembly to deliberate and make decisions regarding safety issues. It is also implementing USOAP and USAP to supervise safety functions of member States. After MH 370 disappeared in 2014, ICAO is developing Global Tracking System whereby there should be no loophole in tracking the location of aircraft anywhere in world with the information provided by many stakeholders concerned. MH 17 accident drove ICAO to install web-based repository where information relating to the operation in conflict zones is provided and shared. In addition, ICAO has been initiating various solutions to emerging issues such as ebola outbreak and operation under extreme meteorological conditions. Considering the necessity of protection and sharing of safety data and information to enhance safety level, ICAO is now suggesting enhanced provisions to do so, and getting feedback from member States. It has been observed that ICAO has been approaching issues towards problem-solving from four different dimensions. First regarding time, it analyses past experiences and best practices, and make solutions in short, mid and long terms. Second, from space perspective, ICAO covers States, region and the world as a whole. Third, regarding stakeholders it consults with and hear from as many entities as it could, including airlines, airports, community, consumers, manufacturers, air traffic control centers, air navigation service providers, industry and insurers. Last not but least, in terms of regulatory changes, it identifies best practices, guidance materials and provisions which could become standards and recommended practices.

• Korean Journal of Occupational Health Nursing
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• v.2
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• pp.40-51
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• 1992

본 연구는 병원에서의 산업보건관리 실태를 파악하기 위하여 전국에 있는 병원을 대상으로 1992년 12월 1일부터 1993년 1월 23일까지 설문조사를 설시하였다. 설문조사에 응당한 병원은 41개병원으로 회수율은 51.9%였다. 조사에 이용된 설문지는 산업안전보건법 내용을 기초로 하여 본 연구자가 작성한 것이며 안전보전에 관한 제반 규정, 안전보건관리체계, 근로자건강관리, 작업환경관리, 보건교육, 보건관련시설, 질병 및 상해에 대한 보상 등에 관한 45개문항으로 구성되어 있다. 분석결과는 다음과 같다. 첫째, 전체 병원 중 68.3%가 안전보건관리 규정이 있다고 답하였으며, 77.5%의 병원이 단체협약 중 근로자의 안전과 보건에 관한 조항을 포함시키고 있는 것으로 나타났다. 단체협약에 포함된 내용 중에는 정기건강진단(23.7%)과 질병 및 상해에 대한 보상(20.9%), 안전보건위원회의 구성(18.1%)등이 많았다. 둘째, 대상 병원중 66.7%가 안전보건관리책임자, 관리감독자, 안전담당자를 두고 있는 것으로 나타났고, 근로자수가 1,000명 이상인 병원은 83.3%가 이들 인력을 선임하고 있다. 그러나, 보건관리자와 안전관리자를 전담으로 두고 있는 경우는 한 곳도 없었으며 50%이내에서 겸직으로 선임하고 있었다. 또한, 안전보건위원회를 운영하고 있거나 노사협의회로 이를 대치하고 있는 병원은 54.2%로 절반 수준에 머물렀고, 그나마 정기적으로 운영을 하고 있다고 답한 병원은 3개 병원 밖에 되지 않았다. 세째, 근로자 건강관리를 위한 건강진단 실시 현황을 보면, 채용시검진 97.6%, 일반건강진단 100.0%, 특수 건강진단 24.4%가 실시하고 있었다. 건강진단에서 주로 실시하고 있는 항목은 흉부 X선검사, 시력, 혈압, 혈청GOT/GPT, 체중, 신장등이었다. 그러나, 병원에서 감염될 수 있는 기회가 높은 간염항원/항체검사의 실시율은 85.7%로 아직도 실시하지 않는 병원이 있음을 알 수 있다. 네째, 작업환경관리를 위하여 정기적으로 환경측정을 실시하는 병원은 21.6%였고 주로 측정하는 항목은 방사선이었다. 특히 소음, 조명, 분진에 대한 측정이 이루어지지 않음은 근로자뿐아니라 환자의 안위에도부정적인 영향을 미칠 수 있다. 다섯째, 안전한 작업과 근로자의 건강을 위하여 정기적인 보건교육을 설시하고 있는 병원은 불과 5.6%였다. 교육내용은 주로 안전에 관한 것이었다. 여섯째, 근로자의 일상적인 건강문제를 해결해주는 의무실을 독립적으로 마련하고 있는 병원은 한 곳도 없었고, 교대근무자나 당직자를 위한 수면시설은 44.7%, 작업 후에 사용할 수 있는 샤워시설은 35.1%의 병원이 마련하고 있었다. 일곱째, 근무중 다치거나 병에 걸렸을 때 치료비에 대한 부담은 대체로 병원이 하고 있으며 치료기간 중 근무는 병가나 휴직으로 처리되고 있다. 이는 병원이 산재보상보험법에 적용을 받지 않은 사업으로 분류되어 있는 현실에 기인된 것으로 보상과 관련된 부담을 병원이나 근로자 모두가 안게 되는 결과를 초래하게 되는 것이다. 이상에서 볼 때 병원근로자를 위한 산업보건관리는 주로 건강진단과 질병 및 상해에 대한 보상제도가 이루어지고 있는 실정이다. 그러므로 질병의 예방이나 악화방지 나아가 건강증진을 도모하기 위한 지속적인 노력을 기울이고 있는 병원은 전무한 상태임을 알 수 있다. 이러한 현실을 병원근로자를 위한 산업보건관리에 대한 인식이 전반적으로 부족함을 드러내는 것으로 이를 개선하기 위한 보다 적극적인 노력이 시급히 요청되고 있다.

• Journal of Yeungnam Medical Science
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• v.24 no.2
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• pp.287-295
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• 2007

Background : This study investigated and analyzed the life style of male white- collar workers and their perception of obesity to determine how to improve eating habits and prevent obesity. Materials and Methods : Using the questionnaires distributed to and collected from 300 male white-collar workers in Daegu, the survey was conducted from December 20, 2005 to February 28, 2006. Two hundred sets of collected questionnaires were used for the analysis, and SPSS WIN 12.0 was employed to analyze the data. Results : Forty-two percent of subjects had weights ranging between 71 kg and 80 kg; 39.5%, weighted between 61 kg and 70 kg. The waist measurements of 64.5% of all respondents were between 32 and 34 inches. The lifestyle questions found that 54% of respondents were smokers and 88.5% drank alcohol. In addition, 62.5% of all respondents reported doing exercise, whereas 37.5% reported no exercise. Conclusion : The height and weight of 200 respondents were used to calculate the body mass index (BMI). Only 31.6% had a normal BMI, whereas 32% were found to be overweight, a condition likely to lead to obesity. Meanwhile, 36.5% of respondents were obese or morbidly obese.

• Journal of Korean Foot and Ankle Society
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• v.20 no.1
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• pp.12-18
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• 2016

Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.