• Journal of Preventive Medicine and Public Health
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• v.32 no.2
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• pp.123-129
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• 1999

Objectives: This study was performed to investigate sweets of genetic polymorphisms of glutathione S-transferase M1 (GSTM1), glutathione S-transferase M1 (GSTT1), cytochrome P450 1A1 (CYP1A1) and cytoehrome P450 2E1 (CYP2E1) on lung cancer development. Methods: Ninety-eight lung cancer patients and 98 age-sex matched non-cancer patients hospitalized in Chungbuk National University Hospital form March 1997 to August 1998, were the subjects of this case-control study. Direct interview was done and genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1 were investigated using multiplex PCR or PCR-RFLP methods with DNA extracted from venous blood. Effects of the polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1, lifestyle factors including smoking, and their interactions on lung rancor were statistically analyzed. Results: GSTM1 was deleted in 67.01% of the cases and 58.16% of the controls, and the odds ratio(95% CI) was 1.46(0.82-2.62). GSTT1 deletion was 58.76% for the lung cancer patients and 50.00% for the controls[OR:1.43(0.81-2.51)]. The frequencies of lle/lle, lle/Val and Val/Val of the CYP1A1 polymorphisms were 59.18-18%, 35.71%, and 5.10% for the cases, and 52.04%, 45.92%, 2.04% for the controls, respectively. Risk of lung cancer was not associated with polymorphism of CYP1A1 ($x^2trend=0.253$, p-value>0.05). The respective frequency of c1/c1 c1/c2, c2/c2 genotypes for CYP2E1 were 50.00%, 42.86%, 7.14% for the lung cancer patients, and 66.33%, 30.61%, 3.06% for the controls $(x^2trend=5.783,\;p<0.05)$. c2 allele was a significant risk factor for lung cancer. We also observed a significant association of cigarette smoking history with lung cancer risk. The odds ratio(95% Cl) of cigarette smoking was 3.03(1.58-5.81). In multiple logistic analysis including genotypes of GSTM1, GSTT1, CYP1A1 and CYP2E1, and smoking habit, only snaking habit came out to be a significant risk factor for lung cancer. Conclusion: Genetic polymorphisms of GSTM1, GSTT1, CYP1A1 and CYP2E1 are not so strongly associated with lung cancer as lifestyle factors including cigarette smoking.

• Korean Security Journal
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• no.9
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• pp.69-98
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• 2005

The security industry for civilians (Private Security), was first introduced to Korea via the US army's security system in the early 1960's. Shortly after then, official police laws were enforced in 1973, and private security finally started to develop with the passing of the 'service security industry' law in 1976. Korea's Private Security industry grew rapidly in the 1980's with the support of foreign funds and products, and now there are thought to be approximately 2000 private security enterprises currently running in Korea. However, nowadays the majority of these enterprises are experiencing difficulties such as lack of funds, insufficient management, and lack of control over employees, as a result, it seems difficult for some enterprises to avoid the low production output and bankruptcy. As a result of this these enterprises often settle these matters illegally, such as excessive dumping or avoiding problems by hiring inappropriate employees who don't have the right skills or qualifications for the jobs. The main problem with the establishment of this kind of security service is that it is so easy to make inroads into this private service market. All these hindering factors inhibit the market growth and impede qualitative development. Based on these main reasons, I researched this area, and will analyze and criticize the present condition of Korea's private security. I will present a possible development plan for the private security of Korea by referring to cases from the US and Japan. My method of researching was to investigate any related documentary records and articles and to interview people for necessary evidence. The theoretical study, involves investigation books and dissertations which are published from inside and outside of the country, and studying the complete collection of laws and regulations, internet data, various study reports, and the documentary records and the statistical data of many institutions such as the National Police Office, judicial training institute, and the enterprises of private security. Also, in addition, the contents of professionals who are in charge of practical affairs on the spot in order to overcomes the critical points of documentary records when investigating dissertation. I tried to get a firm grasp of the problems and difficulties which people in these work enterprises experience, this I thought would be most effective by interviewing the workers, for example: how they feel in the work places and what are the elements which inpede development? And I also interviewed policemen who are in charge of supervising the private escort enterprises, in an effort to figure out the problems and differences in opinion between domestic private security service and the police. From this investigation and research I will try to pin point the major problems of the private security and present a developmental plan. Firstly-Companies should unify the private police law and private security service law. Secondly-It is essential to introduce the 'specialty certificate' system for the quality improvement of private security service. Thirdly-must open up a new private security market by improving old system. Fourth-must build up the competitive power of the security service enterprises which is based on an efficient management. Fifth-needs special marketing strategy to hold customers Sixth-needs positive research based on theoretical studies. Seventh-needs the consistent and even training according to effective market demand. Eighth-Must maintain interrelationship with the police department. Ninth-must reinforce the system of Korean private security service association. Tenth-must establish private security laboratory. Based on these suggestions there should be improvement of private security service.

• Korean Journal of Agricultural Science
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• v.4 no.2
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• pp.215-228
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• 1977

In order to provide good germplasm for developing good corn hybrids, a total of 948 Korean indigenous corn lines were collected from various parts of country and major morphological characterstics of ears were investigated. The results obtained were as follows; 1) Ear Type; From the east-north mountaionus region where more than 80% of total corn production is practiced, cylinder (type I) or similar types to cylinder corn were collected, and from the southern plain region, where rather small scales of corn is grown, cone type (type IV) or similar types to cone were prevalent. 2) Kernel color; In the ear colors of all the indigenous corn lines collected from ten regions, ears with mono color were 54.4%, ears with two color mixed were 39.0% and ears with three or more color mixed were 6.6%. In northern mountainous region, region A and region I, ear color was mostly white or white plus other colors, while in other regions ear color was yellow or yellow plus other colors. 3) Denting; Dent type was only 4.3% of Korean indigenous corn lines collected, and others were flint type. Dent type was collected from northern regions, where foreign corn varieties were introduced and grown. 4) Ear row number; Ear row numbers of indigenous corn lines collected were 12 to 16. There was no significant differences among the ear row numbers in a ear ciassified by regions. However, it was observed that ear row number was closely related to kernel size. For instance, the ears with 24 ear-rows were the smallest in kernel size. 5) Quality of starch; 70.9% of the indigenous corn lines collected were kernels with hard starch. Corn with soft starch was 26.0% and medium type was 3.1%. In region A and region I, where lot of corn is grown, corn with hard starch was more frequently collected. 6) Pop corn and waxy corn; In all the indigenous corn lines collected, popcorn was distributed uniformly through the regions except region I, and waxy corn was found more in the northern mountainous region. 7) Ear length; The mean ear length of indigenous corn lines collected was 13cm. In region A and region I ear length was larger than that in other regions. 8) Ear diameter; The mean ear diameter of indigenous corn lines collected was 3.3cm. In region A and region I ear diameter was larger than that in other regions. 9) Kernel length, kernel width and kernel thickness; The mean kernel length, kernel width and kernel thickness of indigenous corn lines collected were 0.82cm, 0.42cm, and 0.78cm, respectively. The kernel size in the region A and region I was larger than that in other regions. 10) Ear weight; The mean ear weight of indigenous corn lines collected was 58.04gr. Ear weight was remarkably heavier in region A and region I. The heaviest ear weighed 330gr, and the lightest ear weighed 5 gr. 11) Kernel weight of a ear and 100 kernel weight; Kernel weight of a ear and 100 kernel of indigenous corn lines collected were 47.07gr and 15.07gr, respectively. Kernel weights and 100 kernel weights were much heavier in region A and region I than other regions.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.241-250
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• 1999

Background: Persistent nonproductive cough is a major adverse effect encountered with ACE inhibitor treatment and the most frequent reason for withdrawal of the drug. The mechanism of cough was postulated to be associated with accumulation of bronchial irritants which are substrates of ACE. It has been speculated that occurrence of this adverse effect is genetically predetermined ; in particular, variants of the genes encoding ACE. To investigate this relationship, we determined ACE gene Insertion/Deletion polymorphism in subjects with and without a history of ACE inhibitor-induced cough. Methods: Among the 339 patients with ACE inhibitor treatment, subjects who developed cough that resolved when not taking medication were designated to cough group and other subjects who did not complain cough were designated to non-cough group. Clinical characteristics of the patients were collected by review of medical records. ACE genotypes were determined by PCR amplification of DNA from peripheral blood and agarose gel electrophoresis. Results: 37 patients complained of dry cough(cough group) and 302 patients did not complained of cough(non-cough group). The incidence of ACE inhibitor induced dry cough was 10.9%. There was a preponderance of females in the cough group (M : F=24.3% : 75.7%) compared to the non-cough group (M : F=49.7% : 50.3%, p=0.004). There was no significant difference in mean age, underlying diseases, and kinds and frequencies of ACE inhibitors and their mean dosage between the both groups. ACE genotypic frequencies were I/I : I/D : D/D=16.2% : 18.9% : 64.9% in the cough group and 18.9% : 18.2% : 62.9% in the non-cough group which showed no significant difference between the both groups(p=0.926). Allelic frequencies were I : D = 25.7% : 74.3% and 28.0% : 72.0% in the cough and non-cough group respectively and the difference was not significant(p = 0.676). Conclusion: The incidence of ACE inhibitor-induced cough are 10.9%, and women are more susceptible to ACE inhibitor-induced cough. ACE inhibitor-induced dry cough is not associated with ACE gene Insertion/Deletion polymorphism.

• Korean Journal of Poultry Science
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• v.30 no.4
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• pp.235-244
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• 2003

This study was carried out to estimate the effects of strain and generation on the major production performances of Korean native chicken. The data were collected from 11,583 birds of the 7 generations over the year 1995 through 2001 at National Livestock Research Institute, Korea. Results obtained were summarized as follows: The body weights at 150 and 270 days of age were 1,557.7 and 1880.7, 1,471.7 and 1,738.2, 1,393.5 and 1,694.9, 1,591.2 and 1,910.0, 1,545.6 and 1,763.6g in Red Brown, Yellow Brown, Gray Brown, Black, and White strains, respectively. The Coefficient of Variations (CVs) of the body weights at 150 and 270 days of age were 9.65~13.79% and 13.29~15.16%. The ages at first egg were 150.0, 148.3, 149.5, 152,8 and 147.7 days in Red Brown, Yellow Brown, Gray Brown, Black and White strains, respectively and the CVs were between 9.33 and 10.11%. The egg weights at the first egg and 270 days of age were 33.2 and 50.8, 32.2 and 49.2, 32.2 and 49.1, 33.0 and 50.0, 30.7 and 47.8g respectively. The CVs of the egg weights of the first egg and at 270 days of age were 13.54~15.27% and 6.93~7.36%. The numbers of eggs produced by 270 days of age were 77.0, 79.3, 77.3, 73,7, 75.4, respectively, and observed CVs were between 29.98~36.99%. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The significant strain effects were investigated in all the major economic traits in Korean native chicken. The highest least square (LS) means of the body weights at 150 and 270 days of age were observed in Black strain as 1,594.38 and 1,911.57g. The earliest LS mean of the ages at first egg was 146.88days in White strain. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in Red Brown strain as 32.20 and 50.74g. The LS mean of the largest number of egg production was 79.50 eggs in Yellow Brown strain. Also, The significant generation effects were investigated in all the major economic traits. The highest LS means of the body weights at 150 and 270 days of age were observed in the generation 3 as 1,599.74 and 1,905.01g. The earliest LS mean of the age at first egg was 143.31 days in 4th generation. The heaviest LS means of egg weights at the first egg and 270 days of age were observed in 7th and 5th generation as 35.68 and 50.42g. The LS means of the largest number of egg production was 78.53 eggs in generation 6. In general, light body weight, short time for the age at first egg, heavy egg weight, and large number of egg production were observed as the generation proceeded.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.54 no.1
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• pp.124-133
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• 2009

Demand for the high quality barley with fibroid material and functional substances has been increasing in recent although the amount of barley consumption decreased drastically during the last two decades. But the limited information on quality of barley makes consumers hard when they purchase barley for their own consumption. Therefore, 51 brand barley, .i.e., 28 naked barley and 23 waxy barley from supermarkets and 10 polished barley from local markets were collected, and their external quality were analyzed to provide basic information on brand barley. Among 51 brand barley, 56% were 1kg package and 25% were 800 g package and there was no significant difference ($1{\pm}3.62\;g$) between printed and actual weighs. The weight of 1,000 grains of naked barley and waxy barley ranged $18.6{\sim}26.7\;g$ and $14.6{\sim}24.7\;g$, respectively. Thousand grain weight of 38% of naked barley ranged $20{\sim}22\;g$, while that of 43% of waxy barley ranged $18{\sim}20\;g$. The ratio of normal grains was 88% and 94% for naked barley and waxy barley, respectively, when separated with 1.7 mm sieve. Although 82% of brand barley products were free from foreign substances, in 18% of brand barley products, sands, pieces of cloth and wood, other kinds of grain and insect larvae were found, Average test weight of brand barleys was $843g{\cdot}L^{-1}$ with range of $805{\sim}917g{\cdot}L^{-1}$. Water content was less than 14% in 7.8% of barley products, while it was $14{\sim}15%$ in 62.7% of them. Average whiteness of brand barley was 31.06, while waxy barley had higher whiteness with 27.28 than naked barley with 34.16. Heated water uptake rate of milled naked barley and milled waxy barley were 215.4% and 231.7%, respectively, while expansion rate of milled naked barley and milled waxy barley were 379.7% and 401.6%, respectively. Barley from local markets were as good as brand barley products in 1,000 grain weight, ratio of normal grains, inclusion of foreign substances, test weight, water content, whiteness, water uptake rate, and expansion rate, but they showed higher ratio of foreign substances included.

• Journal of Korean Society of Forest Science
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• v.14 no.1
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• pp.1-20
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• 1972

The trend and achievements of forest genetics research in abroad were investigated through observation tours and reference work and following facts were found to be important aspects which should be adopted in the forest genetics research program in Korea. Because of world wide recognization on the urgency of taking a measure to reserve some areas of the representative forest type on the globe before the extingtion of such forest type as the results of continuous exploitations of the natural forests to meet the timber demand all over the world, it is urgently needed to take a measure to reserve certain areas of natural stand of Pinus koraiensis, Pinus parviflora, Pinus densiflora f. erectra, Abies koreana, Quercus sp., Populus sp., etc. as gene pool to be used for the future program of forest tree improvement. And the genetic studies of those natural forest of economic tree species are also to be performed. 1. Increase of the number of selected tree for breeding purpose. Because of the fact that the number of plus tree at present is too small to carry out selection program for tree improvement, particularly for the formation of source population for recurrent selection of parent trees of the 2nd generation seed orchard it is to be strongly emphasized to increase the number of plus tree by alleviating selection criteria in order to enlarge the population size of plus trees to make the selection program more efficient. 2. Progeny testing More stress should be placed on carrying out progeny testing of selected trees with open pollinated seeds. And particular efforts are to be made for conducting studies on adult/juvenile correlation of important traits with a view to enable to predict adult performances with some traits revealed in juvenile age thus to save time for progeny testing. 3. Genotype-environment interaction Studies on genotype and environment interaction should be conducted in order to elucidate whether the plus trees selected on the good site express their superiority on the poor site or not and how the environment affect the genotype. And the justification of present classification of seed distribution area should be examined. 4. Seed orchard of broad leaf tree species. Due to the difficulty of accurate comparison of growth rate of neighbouring trees of broad leaf tree species in natural stand, it is recommended that for the improvement of broad leaf trees a seedling seed orchard is to be made by roguing the progeny test plantation planted densely with control pollinated seedlings of selected trees. 5. Breeding for insect resistant varieties. In the light of the fact that the resistant characteristics against insect such as pine gall midge (Thiecodiplosis japonensis U. et I.) and pine bark beetle (Myelophilus pinipera L.) are highly correlated with the amount and quality of resin which are known as gene controlled characteristics, breeding for insect resistance should be carried out. 6. Breeding for timber properties. With the tree species for pulp wood in particular, emphasis should be placed upon breeding for high specific gravity of timber. 7. Introduction of Cryptomeria and Japanese Cypress In the light of the fact that the major clones of Cryptomeria are originated from Yoshino source and are being planted up to considerably north and high elevation in Japan, those species should be examined on their cold resistance in Korea by planting them in further northern part of the country.

• Journal of Sasang Constitutional Medicine
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• v.10 no.2
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• pp.533-564
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• 1998

In order to know the effect of proliferation and differentiation on edipocyte 3T3-L1 by prescriptions and herbs, Taeyangin(太陽人)'s Okapijangcheok-tang(五加皮壯脊湯) Mihudeungsikjangtang Acanthopanacis Cortex(五加皮) Phragmitis Rhizoma(蘆根) and Taeumin(太陰人)'s Taeumjowi-tang(太陰調胃湯) Cheongsimyonja-tang(淸心蓮子湯) Cheongpaesagan-tang(淸肺瀉肝湯) Galkeunbupyong-tang(葛根浮萍湯) Coicis Semen(薏苡仁) Rhei Undulati Rhizoma(大黃) Mori Cortex(桑白皮) Ulmi Cortex(楡根白皮) Holotrichia Vermiculus Kalopanaxii Cortex(海桐皮) Ephedrae Herba(麻黃) Imperatae Rhizoma(白茅根), were used and had some effects. 1. The proliferation effect of edipocyte 1) At the Taeyangin(太陽人)'s prescriptions and herbs, Okapijangcheok-tang(五加皮壯脊湯) Mihudeungsikjang-tang Acanthopanacis Cortex(五加皮) have a control effect at the boiling water-extract and ethyl alcohol-extract. Phragmitis Rhizoma(蘆根) have a control effect at the ethyl alcohol-extract. 2) At the Taeyangin(太陽人)'s prescriptions and herbs, Taeumjowi-tang(太陰調胃湯) Cheongsimyonja-tang(淸心蓮子湯) Cheongpaesagan-tang(淸肺瀉肝湯) Galkeunbupyong-tang(葛根浮萍湯) have a control effect at the boiling water-extract and ethyl alcohol-extract. Coicis Semen(薏苡仁) Rhei Undulati Rhizoma(大黃) Morl Cortex(桑白皮) Ulmi Cortex(楡根白皮) Kalopanaxii Cortex(海桐皮) · Ephedrae Herba(麻黃) of the boiling water-extract, Holotrichia Vermiculus Kalopanaxii Cortex(海桐皮) of ethyl alcohol-extract have a control effect on edipocytes. Rhei Undulati Rhizoma(大黃) Ulmi Cortex(楡根白皮) Ephedrae Herba(麻黃) of high-density have a cyto-toxicity. 2. The differentiation effect of edipocyte 1) At the Taeyangin(太陽人)'s prescriptions and herbs during the natural differentiation, Phragmitis Rhizoma(蘆根) of the boiling water-extract, Okapijangchek-tang(五加皮壯脊湯) Acanthopanacis Cortex(五加皮) of the ethyl alcohol-extract have a cyto-toxicity on the first-differentiation. 2) At the Taeumin(太陰人)'s prescriptions and herbs during the natural differentiation, Ulmi Cortex (楡根白皮) Kalopanaxii Cortex(海桐皮) of the boiling water-extract have a cyto-toxicity on the first-differentiation. Cheongsimyonja-tang(淸心蓮子湯) Ephedrae Herba(麻黃) of ethyl alcohol-extract have a control effect on the redifferentiation. 3) At the Taeyangin(太陽人)'s prescriptions and herbs on the first-differentiation during the induced differentiation, Acanthopanacis Cortex(五加皮) of ethyl alcohol-extract has a control effect. Okapijangchek-tang(五加皮壯脊湯) Acanthopanacis Cortex(五加皮) Phragmitis Rhizoma(蘆根) of the boiling water-extract have a cyto-toxicity. 4) At the Taeumin(太陰人)'s prescriptions and herbs on the first-differentiation during the induced differentiation, Coicis Semen(薏苡仁) Ephedrae Herba(麻黃) Imperatae Rhizoma(白茅根) of the boiling water-extract and Ephedrae Herba(麻黃) of the ethyl alcohol-extract have a control effect. Kalopanaxii Cortex(海桐皮) of the boiling water-extract and the ethyl alcohol-extract has a cyto-toxicity. Considering this result, the Taeyangin(太陽人) Taeumin(太陰人)'s prescriptions and herbs have a control effect on edipocytes during the proliferation. Acanthopanacis Cortex(五加皮), Coicis Semen(薏苡仁) Ephedrae Herba(麻黃) Imperatae Rhizoma(白茅根) have a control effect on edipocytes during the induced differentiation. In the future, for treating a obesity need a vivo assay and hope this study to help to know the mechanisms of obesity.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.27-38
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• 1981

오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.