• 국제학술발표논문집
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• The 9th International Conference on Construction Engineering and Project Management
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• pp.1254-1254
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• 2022

The Multi-family Residential is one of the most famous building types for a rental property in the US. Often times it includes multiple residential buildings and some amenity facilities, including a clubhouse or leasing office, swimming pool, dog park, and garages. Since the building type is built for rental purposes, the construction planning is phased and it makes the project complicated. Detailed planning and execution are important for successful construction management. This paper provides some management practices that are applied to one of the multi-family residential construction projects in Phoenix, AZ. The Front End Planning (FEP) process performed by both owner and contractor is the first key to a successful construction project. Specifically, the early review of phased turnover strategy, grading, fire/Americans with Disabilities Act (ADA) compliance, and Mechanical/ Electricity/Plumbing/Technology (MEPT) will provide absolute benefit to the project. Second, using a scheduling method to control short-term schedules and long-term can provide the ability to manage the issues with agility. Third, material delivery and procurement dominate the both project schedule and cost. With this COVID-19 circumstance, it is hard to expect the material, equipment, and labor forces to be delivered on time with the contracted price. Managing floats are more than important to managing construction productivity. Risk management should work to share the risks fairly. Lastly, turnover is directly linked with the profit of the project for both owner and contractor. The communication between the owner and contractor to re-schedule the proper turnover schedule is important for the phased construction project.

• 식품과학과 산업
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• 제51권3호
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• pp.174-184
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• 2018

규제란 국가가 특정한 행정목적의 실현을 위해 국민의 권리를 제한하거나 의무를 부과하는 것으로서 법령에 규정되는 사항을 의미한다. 산업 활동에 있어 정부의 규제는 중요한 영향력을 끼친다. 매정부마다 정부의 규제를 산업활동에 저해를 미치는 주요 요인으로 보고, 규제 개혁을 중요 정책 과업으로 삼는 것에서도 이러한 경향을 엿볼 수 있다. 그러나 식품안전과 같은 '안전'과 관련된 규제는 규제 개혁이나 규제 완화의 기치에서는 약간 벗어나 있다. 국민의 건강과 안전을 향상시킨다는 중대한 목적 하에서는 규제가 조금 불합리하거나 피규제자(주로 산업)에 많은 부담이 주어진다 하더라도 쉽게 용인될 수 있기 때문이다. 실제로 안전과 관련된 규제는 지속적으로 규제강화의 경향을 보이고 있다. 규제는 피규제자의 행위교정을 통해 정책의 목적을 달성하게 되므로, 식품안전규제의 피규제자인 식품 산업은 규제이행을 위한 많은 의무와 비용을 부담하여야 한다. 이에 정부는 규제의 신설 강화시에 규제영향분석서를 작성하고 그 과정에서 규제로 인해 발생될 비용과 편익을 분석한다. 규제로 인하여 국민의 일상생활과 사회 경제 행정 등에 미치는 여러 가지 영향을 객관적이고 과학적인 방법을 사용하여 미리 예측 분석함으로써 규제의 타당성을 판단하는 기준 근거로 활용하기 위함이다. 비록 규제영향분석 및 규제비용편익분석의 주체는 정부이지만, 실제로 행위의무와 규제이행 비용을 부담하게 되는 산업체의 역할이 매우 중요하다. 규제 행위의무 이행을 위해 소요되는 인력규모와 인건비, 규제제약으로 인해 발생되는 기회비용, 규제의무 이행을 위해 소요되는 실제 비용단가 등을 정확하게 산출해 낼 수 있는 것은 행위의 주체인 산업체이기 때문이다. 식품산업은 이러한 정보를 적극적으로 수집 축적공개하여 규제로 인해 자신들이 부담해야 하는 비용과 부담의 규모를 알리고, 이러한 객관적이고 실제적인 정보가 정부의 합리적인 정책결정에 고려될 수 있게끔 노력하여야 할 것이다.

• 대한간호학회지
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• 제20권2호
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• 한국의료질향상학회지
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• 제7권1호
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.35-47
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• 1999

노인에서 처방약 복용에 대한 불순응의 문제는 의학적으로 심각한 문제의 발생과 경제적인 손실을 가져오게 된다. 이 연구는 1996년 7월 24 일부터 8월 13일 사이에 경상북도 김천시 금릉군에 거주하는 60세 이상의 농촌 노인을 대상으로 이루어진 단면적인 면접조사이다. 노인에서의 비고이적인 약물복용 불순응의 원인이 되는 약물복용 능력의 실태를 파악하고, 약물 복용능력과 건강상태, 일상적 생활 활동, 가족적 지지, 그리고 인지기능을 비롯한 다양한 변수, 일반적 특성 등과의 관련성을 조사 분석함으로써 약물 복용 실행능력을 예측할 수 있는 예측자를 찾고자 하였다. 현재 복용하고 있는 약물이 있다고 답한 사람은 48.8%였다. 93%가 혼자서 정확한 시간에, 정확한 용량으로 복용할 수 있다고 답하였고, 6%가 약간의 도움이 필요하다고 하거나 혼자 복용할 수 없다고 답하였다. 약물 복용 수행능력과 일반적 특성 및 연구 변수들간의 차이에는 연령과 교육수준, IADL, MMSE-K가 혼자서 독립적으로 복용할 수 없는 군 사이에 유의한 차이가 있었으며, 상관분석에는 ADL, IADL, MMSE-K, BDI가 유의한 상관이 있었다. 단일변수분석과 상관분석에서 약물 복용 능력과 유의한 관련성을 보인 변수를 선택하여 투입한 로지스틱 회귀분석에서 IADL과 성이 최종적으로 선택되었다. 다른 건강수준 측정법 보다 수단적 일상생활 정도는 약물복용 수행능력에 더 민감한 예측자로의 역할이 기대되므로 투약관리와 약물 복용 수행 능력에 대한 정신적 상태를 평가하는 고식적 방법에 추가정보를 제공할 수 있을것으로 판단된다. 추후 약물복용 순응도의 다면적인 면을 고려한 연구가 입 퇴원환자를 중심으로 한 정확한 투약 순응도와 규모 파악, 이를 향상시킬 수 있는 구체적인 방안을 모색하는 방향을 중재 연구와 인지기능 및 운동기등 등의 정신 및 신체조건에 따른 약물 복용 순응도에 초점이 맞춘 다양하고 집중적인 연구자 필요할 것으로 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제33권3호
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• pp.285-298
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• 2000

본 연구는 지역사회에서의 소화불량환자의 Helicobacter pylori 양성률, 치료순응률 및 관련요인을 분석하고, 1년 후 요소호기검사로 추적검사를 실시하여 Helicobacter pylori 박멸률 및 관련 요인, Helicobacter pylori 박멸과 증상 호전과의 관계 등을 분석하고, Helicobacter pylori 치료 대안별 비용을 추정하고자 시행되었다. 경주시에 거주하는 30세 이상의 성인을 대상으로 1998년 3월 510명의 소화불량 증상 보유자를 선정하여 혈청검사 (ELISA)를 실시하였다. 대상자 510명 중 혈청검사 양성자 375명(73.5%)중 내시경검사에 동의한 304명에 대하여 CLO검사를 실시하였고, CLO검사 양성자 204명 에 게 tripotassium dicitrato bismuthate, amoxicillin, metronidazole의 3제요법을 실시하였다. 연구결과를 요약하면 다음과 같다. 소화불량자 510명 중 혈청검사에 의한 양성률은 73.5%였고, 혈청학적 검사 양성자 375명 중 내시경검사 수진율은 304명으로 81.1%였다. 이 중 CLO검사 양성자는 204명으로 67.1%였다. Helicobacter pylori 박멸여부를 판정하기 위한 1년 후 추적검사 완료자는 181명으로 88.7%였으며, 이 중 투약순응자는 122명으로 추적완료자의 67.4%였다. 추적완료자 중요소호기검사상 박멸된 대상자는 87명으로 박멸률은 48.1%였다. 투약순응자의 경우 122명 중 70명이 박멸되어 박멸률은 57.4%였다. CLO 양성여부와 대상자의 특성과의 관련성을 분석한 결과 연령, 성별, 주관적 경제적 수준, 흡연, 음주, 비타민 C 복용여부, 규칙적 식사 여부와 관련성이 없었다. 소화불량 증상 중 '상복부 통증' 이외의 모든 증상과 CLO양성 여부와는 유의한 관련성이 있었다(p<0.05). 추적검사 완료자에서 연령과 음주여부는 투약순응률과 유의한 관련성이 있었으나(p<0.05),성별, 흡연여부, 비타민 C 복용여부, 규칙적 식사 여부와는 관련성이 없었다. 치료순응여부와 Helicobacter pylori 박멱률간에는 통계적으로 유의한 관련성이 있었으나(p<0.01), 그외 대상자들의 특성과 Helicobacter pylori 박멸률 간에는 관련성이 없었다. Helicobacter pylori가 박멸된 군과 박멸되지 않은 군의 증상 호전율은 각각 62.1%, 59.6%였으나 통계적으로 유의하지는 않았다. 대안별 비용을 분석하였는데, 대안 I은 소화불량환자 전원에게 3제요법을 시행한 후 요소호기검사를 시행하는 방법이고, 대안 II는 소화불량환자를 대상으로 혈청검사를 시행 후 양성자에게 3제요법을 시행하고 요소호기검사를 시행하는 방법이며, 본 연구에서 적용된 대안 III은 소화불량환자를 대상으로 혈청검사를 시행 후 양성자에게 내시경검사와 CLO검사를 실시하고, 양성자에게 3제요법을 시행한 후 요소호기검사를 시행하는 방법이다. Helicobacter pylori 박멸을 위한 대안별 비용을 분석하면, 1인당 치료 비용은 대안 I 이 61,761원, 대안 II는 51,549원, 대안 III은 58,328원이었다. 대안별 비용과 항생제 내성 문제, 투약대상자의 수 등의 장 단점을 고려할 때 비용면에서는 대안 II가, 투약대상자수, 항생제 내성 문제, 위암의 조기발견 가능성 등을 고려하면 대안 III이 좋은 대안이라 할 수 있다. 지역사회 소화불량환자에서 혈청학적 검사 양성자 중 CLO 양성자율이 67.1%로 높고, 3제요법에 의한 치료율은 48.1%(치료순응자의 치료율은 57.4%)이고, 증상호전율은 60%를 상회하므로, Helicobacter pylori의 높은 감염률을 고려하면 지역사회에서 소화불량환자를 대상으로 한 집단검진 및 박멸사업의 시행은 의의가 있을 것으로 생각된다. 그러나 투약 대상자 선정을 위한 선행 검사와 치료약제의 선택을 위한 추가적인 연구는 필요하다. 또한 치료방침에 따른 투약순응률을 향상시키는 방안이 제시되어야 할 것이다. 향후 지역사회에서의 Helicobacter pylori에 대한 연구가 더 수행되어야 하며, 재감염률 등의 분석을 위 한 코호트를 구축하는 것이 필요하다. 또한 정책의 결정을 위한 근거자료로 활용할 수 있는 비용-편익분석이나 비용-효과분석을 할 수 있는 장기적인 연구들이 수행되어야 할 것이다.

• 성인간호학회지
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• 제28권3호
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• pp.266-278
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• 2016

Purpose: The purpose of this study was to identify the effects of reinforced walking exercise on dyspnea-fatigue symptoms, daily activities, walking ability and health related quality of life (HRQoL) in heart failure patients. Methods: This study used a randomized controlled trial design. The participants (experimental group=16, control group=25) were recruited from a university hospital in Kyeong-nam area. Data were collected from March to September, 2015. The reinforced walking exercise included goal setting and feedback (telephone and text message) provided for 12 weeks. Dyspnea-Fatigue Index, Korean Activity Scale/Index (KASI), six-minute walking distance (6MWD) and HRQoL were measured. Data were analyzed using descriptive statistics, t-test, Fisher's exact test, $x^2$ test, and Kolmogrove-Smirnov test. Results: Prior to the intervention there were no differences in the research variables between two groups. The exercise compliance in the experimental group was 100% (walking for 50 minutes per day, 5 times per week). The experimental group had improved dyspnea-fatigue symptoms (t=8.63, p<.001), daily activities (t=-4.92, p<.001), longer 6MWD (t=-5.66, p<.001), and increased HRQoL (t=-9.05, p<.001) compared to the control group. Conclusion: The reinforced walking exercise could be a cost-effective intervention in heart failure patient, which could enhance patients' outcomes, such as improving dyspnea-fatigue symptoms, daily activities, walking ability, and quality of life.

• 한국임상약학회지
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• 제16권2호
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• pp.92-95
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• 2006

Medication counseling improves patients' compliance, which enhances the effectiveness of treatment and reduces the medical cost consequently. Since separation of dispensary from medical practice took place, most patients have had to go to pharmacy after receiving prescription from hospital. The importance of medication counseling in pharmacy thus has been emphasized. To study the present conditions of medication counseling from the pharmacists and the patients satisfaction with them, we conducted a survey with questionnaires. The subjects were 146 outpatients and 55 pharmacies located in Yeongdeungpo-gu. The research showed that 69.9% of the outpatients had received medication counseling and only 35.5% of them were satisfied with it. The main reason for their unsatisfaction was insufficiency of explanation. A number of patients(75.3%) were thinking that medication counseling from the pharmacists is necessary for appropriate administration and optimal efficacy of the medicine. Among 55 pharmacies involved in the research, 17 of them(30.9%) answered that they have been giving patients medication counseling, which were mostly verbally done. Only 8 of them(l4.5%) were providing medication information sheets for some specific drugs. The pharmacists referred to a few problems disturbing optimal medication counseling like these: 1) Lack of time, 2) insufficient information, 3) inappropriate counseling skills. To improve these problems, they hope to get more information about prescription and specific medicines from pharmacy in hospital. If hospital decides to hold the lectures on medication counseling, about 80% of the pharmacists tend to take part in them.

• 정신신체의학
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• 제4권1호
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• pp.138-145
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• 1996

동일한 질병을 갖고 있거나, 같은 증상을 호소하는 환자의 경우라도 병과 관련된 행동은 사람마다 각기 다르다. 이러한 행동 양식을 잘 이해하는 것은 병의 진단과 치료 방법, 치료 순응도와 치료 효과를 결정하는 데에 중요한 요소가 된다. 비정상적인 질병 행동은 병자 역할이 핵심이 되며, 간혹 병을 부정하거나 무시하는 반대의 경우도 있다. 비정상적인 질병행동에 대한 평가는 기질적 원인이 밝혀지지 않는 여러 기능성 장애를 규명하는 한가지 방법으로 이용될 수 있으며, 인지 치료 내지는 재활, 직업 치료시에도 활용할 수 있는 중요한 개념으로 알려져 있다. 향후 한국인에게 맞는 치료법의 개발을 위해서는 각 질병에 따른 의학 역사적 관점, 사회 문화적 요소가 어우러진 통합적인 질병 행동 연구가 필요하리라 사료된다. 이는 의료 경제 측면에서도 필수적인 내용이 될 것이다.

• 한국IT서비스학회지
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• 제19권3호
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• pp.57-73
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• 2020

The proportion of digital evidence in criminal cases has increased, while at the same time, the spread of the Internet has made it easy to delete information that is stored in another place and thus, the Internet is being used to delete online criminal evidence. To respond quickly and effectively to cybercrime, 29 countries signed the Convention on Cybercrime in 2001 through the Council of Europe. Article 16 of the Convention relates to the expedited preservation of stored computer data and requires signatories to adopt legislative measures to enable its competent authorities to order expeditious preservation of specified computer data where there are grounds to believe that the data is particularly vulnerable to loss or modification. More than 60 countries have joined the Convention since 2001 and have made efforts to improve their legal system in line with it. The United States legislated 18 U.S.C. § 2703(f) to preserve electronic evidence pending the issuance of a court order. The German Code of Criminal Procedure §§ 94~95 allows prosecution authorities to seize evidence or issue production orders without court control in urgent circumstances. A custodian shall be obliged to surrender evidence upon a request that evidence be preserved, and non-compliance results in punishment. Japan legislated the Criminal Procedure Act § 197(3) and (4) to establish a legal base for requesting that electronic records that are stored by an ISP not be deleted. The Korean Criminal Procedure Act § 184 outlines procedures for the preservation of evidence but does not adequately address the expeditious preservation of digital evidence that may be vulnerable to deletion. This paper analyzes nine considerations, including request subjects, requirements, and cost reimbursement to establish directions to improve the legal system for the expedited preservation of digital evidence. A new method to preserve online digital evidence in urgent cases is necessary.