• 지역사회간호학회지
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• 제12권2호
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• pp.361-374
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• 2001

This study was done to identify a status of home visiting project as a community health nursing system, that was the organization. personal who have age, educational background, marital status, position, experience of the home visiting in the public sectors in part of Seoul. Kyonggi, Kang-won area, It was done to provide basis data for the development of effective visiting nurses project in the health sectors, where was Health Centers in urban and rural. Branch of Health Center in rural and Health posts. The question airs were distributed 352 public health workers who working place was 118 health workers in 12 health centers in Seoul. 56 public health workers among 39 health center and other public health sectors in Kyonggi and 178 public health workers among health center and health care sectors. Data collected from October to December. 2000. The analysis by SAS system with F test, percentage and frequency. The major result were as follows. The general characteristics of the respondent show that most of them were graduates from community college and RN-BS with broadcast that they had not completed CPHN course but only two health workers have trained for the visiting nurses project. As for their grade in the position, the most of health workers have seventh level and the other CHP were above sixth level in the health care post that in the government structure. This indicates that workers do not have great authority in decision making, the most period of works in the position was one and two years indicating that they change jobs frequently. On an average their clinical experience was 4.11 years which is ideal for the total service. As for preparation of staff for home visiting workers education on visiting nurses program have to receive short term or longer term training course for strong emphasis. The analysis showed that public health visiting workers responds about active job performance that based on an area, approach of acting by districts, education and position are shown statistically significant difference between acceptance of the visiting nursing job show the same as well as visiting nurses project. Special concerns for visiting Nursing care spread came to burden, many of activity carry out main solution is covered the health problem connective support system needs of quality and quantity which out health problem. As 71.1% of visiting health service held on the poor population was under the guardianship of the law, but people who health insurance wide application under law shown a tendency to increase gradually. The general characteristics of the patients showed 56.2% of female on average of age was 66.1 years old, they have health problem was the most of 47.6% of high blood pressure and stroke, the other and as a problem that economics, which is complex welfare with out health problem. Community health care service should be combined health and social work program. The form of delivery of visiting health care given the most guide and education with counselling and support. (33.6%) Among the six category of visiting care service shown statistically significant difference and next is fundamental care, remedy care with priority.

• 한국건설관리학회논문집
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• 제16권5호
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• pp.54-64
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• 2015

모듈러 건축공법은 공장 생산, 운송, 현장설치 프로세스를 통해 기존 현장중심 건축공법에 비해 품질향상 및 공기단축이 가능한 특징을 가지고 있다. 특히 모듈러 유닛의 제작과 시공이 분리되어 수행되기 때문에 다수의 프로젝트가 동시에 수행될 경우 각 프로젝트에 따라 생산해야하는 모듈의 크기, 수량, 납기일, 생산 유형 및 과정을 고려하는 SCM(Supply Chain Management) 관점의 공장 생산 공정 계획 수립이 필요하다. 그러나 현재 모듈러 유닛 공장 생산 계획은 개별 프로젝트 중심으로 수립되고 있어 다중 모듈러 건축 프로젝트 수행 시 모듈러 유닛 제작공장의 한정된 자원과 설치 현장별 프로젝트 요구조건들을 동시에 고려한 공장 생산계획을 도출하는데 한계가 있다. 따라서 본 연구에서는 다양한 변수 간 상호 연계성 및 제약조건으로 공정 계획 최적화 결과 도출이 가능한 유전자 알고리즘 방법을 통해 모듈러 유닛 제작공장의 한정된 자원과 설치 현장별 요구사항이 반영된 모듈러 유닛 공장 생산 공정계획 최적화 수립 모델을 제시하며 이를 사례분석을 통해 검증하였다. 연구 결과, 기존 다중프로젝트의 공장생산계획에 비해 평균 7.9%의 현장설치 공기단축 및 43%의 최대 야적장 이용률 감소가 가능하였다. 향후 본 연구 내용을 바탕으로 제약 조건 범위 확장 및 생산성 데이터 추가가 될 경우 다중 모듈러 건축 프로젝트의 모듈러 유닛 공장 생산 계획 수립과 현장시공프로세스 구축을 동시에 지원할 수 있는 기초 자료로 활용될 수 있다.

• 대한핵의학회지
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• 제31권4호
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• pp.433-439
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• 1997

낭성뇌종양은 낭 내부에 베타선을 방출하는 방사성동위원소를 주입하여 낭 내부 및 낭벽에 존재하는 암세포에 일정량의 방사선 에너지를 전달함으로써 그 치료 효과를 기대할 수 있다. 본 연구에서는 $^{166}Ho$-chitosan 복합체를 낭성뇌종양 치료에 이용하고자 할 때 낭의 크기와 주입되는 방사능의 변화에 따라 낭벽에 전달되는 방사선 흡수선량이 어떻게 변화하는가를 평가하고자 한다. 구형의 종양성 낭 모델에 대하여 Monte Carlo code인 EGS4를 이용하여 $^{166}Ho$ 베타선의 에너지 전달 현상에 대한 모사계산을 수행한다. 종양성 낭 내부에 주입된 $^{166}Ho$-chitosan 복합체의 낭내 분포는 낭 내부액과 섞여있거나 낭벽 표면에 부착되는 두 가지 경우를 고려한다. 방사선 조사의 표적 영역으로서, 낭벽의 표면으로부터 매 1mm 깊이의 체적을 설정하여 4mm 깊이까지 고려한다. 직경이 각 1cm, 2cm, 그리고 3cm 인 종양성낭을 평가 대상으로 설정한다. 직경이 3cm인 종양성 낭에 10mCi의 $^{166}Ho$-chitosan 복합체가 주입되어 낭 내부에 균일하게 분포하였다고 가정하였을 경우에 1mm 두께의 낭벽에 전달되는 방사선 흡수선량은 매 1mm 깊이의 낭벽 체적에서 각각 40.06Gy, 14.96Gy, 5.315Gy, 1.660Gy으로 계산되었다. 한편, 낭 내부에 주입된 10mCi의 $^{166}Ho$-chitosan 복합체가 낭벽에 균일하게 분포하였다고 가정하였을 경우에는 매 1mm 두께의 낭벽 체적에 전달되는 방사선 흡수선량이 601.7Gy, 188.7Gy, 73.87Gy, 27.80Gy로 평가되었다. 낭 내부에 주입된 $^{166}Ho$-chitosan 복합체가 낭벽에 부착될 가능성이 있음이 한 임상 적용 예에서 시사된 바, 정확한 $^{166}Ho$-chitosan 복합체의 낭 내부벽 부착률을 확인함으로써 낭벽에 대한 흡수선량을 예시하고 이를 근거로 주입할 $^{166}Ho$-chitosan 복합체의 양을 결정해야 할 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1437-1443
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• 2016

Background: We investigated four factors, height, weight gain since age 20, physical activity, and alcohol drinking, for associations with risk of breast cancer (BC) according to menopausal status, using the latest data of the Japan Collaborative Cohort Study (JACC Study). Materials and Methods: We confined the analysis to 24 areas available of cancer incidence information, excluding women with a previous diagnosis of BC. Baseline data were collected from 38,610 (9,367 premenopausal, and 29,243 postmenopausal) women during 1988 and 1990. The study subjects were followed-up at the end of 2009, and 273 (84 premenopausal, and 189 postmenopausal) cases of BC were newly diagnosed in 501,907 person-years. The Cox model was used to estimate a hazards ratio (HR) and its 95% confidence interval (CI) of BC risk. Results: As a result of the multivariate analysis adjusting for age at baseline survey, age at menarche, number of live births, and, age at first delivery, weight gain since age 20 of 6.7 kg-9.9 kg, and ${\geq}10.0kg$ were significantly associated with increased risk for postmenopausal BC (HR=2.48, 95% CI 1.40-4.41, and, HR=2.94, 95% CI 1.84-4.70, respectively). Significantly increased trend of BC risk was also observed in weight gain since age 20 (p for trend, p<0.001). Amount of ethanol intake per day${\geq}15.0g$ was significantly associated with increased risk for postmenopausal BC in the multivariable-adjusted analysis (HR=2.74, 95% CI 1.32-5.70). Conclusions: Higher weight gain in adulthood and larger amounts of ethanol intake were significantly associated with increased risk of BC in Japanese postmenopausal women. None of the investigated factors were significantly associated with BC risk in Japanese premenopausal women.

• 대한화학회지
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• 제58권6호
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• pp.575-579
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• 2014

종양 조직으로 약물을 효과적으로 전달하기 위하여 리포솜의 개발이 활발이 연구되고 있다. 그러나 리포솜이 종양조직에 효과적으로 축적됨에도 불구하고, 낮은 약물 방출 때문에 리포솜의 치료 효과가 제한적이다. 따라서 우리는 외부 자극에 의하여 약물방출을 최대화 시킬 수 있는 온도민감성 리포솜을 개발하였다. 모델약물인 독소루비신은 pH 전위차 방법에 의하여 리포솜 내부에 봉입하였다. 리포솜의 입자 크기는 $142.0{\pm}6.24nm$ 이었고, 표면전하는 $-10.55{\pm}1.12mV$ 이었다. 온도민감성 리포솜으로부터 약물의 방출은 형광광도계로 측정하였으며 $42^{\circ}C$ 이상에서 5분 이내에 80% 이상의 방출률을 나타냈다. 초음파에 의해 온도민감성 리포솜으로부터 방출된 독소루비신의 세포독성은 초음파를 조사하지 않은 온도민감성 리포솜보다 월등히 우세하였다. 이번 연구에서 우리는 초음파에 의하여 온도민감성 리포솜으로부터 온도에 민감한 약물방출을 증명하였고, 이것은 외부 자극에 의한 종양조직의 약물 농도를 증가시킬 수 있는 암치료에 효과적일 것이다.

• 한국병원경영학회지
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• 제3권1호
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• pp.34-61
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• 1998

A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.

• Asian-Australasian Journal of Animal Sciences
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• 제24권3호
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• pp.303-321
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• 2011

The availability and efficient use of the feed resources in Asia are the primary drivers of performance to maximise productivity from animals. Feed security is fundamental to the management, extent of use, conservation and intensification for productivity enhancement. The awesome reality is that current supplies of animal proteins are inadequate to meet human requirements in the face of rapidly depleting resources: arable land, water, fossil fuels, nitrogenous and other fertilisers, and decreased supplies of cereal grains. The contribution of the ruminant sector lags well behind that of non-ruminant pigs and poultry. It is compelling therefore to shift priority for the development of ruminants (buffaloes, cattle, goats and sheep) in key agro-ecological zones (AEZs), making intensive use of the available biomass from the forage resources, crop residues, agro-industrial by-products (AIBP) and other non-conventional feed resources (NCFR). Definitions are given of successful and failed projects on feed resource use. These were used to analyse 12 case studies, which indicated the value of strong participatory efforts with farmers, empowerment, and the benefits from animals of productivity-enhancing technologies and integrated natural resource management (NRM). However, wider replication and scaling up were inadequate in project formulation, including systems methodologies that promoted technology adoption. There was overwhelming emphasis on component technology applications that were duplicated across countries, often wasteful, the results and relevance of which were not clear. Technology delivery via the traditional model of research-extension linkage was also inadequate, and needs to be expanded to participatory research-extension-farmer linkages to accelerate diffusion of technologies, wider adoption and impacts. Other major limitations concerned with feed resource use are failure to view this issue from a farming systems perspective, strong disciplinary bias, and poor links to real farm situations. It is suggested that improved efficiency in feed resource use and increased productivity from animals in the future needs to be cognisant of nine strategies. These include priorities for feed resource use; promoting intensive use of crop residues; intensification of integrated ruminant-oil palm systems and use of oil palm by-products; priority for urgent, wider technology application, adoption and scaling up; rigorous application of systems methodologies; development of adaptation and mitigation options for the effects of climate change on feed resources; strengthening research-extension-farmer linkages; development of year round feeding systems; and striving for sustainability of integrated farming systems. These strategies together form the challenges for the future.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.207-223
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• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

• 대한교통학회지
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• 제27권1호
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• pp.97-105
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• 2009

물류표준화는 표준화에 따른 비용절감 및 효율성 제고 등으로 인해 산업 부문뿐만 아니라 국민경제에 미치는 영향이 지대할 것으로 예상된다. 따라서 세계 각국은 물류부문의 글로벌 표준화를 선도하기 위하여 국가별로 다양한 노력을 기울이고 있으나 우리나라에서는 아직까지 물류 분야의 표준화가 본격적으로 추진되고 있지 않은 실정이다. 또한 물류표준화의 효과를 측정하는 연구가 미흡한 실정이며, 특히 물류표준화의 근간이 되는 파렛트 표준화의 효과평가 및 평가척도 개발에 대한 연구는 현재까지 전무한 실정이다. 물류표준화가 시행되기 위해서는 우선 표준화의 필요성 및 그에 따른 효과를 명확히 제시해야 할 필요가 있다. 이를 위해 물류표준화의 효과 측정 및 효과 평가방법을 명확히하여 물류표준화의 효과를 정량적으로 제시하여야 한다. 따라서 본 연구에서는 일관수송 중심의 물류표준화의 근간이 되는 일관수송용 파렛트 표준화의 효과평가방안에 대해 살펴보고, 표준화에 따른 효과를 평가하기 위해 효과평가척도(MOE)를 선정하였다. 효과평가척도 선정을 위해 우선 예비효과평가척도를 선정하였는데, 그 결과 차량적재율 수 배송 비용 창고보관효율 창고 자동화율 상 하역 소요인력 등 12개의 척도가 선정되었다. 이와 같이 선정된 예비효과평가척도를 이용하여 전문가 평가와 업체 대상 응답가능성 조사 결과를 바탕으로 최종 효과평가척도를 선정한 결과 차량/트럭 적재율 창고보관 효율 상 하역 시간, 포장비용 비중, 일관수송 비율이 파렛트 표준화에 따른 효과평가를 위한 척도로 선정되었다.

• 보건행정학회지
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• 제29권4호
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• pp.513-522
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• 2019

Background: South Korea operates a Medical Aid (MA) program targeting selected low-income individuals to ensure medical service delivery to the disadvantaged while enhancing self-sufficiency of work-capable beneficiaries. However, as reasons behind welfare exits are diverse and do not always infer poverty relief or the provision of appropriate levels of health care services, this study aimed to investigate the association between changes in MA status and health care utilization. Methods: This study used the 2006 to 2015 National Health Insurance claims data. The impact of changes in annual MA status on health care utilization (yearly number of outpatient visits, inpatient visits, length of stay, and emergency department [ED] visits) was investigated using the generalized estimating equation model. Results: In 117,943 adult subjects aged 20 to 64, compared to the 'MA to MA' group, the 'MA to MA exit' group showed general decreases in utilization (outpatient visits: β=-3.93, p<0.0001; hospital admissions: relative risk [RR], 0.87; 95% confidence interval [CI], 0.83-0.91; length of stay: β=-3.64, p<0.0001; ED visits: RR, 0.83; 95% CI, 0.77-0.90). Similar patterns were found in the 'MA exit to MA exit' group (outpatient visits: β=-5.72, p<0.0001; admissions: RR, 0.91; 95% CI, 0.87-0.94; length of stay: β=-5.87; p<0.0001; ED visits: RR, 0.81; 95% CI, 0.75-0.88). Likewise, in 74,747 older adult subjects aged 65 or above, the 'MA to MA exit' group showed reduced levels of utilization (outpatient visits: β=-1.51; p=0.0020), as well as the 'MA exit to MA exit' group (admissions: RR, 0.92; 95% CI, 0.89-0.95; length of stay: β, -5.45; p<0.0001; ED visits: RR, 0.90; 95% CI, 0.83-0.97). Conclusion: MA exit was associated with general decreases in health care utilization. Utilization patterns of individuals with experiences of receiving MA benefits should be monitored to promote the ideal use of health care services while preventing potential financial barriers present in accessing medical care.