• 지역사회간호학회지
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• 제12권1호
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• pp.288-298
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• 2001

This article makes an attempt to evaluate the extent of developing community health nursing knowledge and to suggest the direction of developing a body of knowledge henceforth through the results of analysis for contents and outcomes of all literatures. which have been published in the Journal related to community health nursing. Refer to the following for the result of this article. 1. The total number of literatures analyzed amounted to 100 pieces in Journal of community health nursing society. 78 in Journal of industrial nursing society, 134 in Journal of school health society. 40 in Journal of home care nursing society. 2. Journal of community health nursing society Health needs and educational-behavioral diagnoses, which are more concrete nursing assessments and diagnoses. formed the main current(54%) of articles published in Journal of community health nursing society since 1992. There was a quantitative growth as well as a qualitative advance. Through a classification by the type of a body of knowledge. It was found that the knowledge providing nursing practice with bases, commanded an overwhelming majority(71.8%). Also, Researches on systemic supports for nursing practice are showing a tendency to increase. 3. Journal of industrial nursing society 52.6% of research papers presented in Journal of industrial nursing society dealt with health problem of workers. assessment of risk factors, diagnosis of health behaviors. Because of the beginning of an industrial nursing, the domain of nursing management to establish the role and task, work condition, training. documentary system made up 23 percent of research, subjects. A knowledge providing nursing practice with bases have a majority, 69.2%. In addition. the subject concerning a systemic support and quality assurance was scarce but continuously presented. 4. Journal of school health society The major point of this journal is the identification of health problems and risk factors which belong to assessment and diagnosis domain(56.8%) regardless of year, Because of the interdisciplinary characteristic. The knowledge on quality assurance of nursing practice is relatively rare. But, articles related to a systemic support is plentiful. 5. Journal of home care nursing society In its infancy, there was a large number of papers concerning need assessment and diagnosis, Comparing others, this journal has introduced a good many of articles related to program management. delivery system. service fee, etc that belong to domain of systemic support for nursing practice. 6. It is showing definitely that quantity and extent of research have grown for a short period. See the analysis in terms of nursing process, studies related to the domain of assessment and diagnosis command an absolute majority regardless of kinds of journal. Although articles referring to program management and implementation is increasing in number, it is scarce to evaluate a nursing program and grope for an improvement. Also, program development based on a theoretical framework is little. Therefore much more scientific effort to ensure profession should be executed. 7. In the methodological aspect, longitudinal study needs to be carried out so that we could show the evidence based nursing theory. To develop a more general theory, we have to conduct a study of various subjects and improve a validity of tools through a repeat test. In addition, the effort for interdisciplinary cooperation is needed.

• 벤처창업연구
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• 제16권1호
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• pp.147-159
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• 2021

2020년 코로나19 팬데믹 현상 이후에 소비자들의 온라인 소비가 급증하고 있으며 무점포 온라인 소매판매채널이 높은 성장세를 보이고 있다. 특히 소셜미디어가 기업의 브랜드와 제품을 알리는 홍보수단에서 직접적인 거래가 발생하는 SNS마켓으로서 위상이 높아지고 있다. 본 연구에서는 코로나19 팬데믹 현상 이후 달라진 소비자들의 행동변화가 온라인에서 농식품을 구매하는 경우 기존 인터넷 쇼핑몰과 개방형 SNS마켓과 폐쇄형 SNS마켓 등의 온라인 쇼핑매체를 선택하는데 어떠한 차이를 보이는지, 또한 농식품 제품 선택에 있어서 어떠한 유형의 제품을 선호하는지를 알아보고자 하였다. 본 연구를 위해 독립변수로 소비자의 인구통계학적 특성, 소비자 지각위험, 식생활 라이프스타일로 설정하여 온라인 구매채널 유형과 농식품 제품 선택에 미치는 영향을 알아보았다. 실증분석 결과를 요약하면 다음과 같다. 소비자들이 온라인에서 농식품을 구매하는 경우 인터넷 쇼핑몰과 개방형 SNS마켓, 폐쇄형 SNS마켓 등의 쇼핑채널을 선택하는데 있어 인구통계학적 특성과 소비자지각위험, 식생활 라이프스타일의 세부요인에서 다음과 같은 유의미한 차이가 있는 것으로 나타났다. 개방형 SNS마켓을 선택하는 소비자는 여성보다 남성이 높고, 가구소득이 낮으며 건강과 맛을 추구하는 소비자들이 높게 나타났다. 폐쇄형 SNS마켓을 선택하는 소비자는 지방에 거주하며 배송에 대한 위험인지도가 높은 소비자들로 분석되었다. 기존 인터넷 쇼핑몰을 선택하는 소비자는 학력이 높고 개인소득이 높으며 맛과 경제성을 추구하는 소비자들이 높은 것으로 나타났다. 본 연구를 통해 자신의 제품특성에 적합한 온라인쇼핑매체를 선택하는데 어려움을 겪는 농업인들에게 판단의 단초를 제공하여 실무적인 도움을 주고자 하였으며, 농식품 쇼핑채널로서 소셜미디어를 단순 홍보채널이 아닌 직접적인 거래가 발생하는 마켓으로서 접근하였다는 점에서 기존 연구들과 차별화 할 수 있다.

• 마케팅과학연구
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• 제19권4호
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• pp.32-43
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• 2009

信任在心理学, 经济学, 社会学中已被广泛研究, 其重要性不仅在市场营销中被强调, 在一般商业原则中也被强调. 供应商和买家之间的关系与过去不同, 过去的关系需要相当大的私人网络优势, 并可能涉及不道德的商业行为. 而在以工业营销成功的为核心的二十一世纪激烈的全球竞争中, 供应商和买家之间的关系是伙伴关系. 在相互合作的高级别信任的基础上, 通过交换的关系, 这会给买家和供应商带来长期的利益, 竞争力增强和交易成本的降低以及其他福利. 尽管现有的研究有信任的重要性, 但是在购买与供应关系中却忽视了信任的作用, 也没有系统地分析信任对关系的影响. 因此, 深入研究, 确定买家和商业服务供应商之间信任和关系绩效之间的联系是绝对需要的. 本研究中的商业服务, 包括那些支持制造业, 正作为下一代经济增长的引擎而吸引着人们的注意. 韩国政府已选择其作为制造业发展的战略领域. 由于商业服务开放市场的需求日趋激烈, 商业服务业的竞争力应该比以往得到更多的提倡. 本研究的目的是探索相互信任对买家和供应商之间的关系绩效的影响. 具体来说, 本研究在商业服务交易中提出了一个关于信任-关系绩效的理论模型, 并实证检验根据模型而提出的假设. 这项研究表明, 研究结果有战略意义. 本研究通过多种方法收集经验数据. 这些方法包括通过电话, 邮件和面试. 作为样本的公司是在韩国供应和购买商业服务的以知识为本的公司. 本研究收集的是二进的基础数据. 每个样本公司对包括购买公司及其相应的供应公司. 并跟踪调查每个公司对的相互信任. 本研究为商业服务的买卖双方提出了信任-关系绩效的模型. 该模型由信任和它的前因和后果. 买家的信任分为对供应公司的信任和对销售人员的信任. 根据Doney 和Cannon (1997)的研究我们在个人水平和组织水平上观察信任. 通常情况下, 买方是信任的受体, 但这项研究我们建议以供应商为观察受体. 因此, 它独特的关注了双边角度的知觉风险. 换言之, 供应商和买家一样, 是信任的主体, 因为交易通常是双边的. 从这个角度来看, 供应商对买家信任和买方对供货商的信赖一样重要. 供应商的信任从某种程度上受它信任的买方公司和买家的影响. 这种使用个人水平和组织水平的信任分类是根据Doney 和Cannon (1997)的研究. 信任影响供应商的选择, 这是一项双向放的工作. 供应商们积极参与供应商选择过程中, 和买家密切的一起工作. 此外, 该过程从某种程度上受每一方信任的合作伙伴的影响. 挑选过程包括一些步骤: 识别, 信息检索, 供应商选择和绩效评价. 作为这一进程的结果, 买家和供应商都进行绩效评估, 并就这些结果为基础, 采取有形或无形的纠正行动. 本研究中使用的关于信任的测量问项是根据Mayer, Davis 和 Schoorman (1995) 以及Mayer和Davis (1999)的研究发展起来的. 根据他们的建议, 有关信任的三个方面的研究包括有能力, 善和完整. 根据商业服务这个背景我们调整了原来的问题. 例如, 如 "他/她的专业能力" 已被改为 "当我们讨论我们的产品时销售人员表现出专业能力. "这项研究使用的测量问项不同于在以往的研究中使用的问项（Rotter 1967; Sullivan和Peterson 1982; Dwyer和Oh 1987. 本研究中有关信任的前因后果的测量问项是根据Doney和Cannon (1997)的研究为基础制定的. 根据商业服务这个背景我们调整了原来的问题. 特别是, 问题被设计为对买家和供应商以解决下列因素: 信誉 (诚信, 客户服务, 良好意愿), 市场地位 (公司规模, 市场份额, 在行业中的地位), 愿意定制（产品, 过程, 交付), 信息共享(专有信息, 个人信息), 愿意保持良好关系, 认为专业, 权威授权, 买方与卖方的相似性, 以及接触频率. 作为信任相应的变量, 我们对关系绩效进行了测试. 关系绩效分为有形的影响, 无形影响, 和副作用. 有形的影响包括财务业绩;无形的影响, 包括关系的改善, 网络开发, 以及内部员工的满意度;副作用包括既不是有形影响也不是无形影响的影响. 我们联系了350对公司, 105对公司答复了我们. 由于不完整我们删除了5对公司, 105对公司被用于数据分析. 用于数据分析的回应率为30%(三百五十零分之一百零五), 高于工业营销的平均回复比率. 至于回复的公司的特点, 大多数的公司运作的商业服务既为买方(85.4%)也为供应商(81.8%). 大部分买家是做消费品贸易(76%), 而供应商的大部分(70%)是做工业品贸易. 这可能意味着买家的过程是购入材料, 部件和组件从而生产消费品成品. 正如他们对他们与合作伙伴关系的长度的报告表示, 供应商比买家有更长的商业关系. 假设1测试买方-供应方特点对信任的影响. 销售人员的专业度(t=2.070, p<0.05)和权威授权(t=2.328, p<0.05)积极影响买方对供应方的信任. 另一方面, 权威授权(t=2.192, p<0.05)积极影响供应方对买方的信任. 对买方和供应方来说, 权威授权的程度对保持对彼此的信任有关键作用. 假设2测试买卖双方关系特点对信任的影响. 买家倾向于信任供应方, 因为供应方总是尽全力联系买方(t=2.212, p<0.05)这种倾向性在供应方方面也表现得很强(t=2.591, p<0.01). 另一方面, 供应商对买方的信任是由于供应商感知买家与自己的相似性(t=2.702, p<0.01). 这一发现证实了Crosby, Evans, 和Cowles(1990)的研究结果. 他们的结果表明供应方和买方通过商务或私务的定期会议来建立彼此的联系. 假设3测试信任对感知风险的影响. 结果表明无论对买方还是供应方, 信任越低, 感知风险就越大(买方: t =-6.621, p<0.01; 供应方: t=-2.437, p<0.05). 有趣的是, 这一趋势已被证明对买方更强. 这种较高水平的感知风险的一个可能的解释是在商业服务交易中买方通常比供应方感知到更大的风险. 为此, 有必要对供应商对买方实施减少风险的战略. 假设4测试信任对信息搜集. 根据结果, 对供应方和买方, 与预期相反, 信任取决于他们合作伙伴的名誉(买方t=2.929, p<0.01; 供应方t=2.711, p<0.05). 这一发现表明, 具有良好信誉的供应商往往是可信的. 以往的经验并没有显示出任何与买家或供应商信任的重要关系. 假设5测试信任对供应方/买方选择的影响. 与买方不同, 当供应方认为以往与买方的交易重要时, 供应方倾向信任买方(t=2.913 p<0.01). 但是, 本研究并没有现实资源忠诚和买方对供应方的信任之间有显著关系. 假设6测试的是信任对关系绩效的影响. 对买方和供应方, 当财务表现被报告提高时, 他们比较信任他们的合作伙伴(买方: t=2.301, p<0.05;供应方: t=3.692, p<0.01). 有趣的是, 这种趋势在供应方比较明显. 类似的, 当竞争力被报告提高时, 买卖双方比较信任他们的合作伙伴(买方t=3.563, p<0.01 ; 供应方t=3.042, p<0.01). 对供应方来说, 当对买方信任时效率和生产力会提高(t=2.673, p<0.01). 其他绩效指标与信任没有显著关系. 这项研究结果有一定的战略意义. 首先和最重要的是, 以信任为基础的交易对供应商和买家而言都是有益的. 根据研究证实, 通过努力建立和保持相互信任可以使财务表现提高. 同样, 可以通过同样的努力提高竞争力. 第二, 以信任为基础的交易能够减少购买情况中的感知风险. 这对供应商和买家都有启示. 人们普遍认为, 在一个高度参与的采购情况中买家感知到更高的风险. 为了减少风险, 以往的研究已建议供应商制定降低风险的策略. 而本研究的特点是从双边角度关注知觉风险. 换言之, 供应商也容易存在风险, 特别是当他们提供的服务, 需要非常先进的技术, 操作和维护. 因此, 购买者和供应商必须一起密切合作解决问题. 因此, 相互信任在问题解决过程中起着关键作用. 第三, 在这项研究中发现, 销售人员有更多的授权, 他或她越被信任. 这一发现从战术角度看是非常重要的. 建立信任是一个长期的任务, 然而, 当互信尚未开发, 供应商能够通过授权销售人员做出某些决定来克服遇到的问题, 这一结论也适用于供应商.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• 한국의학물리학회지:의학물리
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• 제25권2호
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• pp.79-88
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• 2014

내부표적체적을 기반으로 계획된 간암 환자의 세기조절방사선치료에서 호흡에 의한 장기의 움직임 영향을 적용하여 체내 실제 종양 부피와 중요 장기 부피에서의 선량분포를 재계산하고, 호흡동조 방식의 세기조절방사선치료 계획 결과와 비교를 통한 선량적 특성을 분석하였다. 내부표적체적은 MIM 프로그램을 사용하여 형성하였고, 호흡에 의한 장기 움직임을 모사할 수 있는 구동 팬텀을 사용하였다. 체내 선량분포는 세기조절방사선치료의 품질보증 과정에서 2차원 다이오드 검출기 배열 장치인 MapCHECK2로 측정한 조사면 별 측정 결과를 기반으로 3DVH 프로그램으로 재계산 하였다. 내부표적체적 기반의 세기조절방사선치료 수행 시 계획표적체적에 충분히 처방선량이 조사되었지만, 선량의 균일도는 호흡동조 방식의 세기조절방사선치료와 비교 시 열등한 결과를 보였다. 상대적으로 더 큰 조사면을 사용하는 내부표적체적 기반의 세기조절방사선치료에서 손상위험장기체적에 더 높은 선량이 조사됨을 확인할 수 있었지만, 척수에 증가된 선량은 부작용 발생확률에 큰 영향을 주지 않는 적은 양이었고, 정상 간이나 신장 부위의 증가된 선량도 최적화 과정에서 좀 더 선량감소 조건을 강화한다면 큰 영향이 없을 것으로 평가되었다. 호흡동조 방식의 세기조절방사선치료가 치료계획에서는 더 좋은 선량분포를 보이고 있으나, 실제 구현 과정에서 다엽콜리메이터의 움직임 오류로 인한 선량의 오차와 치료시간의 증가 측면의 단점이 있으므로, 환자 호흡 상태 및 손상위험장기의 선량제한 값에 대한 사전 분석을 통해 환자 별 최적의 세기조절방사선치료 기법을 선정하여 적용하는 것이 타당하다고 생각된다.

• Clinical and Experimental Pediatrics
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• 제50권11호
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• pp.1072-1077
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• 2007

목 적 : 엄마 젖을 먹는 신생아에서 조기 모유황달과 모유 황달의 발생 빈도가 우리나라에서는 더 높은 것으로 추정되나 이에 대한 연구가 부족하여, 모유를 수유하는 우리나라 건강한 만삭아의 모유 황달의 발생 빈도를 알아보고자 하였다. 방 법 : 2005년 1월부터 2005년 12월까지 1년 동안 제일 병원에서 출생하고 제일 병원 산후 관리 센터에 입실하여 7일 이상 추적 관찰이 가능한 건강한 만삭아 839명을 대상으로 하였고, 육안적으로 황달이 관찰된 경우 경피적 빌리루빈 측정기 JM-103 jaundice meter(Konica Minolta sensing, Inc., Osaka, Japan)를 이용하여 매일 경피적 빌리루빈치의 변화를 조사하여, 이를 통하여 모유 수유를 하는 건강한 만삭아의 황달 발생 빈도를 알아 보았다. 결 과 : 대상아 중 완전 모유 수유 군은 251명(29.9%), 혼합 수유 군은 568명(67.7%), 조제 분유 수유 군은 20명(2.4%) 이었으며, 세 군간에서 성별, 출생 체중, 아프가 점수, 산과적 위험 인자 등의 유의한 차이는 없었으나, 분만 형태에서는 완전 모유 수유 군에서 질식 분만이 유의하게 많았다. 모유 황달은 완전 모유 수유 군에서 31예(10.8%), 혼합 수유 군에서 21예(4.4%)로 전체 모유 수유아의 6.3%에서 나타났고, 완전 모유 수유 군에서 혼합 수유 군보다 통계적으로 유의하게 높았으며, 조기 모유 황달은 완전 모유 수유 군에서 63예(24.3%), 혼합 수유 군에서 149예(26.2%)로 모유 수유아의 25.6%에서 나타났으나, 완전 모유 수유 군과 혼합 수유 군에서 통계적으로 유의한 차이는 없었다. 결 론 : 모유를 수유하는 우리나라의 건강한 만삭아에서 모유 황달의 발생 빈도는 6.3%, 조기 모유 황달의 발생 빈도는 25.6%였으며, 서양인에 비하여 모유 황달의 발생 빈도가 높은 것을 알 수 있었다.

• 여성건강간호학회지
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• 제5권3호
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• pp.389-409
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• 1999

This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

• Clinical and Experimental Pediatrics
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• 제48권10호
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• pp.1102-1106
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• 2005

목 적 : 저자들은 혈청 빌리루빈 25 mg/dL 이상의 중증 고빌리루빈혈증의 발병 원인과 치료 및 예후에 대해 알아보고자 하였다. 방 법 : 1994년 10월부터 2004년 6월까지 성균관대학교 삼성서울병원 신생아 집중치료실에 입원하여 고빌리루빈혈증으로 진단 받은 환아들 중 혈청 빌리루빈치가 25 mg/dL 이상이면서 다른 동반 질환을 가지지 않고 추적관찰이 가능했던 48명을 대상으로 하여 치료 방법에 따라 광선치료군(1군, n=42)과 교환수혈군(2군, n=6)으로 분류하고 인구 통계학적 특징, 발병 시기, 발병 원인 및 치료에 따른 예후의 차이에 대해서 후향적으로 조사하였다. 결 과 : 재태주령은 두 군간(1군; $39{\pm}1$주, 2군; $37{\pm}4$주)에 유의한 차이가 없으며 출생체중은 2군($2,852{\pm}1,085g$)이 1군($3,137{\pm}437g$)에 비해 유의하게 작았으나(P<0.05), 2군에서 820 g의 환아가 포함되어 있어 통계적인 영향을 주었다. 발병 원인으로는 두 군 모두 특발성이 가장 많았으며 황달의 첫 임상적 발현 시기, 첫 혈청 빌리루빈 검사 시기 및 입원 시기는 군간에 유의한 차이가 없었다. 최고 혈청 빌리루빈치는 1군($29{\pm}6mg/dL$)에 비해 2군($45{\pm}16mg/dL$)에서 더 의미 있게 증가하였고(P<0.05), 치료 기간, 치료 후 혈청 빌리루빈의 감소 정도 및 신경학적 예후는 군간에 차이가 없었다. 결 론 : 증증 고빌리루빈혈증의 치료에 있어서 현재의 치료 지침으로도 적절한 치료가 이루어질 수 있으나 조기 진단 및 치료를 위해서는 중증 고빌리루빈혈증의 위험성이 높을 경우 생후 1주일 이내에 황달에 대한 추적 관찰이 필요할 것으로 사료된다.

• 한국관광식음료학회지:관광식음료경영연구
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• 제13권2호
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• pp.45-69
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• 2002

This study is designed to examine feasibility and limitation of outsourcing in cooking Western food in a hotel, to interpret importance of outsourcing(eg. outside order, outside procurement, outside supply) in a broad sense in order to reinforce the core capacity in the cooking department, and to know whether the cooking human power is efficiently used and how much the chefs recognize outsourcing of food materials. As many companies conduct restructuring to cut down its size, the reduction of human power led the Western food cooking in the hotel to lower core capacities, lower quality, and lower efficiency. In addition, the sagging morale of chefs undermined creativity. To change from the traditional kitchen to an economic kitchen needs to look into importance of outsourcing, cognitive attitude of chefs, relation with outside suppliers. Here suggests performance of positive changes in the structure The study examined feasibility and limitation of outsourcing in the hotel kitchen as well as chefs' cognitive attitude toward outsourcing of food materials to reinforce core capabilities of the hotel kitchen. 1. Companies of outsourcing are selected according to variability of price conditions, flexibility of contract conditions, popularity of the outsourcing company, and reputation of the outsourcing company. 2. The importance of outsourcing in the Western food cooking is divided into 4 factors such as standard of selecting outsourcing companies, policies of cooking manu, quality of cooking, and quantity of cooking. 3. The most feasible section in outsourcing of food materials is a process of kneading flour for bread, which shows that many Western-food chefs expect to put higher possibility of outsourcing on the kneading. In other words, when it comes to confectionery and bakery, there are many outside expert processing companies supplying high quality products. In the order of outsourcing feasibility, sauce is followed by processed vegetable, garnish of main dish, and soup. The least feasible section in outsourcing of food materials is appetize. Appetize includes a concept of a improvised dish and needs speed. Due to its color, freshness, and sensibility of taste, the appetize plays a key role in the Western food cooking. 4. When outsourcing is taken in place, the highest risk is to lower the inner cooking skills. Therefore chefs in charge of the Western food sequently recognize both internal problems including storage of cooking skills, unstability of layoffs, and loss of cooperation between departments, and external problems including inferior goods, difficulty of differentiating manu, delay of delivery, and expiration date. It shows that most of the Western food chefs consider risks of the internal problems at first. 5. A effective outsourcing needs appropriate selection of outsourcing companies, maintenance of credibility, active communication, check and management of hygiene. However regardless of their position or career, chefs in charge of the Western food have the same cognitive attitude toward selecting successful outsourcing companies after the outsourcing system is enforced. The core of cooking, or a final stage in the full process of so-called artistic cooking, should be treated with insourcing. Reduction of several cooking processes resulted in shortened cooking time, increased efficiency, faster cooking, cutting the waiting-lines, and finally more room for customers. The outsourcing system can reduce or eliminate the following processes in cooking: buying various food materials, checking, storing, preparing, and processing. Especially in the Western food cooking department of a hotel, the outsourcing system should be enforced to make an economic kitchen and to efficiently manage it. Wow it's time to change from the traditional kitchen to an economic kitchen in the hotel cooking department. For that, the cooking department should become a small but strong organization by outsourcing except its core work.

• KDI Journal of Economic Policy
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• 제30권1호
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• pp.71-130
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• 2008

본 연구는 그동안 사회적 안전망이 미흡한 가운데 우리나라의 고령인구 부양에 중요한 역할을 해온 사적소득이전에 대한 미시적 분석을 통해 향후 노후소득보장정책에 시사점을 제공하고 있다. 한국노동패널 자료에 따르면, 만 60세 이상 노인가구주 세대의 다섯 가구 중 두 가구는 매월 자식들로부터 생활비 등의 경제적 도움을 받고 있는 것으로 조사되었으며, 공공부조 등 공적소득이전은 사적소득이전을 구축하는 효과를 가진 것으로 나타났다. 또한 지금까지는 사적이전이 공적이전보다 빈곤완화효과가 큰 것으로 나타났지만, 외환위기 후 복지지출의 확대와 함께 공적이전의 비중이 대폭 높아져, 공적이전을 주 소득원으로 살아가는 만 60세 이상 고령자는 2003년 기준으로 약 4분의 1에 달하는 것으로 조사되었다. 그러나 같은 해 기준으로 국민기초생활보장제도의 보호지정을 실질적으로 필요로 하면서도 수급권에서 배제된 것으로 추정되는 노인가구주 세대는 약 12%로서, 이들 가구의 빈곤 해소를 위해서는 예산 확보와 함께 사각지대를 없애기 위한 전달체계 개선이 필요할 것으로 보인다. 이처럼 여전히 광범한 빈곤노인계층이 존재하는 한편, 고령인구에 대한 사적 부양이 공적 부양으로 전환되면서 재정건전성이 우려되고 있는 현 상황에서 소득재분배의 효과가 적고 경직적 비용부담이 큰 보편급여의 확대보다는 취약노인계층에 대한 집중적인 지원을 강화할 필요가 있을 것이다.