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Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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Serial Changes of Serum Thyroid-Stimulating Hormone after Total Thyroidectomy or Withdrawal of Suppressive Thyroxine Therapy in Patients with Differentiated Thyroid Cancer (분화성 갑상선 암 환자에서 갑상선 전절제술후 또는 갑상선 호르몬 억제 요법 중단에 따른 갑상선 자극호르몬의 변화)

  • Bae, Jin-Ho;Lee, Jae-Tae;Seo, Ji-Hyoung;Jeong, Shin-Young;Jung, Jin-Hyang;Park, Ho-Yong;Kim, Jung-Guk;Ahn, Byeong-Cheol;Sohn, Jin-Ho;Kim, Bo-Wan;Park, June-Sik;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.516-521
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    • 2004
  • Background: Radioactive iodine (RAI) therapy and whole-body scanning are the fundamentals of treatment and follow-up of patients with differentiated thyroid cancer. It is generally accepted that a Thyroid-Stimulating Hormone (TSH) level of at least 30 ${\mu}U/ml$ is a prerequisite for the effective use of RAI, and that it requires 4-6 weeks of off-thyroxine to attain these levels. Because thyroxine withdrawal and the consequent hypothyroidism are often poorly tolerated, and occasionally might be hazardous, it is important to be certain that these assumptions are correct. We have measured serial changes in serum TSH after total thyroidectomy or withdrawl of thyroxine in patients with thyroid cancer. Subjects and Methods: Serum TSH levels were measured weekly after thyroidectomy in 10 patients (group A) and after the discontinuation of thyroxine in 12 patients (group B). Symptoms and signs of hypothyroidism were also evaluated weekly by modified Billewicz diagnostic index. Results: By the second week, 78% of group A patients and 17% of group B patients had serum TSH levels ${\geq}30{\mu}U/ml$. By the third week, 89% of group A patients and 90% of group B patients had serum TSH levels ${\geq}30{\mu}U/ml$. By the fourth week, all patients in two groups achieved target TSH levels and there were no overt hypothyroidism. Conclusion: in all patients, serum TSH elevated to the target concentration (${\geq}30{\mu}U/ml$) within 4 weeks without significant manifestation of hypothyroidism. The schedule of RAI administration could be adjusted to fit the needs and circumstances of individual patients with a shorter preparation period than the conventional.

A Study on Aviation Safety and Third Country Operator of EU Regulation in light of the Convention on international Civil Aviation (시카고협약체계에서의 EU의 항공법규체계 연구 - TCO 규정을 중심으로 -)

  • Lee, Koo-Hee
    • The Korean Journal of Air & Space Law and Policy
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    • v.29 no.1
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    • pp.67-95
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    • 2014
  • Some Contracting States of the Chicago Convention issue FAOC(Foreign Air Operator Certificate) and conduct various safety assessments for the safety of the foreign operators which operate to their state. These FAOC and safety audits on the foreign operators are being expanded to other parts of the world. While this trend is the strengthening measure of aviation safety resulting in the reduction of aircraft accident. FAOC also burdens the other contracting States to the Chicago Convention due to additional requirements and late permission. EASA(European Aviation Safety Agency) is a body governed by European Basic Regulation. EASA was set up in 2003 and conduct specific regulatory and executive tasks in the field of civil aviation safety and environmental protection. EASA's mission is to promote the highest common standards of safety and environmental protection in civil aviation. The task of the EASA has been expanded from airworthiness to air operations and currently includes the rulemaking and standardization of airworthiness, air crew, air operations, TCO, ATM/ANS safety oversight, aerodromes, etc. According to Implementing Rule, Commission Regulation(EU) No 452/2014, EASA has the mandate to issue safety authorizations to commercial air carriers from outside the EU as from 26 May 2014. Third country operators (TCO) flying to any of the 28 EU Member States and/or to 4 EFTA States (Iceland, Norway, Liechtenstein, Switzerland) must apply to EASA for a so called TCO authorization. EASA will only take over the safety-related part of foreign operator assessment. Operating permits will continue to be issued by the national authorities. A 30-month transition period ensures smooth implementation without interrupting international air operations of foreign air carriers to the EU/EASA. Operators who are currently flying to Europe can continue to do so, but must submit an application for a TCO authorization before 26 November 2014. After the transition period, which lasts until 26 November 2016, a valid TCO authorization will be a mandatory prerequisite, in the absence of which an operating permit cannot be issued by a Member State. The European TCO authorization regime does not differentiate between scheduled and non-scheduled commercial air transport operations in principle. All TCO with commercial air transport need to apply for a TCO authorization. Operators with a potential need of operating to the EU at some time in the near future are advised to apply for a TCO authorization in due course, even when the date of operations is unknown. For all the issue mentioned above, I have studied the function of EASA and EU Regulation including TCO Implementing Rule newly introduced, and suggested some proposals. I hope that this paper is 1) to help preparation of TCO authorization, 2) to help understanding about the international issue, 3) to help the improvement of korean aviation regulations and government organizations, 4) to help compliance with international standards and to contribute to the promotion of aviation safety, in addition.

Geology of Athabasca Oil Sands in Canada (캐나다 아사바스카 오일샌드 지질특성)

  • Kwon, Yi-Kwon
    • The Korean Journal of Petroleum Geology
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    • v.14 no.1
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    • pp.1-11
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    • 2008
  • As conventional oil and gas reservoirs become depleted, interests for oil sands has rapidly increased in the last decade. Oil sands are mixture of bitumen, water, and host sediments of sand and clay. Most oil sand is unconsolidated sand that is held together by bitumen. Bitumen has hydrocarbon in situ viscosity of >10,000 centipoises (cP) at reservoir condition and has API gravity between $8-14^{\circ}$. The largest oil sand deposits are in Alberta and Saskatchewan, Canada. The reverves are approximated at 1.7 trillion barrels of initial oil-in-place and 173 billion barrels of remaining established reserves. Alberta has a number of oil sands deposits which are grouped into three oil sand development areas - the Athabasca, Cold Lake, and Peace River, with the largest current bitumen production from Athabasca. Principal oil sands deposits consist of the McMurray Fm and Wabiskaw Mbr in Athabasca area, the Gething and Bluesky formations in Peace River area, and relatively thin multi-reservoir deposits of McMurray, Clearwater, and Grand Rapid formations in Cold Lake area. The reservoir sediments were deposited in the foreland basin (Western Canada Sedimentary Basin) formed by collision between the Pacific and North America plates and the subsequent thrusting movements in the Mesozoic. The deposits are underlain by basement rocks of Paleozoic carbonates with highly variable topography. The oil sands deposits were formed during the Early Cretaceous transgression which occurred along the Cretaceous Interior Seaway in North America. The oil-sands-hosting McMurray and Wabiskaw deposits in the Athabasca area consist of the lower fluvial and the upper estuarine-offshore sediments, reflecting the broad and overall transgression. The deposits are characterized by facies heterogeneity of channelized reservoir sands and non-reservoir muds. Main reservoir bodies of the McMurray Formation are fluvial and estuarine channel-point bar complexes which are interbedded with fine-grained deposits formed in floodplain, tidal flat, and estuarine bay. The Wabiskaw deposits (basal member of the Clearwater Formation) commonly comprise sheet-shaped offshore muds and sands, but occasionally show deep-incision into the McMurray deposits, forming channelized reservoir sand bodies of oil sands. In Canada, bitumen of oil sands deposits is produced by surface mining or in-situ thermal recovery processes. Bitumen sands recovered by surface mining are changed into synthetic crude oil through extraction and upgrading processes. On the other hand, bitumen produced by in-situ thermal recovery is transported to refinery only through bitumen blending process. The in-situ thermal recovery technology is represented by Steam-Assisted Gravity Drainage and Cyclic Steam Stimulation. These technologies are based on steam injection into bitumen sand reservoirs for increase in reservoir in-situ temperature and in bitumen mobility. In oil sands reservoirs, efficiency for steam propagation is controlled mainly by reservoir geology. Accordingly, understanding of geological factors and characteristics of oil sands reservoir deposits is prerequisite for well-designed development planning and effective bitumen production. As significant geological factors and characteristics in oil sands reservoir deposits, this study suggests (1) pay of bitumen sands and connectivity, (2) bitumen content and saturation, (3) geologic structure, (4) distribution of mud baffles and plugs, (5) thickness and lateral continuity of mud interbeds, (6) distribution of water-saturated sands, (7) distribution of gas-saturated sands, (8) direction of lateral accretion of point bar, (9) distribution of diagenetic layers and nodules, and (10) texture and fabric change within reservoir sand body.

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Understanding Human Nobility Epoch, the Prerequisite of the Era of Resolution of Grievances (해원시대를 전제하는 인존시대에 대한 이해)

  • Park, Yong-cheol
    • Journal of the Daesoon Academy of Sciences
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    • v.27
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    • pp.135-169
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    • 2016
  • While examining the religious ideas implied by Jeungsan's Great Works of the Reordering of Universe, we find special ideas which cannot be found in any other religions, and these ideas are presented in diverse ways. Most of all, the representative idea is that of human nobility; a distinctive idea which makes Daesoonjinrihoe different from other religions. Thus, this research focuses on the following questions: when was Human Nobility concretely realized? What kind of organic relationship does human nobility have between the divine world and the world of humanity? In light of the forthcoming Era of Human Nobility, what are some concrete images which can be drawn from the interaction between the realms of heaven and humanity wherein preordinations are plotted in heaven and then carried out by humankind? Prior to formulating my own sense of the subject matter, I consulted 43 previous discussions and dissertations and arranged them chronologically so as to examine their correlation. From these sources and my own insights, I was able to gain a sense of the starting point of the era of human nobility and its tenor. I have found the following problems in previous research on the uniqueness and distinctness of human nobility: ①The conceptual undertones of human nobility have not been adequately gleaned. ②There do not seem to be any dissertations which examine the way in which human nobility is connected with the doctrines of the creative conjunction between yin and yang, the harmonious union of divine beings and human beings, and the resolution of grievances for mutual beneficence. ③In most dissertations, not only is the starting point of the Era of Human Nobility regarded as concurrent with the start of the 50,000 years of earthly paradise in the Later World, but also the point of division between the former world and the later world is widely disputed. ④In-depth and fully realized studies dealing with the subject of human nobility are not easily found. ⑤There is little sense of progression in the research on human nobility because scholars are not sufficiently engage with one another to achieve common consensus. Therefore, in this dissertation, I have provided answers to the problems I discovered in previous research. I have developed my own tenor as follows: ①By giving priority to the Jeongyeong, I have closely investigated the period which divides the Former World and the Later World. Then, I produced a chronological timeline to demonstrate the progression: the Former World → the Era of the Resolution of Grievances → the Later World. This aids in the comprehension of human nobility. ②The Era of Human Nobility was preceeded by the opening of the Era of the Resolution of Grievances of human world which began in 1901. Human nobility is stipulated as a regulatory system for the universe set in motion by the opening the Era of Resolution of Grievances. ③While synthetically examining the aspects of transition which enable the Ear of Human Nobility to be realized, the period to be studied is stipulated as beginning from 1901 and ending at the start of the Later World. The subjects are defined as the flowing from Jeungsan, the first leader of human nobility, to the noble individuals empowered by Dao and the noble populace. In the Era of Human Nobility, studying the transition process by which human nobility is realized requires delving into the resolution of grievances. Although this method is essential to understanding Daesoon ideas, in actuality it does not hinge upon speculative exegetical theorizing but instead it was gained through eisegetical rigor.

Research for Space Activities of Korea Air Force - Political and Legal Perspective (우리나라 공군의 우주력 건설을 위한 정책적.법적고찰)

  • Shin, Sung-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.18
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    • pp.135-183
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    • 2003
  • Aerospace force is a determining factor in a modem war. The combat field is expanding to space. Thus, the legitimacy of establishing aerospace force is no longer an debating issue, but "how should we establish aerospace force" has become an issue to the military. The standard limiting on the military use of space should be non-aggressive use as asserted by the U.S., rather than non-military use as asserted by the former Soviet Union. The former Soviet Union's argument is not even strongly supported by the current Russia government, and realistically is hard to be applied. Thus, the multi-purpose satellite used for military surveillance or a commercial satellite employed for military communication are allowed under the U.S. principle of peaceful use of space. In this regard, Air Force may be free to develop a military surveillance satellite and a communication satellite with civilian research institute. Although MTCR, entered into with the U.S., restricts the development of space-launching vehicle for the export purpose, the development of space-launching vehicle by the Korea Air Force or Korea Aerospace Research Institute is beyond the scope of application of MTCR, and Air Force may just operate a satellite in the orbit for the military purpose. The primary task for multi-purpose satellite is a remote sensing; SAR sensor with high resolution is mainly employed for military use. Therefore, a system that enables Air Force, the Korea Aerospace Research Institute, and Agency for Defense Development to conduct joint-research and development should be instituted. U.S. Air Force has dismantled its own space-launching vehicle step by step, and, instead, has increased using private space launching vehicle. In addition, Military communication has been operated separately from civil communication services or broadcasting services due to the special circumstances unique to the military setting. However, joint-operation of communication facility by the military and civil users is preferred because this reduces financial burden resulting from separate operation of military satellite. During the Gulf War, U.S. armed forces employed commercial satellites for its military communication. Korea's participation in space technology research is a little bit behind in time, considering its economic scale. In terms of budget, Korea is to spend 5 trillion won for 15 years for the space activities. However, Japan has 2 trillion won annul budget for the same activities. Because the development of space industry during initial fostering period does not apply to profit-making business, government supports are inevitable. All space development programs of other foreign countries are entirely supported by each government, and, only recently, private industry started participating in limited area such as a communication satellite and broadcasting satellite, Particularly, Korea's space industry is in an infant stage, which largely demands government supports. Government support should be in the form of investment or financial contribution, rather than in the form of loan or borrowing. Compared to other advanced countries in space industry, Korea needs more budget and professional research staff. Naturally, for the efficient and systemic space development and for the prevention of overlapping and distraction of power, it is necessary to enact space-related statutes, which would provide dear vision for the Korea space development. Furthermore, the fact that a variety of departments are running their own space development program requires a centralized and single space-industry development system. Prior to discussing how to coordinate or integrate space programs between Agency for Defense Development and the Korea Aerospace Research Institute, it is a prerequisite to establish, namely, "Space Operations Center"in the Air Force, which would determine policy and strategy in operating space forces. For the establishment of "Space Operations Center," policy determinations by the Ministry of National Defense and the Joint Chief of Staff are required. Especially, space surveillance system through using a military surveillance satellite and communication satellite, which would lay foundation for independent defense, shall be established with reference to Japan's space force plan. In order to resolve issues related to MTCR, Air Force would use space-launching vehicle of the Korea Aerospace Research Institute. Moreover, defense budge should be appropriated for using multi-purpose satellite and communication satellite. The Ministry of National Defense needs to appropriate 2.5 trillion won budget for space operations, which amounts to Japan's surveillance satellite operating budges.

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