• 보건행정학회지
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• 제25권4호
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• pp.253-255
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• 2015

The concept of precision medicine-prevention and treatment strategies that take individual variability into account-is hot issue of US in the year 2015. Precision medicine is a new concept that approach patients individually by there characteristics, such as genome, life style, environmental exposure, etc. For developing the precision medicine, National Institute of Health of US has been prepared the Precision Medicine Initiative Cohort Program, at least 1 million people cohort. The US President Obama announced the Precision Medicine Initiative on 30th January 2015. He announced that he will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients. Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others. This is changing with the emergence of precision medicine, an innovative approach to disease prevention and treatment that takes into account individual differences in people's genes, environments, and lifestyles. Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient's health, disease, or condition, and to better predict which treatments will be most effective. The healthcare researcher should prepare the new medicine era such as bio-information technology convergence, big data study.

• 보건행정학회지
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• 제30권3호
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• pp.270-276
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• 2020

Entering the fourth industrial revolution era, health technology is rapidly developing and the people's needs for medical services are gradually increasing. Establishing a life cycle management of health technology has emerged as a new policy agenda to cope with these changes. However, the management of health technology have been conducted without continuity and with several problems pointed out. Therefore, we suggest the reform agendas by stages to establish system for a life cycle management of health technology in the fourth industrial revolution era as follows. In the stage of development, it is important not only to provide research funding, but also consulting by professional about whole cycle of health technologies. In the phase of market entry, there are needs for enhance the system that would expand the early adoption for innovative technology and increase its effectiveness. After the spread of health technology to clinical settings, a reassessment and post management system should be established that have an institutional framework with strong price adjustment and exit mechanism. Furthermore, we hope that discussions will be brisk in macro perspective on the balancing of development in healthcare industry, health of people and national health insurance finance.

• Asian-Australasian Journal of Animal Sciences
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• 제20권4호
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• pp.605-614
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• 2007

Feeding pigs used to be a means of managing domestic resources that may otherwise have been wasted into valuable animal protein. Feeding pigs thus was a form of husbandry. Following recent rapid industrial development, pig rearing has changed from extensive to intensive, but this transformation has been associated with major concerns. The concentration of large amounts of pig manure in small arrears is environmentally hazardous. Moreover, high densities of animals in intensive production systems also impose a health threat for both animals and humans. Furthermore, the use of growth promoters and preventive medicines for higher production efficiencies, such as in-feed antibiotics, also induces microbial resistance thus affects human therapeutics. In addition, consumers are questioning the ethics of treating animals in intensive production systems. Animal welfare, environmental and bio-safe issues are re-shaping the nature of pig production systems. Feeding pigs thus involves not only the consideration of economic traits, but also welfare traits and environmental traits. Thus, a focus on technological feasibility, environmental sustainability and social desirability is essential for successful feeding operations. Feeding pigs now involves multiple projects with different sustainability goals, but goal conflicts exist since no pattern or scenario can fulfill all sustainability goals and the disagreements are complicated by reduced or even no use of in-feed antibiotics. Thus it is difficult to feed pigs in a manner that meets all goals of high quality, safe product, eco- and bio-sustainability, animal welfare and profit. A sustainable pig production system thus requires a prioritization of goals based on understanding among consumers, society and producers and needs to view from both a local and global perspective.

• 한국경영과학회지
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• 제14권2호
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• pp.185-185
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• 1989

Business process reengineering(BPR) aims at a radical redesign of our business processes in order to achieve dramatic improvements in their performance. However, the fact that many BPR projects have failed hesitates the companies who have started to use BPR or who are planning to do so. Implementing a radical plan from a cross-functional perspective needs a more careful consideration of process vision, preventive measures and contingency plan. Our research suggests to use a visual decision making process (VDMP) in the development of a process vision and implementation plan. A BPR project of Carlson School of Management (CSOM) at the University of Minnesota is illustrated to show our suggested methodology.

• 보건행정학회지
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• 제28권3호
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• pp.197-201
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• 2018

There is a general consensus that many health care problems are attributable to the structural defects of the health care delivery system in Korea. The basic policy aimed to address these problems is to reform the delivery system so as that it incorporates two core principles: (1) stratification of medical care institutions into primary, secondary, and tertiary care providers according to the capability to perform specialized and complex services; (2) patients seeking care starting from the primary care provider and, if necessary, to be referred to the other provider step by step. This policy has been consistently pursued for about 30 years, but the achievement is far from success. Thus it is believed that the feasibility of the policy should be questioned. Starting from this question, based upon the observation of the current structure of the delivery system and its expected changes, the reform policy was discussed focusing on the assessment of its feasibility from both practical and theoretical viewpoints. The discussion leads to cast doubt on the policy for its possibility of making planned changes and producing expected desirable effects. Therefore it is advisable to investigate a wide range of alternative strategies and models for improving health care delivery.

• 대한건축학회논문집:구조계
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• 제35권12호
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• pp.181-188
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• 2019

The maintenance of school building is pivotal issue. However, it is difficult to obtain basic analysis data for LCC(Lifecycle Cost) analysis and maintenance planning of school building. Therefore, this study proposed System Dynamics(SD) techniques to make maintenance decisions for school building. The interaction between the major parameters related to the aging of a building, maintenance activities, and cost were expressed in Causal Loop Diagram. Based on this, the formula for the relationship between causal maps was defined and converted to Stock and Flow Diagram. Through the completed SD model the 50-year plan of 214 educational building were tested by considered in account budget, maintainability, and budget allocation opinions. As a result, the integrated SD model demonstrated that it can support strategic decision making by identifying the status class and LCC behavior of school buildings by scenario. According to the scenario analysis, the rehabilitation action of preventive maintenance that primarily repairs the buildings in condition grade C showed the best performance improvement effect relative to the cost. Therefore, if the proposed SD model is expanded to consider the effects of other educational policies, the crucial performance improvement budget can be estimated in the long-term perspective.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(환경)
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• pp.405-411
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• 1994

Hazardous wastes released into the general environment are of concern to the public and to public health authorities. In response to this concern, the Comprehensive Environmental Response, Compensation, and Liability Act, as amended (commonly called Superfund), was enacted in 1980 to provide a framework for environmental, public health, and legal actions concerning uncontrolled releases of hazardous substances. The Agency for Toxic Substances and Disease Registry (ATSDR) was created by Superfund to address the public health issues of hazardous wastes in the community environment. Two key Agency programs, Public Health Assessments and Toxicological Profiles, are designed to assess the risk to human health of exposures to hazardous substances that migrate from waste sites or through emergency releases (e.g., chemical spills). The Agency's public health assessment is a structured process that permits ATSDR to identify which waste sites or other point sources require traditional public health actions (e.g.. human exposure studies, health studies, registries, health surveillance, health advisories). The ATSDR qualitative public health assessment complements the U.S. Environmental Protection Agency's quantitative risk assessment. For Superfund purposes, both assessments are sitespecific. ATSDR's toxicological profiles are prepared for priority hazardous substances found most frequently at Superfund sites. Each profile presents the current toxicologic and human health effects information about the substance being profiled. Each profile also contains Minimal Risk Levels (MRLs), a type of risk assessment value. This paper covers ATSDR's experience in conducting public health assessments and developing MRLs, and it relates this experience to recommendations on how to improve chemical risk assessments.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.799-805
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• 2016

Background: There is no standard treatment for patients with platinum-resistant or refractory epithelial ovarian cancer. Single agent chemotherapies have evidence of more efficacy and less toxicity than combination therapy. Most are very expensive, with appreciable toxicity and minimal survival. Since it is difficult to make comparison between outcomes, economic analysis of single-agent chemotherapy regimens and best supportive care may help to make decisions about an appropriate management for the affected patients. Objective: To evaluate the cost effectiveness of second-line chemotherapy compared with best supportive care for patients with platinum-resistant or refractory epithelial ovarian cancer. Materials and Methods: A Markov model was used to estimate the effectiveness and total costs associated with treatments. The hypothetical patient population comprised women aged 55 with platinum-resistant or refractory epithelial ovarian cancer. Four types of alternative treatment options were evaluated: 1) gemcitabine followed by BSC; 2) pegylated liposomal doxorubicin (PLD) followed by BSC; 3) gemcitabine followed by topotecan; and 4) PLD followed by topotecan. Baseline comparator of alternative treatments was BSC. Time horizon of the analysis was 2 years. Health care provider perspective and 3% discount rate were used to determine the costs of medical treatment in this study. Quality-adjusted life-years (QALY) were used to measure the treatment effectiveness. Treatment effectiveness data were derived from the literature. Costs were calculated from unit cost treatment of epithelial ovarian cancer patients at various stages of disease in King Chulalongkorn Memorial Hospital (KCMH) in the year 2011. Parameter uncertainty was tested in probabilistic sensitivity analysis by using Monte Carlo simulation. One-way sensitivity analysis was used to explore each variable's impact on the uncertainty of the results. Results: Approximated life expectancy of best supportive care was 0.182 years and its total cost was 26,862 Baht. All four alternative treatments increased life expectancy. Life expectancy of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 0.510, 0.513, 0.566, and 0.570 years, respectively. The total cost of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 113,000, 124,302, 139,788 and 151,135 Baht, respectively. PLD followed by topotecan had the highest expected quality-adjusted life-years but was the most expensive of all the above strategies. The incremental cost-effectiveness ratios (ICER) of gemcitabine followed by BSC, PLD followed by BSC, gemcitabine followed by topotecan and PLD followed by topotecan was 344,643, 385,322, 385,856, and 420,299 Baht, respectively. Conclusions: All of the second-line chemotherapy strategies showed certain benefits due to an increased life-year gained compared with best supportive care. Moreover, gemcitabine as second-line chemotherapy followed by best supportive care in progressive disease case was likely to be more effective strategy with less cost from health care provider perspective. Gemcitabine was the most cost-effective treatment among all four alternative treatments. ICER is only an economic factor. Treatment decisions should be based on the patient benefit.

• 한국산학기술학회논문지
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• 제16권8호
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• pp.5501-5507
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• 2015

이 연구는 사회복지사 대상 죽음교육 프로그램을 만들기 위해 DACUM 기법을 활용한 직무분석을 통해 사회복지사들이 현장에서 실제로 적용 가능한 의료적 시각과 인문학적 시각을 동시에 수용하는 융합된 죽음 교육 프로그램에 대한 사회복지사의 책무와 과업들을 규명하고자 하였다. 연구기간은 2015년 3월 2일부터 동년 3월 10일까지 직무분석을 위해 DACUM 위원 8명으로 구성된 보건의료 및 인문사회분야의 전문 교수진으로 구성되어 의료적, 인문학적 시각 및 사회적 시각으로 조사하였다. 연구결과, '상실과 애도' 책무에 대한 과업으로 '죽음의 수용과 이해'와 '상실 스트레스 치유 및 자살 예방 교육'이 중점이 되어야 함을 알 수 있었다. '죽음교육의 필요성' 책무에 대한 과업으로 '전통사회의 죽음과 현대사회의 죽음'이 '자신의 죽음과 관련된 문제의 이해'등으로 나타났다. 본 연구결과 인문학적 시각에 의한 죽음의 수용과 이해를 위한 힐링과 치유가 강조된 죽음교육 프로그램의 개발이 필요함을 시사해 주고 있다.

• 시큐리티연구
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• 제29호
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• pp.301-336
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• 2011

이 논문은 최근 전 세계적으로 확산되어 다양한 분야에서 폭넓게 사용되고 있는 Social Network Service(SNS)가 오히려 사이버 범죄나 산업스파이 등과 같은 각종 불법적 행위에 악용되고 있는 상황에 즈음하여, 특히 SNS가 가지는 보안상 취약성으로 인한 위험뿐만 아니라 기업의 기밀정보 핵심기술이나 개인정보 유출, 프라이버시 침해, 신원 절도(ID Theft), 타인 정보의 오 남용, 지적재산권 침해 및 관련 법적 문제, 범죄 증거 및 수사자료 활용, 아동 포르노 등 성범죄에의 악용, 온라인상에서의 집단 따돌림(On-line Bullying) 등 각종 사회 경제적 우려가 중대하고 심지어는 테러나 사회적 파장이 큰 범죄의 목표 또는 수단이 되기도 하는 등 그 잠재적 위험성이 매우 크다는 점에 주목하였다. 사실상 국내 뿐 아니라 해외에서도 SNS의 위험성이나 Policing(경찰활동)에 미칠 영향 등과 관련한 연구가 거의 전무한 형국인지라 이에 SNS에 대한 위험성의 인식과 Policing 측면에서의 적극적인 검토와 대응이 시급히 요청되고 있는 실정임을 반영하여 이 논문을 통해 SNS의 잠재적 위험성에 대한 이론적 분석과 같은 학술적인 측면뿐만 아니라 경찰활동에 미칠 수 있는 영향에 대한 실무 실용적 관점에서 접근의 필요성을 인지하여 탐색적 연구를 시도하였다.