• 대한한의학회지
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• 제34권4호
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• pp.21-31
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• 2013

Objectives: The purpose of this study was to evaluate the efficiency of patient and doctor role-play on participatory clinical clerkship by surveying student's satisfaction and assessing the improvement of skill and consultation ability after conducting a role-play in a Korean dermatology department. Methods: In 2013, 79 seniors participated in the clinical clerkship of the dermatology department at the college of Korean medicine. Two students were randomly selected and paired up. After a brief instruction, one student played the role of doctor and the other took the role of patient. After finishing the $1^{st}$ role-play, they swapped roles and conducted a $2^{nd}$ role-play, using another clinical case. When the two role-plays were completed, the students filled in a questionnaire about their satisfaction with the role-play as clinical clerkship. Also, we compared the scores of the $1^{st}$ role-play with those of the $2^{nd}$ role-play measured by a medical resident to assess improvements of students' skill and interview ability. Results: It appears that students' satisfaction with the role-play was quite high, considering that the overall mean score of the questionnaire was 4.30. According to the result of a t-test on 15 assessment questions, the $2^{nd}$ role-play had a higher mean score than the $1^{st}$ role-play in 12 questions, though this difference was not statistically significant. Conclusions: These results demonstrate that role-play is helpful to improve students' satisfaction and clinical performance ability in clinical clerkship. Further research and continuous development are necessary for better clinical clerkship.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.282-291
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• 2004

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

• 농촌계획
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• 제4권1호
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• pp.63-74
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• 1998

The objective of this study is the investigation and analysis of information on the conservation and the sustainable use of coastal wetlands based on the awareness of local residents in Kang-hwa island, Tae-an and Seo-chon. The results are summarized as follows: The degree of the satisfaction on the natural environment is in the order of Tae-an, Kang-hwa and Seo-chon. This order is accorded with the order of the goodness of natural environment. The order for the degree of the satisfaction on the living environment is same as the order for the satisfaction degree on the natural environment. Especially, residents of Seo-chon are not satisfied with the living environment. The residents of all regions are not satisfied with the socio $.$ economic environment. The local resident of Kang-hwa and Tae-an, where natural environment is well-conserved, prefer conservation to development of the region. On the other hand, the local residents of Seo-chon have relatively low preference for conservation of the region. These results show the following consideration for the ideal method of management for the conservation and sustainable development of coastal wetlands. In case of Kang-hwa island, where the, condition the natural environment is well conserved, should be managed with the minimum development with maintenance of the current state must be driven.

• Nuclear Engineering and Technology
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• 제51권4호
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• pp.1098-1108
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• 2019

Korea's first commercial nuclear power plant at Kori site was permanently shut down in 2017 and is currently in transition stage. Preparatory activities for decommissioning such as historical site assessment, characterization, and dismantling design are being actively carried out for successful D&D (Dismantling and Decontamination) at Kori site. The ultimate goal of decommissioning will be to ensure the safety of workers and residents that may arise during the decommissioning of nuclear facilities and, thereby finally returning the site to its original status in accordance with the release criteria. Upon completion of decommissioning, the resident's safety at a site released will be assessed from the evaluation of dose caused by radionuclides expected to be present or detected at the site. Although the U.S. commercial nuclear power plants with decommissioning experience use different site release criteria, most of them are 0.25 mSv/y. In Korea, both the unrestricted and restricted release criteria have been set to 0.1 mSv/y by the Nuclear Safety and Security Commission. However, since the dose is difficult to measure, measurable concentration guideline levels for residual radionuclides that result in dose equivalent to the site release criteria should be derived. For this derivation, site reuse scenario, selection of potential radionuclides, and systematic methodology should be developed in planning stage of Kori site decommissioning. In this paper, for calculation of a preliminary site-specific Derived Concentration Guideline Levels (DCGLs) for the Nuclear Power Plant site, a novel approach has been developed which can fully reflect practical reuse plans of the Kori site by taking into account multiple site reuse scenarios sequentially, thereby striking a remarkable distinction with conventional approaches which considers only a single site scenario.

• 환경영향평가
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• 제32권6호
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• pp.533-544
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• 2023

농림축산식품부는 농촌 중심지의 기능(문화·복지·경제·교육 등)을 강화하고, 중심지의 서비스가 배후마을로 전달되어 연계시키는 정책을 추진해왔다. 이러한 정책목적을 위해 일반농산어촌개발사업 내 농촌중심지활성화사업, 기초생활거점조성사업을 추진중에 있지만 실제 사업을 추진하는 과정에서 농촌 중심지의 기능 강화에 초점이 맞춰져 배후마을과의 서비스 전달 및 연계 등은 활성화되고 있지 않은 실정이다. 따라서 본 연구에서는 무주군 적상면에서 기 수행했던 사업과 지역현황을 분석하여 배후마을 서비스가 연계 및 활성화되지 못한 이유를 분석하여 앞으로 수행하게될 기초생활거점조성 2단계사업의 추진방향을 제시하고자 하였다. 배후마을 서비스가 활성화되지 못한 원인을 분석한 결과, 농촌의 분산거주 및 지형구조의 한계성으로 나타나는 서비스 접근의 불리함과 배후지역의 수요 발굴을 위한 서비스 전달 체계의 미확보 등이 문제점으로 나타났으며 그에 따른 개선방안을 다음과 같이 도출하였다. 첫 번째로, 지형적 한계를 극복하고자 제안한 디딤거점 조성계획이다. 서비스 중간 터미널 기능을 담당할 디딤거점을 설정하여 효율적인 서비스전달이 이루어지도록 한다. 두 번째로, 합리적 의사결정구조를 위해 중심지 및 배후마을 주민 그리고 다양한 계층이 포함된 주민위원회의 효율적 구성과 함께 다양한 소규모 커뮤니티를 운영하여 지역의 견을 촘촘하게 수렴할 수 있는 소통창구 배치계획을 제안하였다. 세 번째로, 지역주민을 전문강사로 양성하는 선순환 지역인력 양성계획이다. 서비스 전달에서 가장 중요한 서비스 전달자, 즉 활동가를 양성하여 지속 가능한 주민 주도 서비스 공급체계를 완성하고자 한다.

• 보험의학회지
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• 제2권1호
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• pp.135-142
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• 1985

For the past 10 years, the socioeconomic status of our country was markedly improved. Accordingly, our foodintake patterns and other alt parts are preparing to blance with developed countries. Especially, be westernizing or improving our foodintake patterns, we intake much fat diet(animal food) while our physical activities decrease and alcohol consumtion's population, smoking population gradually increase. For such reasons, the population of obese tendency and cardiovascular diseases are increased. According to recent reports, among all death causes in our country, cardiovascular diseases(hypertension, hypertensive cardiovascular diseases, ischemic heart diseases) occupyd top rank, we know. I(the author) studied the inter-relation between serum cholesterol level which is the important factor of the cardiovascular diseases and essential hypertension liver diseases, hyperglycemia, some cardiac problems which are main decline causes in life insurance's medical assessment, and body weight distribution. Studied samples were selected on 4,313 cases(male; 1,791, female; 2,522) who were tested liver function test from June, 11th, 1980 to Dec., 31st, 1983 on our medical department's laboratory. I selected two groups in those cases: one group was serum cholesterol level 180mg/dl over(11% of whole LFT examed cases: No=502 cases), the other group was serum cholesterol level 120-160mg/dl(No= 502 cases). For convenience, the group of serum cholesterol level 180mg/dl over was "A" the other group was "B", I described. All examed persons of LFT were resident m Tae-Jon city in that time. On the result, 1) Decline rate is 10.5% on the "A" group, 5.9% on the "B" group. "A" group reveals 1.8 times higher than "B" group. 2) On decline causes, Essential hypertension is 4.0 times higher on the "A" group than "B", liver function's abnormalities are 2.0 times higher on "A" group than "B" and other diseases are same on "A" and "B". On the "A" group, essential hypertension is considerably higher than "B" group. 3) On the body weight distribution, the cases of 70kg(B.W.) over is 19.7% on "A", 10.6% on "B" group. Obese tendency is 1.8 folds higher on "A" group than "B" group. Studing the result, we find high serum cholesterol concentration is closely related with essential hypertension, obese tendency and liver function's abnormalities on the life insurance's medical examination part, also. On the future, we will more carefully consider the serum cholesterol concentration on our medical examnination and assessment of life insurance, I think.

• 환경영향평가
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• 제24권4호
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• pp.332-343
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• 2015

악취로 인한 유해물질의 배출과 이에 따르는 사회적 문제를 해결하는 가장 확실한 방법은 정부기관이 이 문제를 얼마나 적절하게 취급할 수 있는가에 달려 있다고 할 수 있다. 개인마다 악취에 대한 수용성이 다르고, 악취문제 해결을 위한 사회적 비용의 지불의사도 다르기 때문이다. 이는 악취와 같은 부정적 외부효과를 공공부문의 개입에 의해 해결해야하는 이유이기도 하다. 이 연구는 오창산업단지에서 발생하는 악취문제에 대한 주변지역 주민들의 인식을 경험적으로 측정함으로써 행정규제에 대한 인식과 악취수용성의 상관성을 분석해보았다. 분석결과를 살펴보면 첫째, 법적규제에 대한 인식은 악취 수용성에 부정적인 효과를 나타내는 것으로 증명되었다. 즉, 법령과 규제에 대한 문제점을 더 강하게 인식할수록 악취에 대한 수용도가 낮은 것으로 나타났다. 둘째, 악취물질 배출에 관한 규제를 개선해야한다고 인식하는 주민일수록 악취수용성 판단에 더 많은 영향을 받는 것으로 나타났다. 마지막으로, 지방정부의 민원해결에 대한 지역주민들의 만족도는 악취관련 규제에 대한 인식에 영향을 주어 악취 수용성과도 상관관계를 만들어내는 것으로 나타났다.

• 정신신체의학
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• 제21권2호
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• pp.140-146
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• 2013

연구목적 본 연구는 치매 군과 비치매 군의 통증 역치 및 통증 경험의 특성을 비교 하고자 한다. 방 법 2010년 강원 조기치매 검진사업의 일환으로 시행된 것으로, 연구 대상은 지역사회 거주중인 65세 이상 노인 8,302명이었다. 이 중, 한국판 간이정신상태검사(MMSE-KC) 점수가 저하 된 1259명을 선별했고, 이중 365명이 한국형 치매 진단평가 도구(CERAD-K)를 이용한 정밀검진을 받았다. 검사 결과 및 전문의의 판단 하에 정상, 경도인지장애, 치매 군으로 진단 후, 최종 비치매 군 90명, 치매 군 57명이(경도-중등도 알츠하이머형 치매) 분석되었다. 압통각계(Pressure algometer)를 이용하여 실험적으로 통증 역치를 측정했고, 자가보고식 검사인 Brief pain inventory(BPI)를 이용하여 통증 경험(통증 심도, 통증 방해도)을 조사했다. 집단 간 차이 분석은 Pearson Chi-Square와, 혼란변인(성별, 나이, 교육수준, GDS, 당뇨)을 보정한 ANCOVA검정을 시행했다. 결 과 인구학적 특성상 치매 환자 군에서 여성이 많고, 연령이 높고, 교육 연수가 낮았다. 통증 역치는 두 군에서 통계적으로 의미 있는 차이가 발견되지 않았다. BPI결과에서 비치매 군이 어깨 통증, 전체 통증 개수, '통상적 일'의 통증으로 인한 방해를 의미 있게 더 많이 호소했다(p<0.05). 그러나 두 군에서 통증 유병률 및 치료는 차이가 없었다. 결 론 치매 군은 비치매 군보다 통증을 더 적게 경험했다. 이는 치매 환자의 통증 역치는 보존되었으나, 내성이 증가한다는 선행 연구를 뒷받침 하는 증거로 여겨진다. 따라서, 치매 환자를 위한 적극적인 통증 사정 및 치료를 제안한다.

• 대한환경공학회지
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• 제38권2호
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• pp.56-62
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• 2016

본 연구는 쾌적한 주거환경과 지속가능한 정주환경을 구현하기 위한 일환으로 신규 공공 아파트단지에 건설된 생활폐기물 자동집하시설에 대한 운영자와 거주자 평가를 분석하는데 그 목적이 있다. 수도권 소재 10개 지구의 시설 운영 관리 담당 실무자와 이들 지구의 11곳 아파트 단지에 거주하는 사용자들을 대상으로 설문조사를 실시하였다. 분석결과, 생활폐기물 자동집하시설은 경제적 편익이 큰 시스템으로, 효율적인 시설 운영을 위해 전문성 강화, 설계 및 성능 개선, 인력 증원 등을 제시하였다. 이러한 개선사항은 시설에서 접수된 민원, 그리고 투입시설 및 관로시설의 수리 이력과 빈도가 반영된 결과였다. 한편, 거주자들은 생활폐기물 자동집하시설을 긍정적으로 평가하였고, 사용 평가에 대해서는 사용자 친화적 요소가 강화될 필요가 있다고 하였다. 거주자들은 투입시설을 주로 이용하는 점을 고려할 때 개선사항들은 투입구의 안전성, 위생적 관리, 고장 발생 시 신속한 수리, 악취제거, 쓰레기 분리 등이 있었으며, 올바른 시설 이용을 위한 거주자 대상의 교육을 지적하였다. 실제, 생활폐기물 자동집하시설의 운영 관리가 사용자의 부주의와 실수에 의한 고장이 빈번하여 제기되는 민원이 많은 점을 고려할 때 향후 시설 운영 관리의 전문성 강화 뿐만 아니라 거주자 교육이 함께 이루어져야 할 것이다.

• 보건행정학회지
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• 제27권2호
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• pp.167-176
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• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.