• Korean Journal of Radiology
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• 제20권1호
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• pp.148-157
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• 2019

Objective: To evaluate the current status of managing adverse reactions to iodinated contrast media (ICM) for computed tomography in referral hospitals in South Korea compared with hospitals in other countries. Materials and Methods: This survey investigation involved 59 Korean and 15 overseas hospitals using guideline-based questionnaires consisting of 24 items in 7 main categories related to managing adverse reactions to ICM. Results: Informed written consent with risk factor evaluation was appropriately performed in most of the Korean hospitals. There was considerable variability in assessing renal function across the hospitals; serum creatinine level was used as a reference in 76.4% of Korean hospitals. The Korean hospitals preferred a more stringent approach to determining normal renal function (p = 0.01), withholding metformin (p = 0.01), and fasting before ICM exposure (p < 0.001) compared with overseas hospitals. All the Korean hospitals had an emergency protocol and in-hospital system for adverse reactions to ICM. The Korean (87.7%) and overseas hospitals (100%) were similarly equipped with epinephrine (p = 0.332), but only 38.6% of Korean hospitals were equipped with a bronchodilator (p = 0.004). For patients with a previous hypersensitivity reaction to ICM, 62.3% of Korean hospitals pre-medicated with anti-histamine and corticosteroid according to the severity of the previous reaction, and changed the culprit ICM in 52.8%, while skin test was performed in 17%. Conclusion: In general, Korean referral hospitals were well-prepared regarding informed consent, protocol, and an in-hospital system for managing adverse reactions to ICM. Nevertheless, there was considerable variability in details and management, thus requiring standardization by reflecting current guidelines.

• 한국항공우주학회지
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• 제49권10호
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• pp.829-839
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• 2021

무인기를 위한 자율 시스템은 임무 목표, 임무 상황, 무인기의 상태를 기반으로, 목표 달성을 위해 현재 수행할 행동을 결정하는 의사결정 능력을 가진다. 본 논문에서는 지형 충돌 위험이 있는 저고도 운용, 방문 순서를 변경하지 않아야 하는 항로점 집합, 임무 대상 객체의 위치 불확실성 등 현실적인 제약조건 하에서 감시정찰 임무를 자율적으로 수행할 수 있는 의사결정 시스템과 이러한 특성을 효과적으로 표현할 수 있는 임무 정의를 제시한다. 제안한 의사결정 시스템을 Hardware-In-the-Loop Simulation 환경에서 현실적인 임무 상황을 반영한 3종의 시나리오를 통해 검증한다. 무인기의 비행 경로와 임무 상황에서 의사결정 시스템이 선택한 행동을 시뮬레이션 결과로 제시하고, 그 결과를 논의한다.

• 한국가스학회지
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• 제26권2호
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• pp.27-38
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• 2022

선진국에서는 공정안전관리제도의 도입으로 사고는 상당히 감소하였으나, 규제적 성격을 띄며, 실질적인 사업장안전관리의 실태를 보여주기 어렵다는 한계를 보인다. 많은 기관에서 공정안전상태를 포괄적으로 모니터링 할 수 있는 공정안전성과지표의 사용을 권장하고 있다. 본 연구에서는 공정안전성과지표 적용을 위하여 관련 Guideline을 비교·분석하고 사업장의 공정안전시스템을 분석하여 지표로 활용하는 방안을 검토하였다. 문헌적 지표에서는 절차의 준수 여부 위주로 확인하는 반면, 시스템 기반의 지표에서는 안전시스템의 특정 목적을 위한 절차나 검사 등을 명확하게 식별할 수 있도록 하고, 운영상태가 어떤지 측정하여 모니터링 할 수 있다. 이러한 특성은 안전관리 활동을 운영함에 있어 도출되는 보완사항들의 명료성 측면에서 더 유리함을 알 수 있다. 이를 활용하여 사업장 안전관리 수준을 효과적으로 보여줄 수 있다.

• 한국의료질향상학회지
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• 제7권2호
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• pp.204-216
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• 2000

Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

• 한국농림기상학회지
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• 제15권4호
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• pp.320-331
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• 2013

재단법인 국가농림기상센터는 지난 3년간 기상청의 재정지원으로 기후스마트농업의 전제조건인 개별농장 수준의 기상위험 관리서비스를 설계하였다. 이 서비스는 기존 기상청 관측 및 예보시스템 외에 추가적인 자원소모 없이 해당 농지에 주어진 기상조건을 재배중인 작물의 종류와 그 발육단계에 맞게 '기상위험지수'로 정량화하고, 이를 평년기준과 비교하여 재해발생 가능성을 농민에게 일대일로 전달한다. 서비스 실용화에 필요한 기상실황 및 예보의 경관규모 추정기술, 시범 집수역 내 필지별 경과기상 및 예보에 근거한 작목 맞춤형 기상위험 산정기술을 개발하고, 이들 기술의 통합 및 시스템화를 완료하였다. 단일 집수역인 경남 하동군 악양면을 선정하여 이 시스템을 설치하고 230농가 400필지를 대상으로 시범서비스를 구현하였다. 이 과정에서 얻어진 경험을 공유함으로써 향후 농업부문의 기상이변 대응 조기경보서비스 구축에 기여하고자 한다.

• 한국어병학회지
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• 제34권1호
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• pp.81-98
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• 2021

As Korea declared that the entire country is free from ISA (Infectious salmon anaemia) based on the OIE aquatic code in 2019, it is necessary to improve the import quarantine system that meets the level of ISA management in Korea. Currently, Korea imports Atlantic salmon and rainbow trout from countries which have history of ISA outbreak such as Norway and the United States, so there is a constant possibility that trade with these countries will bring ISAV (Infectious salmon anaemia virus) into Korea. Therefore, some amendments to the Aquatic Life Diseases Control Act (ALDCA) are needed to prevent the entry of ISAV into the Korea through international trade. The amendment to the ALDCA should contain a list of countries, zones or compartments that the Korean competent authority has allowed or banned imports of ISA-susceptible fish. In addition, the subordinate statutes or administrative rules of the ALDCA need to be revised so that on-site inspections/audit can be conducted for the evaluation of the ISA management system in exporting countries. After the revision of the subordinate statutes or administrative rules, it is necessary to strengthen the present import conditions in line with those that meet the level of ISA management in Korea. As for the strengthened import conditions, the competent authorities of exporting countries must export only salmonid fish produced in zones or compartments declared freedom of ISA to Korea, and must prove through lab-testing that ISAV should not be detected in the fish exporting to Korea. In addition, official veterinarians/fish health professionals of the exporting country should check the health status of the fish within 72 hours prior to export. Also, competent authorities of the exporting countries must attest that fish storage containers and water, ice and other equipment used for transportation should be cleaned and disinfected to avoid contamination with pathogens, including ISA. Therefore, the proposed measures presented here will further improve the current import condition for salmonid fish and assist decision-making on strategies to reduce the risk of ISA introduction into Korea. Also, it is expected to contribute to maintain the status of ISA-free country.

• 산업경영시스템학회지
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• 제39권4호
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• pp.137-146
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• 2016

In recent years, business environment is faced with multi uncertainty that have not been suffered in the past. As supply chain is getting expanded and longer, the flow of information, material and production is also being complicated. It is well known that development service industry using application software has various uncertainty in random events such as supply and demand fluctuation of developer's capcity, project effective date after winning a contract, manpower cost (or revenue), subcontract cost (or purchase), and overrun due to developer's skill-level. This study intends to social contribution through attempts to optimize enterprise's goal by supply chain management platform to balance demand and supply and stochastic programming which is basically applied in order to solve uncertainty considering economical and operational risk at solution supplier. In Particular, this study emphasizes to determine allocation of internal and external manpower of developers using S&OP (Sales & Operations Planning) as monthly resource input has constraint on resource's capability that shared in industry or task. This study is to verify how Stochastic Programming such as Markowitz's MV (Mean Variance) model or 2-Stage Recourse Model is flexible and efficient than Deterministic Programming in software enterprise field by experiment with process and data from service industry which is manufacturing software and performing projects. In addition, this study is also to analysis how profit and labor input plan according to scope of uncertainty is changed based on Pareto Optimal, then lastly it is to enumerate limitation of the study extracted drawback which can be happened in real business environment and to contribute direction in future research considering another applicable methodology.

• 한국학교보건학회지
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• 제24권2호
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• pp.141-154
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• 2011

Purpose: The purpose is to provide basic information for establishing improvements on performance-based pay's evaluation method of health teachers. Methods: For subjects, 200 teachers at public elementary schools and 200 health teachers at public elementary schools in Gyeonggi-do were conveniently sampled, and then surveyed through a questionnaire. The questionnaire was to recognize recognition of teachers working under the teacher's performance-based pay system, which was quoted in the questionnaire of Choi ji-hye (2005) and Lee mi-gyeong (2008). Inquiry for the recognition of teachers on evaluation of health teacher's performance-based pay system and improvements on the performance-based pay's evaluation method of health teachers were used after consultation with five incumbent health teachers and a review with the thesis director. Results: The performance-based pay's evaluation method of health teachers has the same method with general teachers in schools, so it is not fair to evaluate the performance of health teachers. The ways to improve the performance-based pay evaluation method of health teachers is as follows: first, the approval on improving 'the number of class hours' which is a detailed item of a teacher's performance evaluation criterion to 'the number of health lesson hours per week and the number of students visiting the school infirmary per week'; second, improving 'life guidance' into 'counseling results of medically-treated students, parents of students and personal hygiene guidance'; third, improving 'a teacher in charge' into 'awarding of points by being recognized as a health teacher in charge of all students and considering the economic situation of the region,; forth, improving 'difficulty of position' into 'the number of health-teacher's annual promotion task items and the treatment number of issuing and receiving of official documents', and improving the 'task difficulty' into 'importance and urgency of emergency patient management, risk level and urgency of infectious diseases and avoiding work in charge' appeared to be more than 90% respectively. Conclusion: The performance-based pay system of teachers being carried out every year should be executed by preparing fair evaluation criteria suitable for task properties and the role of health teachers with different evaluation criteria compared to general teachers.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup3호
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• pp.197-200
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• 2016

On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.

• 항공우주정책ㆍ법학회지
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• 제30권1호
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• pp.207-244
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• 2015

항공안전은 계속적인 위험성의 확인과 관리를 통하여 개인에의 위해나 재산손실의 위험이 수용 가능한 수준으로 감소되거나 그 이하로 유지되는 상태를 의미하며, 항공 안전을 증진하기 위한 다양한 방법이 모색되고 있다. 최근 10여 년 간 국제민간항공은 비교적 높은 수준의 안전을 유지하여 왔으나 2014년부터 여러 가지 사고가 발생하면서 국제민간항공계가 다시 긴장하고 있고 ICAO를 중심으로 다각적인 대응방안을 모색하고 있다. 항공안전은 국제민간항공을 지탱하는 가장 중요한 요소이다. 국제민간항공협약(시카고협약)은 서문에서 안전과 질서가 중요함을 강조하였고, 협약의 다수 조문이 안전에 관계되어 있다. 부속서(1-19)는 몇 개를 빼고는 모두 안전에 관한 국제표준과 권고를 규정하고 있다. 특히 부속서 19는 안전관리체제에 대하여 기존의 부속서에 산재되어 있는 규정을 통합했고 도한 새로운 규정을 신설하였다. 또한 ICAO는 안전 문제를 증진하기 위한 의사결정과 입법 기능을 가지고 있으며 항행위원회, 법률위원회, 항공운송위원회 등과 이사회의 심의를 기초로 하여 총회가 최종 결정 권한을 가지고 있다. 보조 기구로서 전문가 그룹, 태스크포스 등을 수시로 설치, 운영하고 있고, 사무국은 이러한 제반 기구의 사무를 보조하고 있다. 또한 ICAO는 USAOP과 USAP 프로그램을 통하여 체약국의 안전 및 보안 수준을 점검하고 있고, 미국, EU, IATA 등이 별도의 안전점검제도를 운영하고 있다. 2014년에 발생한 MH370기 실종 사건은 회원국, 관제기관, 항행시설, 항공기 등이 제공한 정보를 토대로 전세계추적시스템(Global Tracking System)의 구축을 통하여 항공기의 위치를 실시간 추적 가능토록 하여 문제를 해결하려고 하고 있다. 또한 우크라이나 상공에서 격추된 MH17 사건 이후 ICAO는 회원국이 제공한 정보 및 NOTAM, AIP 등 운항정보를 기반으로 정보를 공유하는 웹사이트를 운영함으로써 분쟁지역에서의 위험관리를 통하여 유사한 사고를 방지하려고 하고 있다. 에볼라가 서아프리카에서 발생한 이래 보건당국과 항공당국간의 긴밀한 협조를 통하여 항공기에 의한 전염병의 확산을 막도록 다각적인 조치를 강구하고 있다. 또한 QZ8501 사건은 악기상하에서 제대로 대처하지 못한 운항의 결과로서 이 또한 ICAO를 중심으로 추가적인 보완 조치를 강구하고 있다. 이밖에도 2015년 3월에 발생한 저먼윙즈의 부기장에 의한 항공기 추락사고와 관련 후속 조치의 강구가 요구되고 있다. 국제항공계는 이러한 사고를 예방하고 안전 수준을 더욱 제고하기 위해서는 안전 관련 데이터 및 정보의 보호와 공유가 필수적임을 인식하여 현재 있는 정보 보호 및 공유에 관한 조항 이외에 추가적인 규정을 제의하고 있으며 회원국에 의한 검토를 거쳐 부속서나 ICAO 안내 문서에 반영될 예정으로 있다. ICAO의 문제해결 방식은 네 가지 차원에서 접근되고 있다. 시간적으로 과거의 경험과 정보를 분석하는 토대위에서 단기, 중기, 장기의 대책을 마련하고, 공간적으로는 각 회원국, 지역, 전 세계에 적용될 수 있는 대책을 수립하고 있고, 항공사, 공항, 지역 사회, 소비자, 제조자, 항행서비스 공급자, 관제기관, 산업계, 보험업계 등을 망라하는 이해관계자를 고려하여야 하고, 규제적인 개선을 위하여 최선의 관행, ICAO 안내문서, 표준 및 권고 관행에 반영될 방안을 심의하고 결정하는 구조를 가지고 있다.