• 보건행정학회지
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• 제12권3호
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• pp.1-22
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• 2002

건강은 개인과 가족의 행복, 그리고 국가 발전의 기본 조건이며 국민건강은 국력이다. 건강보호와 증진에 필수적인 의료서비스는 모든 국민이 누려야 할 기본권이며 국가는 이를 제공할 의무가 있다. 산업화로 환경오염의 심화, 국민생활수준의 향상, 생활양상의 변화, 노인 인구의 증가, 의료기술의 발달, 의료서비스에 대한 접근성 향상 등으로 감염성 질병은 감소 하고 암, 심장질환, 당뇨병과 같은 만성, 퇴행성 질환이 중요한 국민건강문제로 대두되었다. 이러한 질병들은 난치병으로 예방이 매우 중요하나 흡연, 음주, 운동, 스트레스 등 행태학적 요인이 중요한 위험인자이므로 예방을 위한 접근방법이 전염성 질병과는 다르다. 질병양상의 변화, 전국민건강보험의 도입, 의사와 의료기관의 증가로 의료공급량의 증가, 의료기술의 발달 등으로 의료이용량이 폭증하여 국민의료비가 연간 30조원을 넘어섰고, 앞으로 계속 증가할 전망이다. 정부는 국민건강수준을 향상하여 삶의 질을 높이는 것을 중요한 정책목표로 설정하였으며, 이를 위해 보건의료서비스 공급체계를 효율화하고 평생건강관리체계를 구축하고자 하였다. 이러한 목표달성을 위하여 공공보건사업을 강화하여 질병예방과 건강증진을 통하여 건강수준을 높이고, 질병치료에 필요한 의료비 증가를 억제해야한다. 주요 공공보건사업의 문제점은 공공보건사업을 위한 정책의 일관성 부재, 보건의료정보체계의 미비, 보건사업계획 및 평가의 합리성 결여, 보건요원의 업무수행능력 부족 등으로 보건사업이 비효율적으로 수행되어 자원이 낭비되고 있다. 지방자치제 하에서 광역자치단체는 능동적으로 보건시책을 세우고, 일선 보건요원들의 사없수행능력을 키우는 역할을 담당할 법적 의무가 있으므로 시 \ulcorner도보건과의 역할을 확대하고 기능을 강화해야 한다. 이를 위한 지방자치단체차원의 전략을 제시하면 다음과 같다. 광역자치단체 차원에서는 ${\circled}1$ 보건정책목표의 확립 : 평생건강관리체계 구축과 보건의료서비스 제공체계 효율화로 삶의 질 향상, ${\circled}2$ 보건사업기획 및 평가기능 강화, ${\circled}3$ 보건의료정보체계 및 주민건강/질병발생 감시체계 확립, ${\circled}41$ 보건요원의 훈련강화, ${\circled}5$ 건강증진센터(가칭) 설치 . 보건의료정보관리, 보건요원 훈련, 보건사업 기획 및 평가 업무담당, 그리고 ${\circled}6$ 지역대학과 협력체계 구축 등이다. 기초자치단체 차원에서는 ${\circled}1$ 보건소 기능의 재정립(전체 지역주민의 건강관리, 보건통계자료수집과 관리 및 주민건강/질병발생 감시, 지역보건사업 계획, 수행 및 평가, 안전하고 건강한 환경조성 및 식품위생관리, 취약계층을 위한 일차의료, 의약관리), ${\circled}2$ 보건소 조직 개편 및 민간의료기관과 협력체계 확립, ${\circled}3$ 전문인력 확보 및 인력구성 조정, 그리고 ${\circled}4$ 방문보건사업의 강화 등이다.

• 식물병연구
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• 제28권4호
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• pp.221-230
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• 2022

Erwinia amylovora에 의해 발생하는 화상병은 2015년에 국내에서 처음으로 보고된 이후 2021년 기준으로 전국 22개 지역으로 전파되었다. 우리나라는 식물방역법에 따라 화상병이 발생한 사과 및 배 과원은 발생주율을 기준으로 모든 기주식물들을 완전히 제거하여 구덩이에 매몰처리한다. 이후, 3년간 화상병균 전파를 막기 위해 매몰지 위에 기주식물 식재를 금하고 있다. 매몰처리법에 의한 화상병균 박멸 효과를 확인하기 위하여, 화상병 감수성 식물을 미끼식물로 이용하여 매몰지에 식재 후 화상병 재발 유무를 확인하였다. 이를 위해, 2019년부터 2021년에 매몰처리한 경기도 안성시와 충북 충주시 소재 매몰지 3곳을 선정하여 미끼식물 감시시설을 설치하였다. 화상병 감수성 식물인 사과(부사)를 미끼식물로 선정하고, 각 감시시설당 5주를 식재하였다. 감시시설은 울타리와 그물로 격리하였다. 또한, 실시간 모니터링을 위한 CCTV와 동작감지기, 그리고 현지 기상상황을 기록하는 센서를 설치하였다. 감시시설을 주기적으로 방문하여 육안으로 화상병 발병 유무를 확인하였다. 미끼식물로부터 화상병 의심 증상을 나타내는 표본을 채취하고 화상병균 특이적 프라이머를 이용하여 loop-mediated isothermal amplification polymerase chain reaction (PCR)과 conventional PCR을 통해 화상병균 감염 유무를 확인하였다. 그 결과, 현재까지 어떠한 미끼식물에서도 화상병균은 검출되지 않았다. 따라서, 현재 시행되고 있는 매몰 후 화상병 기주식물 3년 식재 금지 조항을 완화하는 근거로 본 연구 결과를 제시하고자 하며, 이를 통해 국내 과수산업과 농가의 피해를 최소화하는 데 기여할 수 있을 것이라 생각된다.

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2005년도 Proceedings of KSEH.Minamata Forum
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• pp.87-94
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• 2005

Results from previous studies revealed that metal level in the body is related to certain types of diseases. For example. serum copper level with chronic heart failure, iron and transferrin in the blood serum with acute cerebral vascular diseases, Zn in the CNS, lead with neurotoxicity, hypertension, genetic damage, arsenic with cancer skin lesion, Al with neurobehavioral function (cognitive impairment and memory disorder), and etc. The rate of stroke has increased in recent years and several metals were found to be responsible for causing stroke. This study compared several blood metal concentrations between stroke and non-stroke patients. Patients with stroke (116 samples) and non-stroke (111 samples including lowback pain and others) participated in this study. Total of 227 blood samples were collected and participants completed questionnaires regarding age, gender, occupation, residence, alcohol, smoking, and etc. To be qualified into the stroke group, patients have never experienced stroke previously. Subjects only included ischemic stroke and intracerebral hemorrhage patients diagnosed by brain CT and brain MRI. Patients with high risk of metal exposure such as herbal intake and job related exposure were excluded. 10ml of blood samples were analyzed by ICP-MS method at the Center of Nature and Science at Sangji University. Metal geometric mean (SD) concentrations in blood of study subjects showed higher values, 2.64-36.12%, than WHO reference values in Mn, Ni, Hg, Se, and As. Metal concentration in blood of stroke patients non-adjusted for potential confounders was higher except for Hg and also higher except for Ni in adjusted for potential confounders. Co was significantly higher in stroke patients (p=0.002) than non-stroke patients adjusted for potential confounders. Regression coefficient values of stroke patients was 0.17-8.25 in each metals. Odd ratio of stroke patients had 0.96 (Ni)-2.68 (Co) compared to non-stroke cases. This result means that Co increase of 1 raises the risk ratio of stroke by 2.86 times. Based on the results, metal concentration in blood seems to affect incidence of stroke.

• 한국가금학회지
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• 제40권4호
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• pp.379-388
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• 2013

Avian paramyxovirus (APMV) type 4 and 6 were isolated during an avian influenza (AI) surveillance program of wild birds. This study also conducted experimental infection of wild-bird-origin APMV type 4 and 6 in specific pathogen free (SPF) chickens to study pathogenicity and transmission within domestic flocks. In addition, serological prevalence data of APMV type 4 and 6 in domestic fowls was conducted with chicken sera collected from 2007 to 2009 in order to understand infection status. The results of the animal experiment showed that APMV type 4 and 6 had the ability to infect chickens with sero-conversion and to transmit the virus from infected birds to contacted birds, but showed low pathogenicity. Serological tests revealed that APMV type 4 was widespread in the poultry industry, especially in layer flocks, but the positive rate for APMV type 6 was very low. This study concluded that wild bird-origin APMV type 4 and 6 could infect the chickens by inter-species transmission and the seroprevalence of APMV type 4 was quite high in Korean poultry. However, since almost all the chicken flocks had a high level of antibody titer against APMV type 1, there was possibility of cross reaction between APMV type 1 and 4, which made the interpretations more complicated. In order to understand infection status in the natural environment, additional study is necessary regarding the seroprevalence of APMV type 4 and 6 in the wild bird population.

• 항공우주시스템공학회지
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• 제14권1호
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• pp.68-73
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• 2020

본 논문은 산악 지형, 도심, 함정, 교량 등에서 수직 이·착륙 비행, 제자리 비행, 고정익기처럼 저속 및 고속비행을 할 수 있는 덕티드 추진체를 사용한 수직 이·착륙 초소형 무인 항공기 개발 동향을 기술한다. 이 항공기는 여러 측면에서 헬리콥터와 고정익기와는 비행 특성이 다르다. 미육군 미래 전투 체계와 DARPA의 OAV 프로그램의 목적은 운용자에 안전하고 낮은 음향 특성을 갖는 수직 이·착륙 덕티드 팬 초소형 무인 항공기 개발이다. 현재의 초소형 무인 항공기에 영상/적외선 카메라를 탑재하고 숲이나 언덕 뒤에 숨어 있는 적을 정지비행과 응시로 약 1 시간 동안 감시 및 정찰을 한다. OAV의 Class-I은 개인 병사가 배낭에 담아 운반할 수 있는 크기와 무게의 수직 이·착륙 덕티드 MAV 개발이다. Class-II는 Class-I보다 두 배의 운용 시간과 더 넓은 범위의 비행이 가능한 유기체의 수직 이·착륙 덕티드 팬 초소형 무인 항공기 개발이다. 초소형 무인기는 장시간 운용을 위해 현재의 '호버 및 응시'에서 '퍼치-앤-응시'으로 기술을 발전시켜야 한다. 근 미래의 OAV 개념은 유·무인 지상 차량이 주행하는 동안에 차량의 상부에 자동 이착륙하고, 탑재된 상태로 이동하고, 재급유, 재충전, 재이륙하는 합동 운용으로 임무 능력과 효율성을 확장하는 것이다. 덕티드 MAV는 지상 차량의 착륙 패드에서 자동으로 이착륙하기 위해 저렴한 초소형 GPS를 활용한 고정밀 상대 위치 기술 개발이 필요하다. 또한, VTOL 덕티드 MAV와 유·무인 지상 차량 간에 유기체의 협업 동작이 가능케하는 공통 명령과 제어 아키텍처를 개발할 필요가 있다.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• Asian Pacific Journal of Cancer Prevention
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• 제15권13호
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• pp.5487-5492
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• 2014

Ultrasonography is non-invasive and can give useful clues in the diagnosis of cervical lymphadenopathy, However, differential diagnosis is difficult in some situations even combined with color Doppler imaging. The present study was conducted to evaluate the clinical value of real time elastography in patients with unexplained cervical lymphadenopathy using a quantitative method. From May 2011 to February 2012, 39 enlarged lymph nodes from 39 patients with unexplained cervical lymphadenopathy were assessed. All the patients were examined by both B-mode ultrasound, color Doppler flow imaging and elastography. The method of analyzing elasto-graphic data was the calculation of the 10 parametres ("mean", "sd", "area%", "com", "kur", "ske", "con", "ent", "idm", "asm") offered by the software integrated into the Hitachi system. The findings were then correlated with the definitive tissue diagnosis obtained by lymph node dissection or biopsy. Final histology revealed 10 cases of metastatic lymph nodes, 11 cases of lymphoma, 12 cases of tuberculosis and 6 cases of nonspecific lymphadenitis. The significant distinguishing features for conventional ultrasound were the maximum short diameter (p=0.007) and absent of echogenic hilum (p=0.0293). The diagnostic accuracy was 43.6% (17/39 cases) and there were 17 patients with equivocal diagnosis. For elastography, "mean" (p=0.003), "area%" (p=0.009), "kurt" (p=0.0291), "skew" (p=0.014) and "cont" (p=0.012) demonstrated significant differences between groups. With 9 of the 17 patients with previous equivocal diagnoses (52.9%) definite and correct diagnoses could be obtained. The diagnostic accuracy for conventional ultrasound combined elastography was 69.2% (27/39 cases). There were differences in the diagnostic sensitivity of the two methods (p=0.0224). Ultrasound combined with elastography demonstrated higher rates of conclusive and accurate diagnoses in patients with unexplained cervical lymphadenopathy than conventional ultrasound. The quantitative program showed good correlation with the pathology of different lymph node diseases.

• 대한지역사회영양학회지
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• 제7권6호
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• pp.833-843
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• 2002

This study was carried out to investigate the effect of hygiene education on the microbiological changes of processing utensils and the environmental in the manufacture of cereals and to evaluate the Cd, Pb contents and nutrient compositions of 11 cereals. The result of microbiological evaluation was that fungi, coliforms and staphylococcus species were detected in employees, on equipment, utensils and environments in the first inspection. Fungi were detected in most of the cereals, staphylococcus species were detected in soybeans, perilla seeds and sea tangle How, and bacillus cereus was detected in sorghum and black sesame seeds. The water content of rice, barley, glutinous rice, brown rice and carrot flour in packaged products, and in carrot flour, angelica keiskei, carrot, sea mustard and potato in bulk products was in excess of 8.0%. The Pb content of cereals was 0.14-0.51 mg/kg and Cd was not found. The acid value of Job s tears flour and black sesame seed flour was higher than 5.0 mg/g oil. Cereals were manufactured from 41 different cereals and grains, legumes, seeds and nuts, vegetables, potatoes, seaweeds, fruits, glucose and salt. The average content of cereals and grains, legumes, and seeds and nuts in cereals was 75.75%, 16.19% and 4.93%, respectively. The mean nutrient content per 100 g of cereals was calories 365.8kcal, protein 13.3 g, fats 5.9 g, carbohydrates 63.4 g, Ca 91.8 mg, p 269.9 mg, Fe 3.15 mg, Na 76.2 g, K 421.8 mg, Zn 2.33 mg, Vit. A 12.5 R.E., Vit. B$_1$0.23 mg, Vit. $B_2$ 0.16 mg, Vit. $B_6$ 0.46 mg, Niacin 3.5 mg, Vit. C 1.36 mg, folic acid 62.3 $\mu$g and Vit. E 1.24 mg. When nutrients value of 48 g of cereals and 200 $m\ell$l of milk was compared to 1/3 of the RDA, the values were below than 60% of 1/3 of the RDA except Na, K, Vitamin $B_1$ and C contents. The average carbohydrate : protein : fat ratio of energy intake was 54.27 : 17.45 : 28.28, respectively. Therefore, a training program consisting of the education of the staff in surveillance and standard operating procedures, the elimination of dangerous procedures, sanitation checklist, the implementation of Preparation methods and standard recipes for cereals is required.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3123-3129
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• 2016

Background: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported age-standardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on non-mandatory notification in the registry. Under-reporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. Materials and Methods: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from Feb-May 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and re-abstracting of medical records by independent auditors. The re-abstracting portion comprised 15 data items. Self-administered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. Results: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. Conclusions: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.

• 재무관리연구
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• 제24권3호
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• pp.91-131
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• 2007

본 연구는 한국유가증권시장에서 사이드카가 차익거래와 비차익거래 종목의 주가, 변동성, 그리고 유동성에 미치는 영향을 분석하였다. 선물시장의 급등락으로부터 현물시장을 보호하려는 목적을 갖는 사이드카는 현재 모든 프로그램매매를 대상으로 하고 있으나, 현재의 제도가 바람직한지에 대해서는 논란의 여지가 있다. 사이드카가 프로그램매매 유형별로 차별적인 효과를 갖는지를 검증하기 위해 프로그램매매를 지수차익거래와 비차익거래로 나누어 사이드카가 주가, 변동성, 그리고 유동성에 미치는 영향을 분석한 결과는 사이드카가 지수차익거래와 비차익거래에 미치는 영향에 뚜렷한 차이가 없음을 보인다. 보다 구체적인 분석을 위해 가상사이드카 표본을 구성하고 실제사이드카와 가상사이드카가 차익거래와 비차익거래에 미치는 효과를 분석하였다. 가상사이드카를 이용한 분석결과는 앞서의 결과가 사이드카 발동이라는 특별한 상황의 발생전후에 시장의 주문이 한 방향으로 몰리는 일시적인 현상에 의해 부분적으로 설명될 수 있음을 보여주며, 사이드카 발동은 비차익거래에 비해 차익거래에 상대적으로 큰 영향을 미치고 비차익거래는 큰 영향을 받지 않음을 보여준다. 이는 비차익거래까지를 포함하는 모든 프로그램매매를 적용대상으로 하는 한국유가증권시장의 사이드카 제도에 대한 재검토가 필요함을 말해주는 것이다.