• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• 항공우주정책ㆍ법학회지
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• 제30권2호
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• pp.337-371
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• 2015

교통량증가, 항공노선 다양화 등 운항환경 변화로 우리에게 알려지지 않은 항공기사고 위험요인이 계속 출연하고 있어 우리 국민의 생명을 위협하고 있다. 우리정부는 이와 같은 위험요인이 사고전조가 되기 전에 미리 발굴하여 제거코자 운항현장을 대상으로 안전보고제도를 운영하고 있다. 그러나 이와 같이 좋은 취지로 도입된 보고제도는 오늘날 종사자로부터 많은 오해를 받고 있어 본연의 운영목적 달성을 못 하고 있는 실정이다. 종사자는 안전보고가 정부 또는 관리자에게 규정에서 벗어난 본인의 행위를 보고하는 제도로 이의 후속으로 정부의 행정처분 또는 회사의 인사 상 불이익이 있을 수 있다고 인식하고 있다. 본 논문에서는 미국, 영국 등 국내외 항공안전보고제도 운영현황 및 관련 ICAO국제기준을 살펴보고 우리의 항공분야에 도입 운영되고 있는 안전보고제도 발전방향을 제시하였다. 우선, 안전보고로 정부가 얻고자 하는 정보의 범위를 명확히 하고 이를 얻기 위한 정보원을 대상으로 안전보고제도를 운영해야 한다. 그리고 해당 정보를 담을 수 있는 그릇도 적합한 것을 주어야겠다. 다시 말해, 조종사, 정비사, 관제사 등 직군별 얻고자 하는 정보를 명확히 하고 해당 정보를 담을 수 있는 알맞은 탬플레잇(보고양식)을 맞춤형으로 제시 해야만 원하는 정보를 얻을 수 있다. 이와 더불어, 사람으로부터 얻는 정보의 특징을 잘 이해해야겠다. 해당 핵심정보를 단독으로 알고 있는 사람이 자신의 처분이나 개인정보 유포가두려운 상황에서는 정보를 정부나 회사와 공유하지 않을 가능성이 높다고 하는게 대부분의 경우일 것이다. 핵심 안전정보를 소유하고 있는 사람이 해당 정보를 공유하는 것을 꺼리지 않도록 처분완화, 개인정보보호 등을 관련 제반제도 등이 개선되어야 한다. 정부는 정보의 수집은 물론, 정보의 사후관리에도 보다 체계적 노력을 투자해야 한다. 오늘날 IT기술 발달로 데이터는 기계가 분석해 준다는 인식은 절반은 잘못된 인식이다. 기계는 사람이 인풋을 데이터에 따라 아웃풋을 만들어 낸다. 다시 말해, 인풋을 하는 데이터의 품질과 운영체계 등은 사람이 만들어 내야 한다는 뜻이다. 따라서, 기계가 좋은 정보를 잘 받아들이고 분석할 수 있도록 체계적이고 규칙적인 분류체계 및 안전조사절차를 만들어서 운영해야 할 것이다. 마지막으로 강조하고 싶은 것은 이와 같은 좋은 제도가 도입되더라도 운항현장의 안전보고에 대한 인식이 변화하지 않는 한 제도의 실효성이 낮을 수밖에 없을 것이다. 정부는 제도 개선과 더불어 운항현장을 대상으로하는 교육도 철저하게 실시하여 안전문화가 정착하는 분위기 형성을 위한 노력을 아끼지 말아야 할 것이다.

• KDI Journal of Economic Policy
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• 제30권2호
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• pp.99-128
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• 2008

민간보험은 공적보험과 보완적인 관계를 형성함에도 불구하고 우리나라의 민간보험은 소득계층에 따른 접근성 차이로 인한 사회적 불평등, 도덕적 해이로 인한 공적보험 재정악화 등의 우려를 낳고 있다. 그러나 이에 관한 실증적 분석은 그간 이루어지지 못하여 정책적인 방향을 정립하는 데 장애가 되어 왔다. 본 연구는 건강보험공단, 심사평가원, 민간보험사, 행정자치부 주민등록세대정보 등의 관련 정보를 종합하여 이에 대한 실증분석을 시도했다. 그 결과, 우리나라의 민간보험 가입률은 전 국민의 64%에 달하고 있으며, 고소득층과 저소득층 간에 민간보험 가입률의 차이가 나타나지 않았다. 이는 공적보험의 보장성이 미흡한 상황에서 저소득층 역시 갑작스런 의료지출에 대비하고 있으며, 민간보험이 의료접근성의 계층화를 초래하지 않고 있다는 것을 시사한다. 또한 민간보험 가입자는 평균적으로 미가입자에 비해 의료이용량이 높지 않았으며, Two-Part Model을 통해 다양한 변수를 통제했을 경우에도 동일한 결과가 나타났다. 연령대에 따른 차이로 미루어 이러한 결과는 노동시장과 연관된 한시적인 성격일 것으로 추측되나, 현재로서는 민간보험 가입에 따른 도덕적 해이가 강하게 나타나고 있다는 근거는 발견되지 않았다.

• 대한간호학회지
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• 제8권1호
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• pp.163-180
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• 1978

Much of a person's energy is spent in the effort of becoming a productive member of to-day's complex society. This activity may cause tension, and chronic unrelieved tension is an influential factor in blood pressure elevation. The problem of this study was to identify manifest needs and self-actualization of patients with essential hypertension, and to analyse and compare their manifest needs and selt-actualization with the selected general characteristics of We, sex, religion, occupation and level of education with a control group of patients with normal blood pressure readings. The purpose was to contribute to the planning of nursing interventions toward reducing the impact of complex psycho-somatic factors on the anxiety of patients with essential hypertension. The instruments used included selected items from the Edwards (1959) Personal Preference Schedule (EPPS) as adapted by Hwang (1965) and from the Personal Orientation Inventory (POI) (Shostrom 1964, 1974) adapted by Kim and Lee (1977) to measure manifest needs and self-actualization. The convenience sample was chosen from 149 persons who presented themselves for general physical examinations at Ewha University Medical Centre and 41 patients diagnosed with essential hypertension at three general hospitals in Seoul during June 1 and August 31, 1977. Forty-nine persons from the Ewha group with blood-pressure readings exceeding 150/90 were added to the experimental group. Data were analysed by the S.P.S.S. computer programme using t-test and tests for statistical significance. Statistically significant findings were as follows: A. Blood Pressure and Manifest Needs. 1. with the exception of Autonomy, patients with hypertension had significantly high scores on all variables Abasement, Achievement, Affiliation, Aggression, Dominance, Emotionality, Exhibitionism and Sex. 2. When mean scores of normal persons were compared by age groups, normal persons had higher scores in the following order on Abasement (50's, 40's, 20's, 30's), Achievement (50's, 30's, 40's, 20's), Affiliation (50's, 40's, 30's, 20's), Dominance (50's, 40's, 40's, 20's) and Exhibitionism (30's, 50's, 40's, 20's). In each case, there was a significant difference between the first and last age group scores. 3. When the mean scores of normal persons were compared by sex, normal men had higher scores than women on Achievement, Affiliation, Aggression, Dominance, Exhibitionism and Sex. Male patients had higher scores than female patients on Achievement, Dominance, Exhibitionism and Sex, but female patients scored higher in Emotionality. 4. Normal persons had higher scores related to religion in the following order on Achievement (Buddhism, no religion, Christianity). Hyper tensive patients had higher scores on. Exhibitionism (no religion, Christianity, Buddhism). 5. Normal persons had higher scores related to occupation in the following order on Achievement and Exhibitionism (unemployed, office workers, teachless, businessmen), Emotionality (office workers, unemployed, businessmen, teacher) and Sex (office workers, unemployed, teachers, businessmen). Hypertensive patients had higher scores on Achievement and Aggression (teachers, businessmen, office worker, unemployed), Dominance and Exhibitionism (businessmen, teacher, of ace workers, unemployed) and Sex (teachers, office worker, businessmen, unemployed). 6. Normal persons had higher scores related to level of edification in the following order on Abasement, Emotionality and Autonomy (secondary school graduation, university). Hypertensive patients had higher scores on Abasement (no education, primary, university, secondary), Achievement (no education, secondary, university, primary) , Dominance (university, no education, secondary, primary), Exhibitionism (university, secondary, no education, primary), and Sex (university, secondary, primary, no education). B. Blood Pressure and Self_Actualization 1, Patients with hypertension had significantly lower scores on all variables. 2. Normal persons had higher scores related to age groups in the following order on Existentiality (20's, 30's, 40's, 50's). Hypertensive patients showed no significantly different scores. 3. Normal women had higher scores than men on Time Competence. Normal men had higher scores on Feeling Reactivity. Male patients had higher scores than women on Self-Actualizing Value and Self-Regard. 4. Normal persons ha 1 higher scores related to religion on spontaneity (Buddhism, no religion, Christianity). Hypertensive patients had higher scores on Time Competence and Nature of Man (Buddhism, Christianity, no religion). 5. Normal persons had higher scores related to occupation in the following order on Existentiality (teachers, office workers, businessmen, unemployed) and Self-Regard (unemployed, office workers, teachers, businessmen). Hypertensive patients showed no significantly different scores. 6. Normal persons had higher scores related to level of education in the following order on Existentiality and Self-Acceptance (university, secondary). Hypertensive patients had higher scores on inner-Director (university, secondary, no education, primary) and Existentiality (university, secondary, primary, no education). Recommendations for nursing interventions with hypertensive patients with emotional problems or low self-actualization were made. 1. The nurse should encourage the patient through her interactions with other members of the medical team to accept counselling and health education. 2. Through her therapeutic interpersonal relationships with the patient, the nurse should help him discover the causes of his emotional tension. 3. Through her health teaching with the family, the nurse should encourage them to participate with the medical team in the patient's therapeutic plan and in providing him with the minimum possible emotional support. 4. Through frequent counselling with the obsessive-thinking and inflexible patient, the nurse should reevaluate the patient's behaviour and her interventions. 5. Seriously ill patients should be given needed reeducation by members of the professional medical team.

• 시큐리티연구
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• 제29호
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• pp.163-191
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• 2011

최근 들어 학교폭력문제는 학교 내에서의 구성원간의 범죄양상에서 그치지 않고 외부인의 학교 내 침입범죄로까지 비화되어 학교가 이제는 더 이상 교육만이 이루어지는 범죄로부터의 안전지대는 아니게 되었다. 특히 초등학교의 경우에는 외부 침입자에게 대항하여 이를 제압할 수 있는 사람들이 거의 없기 때문에 침입범죄에 취약한 장소이다. 서울특별시는 2011년 3월 1일부터 관내 국 공립초등학교를 대상으로 학교보안관제도를 시행하고 있다. 하지만 학교보안관 사업이 사실상 경비업법상의 경비업무를 주 내용으로 하고 있음에도 불구하고, 경비업법의 적용을 배제한 채, 서울시와 운영업자의 도급계약에 의한 사법상 계약(私法上 契約)의 한 형태로 운영하고 있어 여러 가지 문제를 야기하고 있다. 첫째, 학교보안관 관련 손해발생 시, 경비업무가 아니므로 원칙적으로는 운영사업자가 가입하고 있는 경비업자 영업배상책임보험 적용이 배제되어, 피해자의 손해보전을 위한 담보가 취약하게 된다. 둘째, 학교보안관의 임무를 계약서에 개별약정하고 있으나, 이것만으로는 부족하고, 경비업법상의 경비원의 의무 등의 관련의무 등의 일반규정 적용이 요구된다. 셋째, 학교보안관의 교육은 상대적으로 보다 체계화된 경비업법상의 교육 프로그램과 연계하도록 하고, 학교폭력예방을 위하여 특별히 필요한 관련 전문교육은 부가 편성 운영하도록 하는 것이 타당하다. 넷째, 서울시의 여론조사결과에도 불구하고, 시민들은 여전히 경찰관 등 학교주변의 순찰강화를 요구하고 있으므로, 경찰과의 적극적인 협력관계를 경비업법의 적용으로 법적 제도적으로 뒷받침할 필요가 있다. 다섯째, 경비업법의 적용으로 인한 경비지도사 제도 운영이나 경찰의 지도 감독, 그리고 각종 행정처분 등으로 학교보안관 사업의 성공을 담보해 낼 수 있다. 따라서 이 연구는 이제부터라도 경비업법을 적용하여 학교보안관 사업이 관리 운영면에서 보다 내실 있고 지속적인 확대 발전이 가능하도록 할 것을 제시하고 있다.

• 한국학교보건학회지
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• 제4권2호
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• pp.176-192
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• 1991

특수학교 보건관리의 방향 설정과 특수학교 양호교사 업무 수행에 있어 질적 향상을 위한 기초 자료를 제시하고자 전국의 102개 특수학교 양호교사를 대상으로 1991년 2월 1일부터 1991년 3월 31일까지 우편 설문 조사를 실시하여 회수된 77개 학교를 대상으로 분석한 결과를 요약하면 다음과 같다. 특수학교의 67.5%가 사립이고, 83.2%가 시 이상 지역에 위치해 있으며, 정신지체학교가 48.1%로 가장 많았다. 특수학교의 평균 학급수는 17.2학급, 평균학생수는 194명, 평균교직원 수는 28명이었다. 양호교사의 평균 연령은 32.7세였고, 97.4%가 전문대학 이상 졸업자였으며, 71.4%가 기혼자였고, 79.2%가 임상이나 보건과 관련된 분야의 과거경력이 있는 것으로 나타났다. 또한 62.3%의 양호교사가 단독 업무를 보고있었으며, 77.9%가 초등에 소속되어 있었다. 대상 특수학교 양호실은 68.9%가 l층에 위치해 있었고, 학교보건 조직은 90.9%가 구성되어 있지 않았으며, 학교보건 인력으로 교의, 치과의, 학교 약사 모두를 위촉하고 있는 곳은 18.2%에 불과했다. 학교보건에 관한 연간 예산은 양호교사의 46.8%가 모르고 있었으며, 학교당 평균 년간지출액은 317,000원으로 그 중 의약품 구입비가 제일 많았다. 학교당 월 평균양호실 이용자수는 71명이었고, 학생 1인당 연간 양호실 이용은 4.4회였으며, 외상으로 인한 이용이 26.6%로 가장 많았다. 양호실 이용자중 1.4%가 의료기관에 의뢰되었는데, 시각장애학교는 고열, 정서장애학교는 골절, 다른 영역학교는 외상으로 가장 많이 의뢰하였다. 특수학교 아동 중 간질 학생수는 956명으로 조사 대상학교 학생수의6.4%를 차지하고 있었다. 신체검사를 2회 이상 실시하고 있는 학교는 22.6% 밖에 되지 않았으며, 98.7%가 보건교육을 실시하고 있고, 성교육은 98.7%가 필요하다고 강조하였다. 보건교육은 개인 위생에 가장 비중을 두고 있었으며, 시각장애 학교는 방송교육, 청각장애 학교는 OHP나 VTR, 다른 영역의 학교는 가정통신문이나 OHP VTR을 가장 많이 사용하는 교육매체였다. 대상 양호교사의 46.8%가 학교보건관리중 보건교육이 가장 어렵다고 하였으며, 중점개선내용으로 49.4%가 특수학교 보건관리에 대한 구체적인 업무 지침이 필요하다고 강조하였다. 사업계획 및 평가, 양호실 관리, 보건교육, 환경관리, 건강관리 등의 양호교사 업무 수행은 비교적 높은 수행율과 자신감을 나타냈으나, 그 중 학교보건 사업의 평가, 체력검사, 보건교육 후 평가, 학교정화구역 관리, 상처 봉합에 대한 수행율과 자신감이 비교적 낮았다. 따라서 특수학교 보건관리의 방향설정과 양호업무의 질적수준 향상을 위하여 학교보건사업에 대한 구체적인 업무지침의 개선과 특수학교 양호교사에 대한 별도교육이 필요한 것으로 생각된다.

• 벤처혁신연구
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• 제5권1호
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• pp.107-127
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• 2022

본 연구는 네덜란드의 지역별 혁신 클러스터정책을 통해 네덜란드 경제의 성장동인을 찾고자 한다. 전통적으로 농업과 물류중심의 경제구조를 가진 네덜란드는 1990년대 지역 클러스터를 만들면서 첨단 허브 국가로서 역할을 충실하게 해왔고 작은 나라임에도 세계 수출의 7위를 차지하는 등 혁신국가의 이미지를 만드는데 성공했다. 그 바탕에는 혁신을 위한 체계적인 분석 접근법으로 '지역 혁신 시스템(Rational Innovation System)'의 개념을 도입하고 지역의 특색을 살린 산학연 모델이 가장 큰 요인으로 작용했다. 여기에는 적절한 중앙정부의 혁신 생태계 조성을 위한 정책적 방향 제시와 지역을 중심으로 한 산학연 모델이 크게 작용한 것으로 평가받고 있다. 이런 점을 종합적으로 살펴 볼 때 본고에서는 다음과 같은 시사점을 발견할 수 있다. 첫째, 혁신 클러스터의 활성화이다. 둘째, Top 9을 중심으로 한 신산업육성정책과 미래산업 전략을 활성화하고 있다. 셋째, 산학연 협력을 구체화하고 있다. 넷째, 스타트업의 창업을 육성하고 있다. 이를 종합하면 네덜란드는 2019년 설립된 TechLeap은 네덜란드의 기술 생태계를 정량화하고 가속화하는 데 도움을 주는데 자본, 시장 및 인재에 대한 접근성을 개선하기 위한 프로그램 및 이니셔티브를 통해 기술 기업이 확장할 수 있는 최적의 환경을 조성해 네덜란드를 미래의 기술 선도기업들을 위한 보금자리로 만들기 위해 노력하고 있다. 첨단농업과 물류국가로 알려진 네덜란드는 4차 산업혁명시대를 맞이하여 로테르담을 중심으로 하는 물류의 항구에서 ICT 기술을 기반으로 하는 '지식항구(brainport)'로 확장하고 있다. 네덜란드는 물류 국가에서 산업화에 성공했지만 최근 지역혁신 생태계를 만들기 위한 중앙정부의 비전 제시와 지역의 특화산업을 연계한 산학연 클러스터 모델이 가장 큰 디딤돌 역할을 하고 있음을 확인할 수 있다. 네덜란드의 혁신정책은 혁신 클러스터 생태계를 중심으로 지역을 개발하고 일자리 창출과 새로운 산업을 위한 투자를 통해 유럽의 '디지털 관문'으로서 역할에 보다 충실할 것으로 전망된다.