• Title/Summary/Keyword: 대학과

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Genetic Counseling in Korean Health Care System (한국 의료제도와 유전상담 서비스의 구축)

  • Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.8 no.2
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    • pp.89-99
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    • 2011
  • Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

The theory of lesson plannig and the instructional structuration : A case study for urban units in Japanese high school (수업설계론과 수업구조화 - 일본 고등학교 도시단원을 사례로 -)

  • ;Sim, Kwang Taek
    • Journal of the Korean Geographical Society
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    • v.29 no.2
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    • pp.166-182
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    • 1994
  • Kyonggi Province in the late Chosun dynasty was a center of superior government offices including 'Han' River water-road transportation and was located in the middle of an 'X'-shaped arterial road network. Because of these reasons, Kyonggi Province had a faster inflow of commodities, informations and technics compared with the other province. At this period of time, every local 'Eup' (name of administrative district) had not been affected by their above administrative districts and had their own autonomy. For this reason, every 'Eup' could be developed as a town, even if its size was small when it had sufficient internal growing conditions. Moreover, the markets ('Si-Jon') in big towns and periodical markets which were spread over the Kyonggi Province played role of commercial functions of town. And because military bases for the defence of the royal capital in Kyonggi Province also took parts of a non-agricultural city role, Xyonggi Provinc had much more possibilities of growing as a town rather than the other provinces. The towns of the late Chosun Dynasty were, except the capital and superior administrative districts which were governed by the 'You-Su', small towns which had only about 3, 000-5, 000 people. Most of the town dewellers were local officials, nobles, merchants, craftmen and slaves. And the farmers who lived near town became a pseudo-towner through suburb agriculture. Among these people, the merchants were leaders of townization. The downtowns were affected by the landform and traffic roads. The most fundamental function of towns were administrative. The opcial's grade, which was dispatched to the local administrative district ('Kun' or 'Hyun'), was decided by the size of population and agricultural land of each county. Large county which was governed by a high ranking opcial had more possibilities to develop as a large town. Because they supervised other opcials of lower rank and obtained more land and population for the town. The phonomena of farm abandonment after the Japanese Invasion of Korea in 1592-1598 stimulated the development of towns for commercial function. The commercial functions of towns were evident in the Si-Jon or Nan-Jon (names of markets) in the big cities such as Hansung and Kaesung, meanffwhile in the local areas it was emerged in the shape of periodical market networks as allied with near markets (which were called as Jang-Si) or permanent markets which were grown up from periodical markets. These facts of commercial development induced the birth of commercial town. Kyonggi Province showed the weak points of its defense system during both wars (Japanese Invasion in 1592 and Manchu's Invasion in 1636). The government reinforced its defense system by adding 4 'You-Su-Bus' and several military bases. Each local districts ('Eup'), where Geo-Jins were established, were stimulated to be a town while Jin-Kwan system were, adjusted and enforced. Among Dok-Jins(name of solitary military bases), Youngjongjin was grown up as a large garrison town which only played a role of defense. The number of towns that took roles of non-agricultural functions in Kyonggi Province was 52. Among these towns, 29 were developed as big towns which had above 3, 000 people and most of these towns were located on the northwest-southeast axes of 'X'-shaped arterial trafic network in the Chosn Dynasty, This fact points out that the traffic road is one of the important causes of the development of towns. When we make hierarchy of the towns of Kyonggi Province according to its population and how many functions it had, we can make it as 6 grades. The virst grade town 'Hansung' was the biggest central town of administration, commerce and defdnse. The 2nd grade town includes 'Kaesung' which had historical inertia that it had been the capital of the Koryo Dynesty. The 3rd grade towns include some 'You- Su-Bus' such as Soowon, Kanghwa, Kwangju and also include Mapo, Yongsan and from this we can imagine that the commercial development in the late Chosun Dynasty extremely affected the townization. The 4th-6th grade towns had smiliar population but it can be discriminated by how many town functions it had. So the 4th grade towns were the core of administration, commerce and defense function. 5th grade towns had administrative functions and one of commercial and defense functions. 6th grade towns had only one of these functions. When we research and town conditions of each grades as the ratio of non-agricultural population, we can find out that the towns from the 1st grade to 4th grade show difference by degree of townization but from the 4th grade to 6th grade towns do not show big difference in general.

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Studies on the Estimation of Growth Pattern Cut-up Parts in Four Broiler Strain in Growing Body Weight (육용계에 있어서 계통간 산육능력 및 체중증가에 따른 각 부위별 증가양상 추정에 관한 연구)

  • 양봉국;조병욱
    • Korean Journal of Poultry Science
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    • v.17 no.3
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    • pp.141-156
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    • 1990
  • The experiments were conducted to investigate the possibility of improving the effectiveness of the existing method to estimate the edible meat weight in the live broiler chicken. A total of 360 birds, five male and female chicks from each line were sacrificed at Trial 1 (body weight 900-1, 000g), Trial 2 (body weight 1.200-1, 400g), Trial 3(body weight 1, 600-1, 700), and Trial 4(body weight 2, 000g) in order to measure the body weight, edible meat weight of breast, thigh and drumsticks, and various components of body weight. Each line was reared at the Poultry Breeding Farm, Seoul National University from the second of july, 1987 to the thirteenth of September, 1987. The results obtained from this study were summarized as follows : 1. The average body weights of each line( H. T, M, A) were $2150.5\pm$34.9, $2133.0\pm$26.2, $1960.0\pm$23.1, and $2319.3\pm$27.9, respectively. at 7 weeks of age. The feed to body weight eain ratio for each line chicks was 2.55, 2.13, 2.08, and 2.03, respectively, for 0 to 7 weeks of age. The viability of each line was 99.7. 99.7, 100.0, and 100.0%, respectively, for 0 to 7 weeks of age.01 was noticed that A Line chicks grow significantly heavier than did T, H, M line chic ks from 0 to 7 weeks of age. The regression coefficients of growth curves from each line chicks were bA=1.015, bH=0.265, bM=0.950 and bT=0.242, respectively. 2. Among the body weight components, the feather. abdominal fat, breast, and thigh and drumsticks increased in their weight percentage as the birds grew older, while neck. head, giblets and inedible viscera decreased. No difference wat apparent in shank, wings and hack. 3. The weight percentages of breast in edible part for each line thicks were 19.2, 19.0, 19.9 and 19.0% at Trial 4, respectively. The weight percentages of thigh and drumsticks in edible part for each line chicks were 23.1, 23.3, 22.8, and 23.0% at Trial 4. respective1y. 4. The values for the percentage meat yield from breast were 77.2. 78.9 73.5 and 74.8% at Trial 4 in H, T, M and A Line chicks. respectively. For thigh and drumstick, the values of 80.3, 78.4. 79.7 and 80.2% were obtained. These data indicate that the percentage meat yield increase as the birds grow older. 5. The correlation coefficients between body weight and blood. head, shanks. breast. thigh-drumstick were high. The degree if correlation between abdominal fat(%) and percentage of edible meat were extremely low at all times, but those between abdominal fat (%) and inedible viscera were significantly high.

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The Correlation between Acholic Stool and the Result of $Tc^{99m}$ DISIDA Hepatobiliary Scintigraphy and Biochemical Test in Neonatal Cholestasis (신생아 담즙 정체증에서 무담즙변의 유무와 $Tc^{99m}$ DISIDA 간담도 주사 결과간의 상관성과 생화학적 검사의 차이에 관한 연구)

  • Joo, Eun-Young;Ahn, Yeon-Mo;Kim, Yong-Joo;Moon, Soo-Ji;Choi, Yun-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.51-61
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    • 2002
  • Purpose: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of $Tc^{99m}$ DISIDA scan and presence of acholic stool. Methods: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent $Tc^{99m}$ DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. Results: Patients who had negative intestinal activity on $Tc^{99m}$ DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on $Tc^{99m}$ DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on $Tc^{99m}$ DISIDA scan. The result of $Tc^{99m}$ DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum level of ALT. Conclusion: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.

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Trends of Study and Classification of Reference on Occupational Health Management in Korea after Liberation (해방 이후 우리나라 산업보건관리에 관한 문헌분류 및 연구동향)

  • Ha, Eun-Hee;Park, Hye-Sook;Kim, Young-Bok;Song, Hyun-Jong
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.809-844
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    • 1995
  • The purposes of this study are to define the scope of occupational health management and to classify occupational management by review of related journals from 1945 to 1994 in Korea. The steps of this study were as follows: (1) Search of secondary reference; (2) Collection and review of primary reference; (3) Survey; and (4) Analysis and discussion. The results were as follows ; 1. Most of the respondents majored in occupational health(71.6%), and were working in university (68.3%), males and over the age 40. Seventy percent of the respondents agreed with the idea that classification of occupational health management is necessary, and 10% disagreed. 2. After integration of the idea of respondents, we reclassified the scope of occupational health management. It was defined 3 parts, that is , occupational health system, occupational health service and others (such as assessment, epidemiology, cost-effectiveness analysis and so on). 3. The number of journals on occupational health management was 510. It was sightly increased from 1986 and abruptly increased after 1991. The kinds of journals related to occupational health management were The Korean Journal of Occupational Medicine(18.2%), Several Kinds of Medical Colloge Journal(17.0%), The Korean Journal Occupational Health(15.1%), The Korean Journal of Preventive Medicine(15.1%) and others(34.6%). As for the contents, the number of journals on occupational health management systems was 33(6.5%) and occupational health services 477(93.5%). Of the journals on occupational health management systems, the number of journals on the occupational health resource system was 15(45.5%), occupational finance system 8(24.2%), occupational health management system 6(18.2%), occupational organization 3(9.1%) and occupational health delivery system 1 (3.0%). Of the journals on occupational health services, the number of journals on disease management was 269(57.2%), health management 116(24.7%), working environmental management 85(18.1%). As for the subjects, the number of journals on general workers was 185(71.1%), followed by women worker, white coiler workers and so on. 4. Respondents made occupational health service(such as health management, working environmental management and health education) the first priority of occupational health management. Tied for the second are quality analysis(such as education, training and job contents of occupational health manager) and occupational health systems(such as the recommendation of systems of occupational and general disease and occupational health organization). 5. Thirty seven respondents suggested 48 ideas about the future research of occupational health management. The results were as follows: (1) Study of occupational health service 40.5%; (2) Study of organization system 27.1%; (3) Study of occupational health system (e.g. information network) 8.3%; (4) Study of working condition 6.2%; and (5) Study of occupational health service analysis 4.2%.

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Comparison of Growth Charateristics, Forage Yield and Growth Analysis in Corn Hybrids for Silage Production (Silage용 옥수수의 생육특성, 수량 및 생육해석의 품종간 비교)

  • 김창호;박상철;이효원;강희경
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.18 no.2
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    • pp.79-88
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    • 1998
  • This experiment was conducted from May to August in 1997 to selected the wrn hybrids being suitable for silage at farm in the Kongju National University through the comparison of growth characteristics, forage yield and growth analysis about native and imported corn hybrids for silage production. In this experiment, trial design was a randomized block design with three replication, testing varieties were 4 hybrids (Suwon 19, Kwanganok, Whengsungok, Suwonok ) of native corn hybrids and 13 hybrids (P 3156, P 3352, P 3144w, DK 501, DK 689, DK 713, DK 729, H 643.99, H 545.64, H 645.12, HC 7466, H 644.18, H ALISEO) of imported corn hybrids. The results obtained are summarized as follows; 1. The emergence rate of H643.99 was the highest with 97.0%. In rice black streaked dwarf virus(RBSOV), the hybrid of HC 7466 was lower infected with 1.6% than other hybrids. The plant hight of P 3144w was the highest with 339 cm and the stem length of P 3156 was the highest with 261 cm. In native com hybrids, the plant height and stem length of Kwanganok were recorded with 306 cm and 235 cm, respectively. 2. Leaf number and leaf area of Kwanganok were the greatest with 16 sheet per plant and $5,180\;{\textrm{m}^2}/l0a$, respectively. H 645.12 and H 545.64 had the greatest in ear to total dry matter ratio with 49.5% and 49.4%, respectively. 3. The fresh matter yield was significantly difference between growth stage, So Suwon 19 had the most level at 15 days before silking, P 3352 had the most level at silking date, Kwananok had the most level at 35 days a after silking. The fresh matter yield of native com hybrids such as Suwon 19 and Kwanganok was not apparent diffreences as compared with imported corn hybrids. 4. As the results of survey with dry weight, the quantity of dry matter accumulation were increase after silking. The varieties of P 3352, P 3156, Kwanganok, OK 713 were more quantity of dry matter production than DK 501, HC 7466. The Kwanganok of native com hybrid and Pioneer strain with high percentage of dry matter were higher dry weight than Limagrain strain. 5. HC 7466 had the largest LAR with $6.53\;{\textrm{cm}^2}/g$, H545.12 had the lowest LAR with $3.30\;{\textrm{cm}^2/g}$. P 3144 had the largest LAI, DeKalb strain including DK 713 were larger apparently than Limagrain strain including HC 7466 with 3.15. 6. The RGR of testing varieties was little difference of statistical significantly, but DK 501, and HC 7466 were lower than other corn hybrids. The CGR of native and American varieties was no apparent differences, but that of Limagrain strains were a large variation. According to the results obtained by this experiment, the eary growth such as emergence rate and RBSDV infection rate of Limagrain strains was more excellent than other strains. P 3156, P 3352, P 3144w, DK 713 and HC 7466 were suitable for silage condition such as dry matter yield, percentage of dry matter and % ear to total dry matter. The fresh and dry matter yield of native corn hybrids such as Suwon 19 and Kwanganok were not apparent differences as compared with imported corn hybrids, but percentage of dry matter was lower than other imported corn hybrids.

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Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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Roles and Preparation for the Future Nurse-Educators (미래 간호교육자의 역할과 이를 위한 준비)

  • Kim Susie
    • The Korean Nurse
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    • v.20 no.4 s.112
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    • pp.39-49
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    • 1981
  • 기존 간호 영역 내 간호는 질적으로, 양적으로 급격히 팽창 확대되어 가고 있다. 많은 나라에서 건강관리체계가 부적절하게 분배되어 있으며 따라서 많은 사람들이 적절한 건강관리를 제공받지 못하고 있어 수준 높은 양질의 건강관리를 전체적으로 확대시키는 것이 시급하다. 혹 건강관리의 혜택을 받는다고 해도 이들 역시 보다 더 양질의 인간적인 간호를 요하고 있는 실정이다. 간호는 또한 간호영역 자체 내에서도 급격히 확대되어가고 있다. 예를들면, 미국같은 선진국가의 건강간호사(Nurse practitioner)는 간호전문직의 새로운 직종으로 건강관리체계에서 독자적인 실무자로 그 두각을 나타내고 있다. 의사의 심한 부족난으로 고심하는 발전도상에 있는 나라들에서는 간호원들에게 전통적인 간호기능 뿐 아니라 건강관리체계에서 보다 많은 역할을 수행하도록 기대하며 일선지방의 건강센터(Health center) 직종에 많은 간호원을 투입하고 있다. 가령 우리 한국정부에서 최근에 시도한 무의촌지역에서 졸업간호원들이 건강관리를 제공할 수 있도록 한 법적 조치는 이러한 구체적인 예라고 할 수 있다. 기존 간호영역내외의 이런 급격한 변화는 Melvin Toffler가 말한 대로 ''미래의 충격''을 초래하게 되었다. 따라서 이러한 역동적인 변화는 간호전문직에 대하여 몇가지 질문을 던져준다. 첫째, 미래사회에서 간호영역의 특성은 무엇인가? 둘째, 이러한 새로운 영역에서 요구되는 간호원을 길러내기 위해 간호교육자는 어떤 역할을 수행해야 하는가? 셋째 내일의 간호원을 양성하는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가 등이다. 1. 미래사회에서 간호영역의 특성은 무엇인가? 미래의 간호원은 다음에 열거하는 여러가지 요인으로 인하여 지금까지의 것과는 판이한 환경에서 일하게 될 것이다. 1) 건강관리를 제공하는 과정에서 컴퓨터화되고 자동화된 기계 및 기구 등 새로운 기술을 많이 사용할 것이다. 2) 1차건강관리가 대부분 간호원에 의해 제공될 것이다. 3) 내일의 건강관리는 소비자 주축의 것이 될 것이다. 4) 간호영역내에 많은 새로운 전문분야들이 생길 것이다. 5) 미래의 건강관리체계는 사회적인 변화와 이의 요구에 더 민감한 반응을 하게 될 것이다. 6) 건강관리체계의 강조점이 의료진료에서 건강관리로 바뀔 것이다. 7) 건강관리체계에서의 간호원의 역할은 의료적인 진단과 치료계획의 기능에서 크게 탈피하여 병원내외에서 보다 더 독특한 실무형태로 발전될 것이다. 이러한 변화와 더불어 미래 간호영역에서 보다 효과적인 간호를 수행하기 위해 미래 간호원들은 지금까지의 간호원보다 더 광범위하고 깊은 교육과 훈련을 받아야 한다. 보다 발전된 기술환경에서 전인적인 접근을 하기위해 신체과학이나 의학뿐 아니라 행동과학 $\cdot$ 경영과학 등에 이르기까지 다양한 훈련을 받아야 할 필요가 있다. 또한 행동양상면에서 전문직인 답게 보다 진취적이고 표현적이며 자동적이고 응용과학적인 역할을 수행하도록 훈련을 받아야 한다. 그리하여 간호원은 효과적인 의사결정자$\cdot$문제해결자$\cdot$능숙한 실무자일 뿐 아니라 소비자의 건강요구를 예리하게 관찰하고 이 요구에 효과적인 존재를 발전시켜 나가는 연구자가 되어야 한다. 2. 미래의 간호교육자는 어떤 역할을 수행해야 하는가? 간호교육은 전문직으로서의 실무를 제공하기 위한 기초석이다. 이는 간호교육자야말로 미래사회에서 국민의 건강요구를 충족시키기는 능력있는 간호원을 공급하는 일에 전무해야 함을 시사해준다. 그러면 이러한 일을 달성하기 위해 간호교육자는 무엇을 해야 하는가? 우선 간호교육자는 두가지 측면에서 이 일을 수정해야 된다고 본다. 그 하나는 간호교육기관에서의 측면이고 다른 하나는 간호교육자 개인적인 측면엣서이다. 우선 간호교육기관에서 간호교육자는 1) 미래사회에서 요구되는 간호원을 교육시키기 위한 프로그램을 제공해야 한다. 2) 효과적인 교과과정의 발전과 수정보완을 계속적으로 진행시켜야 한다. 3) 잘된 교과과정에 따라 적절한 훈련을 철저히 시켜야 한다. 4) 간호교육자 자신이 미래의 예측된 현상을 오늘의 교육과정에 포함시킬 수 있는 자신감과 창의력을 가지고 모델이 되어야 한다. 5) 연구 및 학생들의 학습에 영향을 미치는 중요한 의사결정에 학생들을 참여시키도록 해야한다. 간호교육자 개인적인 측면에서는 교육자 자신들이 능력있고 신빙성있으며 간호의 이론$\cdot$실무$\cdot$연구면에 걸친 권위와 자동성$\cdot$독창성, 그리고 인간을 진정으로 이해하려는 자질을 갖추도록 계속 노력해야 한다. 3. 미래의 간호원을 양성하는 능력있는 간호교육자를 준비시키기 위한 실질적이면서도 현실적인 전략은 무엇인가? 내일의 도전을 충족시킬 수 있는 능력있는 간호교육자를 준비시키기 위한 실질적이고 현실적인 전략을 논함에 있어 우리나라의 실정을 참조하겠다. 전문직 간호교육자를 준비하는데 세가지 방법을 통해 할 수 있다고 생각한다. 첫째는 간호원 훈련수준을 전문직 실무를 수행할 수 있는 단계로 면허를 높이는 것이고, 둘째는 훈련수준을 더 향상시키기 위하여 학사 및 석사간호교육과정을 발전시키고 확대하는 것이며, 셋째는 현존하는 간호교육 프로그램의 질을 높이는 것이다. 첫째와 둘째방법은 정부의 관할이 직접 개입되는 방법이기 때문에 여기서는 생략하고 현존하는 교과과정을 발전시키고 그 질을 향상시키는 것에 대해서만 언급하고자 한다. 미래의 여러가지 도전에 부응할 수 있는 교육자를 준비시키는 교육과정의 발전을 두가지 면에서 추진시킬 수 있다고 본다. 첫째는 국제간의 교류를 통하여 idea 및 경험을 나눔으로서 교육과정의 질을 높일 수 있다. 서로 다른 나라의 간호교육자들이 정기적으로 모여 생각과 경험을 교환하고 연구하므로서 보다 체계적이고 효과적인 발전체인(chain)이 형성되는 것이다. ICN같은 국제적인 조직에 의해 이러한 모임을 시도하는 것인 가치있는 기회라고 생각한다. 국가간 또는 국제적인 간호교육자 훈련을 위한 교육과정의 교환은 한 나라안에서 그 idea를 확산시키는데 효과적인 영향을 미칠 수 있다. 충분한 간호교육전문가를 갖춘 간호교육기관이 새로운 교육과정을 개발하여 그렇지 못한 기관과의 연차적인 conference를 가지므로 확산시킬 수도 있으며 이런 방법은 경제적인 면에서도 효과적일 뿐만 아니라 그 나라 그 문화상황에 적합한 교과과정 개발에도 효과적일 수 있다. 간호교육자를 준비시키는 둘째전략은 현존간호교육자들이 간호이론과 실무$\cdot$연구를 통합하고 발전시키는데 있어서 당면하는 여러가지 요인-전인적인 간호에 적절한 과목을 이수하지 못하고 임상실무경험의 부족등-을 보충하는 방법이다. 이런 실제적인 문제를 잠정적으로 해결하기 위하여 1) 몇몇 대학에서 방학중에 계속교육 프로그램을 개발하여 현직 간호교육자들에게 필요하고 적절한 과목을 이수하도록 한다. 따라서 임상실무교육도 이때 실시할 수 있다. 2) 대학원과정 간호교육프로그램의 입학자의 자격에 2$\~$3년의 실무경험을 포함시키도록 한다. 결론적으로 교수와 학생간의 진정한 동반자관계는 자격을 구비한 능력있는 교수의 실천적인 모델을 통하여서 가능하게 이루어 질수 있다고 믿는 바이다.

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Application and Expansion of the Harm Principle to the Restrictions of Liberty in the COVID-19 Public Health Crisis: Focusing on the Revised Bill of the March 2020 「Infectious Disease Control and Prevention Act」 (코로나19 공중보건 위기 상황에서의 자유권 제한에 대한 '해악의 원리'의 적용과 확장 - 2020년 3월 개정 「감염병의 예방 및 관리에 관한 법률」을 중심으로 -)

  • You, Kihoon;Kim, Dokyun;Kim, Ock-Joo
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.105-162
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    • 2020
  • In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.

The Relics of Wae Lineage and the Keyhole-Shaped Mounds in the Honam Area (호남지역(湖南地域)의 왜계자료(倭系資料)와 전방후원형고분(前方後圓形古墳))

  • Tsuchida, Junko
    • Korean Journal of Heritage: History & Science
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    • v.51 no.2
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    • pp.170-203
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    • 2018
  • From the period of Japanese colonialism up to the present, the researchers of archaeology and ancient history in Korea and Japan have paid much attention to the Honam area. Recently the ruins and relics of Wae lineage are often discovered at archaeological excavation sites in this region. In particular, at least 17 keyhole-shaped mounds were confirmed. The fact that three mounds were built on one site was newly revealed. Haniwa, a representative earthenware object of the Kofun period in Japan, was discovered as well. Therefore, the study of a historical meaning of archaeological materials about Wae lineage in the Honam area thus far must be reexamined. The ruins and relics of Wae lineage in the Honam area have been studied by selecting only specific cases. I identified all the ruins and relics of Wae lineage in the Honam area and analyzed the process of their change in this paper. I reviewed the relationship between Wae and Mahan, and the purpose of their negotiation based on archaeological characteristics, changing processes, and historical records on a quarterly basis. The ruins and relics of Wae lineage have increased and widely spread since the early period of the 5th century in the Honam area. This tendency continued until the late period of the 6th century. Weapons of Wae lineage were introduced and tombs in the style of Wae were built from the late 4th century to the early period of the 5th century (TG232~TK216 period). Sueki was introduced from the middle to late period of the 5th century (TK208~TK23 period). Keyhole-shaped mounds and tombs in the style of Wae were built from the late period of the 5th century to the early period of the 6th century (TK47~MT15 period). Japanese weapons were introduced from the middle to late period of the 6th century (TK10~TK209 period). In other words, the archaeological appearance is different in each quarterly period. There was an intensive diplomatic relationship between Baekje and Wae in the TG232~TK216 period. The military might be included in a mission of Wae. The materials of Wae lineage of this period are likely to be related to this. Sueki spread to the inland part of the Honam area in the TK208~TK23 period. This Sueki tends to be excavated on advantageous sites for the accumulation and distribution of supplies. The main characters of the keyhole-shaped mounds are presumed to be a group of traders which were under the control of a certain influence in the north of Kyushu. The keyhole-shaped mounds were abruptly built at some distance from mounds of the leaders in the Honam area. Additionally, there was no special influence base to which the characters of the keyhole-shaped mounds belonged in the surroundings. However, it might have been impossible for the group of traders to build the keyhole-shaped mounds without the support from the residents at all because there was a big difference in the building technology of the keyhole-shaped mounds between Japan and the Honam area. The time of building some keyhole-shaped mounds is the same or almost the same with that of the mounds built for the regional leaders. This proves a close relationship with the residents as well. What do the archaeological materials of Wae lineage which have been used and buried mean over 200 years in the Honam area? Geumgwan Gaya, which had exported iron resources to Japan, perished in the early period of the 5th century. Instead of Gaya, the Honam area might have played an important role to supply the necessary resources to Japan. We assume that the Japanese (Wae) actively worked to acquire various resources focusing on the underground resources in the Honam area.