• Cross-Cultural Studies
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• v.48
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• pp.289-323
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• 2017

L'Espoir, a novel by Andre Malraux, contains traits of the genre of literacy reportage that depicts the full account of the Spanish Civil War as non-fiction based on his personal experience of participating in war; the novel has been dramatized into a semi-documentary film that corresponds to reportage literature. A semi-documentary film is the genre of film that pursues realistic illustration of social incidents or phenomenon. Despite difference in types of genre of the novel and the film L'Espoir, such creative activities deserve close relevance and considerable narrative connectivity. Therefore, $G{\acute{e}}rard$ Genette's narrative discourse of novel and film based on narrative theory carries value of research. Every kind of story, in a narrative message, has duplicate times in which story time and discourse time are different. This is because, in a narrative message, one event may occur before or later than another, told lengthily or concisely, and aroused once or repeatedly. Accordingly, analyzing differing timeliness of the actual event occurring and of recording that event is in terms of order, duration, and frequency. Since timeliness of order, duration, and frequency indicates dramatic pace that controls the passage of a story, it appears as an editorial notion in the novel and the film L'Espoir. It is an aesthetic discourse raising curiosity and shock, the correspondence of time in arranging, summarizing, deleting the story. In addition, Genette mentions notions of speech and voice to clearly distinguish position and focalization of a narrator or a speaker in text. The necessity to discriminate 'who speaks' and 'who sees' comes from difference in views of the narrator of text and the text. The matter of 'who speaks' is about who portrays narrator of the story. However, 'who sees' is related to from whose stance the story is being narrated. In the novel L'Espoir, change of focalization was ushered through zero focalization and internal focalization, and pertains to the multicamera in the film. Also, the frame story was commonly taken as metadiegetic type of voice in both film and novel of L'Espoir. In sum, narrative discourse in the novel and the film L'Espoir is the dimension of story communication among text, the narrator, and recipient.

• Korean Journal of Heritage: History & Science
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• v.48 no.3
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• pp.80-95
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• 2015

The purpose of this study is to establish an effective protection and management system for World Heritage (WH) nomination of Southwestern Coast Tidal Flat (SCTF) by proposing a model of protection and management. SCTF has a potential to become a representative best practice to achieve a sustainable development for human society. SCTF has a potential Outstanding Universal Values (OUVs) for WH nomination, thus a harmony between human and nature for wise use of natural resources needs to be pursued. It is required to present the system of SCTF's protection and management and to analyze present status of the regions in the Tentative List by comparing the case which were already inscribed as WH. For better protection of nominated areas, SCTF should expand an area for protection with additional designation. For the management system, two separate management systems such as the Department of Culture & Tourism and the Department of Oceans & Fisheries need to be reconciled. Because of this overlapping management structure, the management of the nominated sites has been inefficient and long-term management plan is lacking. Therefore, it is necessary to integrate conflicting management system of each local government and make a long-term, integrated management plan. To make an efficient and sustainable protection and management, it is essential to set up a collaboration system by integrating various stakeholders such as central and local governments, academic organizations, local residents, and NGOs. As in the case of Wadden Sea, the combined community system of the stakeholders mentioned above should be established. Because it is essential for local residents to understand a basic concepts for protection and management, it is necessary to establish capacity-building of local people. The protection and management structure should be set up by bottom-up processes, that is the proper structure shoud be based on thorough research on local society as well as thorough communication with local residents to make relevant laws and policies. This study also propose the proper plan for better conservation and management of SCTF.

• Journal of Intelligence and Information Systems
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• v.25 no.1
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• pp.127-137
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• 2019

Recidivism prediction has been a subject of constant research by experts since the early 1970s. But it has become more important as committed crimes by recidivist steadily increase. Especially, in the 1990s, after the US and Canada adopted the 'Recidivism Risk Assessment Report' as a decisive criterion during trial and parole screening, research on recidivism prediction became more active. And in the same period, empirical studies on 'Recidivism Factors' were started even at Korea. Even though most recidivism prediction studies have so far focused on factors of recidivism or the accuracy of recidivism prediction, it is important to minimize the prediction misclassification cost, because recidivism prediction has an asymmetric error cost structure. In general, the cost of misrecognizing people who do not cause recidivism to cause recidivism is lower than the cost of incorrectly classifying people who would cause recidivism. Because the former increases only the additional monitoring costs, while the latter increases the amount of social, and economic costs. Therefore, in this paper, we propose an XGBoost(eXtream Gradient Boosting; XGB) based recidivism prediction model considering asymmetric error cost. In the first step of the model, XGB, being recognized as high performance ensemble method in the field of data mining, was applied. And the results of XGB were compared with various prediction models such as LOGIT(logistic regression analysis), DT(decision trees), ANN(artificial neural networks), and SVM(support vector machines). In the next step, the threshold is optimized to minimize the total misclassification cost, which is the weighted average of FNE(False Negative Error) and FPE(False Positive Error). To verify the usefulness of the model, the model was applied to a real recidivism prediction dataset. As a result, it was confirmed that the XGB model not only showed better prediction accuracy than other prediction models but also reduced the cost of misclassification most effectively.

• Journal of Korean Society of Coastal and Ocean Engineers
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• v.33 no.6
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• pp.298-307
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• 2021

Typhoons occur intensively between July and October, and the sea level is the highest during this time. In particular, the mean sea level in summer in Korea is higher than the annual mean sea level about 14.5cm in the west coast, 9.0 to 14.5cm in the south coast, and about 9.0 cm in the east coast. When the rising the sea level and a large typhoon overlap in summer, it can cause surges and flooding in low-lying coastal areas. Therefore, accurate calculation of the surge height is essential when designing coastal structures and assessing stability in order to reduce coastal hazards on the lowlands. In this study, the typhoon surge heights considering the summer mean sea level rise (SH_m) was calculated, and the validity of the analysis of abnormal phenomena was reviewed by comparing it with the existing surge height considering the annual mean sea level (SH_a). As a result of the re-analyzed study of typhoon surge heights for BOLAVEN (SANBA), which influenced in August and September during the summer sea level rise periods, yielded the differences of surge heights (cm) between SH_a and SH_m 7.8~24.5 (23.6~34.5) for the directly affected zone of south-west (south-east) coasts, while for the indirect southeast (south-west) coasts showed -1.0~0.0 (8.3~12.2), respectively. Whilst the differences between SH_a and SH_m of typhoons CHABA (KONG-REY) occurred in October showed remarkably lessened values as 5.2~ 14.2 (19.8~21.6) for the directly affected south-east coasts and 3.2~6.3 (-3.2~3.7) for the indirectly influenced west coast, respectively. The results show the SH_a does not take into account the increased summer mean sea level, so it is evaluated that it is overestimated compared to the surge height that occurs during an actual typhoon. Therefore, it is judged that it is necessary to re-discuss the feasibility of the surge height standard design based on the existing annual mean sea level, along with the accurate establishment of the concept of surge height.

• Analytical Science and Technology
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• v.22 no.4
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• pp.285-292
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• 2009

It has been observed that, after long term storage, some ammunitions are misfired by tamping (combustionstopping) due to aging of the chemicals loaded in the ammunitions. Used in ammunitions are percussion powder which provides the initial energy, igniter which ignites the percussion powder, and a delay system that delays the combustion for a period of time. The percussion powder is loaded first, followed by the igniter and then the delay system, and the ammunitions explode by the energy being transferred in the same order. Tamping occurs by combustion-stopping of the igniter or insufficient energy transfer from the igniter to the delay system or the combustion-stopping of the delay system, which are suspected to be caused by low purity of the components, inappropriate mixing ratio, size distribution of particulate components, type of the binder, blending method, hydrolysis by the humidity penetrated during the long term storage, and chemical changes of the components by high temperature. Goal of this study is to find the causes of the combustion-stopping of the igniter and the delay system of the ammunitions after long term storage. In this study, a method was developed for testing of the combustion-stopping, and the size distributions of the particulate components were analyzed with field-flow fractionation (FFF), and then the mechanism of chemical change during long term storage was investigated by thermal analysis (differential scanning calorimetry), XRD (X-ray diffractometry), and XPS (X-ray photoelectron spectroscopy). For the ignition system, M (metal)-O (oxygen) and M-OH peaks were observed at the oxygen's 1s position in the XPS spectrum. It was also found by XRD that $Fe_3O_4$ was produced. Thus it can be concluded that the combustion-stopping is caused by reduction in energy due to oxidation of the igniter.

• Korean Journal of Environmental Biology
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• v.41 no.3
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• pp.179-192
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• 2023

In this study, changes in the microbial ecosystem of the Yeongheungdo island coastal waters were investigated for five years to collect basic data. To evaluate the influence of distance from the coast on the microbial ecosystem, four sites, coastal Site (S1) and 0.75, 1.5, and 3 km away from the coast, were set up and the changes in physicochemical and biological factors were monitored. The results showed seasonal changes in water temperature, dissolved oxygen, salinity, and pH but with no significant differences between sites. For nutrients, the concentration of dissolved inorganic nitrogen increased from 6.4 μM in April-June to 16.4 μM in July-November, while that of phosphorus and silicon phosphate increased from 0.4 μM and 2.5 μM in April-June to 1.1 μM and 12.0 μM in July-November, respectively. Notably, phosphorus phosphate concentrations were lower in 2014-2015 (up to 0.2 μM) compared to 2016-2018 (up to 2.2 μM), indicating phosphorus limitation during this period. However, there were no differences in nutrients with distance from the coast, indicating that there was no effect of distance on nutrients. Phytoplankton (average 511 cells mL^-1) showed relatively high biomass (up to 3,370 cells mL^-1) in 2014-2015 when phosphorus phosphate was limited. Notably, at that time, the concentration of dissolved organic carbon was not high, with concentrations ranging from 1.1-2.3 mg L^-1. However, no significant differences in biological factors were observed between the sites. Although this study revealed that there was no disturbance of the ecosystem, further research and more basic data on the microecosystem are necessary to understand the ecosystem of the Incheon.

• Tuberculosis and Respiratory Diseases
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• v.44 no.4
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• pp.871-888
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• 1997

Background : It is now thought that the earliest manifestation of idiopathic pulmonary fibrosis is alveolitis, that is, an accumulation of inflammatory and immune effector cells within alveolar walls and spaces. Inflammatory cells including alveolar macrophages and resident normal pulmonary tissue cells participate through the release of many variable mediators such as inflammatory growth factors and cytokines, which contribute to tissue damage and finally cause chronic pulmonary inflammation and fibrosis. This study was performed to investigate the source and distribution pattern of transforming growth factor-${\beta}_1$(TGF-${\beta}_1$), platelet derived growth factor(PDGF), basic fibroblast growth factor(bFGF), interleukin 1(IL-1), interleukin 6(IL-6), tumor necrosis factor-$\alpha$ (TNF-$\alpha$) and the role of these mediators on bleomycin(BLM)-induced pulmonary injury and fibrosis in rats. Method : Wistar rats were divided into three groups(control group, BLM treated group, BLM and vitamine E treated group). Animals were sacrificed periodically at 1, 2, 3, 4, 5, 7, 14, 21, 28 days after saline or BLM administration. The effects were compared to the results of bronchoalveolar lavage fluid analysis, light microscopic findings, immunohistochemical stains for six different mediators(TGF-${\beta}_1$, PDGF, bFGF, IL-1, IL-6 and TNF-$\alpha$) and mRNA in situ hybridization for TGF-${\beta}_1$. Results : IL-1 and IL-6 are maximally expressed at postbleomycin 1~7th day which are mainly produced by neutrophils and bronchiolar epithelium. It is thought that they induce recruitment of inflammatory cells at the injury site. The expression of IL-1 and IL-6 at the bronchiolar epithelium within 7th day is an indirect evidence of contribution of bronchiolar epithelial cells to promote and maintain the inflammatory and immune responses adjacent to the airways. TNF-$\alpha$ is mainly produced by neutrophils and bronchiolar epithelial cells during 1~5th day, alveolar macrophages during 7~28th day. At the earlier period, TNF-$\alpha$ causes recruitment of inflammatory cells at the injury site and later stimulates pulmonary fibrosis. The main secreting cells of TGF-${\beta}_1$ are alveolar macrophages and bronchiolar epithelium and the target is pulmonary fibroblasts and extracellular matrix. TGF-${\beta}_1$ and PDGF stimulate proliferation of pulmonary fibroblasts and TGF-${\beta}_1$ and bFGF incite the fibroblasts to produce extracellular matrix. The vitamine E and BLM treated group shows few positive cells(p<0.05). Conclusion : After endothelial and epithelial injury, the neutrophils and bronchiolar epithelium secrete IL-1, IL-6, TNF-$\alpha$ which induce infiltration of many neutrophils. It is thought that variable enzymes and $O_2$ radicals released by these neutrophils cause destruction of normal lung architecture and progression of pulmonary fibrosis. At the 7~28th day, TGF-${\beta}_1$, PDGF, bFGF, TNF-$\alpha$ secreted by alveolar macrophages sting pulmonary fibroblasts into proliferating with increased production of extracellular matrix and finally, they make progression of pulmonary fibrosis. TNF-$\alpha$ compares quite important with TGF-${\beta}_1$ to cause pulmonary fibrosis. Vitamine E seems to decrease the extent of BLM induced pulmonary fibrosis.

• Journal of Intelligence and Information Systems
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• v.24 no.2
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• pp.221-241
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• 2018

Deep learning is getting attention recently. The deep learning technique which had been applied in competitions of the International Conference on Image Recognition Technology(ILSVR) and AlphaGo is Convolution Neural Network(CNN). CNN is characterized in that the input image is divided into small sections to recognize the partial features and combine them to recognize as a whole. Deep learning technologies are expected to bring a lot of changes in our lives, but until now, its applications have been limited to image recognition and natural language processing. The use of deep learning techniques for business problems is still an early research stage. If their performance is proved, they can be applied to traditional business problems such as future marketing response prediction, fraud transaction detection, bankruptcy prediction, and so on. So, it is a very meaningful experiment to diagnose the possibility of solving business problems using deep learning technologies based on the case of online shopping companies which have big data, are relatively easy to identify customer behavior and has high utilization values. Especially, in online shopping companies, the competition environment is rapidly changing and becoming more intense. Therefore, analysis of customer behavior for maximizing profit is becoming more and more important for online shopping companies. In this study, we propose 'CNN model of Heterogeneous Information Integration' using CNN as a way to improve the predictive power of customer behavior in online shopping enterprises. In order to propose a model that optimizes the performance, which is a model that learns from the convolution neural network of the multi-layer perceptron structure by combining structured and unstructured information, this model uses 'heterogeneous information integration', 'unstructured information vector conversion', 'multi-layer perceptron design', and evaluate the performance of each architecture, and confirm the proposed model based on the results. In addition, the target variables for predicting customer behavior are defined as six binary classification problems: re-purchaser, churn, frequent shopper, frequent refund shopper, high amount shopper, high discount shopper. In order to verify the usefulness of the proposed model, we conducted experiments using actual data of domestic specific online shopping company. This experiment uses actual transactions, customers, and VOC data of specific online shopping company in Korea. Data extraction criteria are defined for 47,947 customers who registered at least one VOC in January 2011 (1 month). The customer profiles of these customers, as well as a total of 19 months of trading data from September 2010 to March 2012, and VOCs posted for a month are used. The experiment of this study is divided into two stages. In the first step, we evaluate three architectures that affect the performance of the proposed model and select optimal parameters. We evaluate the performance with the proposed model. Experimental results show that the proposed model, which combines both structured and unstructured information, is superior compared to NBC(Naïve Bayes classification), SVM(Support vector machine), and ANN(Artificial neural network). Therefore, it is significant that the use of unstructured information contributes to predict customer behavior, and that CNN can be applied to solve business problems as well as image recognition and natural language processing problems. It can be confirmed through experiments that CNN is more effective in understanding and interpreting the meaning of context in text VOC data. And it is significant that the empirical research based on the actual data of the e-commerce company can extract very meaningful information from the VOC data written in the text format directly by the customer in the prediction of the customer behavior. Finally, through various experiments, it is possible to say that the proposed model provides useful information for the future research related to the parameter selection and its performance.

• Journal of Internet Computing and Services
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• v.14 no.6
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• pp.1-8
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• 2013

Data mining techniques are used to find important and meaningful information from huge databases, and pattern mining is one of the significant data mining techniques. Pattern mining is a method of discovering useful patterns from the huge databases. Frequent pattern mining which is one of the pattern mining extracts patterns having higher frequencies than a minimum support threshold from databases, and the patterns are called frequent patterns. Traditional frequent pattern mining is based on a single minimum support threshold for the whole database to perform mining frequent patterns. This single support model implicitly supposes that all of the items in the database have the same nature. In real world applications, however, each item in databases can have relative characteristics, and thus an appropriate pattern mining technique which reflects the characteristics is required. In the framework of frequent pattern mining, where the natures of items are not considered, it needs to set the single minimum support threshold to a too low value for mining patterns containing rare items. It leads to too many patterns including meaningless items though. In contrast, we cannot mine any pattern if a too high threshold is used. This dilemma is called the rare item problem. To solve this problem, the initial researches proposed approximate approaches which split data into several groups according to item frequencies or group related rare items. However, these methods cannot find all of the frequent patterns including rare frequent patterns due to being based on approximate techniques. Hence, pattern mining model with multiple minimum supports is proposed in order to solve the rare item problem. In the model, each item has a corresponding minimum support threshold, called MIS (Minimum Item Support), and it is calculated based on item frequencies in databases. The multiple minimum supports model finds all of the rare frequent patterns without generating meaningless patterns and losing significant patterns by applying the MIS. Meanwhile, candidate patterns are extracted during a process of mining frequent patterns, and the only single minimum support is compared with frequencies of the candidate patterns in the single minimum support model. Therefore, the characteristics of items consist of the candidate patterns are not reflected. In addition, the rare item problem occurs in the model. In order to address this issue in the multiple minimum supports model, the minimum MIS value among all of the values of items in a candidate pattern is used as a minimum support threshold with respect to the candidate pattern for considering its characteristics. For efficiently mining frequent patterns including rare frequent patterns by adopting the above concept, tree based algorithms of the multiple minimum supports model sort items in a tree according to MIS descending order in contrast to those of the single minimum support model, where the items are ordered in frequency descending order. In this paper, we study the characteristics of the frequent pattern mining based on multiple minimum supports and conduct performance evaluation with a general frequent pattern mining algorithm in terms of runtime, memory usage, and scalability. Experimental results show that the multiple minimum supports based algorithm outperforms the single minimum support based one and demands more memory usage for MIS information. Moreover, the compared algorithms have a good scalability in the results.

• The Korean Nurse
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• v.20 no.4 s.112
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• pp.27-38
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• 1981

오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.