• 제목/요약/키워드: Health Law

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전문병원 지정제도와 인터넷 의료광고의 허용범위 (A study on specialized hospitals and allowed range of internet advertisement)

  • 이병준
    • 법제연구
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    • 제53호
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    • pp.375-418
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    • 2017
  • 최근 전문병원 지정제도가 도입되었는데, 이와 관련하여 인터넷 온라인검색에서 '전문병원' 내지 '전문'이라는 용어를 사용하여 병원을 검색할수 있는지가 문제되고 있다. 이에 본 논문에서는 광고에서 '전문병원' 내지 '전문' 개념을 사용하였을 때 소비자에게 당해 의료기관이 보건복지부지정 전문병원으로 오인될 가능성이 발생할 수 있는지, 그래서 의료법상허위 과대광고에 해당할 수 있는지를 살펴보고 다음과 같은 결론을 도출하였다. 전문병원이라는 명칭은 기본적으로 3가지의 일반적 의미를 가질 수 있고 이러한 일반적 의미와 연관하여 혼동 오인가능성을 가져 온다면 허위 과장광고가 될 수 있을 것이다. 법률에서 이러한 일반적인 의미와 다른 개념을 사용한다고 하여 일반적인 의미가 소비자의 인식에서 사라진다고 할 수 없다. 따라서 전문병원 지정제도를 통하여 의료법에 전문병원을 특수한 의미로 개념정의하고 있더라도 일반적인 인식에 따라 전문병원이라는 단어가 갖는 의미도 고려해야 한다. 첫째, 의료법상으로는 전문병원 지정제도와 연관하여 전문병원을 지정받은 병원만이 전문병원 명칭을 사용할 수 있고 지정받은 진료과목 한도에서만 명칭표시가 가능하다. 따라서 전문병원으로 지정받지 않은 경우및 전문병원 진료과목에 없는 진료과목을 사용한 명칭은 허위 과장광고에 해당할 것이다. 둘째, 전문병원이라는 명칭은 독일법상 사용하는 바와같이 일반병원에 대립되는 개념으로서 제한된 특수영역 한도에서 진료를한다는 의미를 가질 수 있다. 이러한 경우에는 해당 특수 영역에 한해서진료를 하지 않음에도 불구하고 전문병원으로 광고를 한다면 허위 과장광고에 해당할 수 있을 것이다. 셋째, 전문병원이라는 명칭은 전문의에대응하는 개념으로 특정 진료과목에 전문성을 갖춘 병원이라는 의미를가질 수 있다. 따라서 특정 진료과목에 전문성이 없는 병원에서 전문병원명칭을 사용하는 것은 허위 과장광고가 될 것이다. 이러한 결론을 토대로 보건복지부에서 제정한 "전문병원 광고관련 가이드라인"를 살펴보면 광범위한 금지영역을 설정함으로써 의료기관이 갖는 표현의 자유 및 직업 활동의 자유를 제한하고 있음을 알 수 있다. 또한 소비자가 의료기관을 검색할 때 전문성을 갖는 의료기관을 광범위하게 검색하고 싶어 하는데, '전문', '특화', 첨단' 등의 용어를 포괄적으로 금지하여 소비자가 전문성을 갖는 의료기관을 적합하게 찾을 수 있는자유를 부당하게 막고 있다. 전문성을 갖춘 의료기관이 자신을 적절히 광고할 기회를 박탈하고 있는 해당 가이드라인은 전면적으로 재검토 되어야 한다고 생각된다.

병원 간호행정 개선을 위한 연구 (A Study for Improvement of Nursing Service Administration)

  • 박정호
    • 대한간호학회지
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    • 제3권1호
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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한국(韓國)에 있어서의 장내기생충감염(腸內寄生虫感染)의 현황(現況)과 추이(推移) (Current Status and Transition of the Prevalence of Intestinal Parasitic Infections in Korea)

  • 김동찬
    • 농촌의학ㆍ지역보건
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    • 제9권1호
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    • pp.83-108
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    • 1984
  • Out of a total of 58 species of helminthic and protozoan parasitic infections in Korea, so far 38 species were reported as intestinal parasites of man. Quite a few species of the intestinal parasitic infections have long been prevalent throughout the country and this has been a significant public health problem. In this paper, current status and transition of the intestinal parasitic infections in the past years were presented. Chronological reviewing of data show background and prospects of change in the prevalence of infections. In the national prevalence survey on parasitic infections conducted once every five years since 1971, stool examinations were done by both cellophane thick smear and brine flotation techniques. Every egg positive case of Ascaris lumbricoides and Clonorchis sinensis was further examined by Stoll's dilution egg counting technique. In 1981, perianal swab using adhesive cellulose tape was added for Enterobius infection. For protozoan cyst examination conducted by province and city in '81, fecal specimens were fixed in SAF solution and examined by the formalin-ether concentration technique. High prevalence of parasitic infection in ana before the 1960s can be easily understood from the data given by the Ministry of Health and Social Affairs in 1967. From a parasite control point of view, the 1960s was the preparatory period particularly for control of soil-transmitted helminthiasis. Several organizations which have contributed to parasite control were founded in this period and the prevention law of parasitic infections was passed in '66. In the '70s, overall prevalence rates of the common intestinal parasitic infections, which were highly prevalent in the past were turned into reduction phase for the first time. The '80s can be said to be an active control period of parasitic infections. Intestinal helminths According to the reports of the national prevalence survey on parasitic infections, the prevalence of helminthic infections was 84.3%(number of person examined:24,887) in '71, 63.2%(27,178) in '76, and 41.1%(35,018) in '81. By area, the prevalence rate in '81 was 35.1%(20,569) in urban areas and 49.6%(14,447) in rural areas. Intestinal nematodes Ascaris lumbricoides The prevalence of Ascaris infection has decreased significantly in recent years. Among students, the prevalence was 55.4%, in '69 and decreased to 4.7% in '83. In the national prevalence surveys, the prevalence decreased to 13.0% in '81 from 54.9% in '71. By area, the prevalence decreased to 8.5% in '81 from 46.4% in '71 in urban area and 19.4% in '81 from 59.6% in '71 in rural area. By age, the prevalence has become in recent years relatively even in all age groups, although higher prevalence used to be seen in young age groups of around 10 years old, particulary in the highly prevalent rural areas. By sex, the prevalence was higher in the female than in the male. Unfertilized egg positive rates among the ascariasis cases increased gradually up to 55.4% on the average in '81. The intensity of the infection was also significantly decreased. Trichuris trichiura Trichuris infection had also decreased to 23.4% in '81 from 65.4% in '71. By area, the decreasing tendency of the prevalence became faster in urban areas than in the rural areas. The prevalence in urban and rural areas in '71 was 69.7%, and 63.1% respectively and decreased to 19.5% and 29.0% respectively in '81. By age, the prevalence reached a peak at the 10-14 age group and showed relatively even distribution throughout all age groups. By sex, the prevalence was close in young age groups, but in the 30s or over age group, especially in rural area, the prevalence was significantly higher in the female than in the male. The prevalence has much fluctuated depending in the area. The prevalence in rural areas surveyed in the '80s shows a range between 20.9% and 73.7% by locality. It is anticipated that the prevalence of Trichuris infection will drop more rapidly, when mass treatment is conducted. Hookworms Hookworm infection by mostly Ancylostoma duodenale and a few by Necator americanus has decreased to a negligible levels in recent years. In the national prevalence surveys, the prevalence was 10.7% in '71, 2.2% in '76, and 0.5% in '81. The prevalence was higher in rural areas than in urban areas. Wide application of multi-specific anthelminthics in the ascariasis control programmes conducted in the past decade appear to have been effective against hookworm infection. Trichostrongylus orientalis As in the case with hookworm infection, the prevalence of Trichostrongylus infection has reached a negligible levels. In the national prevalence surveys, the prevalence was 7.7% in '71, 1.0% in '76 and 0.2% in '81. Enterobius vermicularis In the national prevalence survey in '81, the egg positive rate was 12.0%. Higher prevalence is expected when examined repeatedly. The prevalence rate was 10.3% in urban area and 14.6% in rural area. In recent surveys conducted in rural areas among schoolchildren, the prevalence was 32.4% in Gimhae Gun in '82 and 64.1% in Yeongyang Gun in '83. By age, the egg positive rate was higher in young age groups of around 10 and sharply decreased in age groups of around 20 and then somewhat increased again in middle age groups. By sex, the prevalence was higher in the female than in the male. Strongyloides stercoralis Strongyloides stercoralis infection has rarely been found in Korea. Three cases were reported in 1914. And 0.1-0.5% were found infected out of 2,642 persons examined at the prisoner-of-war camp on Geojedo in 1956. One case was reported in '54 and '82, respectively. Anisakis spp. No systematic survey has been conducted for anisakiasis In Korea. So far, only several cases have been found 1 case in Seoul in '71, 5 cases in Busan in '81 and 1 case in Busan in '84. Intestinal trematodes Metagonimus yokogawai In the national prevalence survey conducted in 1981, the egg positive rate was 1.24% on the average. High endemic areas are located in the southwestern part of Korea. The prevalence in Hadong Gun was 29.1% on the average in '79. In a survey conducted in 76, the prevalence was 44.0% in Gwangyang, 55.0% in Gogseung and 29.0% in Gurye. The infection is closely correlated with raw sweetfish consumption in these areas. Other intestinal trematodes A human case of Heterophyes heterophyes was reported in 1914. Several species were reported in the '80s : 17 cases of Fibricola seoulensis, 9 cases of Pygidiopsis summa, 8 cases of Heterophyes heterophyes nocens, 1case of Heterophyopsis continua, 2 cases of Stellantchasmus falcatus, 1 case of Stictodora sp., 1 case of Echinostoma hortense, and 4 cases of Echinochasmus japonicus. As the intermediate hosts, snakes and frogs play a role for F.seoulensis and fish for the rest of the species. Intestinal cestodes Taenia saginata and T. solium Egg positive rates in the national prevalence survey were 0.7% in '76 and 1.1% in '81. The prevalence in '81 was 0.6% in urban area and 1.8% in rural area. The proglottid positive rate in Jeju Do was 19.2% on the average. On Udo, Jeju Do in 1983, the egg positive rate among the inhabitants was 2.9%. Hymenolepis nana In the national prevalence survey, egg positive rates were 0.6% in '76 and 0.4% in '81. No difference was seen in the prevalence by area and sex. Hymenolepis diminuta Infected cases were reported : 3 in '64 and I in '66. Egg positive rate in '81 was 0.01% in the national prevalence survey. Diphylobothrium latum So far, about 30 cases have been reported. The cases have been reported more frequently in recent surveys. Mesocestoides sp. A case was reported from a hospitalized patient in Seoul in '67. Spirometra erinacei Two cases were reported in '84 following reidentification of the adult worms collected in '74. Intestinal protozoa Out of a total of 23 species of human protozoan infections in Korea, 13 species were reported as intestinal protozoa : Entamoeba histolytica, E coli, Endolimax nana, Iodamoeba b$\ddot{u}$tschlii, Dientamoeba fragilis, Giardia lamblia, Chilomastix mesnilii, Embadomonas sp., Enteromonas hominis, Trichomonas hominis, Isospora belli, I. Hominis(Sarcocystis hominis), and Balantidium coli. Since the first report on intestinal protozoan infections in 1925, there have been quite a few survey data on the prevalence of the infection. It was found reviewing the data chronologically that up to the early '70s the infection was prevalent around a 30-50%. After that, the protozoan cyst positive rate has shown the tendency of gradual decrease throughout the country. Protozoan cyst survey conducted in Seoul and several provinces in 1981 revealed infection rates of 8.9%(1,310) in Gangweondo, 10.7%(1,703) in Gyenggi Do, 11.7%(1,032) in Jeonra Buk Do, 9.1%(4,116) in Jeonra Nam Do, and 1.4%(5,275) in Seoul. Entamoeba histolytica In the survey conducted by province in '81, the cyst positive rate was 0.8% in Gangweon-do, 0.3% in Gyeonggi Do, 1.4% in both Jeonra Buk Do and Jeonra Nam Do, and 0.2% in Seoul. Giardia lamblia In the survey by province in '81, cyst positive rates were 2.2% in both Gyeonggi Do and Jeonra Buk Do, 1.9% in Jeonra Nam Do, 0.5% in Gangweon Do, and 0.9% in Seoul. Balantidium coli Two cases were reported. One in 1930 and the other in '74. Isospora belli and I. Hominis(Sarcocystis hominis) Isospora belli was reported : 1 case in '56 and 3 cases in '66. I. Hominis, recently identified to be synonymous with Sarcocystis hominis, was reported : 3 cases in '66. Other intestinal protozoa The protozoan parasites other than the above mentioned are generally treated as commensal, although some of them are considered to be pathogenic. The data of '81 show that about 10% of the inhabitants are still infected with protozoa.

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우리나라 가공식품의 칼슘강화 현황에 관한 조사 연구 (A Study on the Current Status of Calcium fortification in the Processed Foods in Korea)

  • 김욱희;김을상;유인실
    • 한국식품영양과학회지
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    • 제31권1호
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    • pp.170-176
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    • 2002
  • 서울시내 백화점과 대형 마트에서 판매되는 칼슘강화식품을 조사하여 이들을 곡류가공품, 우유 및 유제품, 식.어육가공품, 라면류, 레토르트식품, 쥬스 및 음료류, 기타로 분류하고 각 제품에 표기된 영양표시를 중심으로 현재 우리나라 칼슘강화 현황과 영양표시 실태를 살펴보았다. 그러나 본 조사에서는 특정인을 위한 건강보조식품이나 특수영양식품 및 유아용 조제유와 이유식은 대상에서 제외하였다. 조사된 캄슘강화식품은 총 81건이었으며 곡류가공품, 라면류를 중심으로 광범위한 식품군에 강화되었다. 특히 칼슘이 기호식품에 첨가됨으로서 소비자의 식사 패턴과 기호도에 따라 개인별로 칼슘 섭취량의 차이가 클 가능성이 있었다. 그리고 칼슘강화식품은 대부분 칼슘이 단독으로 강화되었고 그 다음으로 칼슘 이외에 1종의 영양소가 추가로 강화된 제품들이 많았고 식품군에 따라서는 약간의 차이를 보였다. 특히 우유 및 유제품 식품군은 다중 강화식품군으로 한 제품과 칼슘과 1~8종의 영양소가 동시에 강화되었다. 또한 같이 첨가되는 영양소의 종류는 DHA가 가장 많았으며 그 외에 비타민류, 무기질류 등이 있었다. 제품의 칼슘함량을 표시하는 기준단위는 주로 '100g/100mL', '포장중량'이었으며 각 제품에 대한 소비자들의 실제 섭취량을 비교하기 위해 칼슘함량을 '1인 분량'당 % RDA로 환산해보면 2.5~27.6% RDA 범위였다. 특히 칼슘이 강화된 제품의 칼슘함량이 '1인 분량'당 10% RDA에도 미달되는 제품들이 많아 강화함량에 대한 전반적인 평가가 필요했다. 영양표시는 표시기준에 규정되지 않은 용어가 사용되고 규정된 용어를 사용하더라도 함량기준에 미달되는 경우가 있는 등 몇 가지 문제점을 드러냈다. 그러므로 영양강화가 제 역할을 다하기 위해서는 시대적인 요구에 능동적으로 대처하는 관련 정부기관의 노력과 식품업계의 강화에 따르는 기술력 향상 및 사후 품질관리가 필요했다. 또한 학술기관에서는 이에 대한 기초연구가 소비자들 대상으로 영양교육을 실시하고 소비자 스스로도 자신에 맞는 식품을 선택할 수 있는 능력을 갖추도록 꾸준한 노력과 관심을 가져야 할 것이다.

참여정부의 자치경찰제 도입방안 (The Method of Participatory Government to Introduce the System of Autonomous Police)

  • 정진환
    • 시큐리티연구
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    • 제10호
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    • pp.355-385
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    • 2005
  • 본 논문은 오랫동안 논의되어 왔던 자치경찰제의 도입방안에 대한 참여정부의 도입안이 확정됨에 따라 주요내용을 분석하고 쟁점사항을 검토하여 보완책을 제시하는데 목적이 있다. 참여정부의 자치경찰 구성은 해당 시${\cdot}$${\cdot}$구가 자치경찰제 도입의 필요성이 있다고 판단되면 의회에서 조례를 제정하여 실시할 수 있도록 했으며, 시장, 군수, 구청 조직에 과단위의 기구로 운영되도록 한다는 것이다. 주요 업무는 방범, 순찰, 교통단속 등 주민생활과 밀접한 치안서비스와 현재 자치단체가 벌이고 있는 보건, 위생, 환경단속의 업무를 수행하게 된다. 그러나 정부안의 수용을 전제로, 예상되는 몇 가지 쟁점사항을 정리하면 다음의 세가지로 요약할 수 있다. 첫째, 경찰의 기본기능과 관련된 논점이다. 정부안에는 자치경찰에게 일반범죄에 대한 수사권을 주지 않고 있어 ‘경찰의 보조원’에 불과한 것이 아닌가, 하는 것이 논점이 되고 있다. 둘째, 지자체간의 치안서비스의 균형성 논란이 제기될 수 있다. 지방 자치단체간에는 치안환경이 상이하고, 따라서 치안수요도 각기 다르다. 그러기에 자치경찰의 치안서비스는 지자체에 따라 질적인 면에서 차이를 보이게 될 것이다. 셋째, 자치단체 예산으로 운영됨으로서 예상되는 논점이다. 자치경찰이 지자체의 예산으로 운영된다는 점에서, (1) 경찰행정이 일반행정의 하위에 놓여 집행력이 약화 될 수 있다. (2) 경찰기관 간에 협조가 원활하게 이루어지지 않을 수 있다. (3) 예비경찰 보유의 어려움으로 인해 경찰의 기동성(機動性)이 다소 떨어질 수도 있다.

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사용후핵연료 관리를 위한 캐나다 공론화 방안 (Canadian Public and Stakeholder Engagement Approach to a Spent Nuclear Fuel Management)

  • 황용수;김연옥;황주호
    • 방사성폐기물학회지
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    • 제6권3호
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    • pp.179-187
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    • 2008
  • 캐나다 AECL이 사용후핵연료 관리 방법으로 심지층 처분 방식을 제시하였으나, Seaborn Panel은 이 방안에는 사회적 수용성이 결여되어 있음을 지적하였다. 이에 따라 캐나다는 사용후 핵연료 관리에 위해 보다 폭넓은 사람들의 참여를 유도할 수 있는 공론화 프로그램이 필요하다는 것을 인식하고 먼저 핵연료폐기물법 (Nuclear Fuel Waste Act, NFWA) 을 제정하였다. NFWA에 따라 Nuclear Waste Management Organization (NWMO) 가 설립되었다. 전문가들이 마련한 세 가지 관리 방법 가운데서 사회적으로 수용 가능하고 기술적으로 안전하며, 환경적으로 책임질 수 있고 경제적으로 실행 가능한 사용후핵연료 장기적 관리방안을 마련하는 것을 NWMO의 임무로 지정하였다. 그러나 이 세가지 관리 방안 중 어느 것도 적합하지 않다고 판단할 때는 제 4의 대안을 고려하는 예외 조항을 두었다. 결과적으로 NWMO는 위의 3가지 방안의 장점 및 특징을 바탕으로 하여 제 4의 대안인 Adaptive Phased Management (APM; 융통성 있는 단계적 관리) 방식을 제안하였다. 이 대안은 실행 단계에서라도 어떤 기술적 발전이나 변화가 생겼을 때 이를 받아들이도록 고안되었다. 캐나다의 사용후핵연료 공론화 과정은 연구 개발 프로그램이 사회적 수용성과 얼마나 깊게 연관되어 있는지를 잘 보여준다. 다시 말해, 비록 자세한 기술적인 연구 개발은 전문 과학자에 의해 수행되어야 하지만, 연구 개발의 객관적인 타당성 확보를 위해서는 대중을 의사 결정 과정에 참여시키고 대중의 의견을 수렴하는 것이 매우 중요하다. 또한 공정성, 공공의 건강과 안전, 안보, 적용성 등과 같은 원칙들을 확보하기 위하여 NWMO는 이와 같은 추상적인 개념들을 대중이 이해하도록 노력하였다. 가능한 많은 대중을 프로그램에 참여시키기 위하여 공론화 회의뿐 아니라 e-dialogue 등과 같이 다양한 의사소통 방법을 사용하였다. 현재 사용후핵연료 관리 방안을 둘러싸고 많은 어려움을 겪고 있는 우리나라의 입장에서 생각할 때, 캐나다 공론화 과정은 우리나라가 앞으로 적절한 사용후핵연료 관리 방안을 찾는 데 많은 교훈과 시사점을 제공할 수 있다. 결과적으로, 숙의적 참여방법의 하나인 공론화 방안이 우리나라에서도 사용후핵연료 문제를 해결하는 하나의 대안이 될 수 있을 것이다.

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임부교실 운영효과 분석을 위한 일 연구 (A study on analyzing effectiveness of childbirth education)

  • 김혜숙;최연순;장순복;정재원
    • 대한간호
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    • 제34권3호
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    • pp.85-98
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    • 1995
  • The purpose of this study is to provide basic data regarding effective learning opportunities in childbirth education classes. Also analysis of the data indicates the optimum conditions for the welfare and improvements in the promotion of health in childbearing mothers. The results of this study are as follows; 1) The average age of the subjects in this study was 30.6 years and the total number of subjects was 58 pregnant women. The average number of children was one and 84.5% of the subjects were unemployed even though 63.8% of them held over bachelor's degrees. It was found that 22.4% of the subjects were living in an extended family. Also 61.5% of them were living with parents-in-law. The number of pregnancies were calssified as one, two, or three to nine times with the percentages of 58.7%, 22.4% and 18.9%, respectively. Further, 72.4% of the subjects had no abortion experience and 15.5% had one aborion experience. While 89.7% of the subjects planned to feed their babies with breastmilk, mixed feeding were used by only 22.4% of the sample. These data were collected at about 6 months after delivery. Thus one can see that a low rate of breastfeeding was common. 2) The length of one period of childbirth education is four weeks. It was found that 36.2% of the subjects participated in childbirth education only once, where as 13.8% participated four times and 19% of the subjects participated in this class more than four times. pregnant at least once. Further, 75.9% of the participants were participated in this education through their own will. Their motivation for participation developed through information, advertisement and posters which contained information on childbirth education. Those with unplanned pregnancies 92.9% participated after a suggestion by the nurses. The number of participants in terms of percentage according to the childbirth education contents can be classified as following. The most active participation was shown in preparation of delivery(77.6%), postpartrm management(56.9%) fetal development(37.6%) and physiology of pregnancy(17.2%). It was found that 75.9% of the subjects were willing to participate again if they were given a chance. The reason can be summarized as following: The content of the education is very helpful(47.7%). Scientific knowledge can be obtained through this program(20.5%). Participation helps in achieving psychological stability(9.1%). Participation enables one to establish a friendly relationship with other participants(6.8%) of the sample. 24.1% of the participants did not want to participate again. The reasons can be as following: They do not want another baby(42.9%). The first paricipation in childbirth education gave enough knowledge about childbirth(21.4%). Another reason for not want to participate again was because they had a cesarean birth(14.3%). Only 7.1% of them responded with a negative view. A response that they do not need childbirth education after their operation can be traced back to the general belief that childbirth education is the place where one prepares for natural birth through the Lamaze breathing technique. Of the subjects, 91.4% suggested that this program could be recommended to other childbearing mothers, because this program gave educational content along with psychological stability for childbearing women. Of the subjects 41.4% did not see any efforts towards the welfare of the baby, where as 88.2% did. Among the subjects 58.6% made some effort to eliminate the discomfort of labor by breathing and imagination and breathing and walking. Further 41.7% of the 24 subjects did not do anything toward the welfare of the baby, because they did have a cesarean section so that they didn't have a chance even though they had been educated about childbirth. Also 33.3% of the subjects did not do anything toward the welfare of the baby, because they lacked a willingness. After leaving the hospital, only 75.9% of the subjects did some exercises. The subjects who tried participate this program with their husband accounted for 20.7% of the sample. Interviewing with the subjects solved some of the uneasiness and. fear of delivery, increased self-confidence in parenting and active coping in the delivery process.

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흡연환자의 효과적인 금연정책에 대한 연구 (A Study on Effective Smoking Cessation Policy of Smoker Patients)

  • 황지민;김응권;박용덕;한지형
    • 치위생과학회지
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    • 제13권1호
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    • pp.77-82
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    • 2013
  • 본 연구는 흡연환자들의 효과적인 금연정책에 대한 의견을 알아보고 향후 금연에 관한 정책적인 방안을 마련하는데 기초자료를 제공하기 위하여 치과에 내원한 환자를 대상으로 시행하였다. 개인의 특성을 파악하기 위해 자기기입식방법으로 설문을 실시하였으며, 그 중 최종적으로 채택된 236부를 자료로 분석하였다. 분석한 결과 다음과 같은 결론은 얻었다. 1. 효과적인 금연정책 중 금연교육이 32.6%로 가장 높게 나타났으며, 금연상담은 28.8%, 금연보조제 처방 18.6%, 금연에 관한 법 12.3%, 담뱃값 인상 7.6%의 순으로 조사되었다. 2. 금연법 필요성은 남자 2.37, 여자 3.00으로 성별에 따라 유의한 차이를 보였으며, 담뱃값 인상의 필요성은 직업과 월평균 가게수입에 따라 유의한 차이를 보였다. 금연상담 필요성은 거주지에 따라 유의한 차이를 보였으며, 서울 2.93, 인천 2.90, 경기 2.88의 순으로 조사되었다. 3. 효과적인 금연정책주관자에 대한 인식을 분석한 결과 금연보조제 처방, 금연교육, 금연상담 모두 금연 상담사가 해야 한다는 응답이 가장 높게 조사되었다. 4. 효과적인 금연정책 주관 기관에 대한 인식을 분석한 결과는 금연보조제 처방은 치과가 해야 한다는 응답이 50.0%로 가장 높게 나타났으며, 금연교육은 보건소가 37.3%, 금연상담은 치과가 44.1%로 가장 높게 조사되었다. 이상의 결과로 보아 효과적인 금연정책 마련과 확대가 시급하며, 치과에 내원한 환자들의 금연을 위해 치과의사와 치과위생사가 더욱 더 적극적으로 상담과 교육 등에 노력을 기울여야 할 것으로 보인다.

음식점 식육 원산지 표시 모니터링 (Monitoring of Restaurant Beef Labeling System)

  • 홍진;임동길;김미경;박경식;윤태형;노기미;정자영
    • 한국식품위생안전성학회지
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    • 제25권2호
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    • pp.162-169
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    • 2010
  • 식품위생법개정에 의한 음식점 식육 원산지 표시제가 시행됨에 따라 표시제도의 정착을 위해 마련한 과학적 한우판별 시험법을 이용하여 소고기 원산지 표시제에 대한 실패를 전국적 규모로 점검하였다. 본 연구에 사용한 한우판별시험법은 앞선 사업에서 검증된 90개의 한우판별용 SNP 바이오마커를 이용한 시험방법으로 소고기원산지표시제의 제도정착에 큰 기여를 하고 있다. 2009년도 식품안전관리지침에 계획도니 음식점 소고기 원산지 표시제 시행 대상 음식점으로는 구이용 쇠고기 판매 음식점으로서 영업장 면접이 $100m^2$이상인 곳 가운데 서울지역 48개 시료 및 지방 168개 시료 등 총 216건에 대하여 원산지 표시실태 모니터링 검사를 실시하였으며, 그 결과 총 검체의 1.3% (3건/216건)가 허위표시임이 파악되었다. 이는 2008년도의 모니터링 검사를 통하여 확인한 허위표시 비율인 5.14%에 비해 감소한 결과로 "음식점식육원산지표시제"가 점차 정착되고 있는 것으로 판단된다. 또한, 한우판별시험법이 마련되기 전 실시했던 음식점 소고기 원산지 표시에 대한 모니터링 실시결과 2005년 34.0%, 2006년 30.1%으로 나타난 반면 한우판별시험법이 확립된 후 모니터링 결과는 2007년도 3.2%, 2008년도 5.14%으로 나타나 한우판별시헙법의 확립이 음식점 소고기 원산지 표시제에 큰 기여를 하고 있음을 증명해 주고 있다.

장기요양서비스 수요의 결정요인 (Determinants of Demand for Long-Term Care)

  • 정완교
    • KDI Journal of Economic Policy
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    • 제31권1호
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    • pp.139-167
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    • 2009
  • 본 논문은 65세 이상 고령인구의 수와 노인들의 건강상태 등만을 중심으로 한 기존의 연구에 더하여, 노인장기요양보험제도 제2차 시범사업의 자료를 이용한 계량분석을 통해 장기요양서비스 수요의 결정요인을 분석하였다. 분석 결과에 따르면, 우선 노인장기요양보험제도상 장기요양서비스 이용에 대한 보험 적용 대상자를 정하는 등급판정에 일상생활활동에서의 장애가 노인들이 많이 앓고 있는 고혈압, 관절염, 치매 등의 질환을 통제하고서도 통계적으로 유의한 영향을 미쳤다. 또한 노인들의 건강상태, 여성, 기초생활수급자 여부, 노인가구 형태, 노인가구의 월평균 소득 등이 장기요양서비스이용 및 이용 양태에 통계적으로 유의한 영향을 미치는 것으로 나타났다. 특히, 노인가구의 월평균 소득을 통제하고서도 장기요양서비스를 무료로 이용할 수 있는 기초생활수급 대상 노인들의 재가서비스 이용확률이 높게 나타나는데, 이는 소득과 더불어 장기요양서비스의 가격도 장기요양서비스 이용을 결정하는 중요한 요인임을 의미한다.

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