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지역사회 건강관리담당자의 만성질환 관리실태:전라남도를 중심으로

  • 김혜숙;박종;정은
    • 농촌의학ㆍ지역보건
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    • 제34권3호
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    • pp.334-345
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    • 2009
  • 본 조사는 전라남도 지역의 20개 보건소와 이들 보건소에 소속된 보건지소, 보건진료소 실무자 총 450명을 대상으로 만성질환에 대한 업무수행 실태와 이와 관련된 교육 훈련 등의 수행실태와 환자 관리실태 등을 파악하여 만성질환 관리를 위한 지역보건사업의 기초자료를 제공하는데 있으며 그 결과는 다음과 같다. 만성질환 실무담당자는 농촌 67.8%, 어촌 87.7%, 도농복합지역 60.9%로 간호사가 가장 많았고, 만성질환자로 등록하여 관리하고 있는 평균 환자수는 고혈압이 농촌 84.4명, 어촌 52.8명, 도농복합지역이 613.6명 이었고, 당뇨병이 농촌 26.4명, 어촌 14.7명, 도농복합지역 124.9명이었으며, 고지혈증이 농촌 5.6명, 어촌 2.9명, 도농복합지역 41.0명이었다. 만성질환 관리를 위한 전문적문인 지원과 공식적인 연계체계를 갖춘 경우는 농촌 17.9%, 어촌 14.7%에 불과하고 도농복합지역은 전무한 상태였다. 만성질환자를 위해 집단 보건교육을 실시하고 있는 경우는 농촌 83.7%, 어촌 70.8%, 도농복합지역이 77.3%였고, 고혈압, 당뇨병에 대한 교육내용은 운동, 식이, 일반적 지식, 금연, 절주, 비만, 약물요법, 합병증, 스트레스에 대한 내용으로 담당자가 직접 시행하고 있었다. 지난 1년간 보건교육을 실시한 평균 횟수는 농촌 9.9회, 어촌 8.3회, 도농복합지역이 11.6회이었고, 만성질환 실무담당자가 교육받기를 원하는 영역으로는 고혈압, 당뇨, 고지혈증의 증상, 진단, 치료 및 합병증이 농촌 43.0%, 어촌 41.1%, 도농복합지역이 47.6%로 도농복합지역이 가장 많았고, 병태생리, 약물요법, 예방 또한 도농복합지역이 많았다. 반면 운동과 식이는 농촌 33.7%로 농촌이 가장 많았고, 스트레스, 비만, 금연, 절주는 도농복합지역이 가장 많았다. 질병 관리를 위한 기초자료는 확보되어 있으나 자료가 미비하다고 응답한 경우가 농촌56.3%, 어촌 52.2%, 도농복합지역이 66.7%이었으며, 만성질환 관리사업 중 가장 중요하다고 생각되는 영역은 환자 조기발견사업이 농촌 52.6%, 어촌 50.7%, 도농복합지역이 36.4%이었고, 지원이 필요한 영역에서 업무표준화가 시급하다고 응답한 경우는 농촌 30.7%, 어촌 35.2%, 도농복합지역 40.9%로 가장 많았다. 전반적으로 타 의료기관과의 협조체계는 잘 이루어지지 않고 있다고 응답하였다. 이상의 결과를 종합하면 전라남도 만성질환 관리 담당자들은 적극적으로 만성병 관리업무를 수행하고 있으나, 고지혈증과 관련한 업무의 전문성부족과 관리를 위한 기초자료의 부족 등을 업무수행의 장애 요인으로 생각하고 있었으며, 업무능력 향상을 위한 연계체계의 구축과 교육의 필요성을 요구하고 있어 이에 대한 적극적인 지원과 대책이 필요할 것으로 사료된다.

원주시 섬강, 원주천의 비오톱유형별 야생조류 서식특성 연구 (Properties of Wildbirds Habitat according to Biotope Types at Seom River and Wonju Stream)

  • 노태환;피재황;최진우;이경재
    • 한국환경생태학회지
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    • 제27권6호
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    • pp.676-689
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    • 2013
  • 본 연구는 강원도 원주시에 도심지를 통과하는 원주천과 외곽의 국가하천인 섬강 전 구간을 조사하여 비오톱유형화를 통해 하천 자연생태 현황을 파악하고, 야생조류 출현위치를 파악하여 비오톱과 야생조류 출현현황의 관계를 분석하였다. 비오톱유형은 규모, 형태, 경관에 따라 중분류하였으며, 수문, 물리환경, 식생에 따라 소분류하였다. 또한 하천공간, 물리환경, 식생, 토지이용에 따라 비오톱유형을 세분류하였으며, 조사 결과 섬강은 21개 유형, 원주천은 19개 유형으로 분류하였다. 야생조류는 2008년 1월과 5월에 조사를 시행하였으며, 각 조류의 출현위치를 표기하여 야생조류 출현지점의 비오톱 속성을 파악하였다. 야생조류 출현 현황은 섬강 전 구간에서 봄철 31종 795개체, 겨울철 49종 4,348개체이었고, 원주천에서는 봄철 34종 427개체, 겨울철 33종 3,442개체이었다. 섬강은 산지형 하천 중 합수부 퇴적지 자연하천 지역에 겨울철 26종 547개체, 봄철 12종 72개체이었으며, 농촌형 하천 중 퇴적지 및 습지식생이 넓게 형성된 자연하천 지역에 겨울철 34종 1,412개체, 봄철 24종 341개체이었다. 이에 농촌형 하천은 하폭이 넓고 유속이 느리며, 다양한 비오톱유형이 있어 야생조류 서식에 양호한 것으로 판단되었다. 본 연구에서는 조사와 표현이 힘든 선형 하천구간에 정밀 비오톱 조사와 유형화를 통해 하천 전체 현황을 파악하였으며, 야생조류 출현현황을 조사하여 생물서식처 복원, 생태하천 조성, 하천정비 등의 기초자료로 활용되며, 원주시 도심 생물다양성 증진을 위한 자료로 활용 가능하다. 또한 하천은 강우에 의해 비오톱 속성이 빈번하게 변경되므로 지속적인 모니터링을 통해 하천생태계가 유지될 수 있도록 관리해야 할 것이다.

접근성 개념을 적용한 문화서비스 평가 -남양주시를 대상으로- (Accessibility Analysis in Mapping Cultural Ecosystem Service of Namyangju-si)

  • 전배석;강완모;이재혁;김성훈;김벼리;김일권;이주은;권혁수
    • 환경영향평가
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    • 제27권4호
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    • pp.367-377
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    • 2018
  • 인간이 생태계로부터 취하는 비물질적인 혜택인 문화서비스에 대한 수요가 최근 국민총소득과 함께 증가하고 있다. 이에 대한 정량적 가치평가를 위해 국내외에서 다수의 연구가 이루어져 왔으나 개인의 사회, 문화적 이질성 등의 주관적 성향과 규모의 차이로 인해 국내 전 지역에 적용하기에는 어려움이 있다. 문화서비스가 발생하기 위해서는 자연생태계와 인간의 접촉이 이루어져야 하며 이러한 관점을 바탕으로 본 연구에서는 접근성이라는 개념을 활용하여 기존 문화서비스 가치평가방법이 가지는 사회, 문화적 주관성을 보완하고자 한다. 국내 전 지역 규모에 적용 가능하며 다양한 이해관계자의 공감대를 형성시킬 수 있는 포괄적인 문화서비스 평가 방법을 제시하는 것이 본 연구의 목적이다. 본 연구에서는 접근성을 근거로 개발된 유럽의 여가 서비스 평가방법 고찰을 통해 국내에 구축된 도로 네트워크와 인구분포현황과 함께 국립생태원에서 수행한 '생태자산 간이평가' 결과를 활용하여 '문화서비스 접근성 평가 (CSOS)'를 남양주시에 시범 적용하였다. 그 결과 남양주시에 산재한 특정 생태자산 및 주거지를 중심으로 우수한 문화서비스 접근성이 존재하는 특정 공간을 도출할 수 있었다. 또한 이를 바탕으로 오늘날 보편적으로 이용되고 있는 SNS 데이터를 활용한 InVEST의 Recreation 평가 모형과 조망점을 활용한 Scenic quality평가 모형간의 차별성과 시범연구로서 가지는 가중치 설정에 대한 한계점을 고찰하였다.

의료기관 경쟁력 향상에 영향을 미치는 핵심 요인 (The Critical Factors on Improvement of Medical institution Competitiveness)

  • 염재광;강창렬
    • 한국병원경영학회지
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    • 제12권1호
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    • pp.1-30
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    • 2007
  • The study carried out a survey with employees of hospitals located in Daejeon, Chungnam, and Chungbuk from Sep. 12 to Sep. 30, 2005 in order to derive primary elements that affect the improvement of hospital's competitiveness. The study investigated and analyzed the employees' recognition on the change of competitive environment caused by the change of medical environment. The study also analyzed the elements that affect the hospital's competitiveness and the competitive strategies of the hospitals. The conclusion of this study can be summarized as follows. 1. Summary 1) Most of the employees responded that there is a rival in the competitive environment and the competitive is intense. Especially when the employees are married, live in urban areas, have an education level of university graduate or are managers, they tend to think the competitive is very intense. Also, they said that the competitive is based upon the quality of medical service. They mentioned the element that has the biggest effect on the competitiveness is the element of medical consumer and they recognized that the medical services in university and general hospitals have more competitiveness than the one-department hospitals. 2) It was investigated that the medical technique service has the most effect on the hospital's competitiveness. Also, the external service of medical techniques also has a large effect on the hospital's competitiveness. 3) When they were asked for the factors that affect the patients' decision on selecting a hospital, most of them responded "capability and technique of the medical staffs." Also, they said that "sufficient explanation from doctors" and "special center and clinic" are the factors that have big effects on the patients' decision. 4) In the SWOT analysis, most of them responded that the strength is the hospital's characteristics and the weakness is insufficient and obsolete equipment. They said the opportunity is the demands for professional medical service and the risk is the intense competitive among the hospitals. 5) In the SWOT strategy, they emphasized the strategy that uses the opportunity and the strength and the strategy that uses the opportunity while overcoming the weakness. 6) As for the basic competition strategy, most of them thought of the strategy of professionalizing the medical service most importantly. Next, they focused on the strategy of distinct service and the strategy of lower prime cost. 2. Conclusion 1) Because service competition between hospitals is happening seriously, need competitiveness security through right awareness transfer and satisfaction upgrade about medical consumer. 2) For medical technique service upgrade that equip Hospital's competitiveness but affects most, must solidify the countermeasure because professionalizing the medical service and newest medical technique induction should be achieved first, and compose task force for the external service of medical techniques improvement. 3) To improve SWOT of hospital, opportunity and the strength strategy choice that rescue hospital's characteristics heightening professionalizing the medical service level is fancied. 4) As for the basic competition strategy, will have to try in phase triangular position of hospital which is trusted medical level upgrade and excellent manpower security and finance independence through upgrade. The study was only done with hospitals in Daejeon, Chungnam and Chungbuk. Also, it is a study from the side of suppliers of medical service so there are limitations. However, the significance of the study is to present the basic data for improvement of hospital's competitiveness by examining the importance of medical techniques and external service of medical techniques that are the main effects on the improvement of hospital's competitiveness.

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정규화LPI와 전단파 속도의 상관관계를 활용한 서울과 경주 지역 액상화 위험도 평가 (Assessment of Liquefaction Potential Using Correlation between Shear Wave Velocity and Normalized LPI on Urban Areas of Seoul and Gyeongju)

  • 송영우;정충기;박가현;김민기
    • 대한토목학회논문집
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    • 제38권2호
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    • pp.357-367
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    • 2018
  • 최근 경주와 포항에서 발생한 지진으로 국내에서 액상화 현상에 대한 관심이 커지고 있다. 지반의 액상화는 포화된 상태에서 지진과 같은 동하중을 받았을 때 과잉간극수압이 발생하여 흙이 강도를 상실하고 물과 같이 거동하는 현상이며 지반 침하와 상부구조물의 전도와 같은 심각한 문제를 야기한다. 따라서 액상화 발생 가능성을 미리 파악하고 대비할 필요가 있다. 액상화의 발생 가능성과 액상화 피해 정도는 일반적으로 액상화 가능 지수(Liquefaction Potential Index, LPI)에 의해 정량적으로 평가된다. LPI의 계산은 시추공 별로 이루어지며 지반응답해석이 필수적인 작업으로 선행되어 많은 시간과 노력이 필요하다. 본 연구에서는 다양한 지하수위 분포를 가지는 넓은 지역의 액상화 평가를 간단히 수행할 수 있도록 전단파 속도와 LPI의 상관관계를 이용한 액상화 평가 방법을 제안하였다. 제안된 방법은 액상화 가능 층의 평균 전단파 속도(${\bar{V}}s^{\prime}liquefiable$)와 액상화 가능 층의 두께로 나누어 정규화한 정규화 LPI의 상관관계를 분석하여 지하수위 별로 다양한 암반노두가속도에 대해 적용 가능한 상관관계식을 제시하고 이용한다. 상관관계를 이용한 액상화 평가 방법의 적용성을 확인하기 위해 서울특별시의 104개 시추조사자료를 이용하여 지하수위 0m, 1m, 2m, 3m에 대해 상관관계식을 제시하였으며 제시한 상관관계식을 이용하여 서울특별시와 경주시의 액상화 발생 가능성을 평가하였다. 지반응답해석을 이용해 계산한 LPI와 상관관계식을 이용해 계산한 LPI를 비교하였으며 제안된 액상화 평가 방법의 적용성을 확인하였다. 마지막으로 제안된 액상화 평가 방법에 따라 결정된 LPI의 분포를 지구통계학적 기법인 크리깅을 통해 지도로 나타내었다.

어패류와 그 제품 섭취양상에 따른 두발중 총수은 및 유기수은 함량 (Mercury Contents of Scalp Hair by Consumption Pattern of Fishes, Shellfishes and its Products)

  • 이원식;김두희
    • Journal of Preventive Medicine and Public Health
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    • 제27권1호
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    • pp.44-58
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    • 1994
  • 어패류 섭취양상에 따른 총수은 및 유기수은의 체내 축적정도를 조사하기 위하여 1991년 6월부터 8월 사이에 경북지방의 해안지역, 도시지역 및 산간지역에서 남자국민학생 115명과 남자 성인 131명, 총 246명의 두발중 총수은 및 유기수은 함량을 수은분석장치 (Model IL 440)를 갖춘 원자흡광분광광도계 (Model IL 551)로 선택적 환원기화법에 의해 분석하였다. 학생군의 경우 생선 및 조개류와 생선통조림 및 어묵류를 선호하는 군의 두발중 총수은(각각 7.728ppm, 6.969ppm) 및 유기수은 함량(각각 6.610ppm, 5.885ppm)이 육류(총수은; 4.822ppm, 유기수은; 3.905ppm)나 야채류(총수은; 3.974ppm, 유기수은; 3.224 ppm)를 선호하는 집단보다 현저히 높았다(각각 p<0.01). 생선통조림을 먹는 방법에 따른 두발중 총수은 및 유기수은 함량은 그대로 먹는 경우가 야채사라다와 섞어서 또는 찌개로 먹는 경우보다 높게 나타났다(p<0.01). 생선통조림, 생선 조리반찬 및 생선회 섭취빈도가 많을 수록 두발중 총수은과 유기수은 함량이 많아 거의 매일 먹는 군이 거의 먹지 않는 군에 비해 2배 이상 높게 나타났으며(p<0.01), 생선을 주로 먹는 방법에 따라서는 회로 먹는 경우가 탕이나 구워서 먹는 경우 보다 현저히 높았다(p<0.01). 성인군의 경우 연령에 따른 두발중 수은 함량은 총수은과 유기수은 함량 모두 40대까지는 연령증가에 따라 증가했으나, 50대 이후는 약간 감소하였다. 직업별로는 어업 및 횟집 종사자가 농부에 비해 2배 이상 높았다. 또한 선호반찬 종류에 따라서는 생선 및 조개류를 선호하는 군이 가장 높았으며, 생선을 먹는 방법에 따른 두발중 수은 함량은 회로 먹는 군이 탕이나 구워서 먹는 군보다 2배 이상 높은 수준을 나타내었다. 생선회, 생선조리반찬 섭취빈도에 따른 두발중 총수은 및 유기수은 함량은 섭취빈도가 증가함에 따라 높아지는 경향을 보였다(각각 p<0.01). 이상의 결과로 보아 두발중 수은 함량은 어패류와 생선통조림의 섭취 빈도가 높을 수록 증가하였으나 중독증상을 나타낼 수 있는 농도에는 크게 못 미쳤다.

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한국인(韓國人)의 연령(年齡) 및 신장별(身長別)에 따른 표준체격치(標準體格値)에 관(關)한 연구(硏究) -7세(歲)부터 20세(歲)까지의 남여(男女)를 중심(中心)으로- (Studies on Standard Physical Growth and Development by Age and Body Height in Korean Youth)

  • 안광태;박순영;박양원
    • Journal of Preventive Medicine and Public Health
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    • 제17권1호
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    • pp.145-172
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    • 1984
  • In order to assess the physical growth pattern of Korean Youth, the authors measured the body height, body weight, chestgirth and sitting height of 40967 persons (24832 males and 16135 females) from primary schools, middle and high schools and colleges of metropolitan (urban) and rural areas, and calculated the mene, standard deviation, standard error and coefficient variance of the body weight chestgirth, sitting height and various pertinent index by body height to demonstrate the standard physical growth and development by body height of sex and age. The following conclusions were obtained. 1. Physical growth and development: Rapid growth of physical growth in terms of body height has been observed among males in the age $7{\sim}15$ and among female $7{\sim}13$. Growth in terms of body height turned out to be slower among students of higher age by both sexes. The age of cross over between to sexes is between 10 to 13 years where upon girls out grows boys. Maximum annual growth were upon girls out grows boys. Maximum annual growth were both of 6.16cm from 8 to 9 years old and 12 to 13 years old for boys and 7.2cm from 8 to 9 and 6.1cm from 9 to 10 for girls. This indicates that girls enter a rapidly growing stage 2 years earlier than boys. Meanwhile, prominent improvement in body height of national students over period of ten year was noticed. 2. The distribution status of body height by age: The distribution status of body height by age were as follows; 7 year of age: boys-30cm range of body height from 104.0cm to 133.9cm, girls-27cm from 104.0cm to 130.9cm 8 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 9 year of age: boys-30cm from 116.0 to 145.9cm girls-33cm from 113.0 to 145.9cm 10 year of age: boys-39cm from 116.0 to 154.9cm girls-39cm from 119.0 to 157.9cm 11 year of age: boys-45cm from 119.0 to 163.9cm girls-39cm from 122.0 to 160.9cm 12 year of age: boys-45cm from 125.0 to 169.9cm girls-42cm from 125.0 to 166.9cm 13 year of age: boys-45cm from 128.0 to 172.9cm girls-42cm from 128.0 to 169.9cm 14 year of age: boys-48cm from 131.0 to 178.9cm girls-36cm from 134.0 to 169.9cm 15 year of age: boys-42cm from 137.0 to 181.9cm girls-33cm from 137.0 to 169.9cm 16 year of age: boys-39cm from 146.0 to 184.9cm girls-30cm from 143.0 to 172.9cm 17 year of age: boys-39cm from 146.0 to 184.9cm girls-27cm from 143.0 to 169.9cm 18 year of age: boys-36cm from 152.0 to 187.9cm girls-27cm from 146.0 to 172.9cm 19 year of age: boys-30cm from 155.0 to 184.9cm girls-24cm from 146.0 to 169.9cm 20 year of age: boys-24cm from 158.0 to 181.9cm girls-l8cm from 149.0 to 166.9cm 3. Standard values of body weight, chest-girth and sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from3-a to 16-a. 4. Standard values of relative body weight, relative chestgirth and relative sitting height by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-b to 16-b. 5. Standard values of physical and nutritional indices (Rohrer index, Kaup index, Vervaeck index and Pelidisi index) by body height of age were found all age groups from 7 to 20 years old and listed in tables from 3-c to 16-c.

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건물일체형 패널형 벽면녹화 식재기반 유형별 건물에너지 성능 분석 (Analysis of Building Energy Reduction Effect based on the Green Wall Planting Foundation Type Using a Simulation Program)

  • 김정호;권기욱;윤용한
    • 한국환경생태학회지
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    • 제29권6호
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    • pp.936-946
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    • 2015
  • 본 연구는 도심의 열환경 개선 및 건물에너지저감 효과가 입증된 벽면녹화 중 기존 건물에 적용 가능한 패널형 벽면녹화 식재기반 유형에 따른 건물에너지 저감 성능을 분석하고자 하였다. 식재기반 유형은 총 4가지 유형으로 하였으며, Case A는 벽면녹화가 미적용된 유형으로 콘크리트 + 단열재로 구성하였다. Case B는 식재층 + 무기다공성블록 + 콘크리트 + 단열재로 구성하였으며, Case C는 식재층 + 코코피트블록 + 콘크리트 + 단열재로 구성하였다. Case D는 식재층 + 마사토블록 + 콘크리트 + 단열재로 구성하였다. 분석항목으로는 열전도율, 열관류율, 건물에너지시뮬레이션을 실시하였다. 식재기반 유형별 열전도율은 Case C(0.053W/mK) > Case B(0.1W/mK) > Case D(0.17W/mK)의 순이었다. 에너지시뮬레이션 결과 중 단위면적당 냉방피크부하저감은 미적용인 Case A 대비 Case C(1.19%) > Case B(1.14%) > Case D(1.01%)이며, 난방피크부하저감은 Case A 대비 Case C(2.38%) > Case B(1.82%) > case D(1.50%)로 산정되었다. 연간 냉 난방부하저감은 미적용 Case A대비 벽면녹화 유형에서 0.92~1.28% 저감률을 나타내었다. 연간 냉난방에너지사용량은 3.04~3.22%의 저감률을 보였으며, 1차에너지사용량은 Case A대비 나머지 유형에서 평균 5,844 kWh/yr의 저감량을 보였다. 연간 이산화탄소발생량은 벽면녹화 미적용 Case A대비 평균 996kg 저감량을 보였다. 식재위치별 에너지성능평가 결과 동향 > 서향 > 남향 > 북향 순이었다. 벽면녹화비율에 따른 에너지성능평가 결과 녹화 비율이 높아짐에 따라 양호한 결과를 나타내었으며, 20~80%의 비율보다 100% 녹화시 약 2배의 저감률을 보였다.

불리(不利)한 환경(環境)의 학령전(學齡前) 아동(兒童)을 위한 보상교육(補償敎育)에 관(關)한 연구(硏究) - 미국(美國) 및 일본(日本)의 보상교육(補償敎育)·프로그램을 중심(中心)으로 - (A Study on the Compensatory Education for the Disadvantaged Children in Preschool Age (Focussed on the Programs of Compensatory Education in the U.S.A. and Japan))

  • 정영숙;이희자
    • 아동학회지
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    • 제1권
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    • pp.65-81
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    • 1980
  • This study is aimed at investigating the compensatory education which was already implemented or is being implemented in the U.S.A. and Japan; and at studying the types of programs and their characteristics; and at sounding out the possibilities of the application of such programs in family and social conditions is Korea. In order to achieve the above mentioned objectives, the established items for the study are as follows: (1) Various types of early children's education (2) Programs of compensatory education for the disadvantaged Children (3) Head Start Program, Early Training Project and Montessori School (4) Integrated Preschool Programs (5) Day-Care Center for employed mothers We investigated the various compensatory education programs for the preschool children who are in economically, socially, culturally disadvantaged conditions. Head Start Programs were federally supported programs for preschool children and opened as summer programs in 1965 for the first time. The purpose of Head Start has been to give preschool children the kinds of experiences they need in preparation for school. The Head Start children were found to be significantly better prepared for school than the normal children. However, after six to eight months, their initial advantages had virtually. disappeared and then the simple problem with Head Start and other such programs was that little long-term good could be evidenced unless the high quality educational environment was maintained. Therefore, to solve this problem, three other programs were funded as part of the overall Head Start. These three programs are the Parent-Child Center, Home Start, and the Child and Family Resources Program. The Early Training Project for disadvantaged children was implemented by Klaus and Gray of Peabody College in 1962. The program was a field research study concerned with the development and testing over time of procedures for improving the educability of young children from low income homes. Its major concern was to study whether it was possible to offset the progressive retardation observed in the public schooling careers of children, living in deprived circumstances. Children, who were trained through the Early Training Project were superior to control groups in the test of IQ and vocabulary as well as linguistic abilities, and preparation for reading. This project showed the possibilities which could prevent preschool children from being disadvantaged socially, culturally and mentally. In 1907, Montessori School was established by Maria Montessori in Italy and her school program has been introduced at present to several countries in the world as one compensatory educations. She first began her experimental methods with retarded children, followed by disadvantaged children from the tenements of Rome. The Montessori approach futures a prepared environment and carefully designed, self-correcting materials. The Montessori curriculum presents tastes that feature sequence, order, and regularity, in addition to those that develop motor and sensory skills. She was interested in children's intellectual development and in developing good work habits. One of the latest developed programs for disadvantaged children is "Integrated Preschool Program" which has successfully integrated handicapped and nonhandicapped children. Several studies have showed that handicapped children in integrated school environments are accepted by and interact with their nonhandicapped peers. In fact, this program provides a number of potential, and perhaps opportunities for nonhandicapped children to serve as valuable resources in fostering the development of their handicapped peers. Next we turn to Japanese programs which are divided into two different types. One is Day-Care Center which was established by Child Welfare Law and the other is kindergarten organized by School Education Law. The kindergarten opened in 1876 and it has been part of school systems since 1947 by the implementation of education law, and the Day-Care Center which started in 1890 for the employed mothers. was changed into Day-Nursery by the enactment of child welfare law in 1947. The laws and operational regulations for the Day-Nursery were set up and were put in effect by the establishment standard acts of children welfare facilities, and the Day-Nursery has been operated in various types by the increasing demand, chiefly because of the socio-economical changes of family structures in both urban and suburban areas. Nursery education for physically and mentally disadvantaged children is for those who are blind, deaf and dumb, mentally retarded; physically disadvantaged by accidents or diseases. Montessori education in Japan was started in 1968 and many research groups for studying Montessori were organized. In 1977, Montessori remedial education society was also organized in which they started a number of studies; a study for developing materials; in-service training for the remedial education; and seminars and lectures, etc It is strongly suggested that we study the early educations that are being implemented in Japan and a variety of compensatory educations that were already implemented in the U.S.A. and modify them for the organization of our own model and properly accommodate them to our social needs.

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소규모 사업장 보건관리대행기관의 간호업무 운영관리 지원체계 (Management and Supporting System on the Occupational Health Nursing Services Provided in Group Occupational Health Agencies of Korea)

  • 유경혜
    • 한국직업건강간호학회지
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    • 제8권2호
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    • pp.193-211
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    • 1999
  • This study was carried out to investigate the management and support system affecting to the occupational health nursing services(OHNS) provided in group occupational health agencies(GOHA). Questionnaire was developed and distributed to 82 nurses who were working in GOHA and who agreed to participate in the survey. The results were as follow: 1. OH nurses responded were mostly in the age of twenty to thirties(89%), married(73.7%), technical college graduates(88.9%), worked in hospital(85.4%) and participated more than 1 year in group occupational health services (96.3%). 2. Fifty eight point four percent of the OH nurses worked in number of workplace more than 30 to less than 60 in the OHNS form. The figure of workplaces undertaken by nurses was ranged greatly from 9 to more than 100. Number of employees who cared by nurses were mostly under 5,000 peoples in 93.3%. The types of industry was mostly manufacturing and located in the order of factory complex area, suburban, urban and others. 3. Most OH nurses(87.8%) were fully involved in the OHNS for the SSE. Their working days to visit SSE was 5 days per week(77.8%) and one day in the GOHA at 41.3%. 4. The OH documents using by nurses were found in more than 23 different types. However, they were largely summarized in the types of 'Workplace Health Management Card', 'Personal Health Counselling Card', 'Daily Health Management Report', 'Visiting List of Workplace' and 'Sick Employee List'. 5. The items of laboratory test provided by GOHA were mostly achieved in the purpose of basic health examination. They were used to be the blood pressure check(98.8%), blood sugar test (98.8%), urine sugar and protein(91.4%), SGOT and SGPT(85.3% each), cholesterol (82.9%), hepa vaccine immunization(82.9%), r-GPT(81.7%), hemoglobin(79.3%) and triglyceride(75.5%). 6. The OH nurses(92.7%) followed the work pattern to visit the GOHA before and after small-scale enterprises(SSE) visit by car driven by nurses in 74.3%. They were payed by GOHA for transportation fees in certain amounts. However, nurse is the main person(75.0%) who covers up in case of traffic accident. If the GOHA has no transportation regulation for the formal workplace visit, data showed that nurses had been responsible to take charge(31.7%). 7. The personnel manager who takes in charge for nursing services was 'nurse' in 61.7% and 41.2% worked as the final decision maker related to nursing work. The OH nurses' opinions about factors affecting to the management were classified in the four areas such as 'Nature(Quality) of health professional'. 'Content of OHNS', 'Delivery system of the GOHS', and 'Others'. The factors were indicated highly in 'Authority as health professional', 'Level of perception of director on the OH' and 'Physical work condition for OHNS'. The things that this study suggests in the recommendation would be summarized in such as the management and supporting system working for SSE in the OHNS is necessary to reform thoroughly. The reconsidered aspects might be in the matters of number of workplaces undertaken by nurses, development of effectively practical health documents, preparation for guideline of the laboratory test in the workpleces, establishment of convenient and encouraging support system and cooperation between other health professionals with respect and skill.

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