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      • KCI등재

        보건의료 통상과 코로나19 사태: 현황과 쟁점

        김나영,안덕근 서울대학교 국제학연구소 2020 국제지역연구 Vol.29 No.2

        The COVID-19 incident highlighted the deep interconnection between domestic healthcare systems, as well as the need for digitalization in the healthcare industry. As the world healthcare market continues to grow and development in transportation has led to repetitive occurrences of pandemics, joint response and joint liability are becoming vital in public health. This paper calls attention to the overall context and importance of healthcare trade in the international trade system, examining the core issues in each related subsectors. The need to maintain good balance between economic and public health incentives has brought WTO, WHO, and WIPO together in international rule-making efforts, and overall tariffs are low as most countries highly depend on trade for domestic healthcare purposes. On the other hand, import/export licensing procedures and trade restrictions are becoming serious trade-barriers and higher cooperation is also needed in standard-development that will alleviate such non-tariff barriers. With the evolving healthcare environment, Korea must adjust its trade policies so as to improve potential global competitiveness, by enhancing openness, providing an investment-friendly environment to improve domestic production and technology capabilities, and implementing a more effective subsidy policy. 코로나 19사태는 세계 보건의료체제의 상호연관성을 부각시키고 디지털 의료의 필요성을 더욱실감하게 하였다. 각국 의료시스템 운영성과를 정부 책임으로 간주하여 국제통상체제 발전과정에서보건의료 분야를 사실상 논외로 다루어 온 과거와 달리, 최근 가속화되는 인구고령화와 글로벌 공급망 확대는 의료교역의 현저한 성장을 초래했고 교통기술의 발달로 반복되는 팬데믹은 국가들의공동대응 및 공동책임의 논리에 더욱더 힘을 실어준다. 본 논문은 그간 국제통상체제에서 본격적으로 다루지 못하던 보건의료 통상의 전반적인 맥락과 중요성을 환기하고, 분야별 핵심 쟁점을 검토해본다. 보건의료는 경제적 논리와 공중보건 목표가 양립해야 하는 만큼 WTO, WHO, WIPO가 함께 관련 공조와 규범을 담당하고 있으며, 각국의 필요 하에 전반적으로 낮은 관세를 유지하는 추세이다. 국가들이 의료기기, 의약품, 의료서비스 부문의 생산기술 및 인프라 측면에서 현저한 차이를보여 무역의존도가 상당히 높기 때문이다. 반면 수출입시 인허가 절차와 수출입 제한 조치가 대표적인 비관세 무역장벽으로 부각되고 있고, 또 디지털 의료분야의 성장에 따라 표준 개발을 통한 국가간 협력이 요구된다. 이렇듯 변화하는 보건의료 환경에 따라 그 동안 보수적으로 유지되던 한국의 의료통상 정책은 지속적으로 도전 받고 있다. 한미FTA 체결이나 세계 의료무역 확대 및 디지털의료 발전과 같은 변화 속에서 향후 세계 의료시장에서의 경쟁 역량을 키우고 보건위기 대응에 협조하기 위해서 한국은 보건의료산업 개방성을 진전시키고 국내 생산 및 기술 역량 제고를 위한 투자환경을 조성함은 물론, 관련 보조금정책을 효과적으로 기획 및 시행해야 한다.

      • KCI등재

        시각적 발작: 비케톤성 고혈당증에 의해 나타나는 가역적 합병증

        김나영,박민수 대한내분비학회 2012 Endocrinology and metabolism Vol.27 No.2

        A 65-year-old man with diabetes mellitus was presented with left visual aura, followed by a versive seizure, each lasting approximately 3 minutes. Neurological examination showed an intermittent left homonymous hemianopsia. Brain magnetic resonance imaging (MRI) showed right occipital lobe lesion, with cytotoxic edema. Blood glucose was 593 mg/dL and serum osmolarity was 309 mOsm/kg. The seizures were controlled by normalization of blood sugar and short-term anticonvulsant, and the lesions were resolved in a follow-up MRI. We report a case of visual seizures associated with non-ketotic hyperglycemia

      • KCI등재

        공용 공간의 접근성을 고려한 대학 기숙사 공실 배정에 관한 연구: A대학교를 중심으로

        김나영,이진호 한국산학기술학회 2020 한국산학기술학회논문지 Vol.21 No.1

        본 논문에서는 대학 기숙사에서 이용 빈도가 높은 특정 공용 공간의 접근성을 높이기 위한 공실 배정에 대해 고려한다. 접근성 향상을 위하여, 학년에 따른 이용 빈도의 차이를 반영하여 학생들의 개인 공실에서 특정 공용 공간까지의 총 이동거리를 최소화하는 정수계획법 모델을 제시한다. 또한 각 공실의 최대 허용 인원을 제한하고 하나의 공실에는 같은 학년으로만 배정되도록 제약하였으며, 제시된 모델은 공급사슬관리에서 다루는 입지 선정 문제와 유사함을 보여준다. 사례 연구를 위하여 제시된 정수계획법 모델을 A대학교 기숙사에 적용하여, 소규모 그룹에 대한 공실 배정 결과를 도출하였으며, 특정 공용 격실을 이용하는 횟수가 많은 저학년 학생일수록 접근성을 고려하여 가까운 곳에 배정되었음을 확인하였다. 추가적으로 고학년부터 공실 배정에 대한 우선순위를 부여할 경우, 저학년이 우선적으로 배정될 때 벌과비용을 목적함수에 추가함으로써 이를 방지하도록 하는 모델을 제시하였다. 이러한 결과를 바탕으로 여러 공용 공간에 대한 학생들의 복합적인 요구들에 부합하도록 공실을 배정하는 방안을 제시할 수 있다. This study examines room assignments to improve accessibility in a university dormitory depending on the student grade, taking into account frequency of using a certain common space. An integer programming model is presented to minimize the total moving distance from the common space to the students' rooms for accessibility. The model also constrains the maximum capacity of a room, and disallows different grade students to be assigned to the same room. This model is similar to a facility location problem used widely in the supply chain management field. Applying our optimization model to a small group at the dormitory of Unversity A as the case study, our results indicate that lower grade students are assigned rooms closer to the common space due to their higher frequency of using that space to guarantee high accessibility. Moreover, if higher grade students are prioritized to select their rooms, we suggest an objective function that imposes a penalty in cases when lower grade students select rooms with priority. Based on the results obtained, we propose assigning rooms to students in a dormitory by considering their complex requirements and convenience to use the common space.

      • KCI등재

        The Effects of Online Planning on CAF in L2 Spoken and Written Performance

        김나영 한국영어교육학회 2018 ENGLISH TEACHING(영어교육) Vol.73 No.3

        The purpose of this study is to investigate the effects of no planning and online planning on complexity, accuracy, and fluency (CAF) in L2 spoken and written tasks. The study was designed into 2x2 with two independent variables: planning conditions (no planning and online planning) and task modality (speaking and writing). First, 80 Korean EFL undergraduates performed two tasks in a laboratory setting: a proficiency-assigning narrative spoken task and a randomly assigned main task. The main task had four different conditions: no planning in speaking, online planning in speaking, no planning in writing, and online planning in writing. The participants’ spoken and written performances were measured and analyzed for syntactic complexity, accuracy, and fluency. The findings demonstrated that the no planning (NP) group improved accuracy and fluency significantly more than the online planning (OP) group in the spoken task and that the NP group improved their fluency more than the OP group in the written task. Additionally, in both planning conditions, the written task increased accuracy more than the spoken task, whereas the spoken task increased fluency more than the written task. It is hoped that these findings will facilitate understanding of the supportive role of planning in task manipulation in terms of L2 learners’ limited attentional resources and its relationship with linguistic performance.

      • KCI등재후보

        Aggressive Glucose Control for Acute Ischemic Stroke Patients by Insulin Infusion

        김나영,장윤숙,박종무,김병건,권오현,이정주,이지성,구자성 대한신경과학회 2009 Journal of Clinical Neurology Vol.5 No.4

        Background and Purpose Hyperglycemia after acute ischemic stroke (AIS) is associated with poor outcomes. However, there is no consensus as to the optimal method for glycemic control. We designed an insulin infusion protocol for aggressive glucose control and investigated its efficacy and safety. Methods We applied our protocol to patients within 48 hours after AIS or transient ischemic attack (TIA) with an initial capillary glucose level of between 100 and 399 mg/dL (5.6-22.2 mmol/L). An insulin solution comprising 40 or 50 U of human regular insulin in 500 mL of 5% dextrose was administered for 24 hours. Capillary glucose was measured every 2 hours and the infusion rate was adjusted according to a nomogram with a target range of 80-129 mg/dL (4.4- 7.2 mmol/L). Changes in glucose and overall glucose levels during insulin infusion were analyzed according to the presence of diabetes or admission hyperglycemia (admission glucose >139 mg/dL or 7.7 mmol/L) by the generalized estimating equation method. Results The study cohort comprised 115 consecutive patients. Glucose was significantly lowered from 160±57 mg/dL (8.9±3.2 mmol/L) at admission to 93±28 mg/dL (5.2±1.6 mmol/L) during insulin infusion (p<0.05). Laboratory hypoglycemia (capillary glucose <80 mg/dL or 4.4 mmol/L) occurred in 91 (71%) patients, 11 (10%) of whom had symptomatic hypoglycemia. Although glucose levels were significantly lowered and maintained within the target range in all patients, overall glucose levels were significantly higher in patients with diabetes or hyperglycemia (p<0.05). Conclusions Our insulin-infusion protocol was effective in glycemic control for patients with AIS or TIA. Further modification is needed to improve the efficacy and safety of this procedure, and tailored intervention should be considered according to glycemic status.

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