A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea

Yong Sung Choi,정성훈,김은선,Eun Sun Kim,Eunhee Lee,Euiseok Jung,So-Yeon Lee,이우령,Hye Sun Yoon,Yong Joo Kim,Ji Kyoung Park,Son Moon Shin,Ellen Ai-Rhan Kim 대한신생아학회 2022 Neonatal medicine Vol.29 No.1

Purpose: Pediatricians have a significant responsibility to educate mothers about the importance of breastfeeding. However, there have been minimal efforts in the courses of resident training in Korea. The purpose of this study is to evaluate the change in knowledge and attitude before and after a 4-week breastfeeding educational intervention among multicenter residents. Methods: Prospective interventional educational research was designed for residents at eight training hospitals in Korea. Institutional reviews were obtained in each hospital. The education curriculum consisted of 14 courses regarding breastfeeding theory and practice. These materials were used to teach pediatric residents for 4 weeks. Knowledge-based tests were administered before the course, and re-tests were administered after the course using different test items of similar levels. Test scores and survey responses were compared before and after the intervention. Results: A total of 73 residents (1st year 20, 2nd year 23, 3rd year 16, and 4th year residents 14) from eight training hospitals completed the intervention. Their average age was 30.3±2.9 years, 17 (23.3%) were male, 22 (30.1%) were married, and eight had more than one child of their own. The mean pre-test score was 61.8±13.4 and the mean post-test score was 78.3±7.5 (P<0.001). The inter-grade difference in the score was significant in the pre-test (P=0.005), but not significant in the post-test (P=0.155). There were more responses of obtaining confidence after the intervention (P<0.001). Conclusion: In our study, pediatric residents showed improvement in their knowledge and confidence level after 4 weeks of the breastfeeding curriculum. This will provide a basis for future policymaking in the training of pediatric residents regarding breastfeedReceived: 6 January 2022 Revised: 15 February 2022 Accepted: 15 February 2022 Correspondence to: Ellen Ai-Rhan Kim, MD Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-3390 Fax: +82-2-3010-6978 E-mail: arkim@amc.seoul.kr A Multi-Center Educational Research Regarding Breastfeeding for Pediatrics Residents in Korea Yong-Sung Choi, MD,PhD1, Sung-Hoon Chung, MD, PhD2, Eun Sun Kim, MD, PhD3, Eun Hee Lee, MD4, Euiseok Jung, MD5, So Yeon Lee, MD, PhD5, Wooryoung Lee, MD6, Hye Sun Yoon, MD, PhD7, Yong Joo Kim, MD, PhD8, Ji Kyoung Park, MD, PhD9, Son Moon Shin, MD, PhD9, and Ellen Ai-Rhan Kim, MD, PhD5 1Department of Pediatrics, Kyung Hee University Hospital, Seoul, Korea 2Department of Pediatrics, Kyung Hee University Hospital at Gangdong, Seoul, Korea 3Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea 4Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea 5Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea 6Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea 7Department of Pediatrics, Nowon Eulji Medical Center, Eulji University, Seoul, Korea 8Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Korea 9Department of Pediatrics, Inje University Busan Paik Hospital, Busan, Korea Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 pISSN 2287-9412 . eISSN 2287-9803 Copyright(c) 2022 By Korean Society of Neonatology This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Original Article 29 Neonatal Med 2022 February;29(1):28-35 https://doi.org/10.5385/nm.2022.29.1.28 ing in Korea.

해양공간 정책시뮬레이션 기술 개발 - 현황 및 도전과제

조성진(Sung-Jin Cho),강전영(Jeon-Young Kang),박재영(Jaeyoung Park),최희정(Hee-Jung Choi),남정호(Jungho Nam) 한국해양환경·에너지학회 2021 한국해양환경·에너지학회 학술대회논문집 Vol.2021 No.5

“실제로 존재하지 않는 대상을 존재하는 것처럼 만들어 놓은 인공물"을 뜻하는 라틴어 '시뮬라크르(simulacre)'에서 파생된 시뮬레이션(simulation)은, 복잡한 문제를 해석하기 위해서 실제와 비슷한 상태(시스템)를 모델로서 구현하고, 반복 연산을 통해 최적해를 찾는 과정을 뜻한다(Baudrillard, 1994). 전통적인 분석적 방법론(analytical method)은 계수 추정을 통해서 특정 시점의 두 변수, 즉 독립변수와 종속변수의 상관성을 규명하는데 반해, 시뮬레이션 방법론(simulation method)은 현상의 재현을 통해서 과정을 파악하는데 목적을 둔다. 이러한 특징으로 말미암아 시뮬레이션 기법은 문제의 최적해보다 현상의 규명에 더 적합한 방법론이다. 자연계 (nature system)의 문제(가령, 산사태의 발생원인)는 요인들 간 단순하고 명확한 관계에 의해서 정의되지만, 인간계(human system)의 문제(가령, 부동산 가격상승의 원인)는 비교적 복잡하고 불명확한 관계에 의해서 규정된다. 따라서 주로 인간관계에서 비롯되는 사회 문제를 해결하기 위한 수단으로써 정책은 시뮬레이션 기술을 적용하기에 적합한 대상이다. 일반적으로 정책은 결과 못지않게 과정도 중요하며(당위성), 현재·미래 문제를 포괄하고, 긍정적·부정적 효과(양면성)를 함께 고려하므로, 시뮬레이션은 이러한 요건에 잘 부합하는 기술이다. 최근 노인복지(백의현, 2019), 미세먼지(심창섭, 2019), 주택시장(최명섭&변세일, 2016), 인구센서스(배장현 외, 2016) 등 다양한 정책분야에서 시뮬레이션 기술이 활용되고 있다. 2019년에 재정된 “해양공간계획 및 관리에 관한 법률”에 근거한 해양공간기본·관리계획, 해양용도구역, 해양공간적합성협의 등은 해양자원의 효율적 이용과 해양공간의 갈등 및 상충을 해소하기 위한 해양수산 분야의 新정책수단이다. 최근 해양관광, 골재채취, 해상풍력, 해상경계분쟁 등 사회적 이용 및 갈등이 심화되면서 실효성 있는 해양공간정책의 요구가 높아지고 있는 실정으로, 해양정책을 정확하게 평가하고 지원할 수 있는 과학적 도구가 절실하다. 해양공간은 환경·생태계, 지역사회, 수산업, 관광업, 에너지개발 등 복잡한 이해관계가 얽혀 있으며, 정책평가 시 이러한 관계를 명확하게 정의하고 고려해야 한다. 본 연구는 해양공간정책 지원도구로써 해양정책시뮬레이터(Ocean Policy Simulator, OPSim)를 제안하며, 대표적인 복잡계 연구방법론으로서 거시적 현상을 미시적 행위자의 상호작용으로 설명하기 위해 제안된 행위자기반모형(Agent-Based Model, ABM)을 적용하고자 한다. ABM은 정책 대상 및 환경의 동적 변화와 더불어, 자연·인문 환경과의 상호작용(상충 또는 시너지)이 활발한 해양 분야에 적합한 방법이지만, 동시에 시뮬레이션 결과에 대한 검증의 어려움과 모델 인자의 초기값에 대한 의존성 등 한계점을 내포하고 있다. 따라서 ABM을 적용한 OPSim 개발 과정에서 빅 데이터를 활용한 AI기술, 자가진화 시뮬레이션 기법(self-evolving simulation), 시스템다이나믹스(system dynamics) 등을 활용하여 한계점을 보완할 수 있다(Scheutz et al., 2016; Kang et al., 2016; Bae et al., 2018; Kavak et al., 2018). Simulation derived from the Latin word "simulacre" for "artificial objects that actually do not exist" means the process of modeling a realistic state (system) to interpret complex problems and finding an optimal solution through repeated operations (Baudrillard, 1994). While a traditional analytical method defines the correlation of two variables (i.e., independent variables and dependent variables) through coefficient estimation, a simulation method aims to identify the process through the reproduction of phenomena. Therefore, a simulation technique is a more suitable methodology for identifying phenomena rather than finding an optimal solution. The problem of the natural system (e.g. landslides) is defined by simple and clear relationships between factors, but that of the human system (e.g. real estate prices) is defined by relatively complex and unclear relationships. Therefore, a policy as a means of solving social problems, primarily derived from human relationships, is suitable for applying a simulation technique. Simulation is a technology that meets these requirements well, as a policy addresses the procedure as important as the result, solving current and future problems, and considering both positive and negative effects. Recently, simulation technology has been used in various policy areas such as welfare for senior citizens (Baek, 2019), fine dust (Shim, 2019), housing market (Choi&Byun, 2016), and population census (Bae et al, 2016). Marine space policies based on the Marine Space Planning and Management Act, which was enacted in 2019, such as marine spatial basic and management plans, marine use zones, and marine space suitability consultations are new political tools for efficient use of marine resources and management of conflicts. As social use and conflicts such as maritime tourism, aggregate collection, off-shore wind power, and maritime border disputes have intensified recently, calls for effective marine spatial policies are increasing, and scientific tools are urgently needed to accurately evaluate marine policies. Since marine space is intertwined with complex interests such as the environment, ecosystem, community, fisheries, tourism, and energy development, a marine spatial policy support tool should define and consider these relationships for policy evaluation. This paper proposes Ocean Policy Simulator (OPSim) as a support tool for marine spatial policy. Specifically, we aim to highlight the usefulness of an agent-based model (ABM) to explore human-nature interactions (i.e., conflict or synergy) and to provide policy implications. Using an ABM for such purposes often meet the issues in regard to verification and validation of the model’s structures and outcomes. However, AI technology using spatiotemporal bigdata, self-evolution simulation techniques, and system dynamics can help to tackle validation and verification procedures in the development process of OPSim using ABM (Scheutz et al., 2016; Kang et al., 2016; Bae et al., 2018; Kavak et al., 2018).

실측유량을 이용한 중랑천 갈수량 산정

권필상 ( Phil Sang Kwon ),신종규 ( Jong Kyu Shin ),조용철 ( Yong Chul Cho ),최경완 ( Kyung Wan Choi ),정우석 ( Woo Seok Jung ),이형진 ( Hyoung Jin Lee ),박수영 ( Soo Young Park ),류덕희 ( Duk Hee Ryoo ) 한국물환경학회 ( 구 한국수질보전학회 ) 2010 공동 추계학술발표회 Vol.2010 No.-

강원,경북지역 낙엽송 지위지수 적합성 평가에 관한 연구

이대성 ( Dae Sung Lee ),이의섭 ( Eui Sub Lee ),최종현 ( Jong Hyun Choi ),서영완 ( Yeong Wan Seo ),최정기 ( Jung Kee Choi1 ) 한국임학회 2014 산림과학 공동학술대회 논문집 Vol.2014 No.-

본 연구는 강원 및 경북지역의 낙엽송 지위지수의 적합도를 평가하기 위해 실시되었다. 연구자료는 강원 및 경북지역의 45개 낙엽송 인공림 표준지 조사로부터 우세목 1본을 선발하여 수간석 해를 통해 분석되었다. 산림청에서 개발된 지위지수표에 의거하여 본 연구대상지의 지위지수를 산정한 결과, 지위지수가 18 이하로 낮은 지역은 8곳(18%)이었으며, 지위지수가 20 이상으로 우수한 지역이 37곳(82%)으로서 대부분 지역에서 지위지수가 우세하였다. 지위지수곡선의 적합도를 평가하기위해 수간석해목의 과거에서 현재까지의 수고생장에 따른 지위지수의 변화를 도시한 결과, 초기 임령 때 지위지수와 차이가 없는 곳은 단지 8지역(18%)이었으며, 지위지수가 2∼4 m 차이가 발생한 지역이 19곳(42%), 6 m 이상 발생한 지역이 18곳(40%)으로 나타났다. This study was performed to evaluate the compatibility of site index for Larix kaempferi in Gangwon and Kyeongbuk regions. The data were collected and analyzed from stem alalysis of one dominant tree at each of 45 permanent plots installed in the regions. The result of site index estimation following the site index table developed by Korean Forest Service (KFS) showed that 8 plots (18%) were less than site index 18 and 37 plot (82%) greater than site index 20. Height growth changes of stemmed trees until present were illustrated in a graphic form to evaluate the compatibility of site index curve. The result showed that only 8 plots (18%) did not show any change of site index as trees age, 19 plots (42%) fluctuated in 2∼4m and 18 plots (40%) over 6m.

김정은 체제의 ‘강성국가’ 건설 전략과 전망 : ‘지식경제강국’을 중심으로

변상정(Byun, Sang Jung),최경희(Choi, Kyong Hui) 연세대학교 동서문제연구원 2012 동서연구 Vol.24 No.2

북한은 금년 공동사설에서 김정일이 1998년에 주장했던 ‘강성대국’ 건설 목표 중 미완의 ‘경제강 국’을 대체 계승하는 김정은 시대의 비전을 제시했다. 김일성의 주체사상으로 ‘정치(사상)강국’이 실현되고 김정일의 핵 보유로 ‘군사강국’이 완성되었으므로 김정은은 ‘새 세기 산업혁명’을 통한 ‘지식경제강국’ 건설을 선언한 것이다. ‘기계공업의 CNC화’로 상징되는 김정은의 ‘최첨단 돌파사 상’과 ‘지식경제강국 건설론’은 김정일 체제 출범시 제시되었던 ‘과학기술중시사상’과 ‘강성대국 건설론’을 계승한 것이다. 연하기계종합공장의 CNC기술 개발과 전 산업에의 CNC 도입은 ‘함남의 불길’과 함께 북한 사회 전체에 CNC화 도미노 현상이 확산되는 분위기를 만들고 있다. 김정 은의 ‘지식경제강국’은 북한의 정치체제와 경제구조의 근간을 훼손하지 않으면서 경제를 재건하기 위한 대안으로 제시된 것으로, 그 본질은 개방보다는 폐쇄적 ‘자력갱생’을 전제하고 있는 제한적 경제발전전략에 불과할 것으로 전망된다. Kim Jong Un, the first chairman of the National Defence Commission of the DPRK, made his first speech during a military parade to commemorate the centenary of the birth of his grandfather, Kim Il Sung. Kim Jong Un underlined that the most important national agenda is becoming a powerful nation through improving the national economy, and resolving the food shortage problem. In addition, he stressed that strong knowledge-based economy must be built by way of new industrial revolution. The economic policy Kim Jong Un set forth involved resolving the food crisis for the people, development of light industry, transition to a powerful knowledge-based economy, land management, and improvement of cultural and education projects. The nation must be established as a strong knowledge-based nation. It was acknowledged that the world is quickly transitioning to the informatization of the economy and North Korea must develop the national economy and build an economic structure that meets international demand. Science and technology should be the forerunner to incorporate science and technology with production and resolve all problems in the economic development process from the science and technology aspect. North Korea may have rebuilt its industries to some degree through the recent reconstruction initiatives. The phrase ‘CNC’ referring to a new initiative to computerize the industrial facilities that started August 2009. But considering North Korea’s inefficient and outdated industrial facilities, the recent reconstruction achievements hardly seem sustainable in the long term. Given the low sustainability of North Korea’s industrial growth, its industrial development is expected to reach its limits soon, forcing the country to consider getting out of isolation and embracing openness and change.

Symptoms of North Korea`s Economic System: Now is the Time to Open up Economically

( Youn Sik Choi ),( Hyung Rok Jung ),( Sung Man Yoon ) 한국국방연구원 2013 The Korean Journal of Defense Analysis Vol.25 No.1

Since suffering economic difficulties, particularly from the 1990s onwards, North Korea, even implicitly, has taken several actions based on the nature of its limited market economy system. North Korean scholars seem to have attempted to practice economic reform and a more open-door policy by learning the capitalistic mark eteconomy system. This paper investigates the current state of trends of North Korean studies associated with economics and management. It is found that even though directly praising and idolizing "Kim Il Sung" and/or "Kim Jong Il" are consistently accomplished, studies on new and subtle issues such as an open-door policy, the global (international) monetary system, compensation, wage (salaries),and self-financing (financing a giupso, in itself, without external financing such as borrowing or issuing shares) drastically increased in the 2000s, especially before and after the announcement of the ``7.1 Economic Management Improvement Measures`` implemented in July 2002. This paper`s findings suggest that North Korea has tried to learn capitalistic market economy system before it takes any steps regarding economic reform. This paper also identifies the political implications in drawing up initiatives in preparation for the era of unification of the two Koreas.

동적 그룹에 적합한 안전하고 효율적인 그룹키 동의 프로토콜

김기성(Kim Ki Sung),김정윤(Kim Jung Yoon),최형기(Choi Hyoung Kee) 한국통신학회 2008 한국통신학회 학술대회논문집 Vol.2008 No.7

최씨 훅을 이용한 복강경 버찌씨 수술

김영혜 ( Young Hye Kim ),박준선 ( Jun Seon Park ),최상준 ( Sang Joon Choi ),송창훈 ( Chang Hoon Song ),한세준 ( Sei Jun Han ),정혁 ( Hyuk Jung ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.6

목적: 버찌씨 수술은 복압성 요실금 수술에 효과적인 수술로 여겨져 왔다. 요실금의 원인이 내인성 요도 괄약근의 결손소견 없이 요도의 과운동성으로 인한 경우 버찌씨 수술이 일반적으로 추천되어진다. 본 연구에서는 복강경 버찌씨 수술에서 최씨 훅의 유용성에 대해 알아보고자 하였다. 연구방법: 2000년 10월부터 2005년 3월까지 본원에서 복강경 버찌씨 수술을 시행받은 47명의 환자를 대상으로 하였다. 27명은 고전적 복강경 버찌씨 수술을 시행하였고 20명은 내골반 근막을 Cooper 인대를 부착하는데 유용한 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행하였다. 결과: 고전적 복강경 버찌씨 수술을 시행한 군과 최씨 훅을 이용한 복강경 버찌씨 수술을 시행한 군의 평균 나이, 분만력, 폐경률, BMI는 두 군간에 통계학적으로 유의한 차이를 보이지 않았다 (p>0.05). 수술 시간은 고전적 복강경 버찌씨 수술은 90.52±15.32분, 최씨 훅을 이용한 복강경 버찌씨 수술은 38.50±10.14분으로 최씨 훅을 이용한 경우 수술시간이 통계적으로 유의하게 짧았다 (p<0.05). 두 군간에 재발률 및 합병증 발생은 통계적 유의성을 보이지 않았다 (p>0.05). 결론: 본 연구에서 본원에서 고안한 최씨 훅을 이용하여 복강경 버찌씨 수술을 시행한 결과 수술 시간을 단축시킬 수 있었으며 수술 효과는 기존 방법과 동일하게 관찰되었다. 이에 최씨 훅은 복강경 버찌씨 수술에서 사용할 때 집도자의 봉합 과정을 단순화시켜 수술 시간을 단축시키므로 복강경 버찌씨 수술에 용이한 기구이다. Objective: Burch operation has been effective method for the treatment of stress incontinence. Burch operation is a well-accepted procedure for treating stress urinary incontinence secondary to urethral hypermobility without intrinsic sphincter deficiency and is the reference standard with which other procedures are compared. This study is to evaluate the effectiveness of the Choi`s hook in laparoscopic Burch operation. Methods: This study included 47 patients who had undergone laparoscopic Burch operation from October 2000 through March 2005. Of these 47 patients, 27 patients underwent traditional laparoscopic Burch operation (Group 1) and 20 patients underwent laparoscopic Burch operation with Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament (Group 2). Results: The mean age of patients of Group 1 was 55.6±9.37 years of age and that of Group 2 was 56.0±5.93 years of age. There is no difference in the mean age of patients (P>0.05). The mean operating time was 90.5±15.32 minutes for Group 1 and 38.5±10.14 minute for Group 2. The mean operating time was shorter in Group 2 than Group 1 (P<0.05). There was no difference in recurrence rate and complication rate between Group 1 and Group 2 (P>0.05). Conclusion: We performed laparoscopic Burch operation with the Choi`s Hook on anchoring the endopelvic fascia to the Cooper`s ligament. When we compared traditional laparoscopic Burch operation with laparoscopic Burch operation with Choi`s Hook, we could shorten the operation time using the Choi`s Hook.

The Effect of Recombinant Human Bone Morphogenetic Protein-4 Concentration on Bone Regeneration in Rat Calvarial Defects

( Eun Kyoung Pang ),( Se Ung Im ),( Chang Sung Kim ),( Seong Ho Choi2 ),( Jung Kiu Chai1 ),( Chong Kwan Kim ),( Soo Boo Han ),( Kyoo Sung Cho ) 대한치주과학회 2003 대한치주과학회 학술대회자료집 Vol.2003 No.2

산업단지 및 일반생활 지역의 공기 중 톨루엔에 대한 개인노출 및 생체시료의 상관성 분석

이병준(Byoungjun Lee),허 정(Jung Heo),정다영(Dayoung Jung),김순신(Sunshin Kim),류현수(Hyeon-Su Ryu),최민지(Min-Ji Choi),솨이지엔페이(Jian-Fei Shuai),임성국(Sung-Guk Im),양원호(Wonho Yang) 한국환경보건학회 2017 한국환경보건학회지 Vol.43 No.4

Objectives: The purpose of this study was to assess the correlation relationship between personal exposure and urinary hippuric acid in biological monitoring for airborne toluene in an industrial complex and in general environments. Methods: Personal exposure to toluene and its metabolite, hippuric acid, in urine were simultaneously measured in occupational environments area near an industrial complex and in general environments. The study subjects were divided into three types: 137 workers who use organic solvents in the workplace, 210 residents living near a dyeing industrial complex, and 379 residents living in general environments. The toluene exposures of workers and residents were measured by a passive sampler for four days. The urine of participants was sampled when the passive samplers of personal exposure were collected. Results: The toluene and hippuric acid concentrations of workers were the highest, followed by the concentrations of residents living near a dyeing industrial complex and residents living in general environments. The coefficient of correlation between the concentrations of toluene and hippuric acid among workers was 0.749 (p<0.01) in the workplace. On the contrary, correlations between the concentrations of toluene and hippuric acid among residents living near a dyeing industrial complex and residents living in general environments were all not significant. The relationship between the concentrations of hippuric acid and toluene in three types could be described by the exponential growth model. Conclusions: This study analyzed the relationships between toluene exposure and the concentrations of hippuric acid in urine in high, middle, and low exposure environments, and could be described by the exponential growth model.