지속적인 휴먼서비스 전달을 위한 협력 네트워크의 회복력에 관한 연구

장한나,황태연,홍민철,정승현,이명석 한국정책분석평가학회 2015 政策分析評價學會報 Vol.25 No.1

협력 네트워크는 다양한 위협요인과 내·외적 충격에 노출되어 있으며 회복력을 갖추지 못한 네트워크는 쉽게 와해되어 실패사례로 전락할 가능성이 높다. 지속적인 협력관계를 위해 네트워크의 회복력이 중요한 요소임에도 불구하고 아직까지 이에 대한 논의가 부족한 실정이다. 본 연구는 협력 네트워크의 유지와 발전을 위한 네트워크 회복력에 관한 연구를 진행하였고, 그 결과는 다음과 같다. 첫째, 충격 이전의 네트워크 초기 특성에 따라 회복력이 상이할 수 있다. 휴먼서비스 네트워크 구축 시 네트워크가 견고해질 수 있도록 정부의 지원 및 가이드라인 제시와 지역사회 내 정당성 확보 및 협력관계 및 신뢰관계 구축이 요구된다. 둘째, 초기 동기 및 정당성의 변질은 협력 네트워크를 와해시킬 만큼의 강력한 위협요인이 될 수 있다. 파트너 간의 합의에 의해 형성된 초기의 동기 및 정당성이 변질되지 않도록 정기적인 모임을 통해 지속적으로 확인할 필요가 있다. 셋째, 협력 네트워크의 위협요인은 하나 이상의 문제가 연쇄되어 나타날 수 있다. 한 차원의 문제가 다른 문제 발생으로 연결되지 않도록 이에 대한 포괄적인 예방 및 대안이 요구된다.

유전자 검사와 언더라이팅

장한나,Jang, Han-Na 한국생명보험의학회 2002 保險醫學會誌 Vol.21 No.-

Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes (Endocrinol Metab 2019;34:382-9, Han Na Jang et al.)

장한나,정혜승 대한내분비학회 2020 Endocrinology and metabolism Vol.35 No.1

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Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes

장한나,양예슬,이성옥,오태정,구보경,정혜승 대한내분비학회 2019 Endocrinology and metabolism Vol.34 No.4

Background: Conflicting results have been reported on the efficacy of insulin degludec/insulin aspart (IDegAsp) compared to basalinsulin in type 2 diabetes. We investigated the effects of changing basal insulin to IDegAsp on glycemic control and sought to identify factors related to those effects. Methods: In this retrospective study of patients from three referral hospitals, patients with type 2 diabetes using basal insulin withhemoglobin A1c (HbA1c) levels less than 11.0% were enrolled. Basal insulin was replaced with IDegAsp, and data were analyzedfrom 3 months before to 3 months after the replacement. Results: Eighty patients were recruited (52.5% male; mean age, 67.0±9.8 years; mean duration of diabetes, 18.9±8.5 years; meanHbA1c, 8.7%±1.0%). HbA1c levels increased during 3 months of basal insulin use, but significantly decreased after changing toIDegAsp (8.28%±1.10%, P=0.0001). The reduction was significant at 6 months in 35 patients whose longer-term data were available. Patients with a measured fasting plasma glucose (m-FPG) lower than their predicted FPG (p-FPG) by regression from HbA1cshowed a significant HbA1c reduction caused by the change to IDegAsp, even without a significantly increased insulin dose. However, patients whose m-FPG was higher than their p-FPG did not experience a significant HbA1c reduction, despite a significantlyincreased insulin dose. Furthermore, the HbA1c reduction caused by IDegAsp was significant in patients with low fasting C-peptidelevels and high insulin doses. Conclusion: We observed a significant glucose-lowering effect by replacing basal insulin with IDegAsp, especially in patients witha lower m-FPG than p-FPG.

Impact of Influenza Infection on Febrile Seizures: Clinical Implications

장한나,이은혜 대한소아신경학회 2018 대한소아신경학회지 Vol.26 No.4

Purpose: Febrile seizures (FSs) are the most common type of seizure in the first 5 years of life and are frequently associated with viral infections. Influenza infection is associated with a variety of neurological conditions, including FSs. The purpose of this study was to evaluate the clinical implications of influenza infection in FSs. Methods: In total, 388 children with FS were divided into two groups: FS with influenza infection (n=75) and FSs without influenza infection (n=313). Their medical records, including seizure type, frequency, duration, and familial history of FSs or epilepsy, were retrospectively reviewed and the clinical characteristics of the two groups were compared. Results: In total, 75 of the 388 children (19.3%) had FSs associated with influenza infection; such children were significantly older than those with FSs without influenza infection (34.9± 22.3 months vs. 24.4± 14.2 months; P<0.001). The children who had more than two febrile seizures episodes were more prevalent in children with FS with influenza infection [40/75 (53.3%) vs. 92/313 (29.4%); P<0.01]. Children older than 60 months were more likely to have influenza infection compared to those aged less than 60 months [11/22 (50%) vs. 64/366 (17.5%); P=0.001]. Conclusion: Influenza infection may be associated with FSs in older children, and with recurrence of FSs. Its role in the development of afebrile seizures or subsequent epilepsy requires further investigation with long-term follow-up.

Management of Spontaneous Spinal Epidural Hematoma Developedin Children with Hemophilia

장한나,윤회수,박영실 대한소아혈액종양학회 2018 Clinical Pediatric Hematology-Oncology Vol.25 No.2

Spinal epidural hematoma (SEH) is a rare neurosurgical emergency in which pressure on the spinal cord leads to acute neurological deficits, and is a rare complication in children with hemophilia. We report three cases of SEH in severe hemophilia A. An 8-month-old boy who presented with non-traumatic acute-onset irritability was found to have SEH and was later diagnosed with hemophilia. The two other patients presented with neck pain and magnetic resonance imaging confirmed the diagnosis of SEH. Two patients who received conservative management fully recovered, however the patient who presented with progressive neurological abnormalities at the time of diagnosis, received surgery but later developed breathing difficulties and quadriplegia. Early diagnosis and immediate, aggressive, clotting factor replacement therapy are crucial when managing SEH in children with hemophilia. Immediate and aggressive factor replacement, accompanied by both neurological monitoring and early imaging, are essential for hemophiliac with suspected SEH.

산에 안정한 폴리아미드 나노여과막의 제조

장한나,안은숙,권세이,송두현,이혜진,김인철 한국막학회 2016 한국막학회 총회 및 학술발표회 Vol.2016 No.11

습식제련 공정은 대부분 황화광석을 원료로 하기 때문에 제련 과정 중 황산 농도 2~15 wt%의 불순물을 함유한 폐 황산이 발생하게 된다. 발생하는 폐 황 산에는 다양한 희소금속들이 포함되어 있으나, 현재 공정수에서 희소금속 처리 기술부족으로 중화되어 폐기되고 있다. 이 과정에서 막분리 공정을 적용할 경우 희소금속을 친환경적이면서 효율적으로 회수할 수 있다. 본 연구에서는 폴리아 미드 계면중합을 위하여 다공성 지지막 위에 방향족 아민모노머와 트리메조일 클로라이드를 사용하여 산에 안정한 폴리아미드 나노여과막을 제조하였고, 제조 된 막의 투과분리 성능에 대하여 살펴보았다. 그리고 제조된 분리막이 내산성을 가지는지 평가하기 위하여 15 wt%의 황산용액에 침지하여 일별 투과수량 및 이온제거율을 측정하였다.

Prevalence of Diabetic Retinopathy in Undiagnosed Diabetic Patients: A Nationwide Population-Based Study

장한나,문민경,구보경 대한당뇨병학회 2022 Diabetes and Metabolism Journal Vol.46 No.4

Background: We investigated the prevalence of diabetic retinopathy (DR) in patients with undiagnosed diabetes through a nationwide survey, compared to those with known diabetes.Methods: Among the participants of the Korean National Health and Nutrition Examination Surveys (KNHANES) from 2017 to 2018, individuals aged ≥40 years with diabetes and fundus exam results were enrolled. Sampling weights were applied to represent the entire Korean population. Newly detected diabetes patients through KNHANES were classified under “undiagnosed diabetes.”Results: Among a total of 9,108 participants aged ≥40 years, 951 were selected for analysis. Of them, 31.3% (standard error, ±2.0%) were classified under “undiagnosed diabetes.” The prevalence of DR in patients with known and undiagnosed diabetes was 24.5%±2.0% and 10.7%±2.2%, respectively (<i>P</i><0.001). The DR prevalence increased with rising glycosylated hemoglobin (HbA1c) levels in patients with known and undiagnosed diabetes (<i>P</i> for trend=0.001 in both). Among those with undiagnosed diabetes, the prevalence of DR was 6.9%±2.1%, 8.0%±3.4%, 5.6%±5.7%, 16.7%±9.4%, and 42.6%±14.8% for HbA1c levels of <7.0%, 7.0%–7.9%, 8.0%–8.9%, 9.0%–9.9%, and ≥10.0% respectively. There was no difference in the prevalence of hypertension, dyslipidemia, hypertriglyceridemia, or obesity according to the presence or absence of DR.Conclusion: About one-third of patients with diabetes were unaware of their diabetes, and 10% of them have already developed DR. Considering increasing the prevalence of DR according to HbA1c level was found in patients with undiagnosed diabetes like those with known diabetes, screening and early detection of diabetes and DR are important.

발포기내의 공간속도에 따른 PTFE 버블의 크기 변화

장한나,이우근,이명화 한국대기환경학회 2019 한국대기환경학회 학술대회논문집 Vol.2019 No.11

Growth and carbon storage of black saxaul in afforested areas of the Aralkum Desert

장한나,안지애,Asia Khamzina,이우균,손요환 한국환경생물학회 2019 환경생물 : 환경생물학회지 Vol.37 No.4

This study aimed to determine the growth and carbon storage of planted Haloxylon aphyllum in the Aralkum Desert in Kazakhstan. Six sites afforested in 2000, 2005, 2009, 2010, 2013, and 2017 were selected. The root collar diameter (cm) and height (m) were measured for all H. aphyllum in 30 m×44 m plots. Biomass accumulation (g m-2) and carbon storage (C g m-2) were calculated using allometric equations and the carbon concentration data of Haloxylon species. The diameters varied from 2.5 cm to 4.3 cm and the height varied from 106.2 cm to 223.7 cm. The growth of H. aphyllum was not linearly related to the afforestation year or soil properties. Tree growth might have been influenced by variations in the microclimate, such as temperature, precipitation, and dust storms. The mean total biomass accumulation was 20.57 g m-2 and ranged from 2.42 g m-2 to 64.53 g m-2. The mean carbon storage was 9.70 C g m-2 and ranged from 1.12 C g m-2 to 30.61 C g m-2. These biomass and carbon storage estimates were smaller than those reported for other Central Asian deserts, but afforestation enabled the generation of vegetative cover and consequently, carbon sequestration in the manmade Aralkum Desert.