굴(Crassostrea gigas)양식 중단 이후 퇴적물 질 회복에 관한 지화학적 지표 탐색

심보람,김형철,강성찬,이대인,홍석진,이상헌,김예진 한국수산과학회 2020 한국수산과학회지 Vol.53 No.5

In order to evaluate the recovery of fishing ground environment after the cessation of aquaculture farming, we examined the variation in sediment quality over time using different geochemical factors and investigated whether these factors are indicators of sediment quality recovery. The study area was an oyster Crassostrea gigas, farm in Tongyeong, Geyongsangnam-do, South Korea, where aquaculture activities had been carried out for 20 years, and the changes in water and sediment environment were monitored for 14 months after the abandonment of the farm. The mean water depth was 14 m, with a tidal range of 3 m, and seawater current velocity ranged from 4.7 to 7.0 cm/s. After the abandonment of the farm, total organic carbon and total nitrogen concentrations in the surface sediments decreased significantly over time compared to those in the control site; in particular, immediately after farm abandonment, acid-volatile sulfide concentrations decreased relatively rapidly. Carbohydrate and protein concentrations in the sediments showed no significant changes; however, lipid concentrations markedly decreased. Further studies on other aquaculture taxa and various aquaculture areas are needed to establish new policies for environmental management of fishing grounds, such as relocation of fishing grounds and determination of optimal fallowing periods.

수성 self-initiating UV 경화형 우레탄 아크릴레이트 수지의 제조와 건조 조건에 따른 물성평가

심보람,김영철 한국공업화학회 2012 한국공업화학회 연구논문 초록집 Vol.2012 No.1

디지털 치료기기의 급여정책 동향과 향후 과제

심보람 한국보건행정학회 2023 한국보건행정학회 학술대회 논문집 Vol.2023 No.1

지역사회단위에서의 COVID-19 발생률의 결정 요인: 법정감염병 발생률과의 비교

심보람,박명배 연세대학교(미래캠퍼스) 빈곤문제국제개발연구원 2021 地域發展硏究 Vol.30 No.2

전 세계적으로 COVID-19가 대유행하는 가운데, 인구집단 간 COVID-19 발생률에 격차가 발생하고 있으나 지역사회 단위에서 발생 위험 요인을 확인한 연구는 아직부족한 실정이다. 이에 이 연구는 지역사회단위 자료를 이용하여 COVID-19 발생의위험요인을 찾고자 하였다. 또한 기존 감염병과의 비교를 통해 COVID-19의 특성을확인하고자 하였다. 이를 위해 이 연구는 보건복지부 및 질병관리청에서 공개하는 COVID-19 발생 자료(2021년 2월 16일 기준 누적) 및 법정감염병 발생 자료(2015~2017년)를 활용하였고, 국가통계포털에서 지역사회 특성에 대한 2차 자료를 수집하였다. 그리고 229개 시군구를 분석단위로 하여, 인구사회학적 요인, 건강수준 및 의료자원, 건강행태 요인과 COVID-19 및 법정감염병 발생률과의 연관성을 확인하기 위한 선형 회귀분석을 실시하였다. 분석 결과, COVID-19의 발생률은 평균 인구 10만 명당 123명이었고, 지역별로 0 명에서 1,023명까지 큰 편차를 보였다. 그리고 인구밀도, 재정자립도, 외출 후 손 씻기실천율이 높을수록, 연간 인플루엔자 예방접종률이 낮을수록 COVID-19 발생률이 높았다. 이 중 인구밀도, 손씻기 실천율, 예방접종률은 법정감염병과도 유의한 연관성을보였으나, 회귀계수의 방향은 COVID-19와 상반되었다. 이러한 차이는 대도시 그리고 특정 집단을 중심으로 확산된 COVID-19의 특성을보여준다. 이 연구는 지역사회 요인을 고려하여 COVID-19 발생률을 분석한 초기 연구 중 하나로, 기존 법정감염병 발생과 위험요인이 다를 수 있음을 학술적으로 확인하였다는 데 의의가 있다.

울산 태화강 하구역 퇴적환경의 시공간적 변화 특성

심보람,김형철,김청숙,황동운,박정현,조윤식,김정배,홍석진,이원찬 해양환경안전학회 2017 해양환경안전학회 학술발표대회 논문집 Vol.2017 No.04

조선 세종대 수령 파견 양상의 변화와 인견 확대

심보람 한국사연구회 2023 한국사연구 Vol.- No.203

The local governance system through prefect (守令) reveals both similarities and differences between the Goryeo and Joseon periods. This paper aims to examine the significance of the shift in personnel appointment practices by expanding King Sejong's reign's calling prefect for an interview (守令引見) in Joseon. The expansion of the calling prefect for an interview (守令引見) during King Sejong's reign was indicative of the intent to ensure stable governance in provinces and implement the civilizing influence of the king through capable prefects. Joseon grappled with a shortage of qualified prefect (守令), similar to its predecessor. During King Sejong's reign, there was a stronger emphasis on the policy of governing provinces through the dispatch of officials deemed excellent as prefect (守令). The expansion of recognition for prefect (守令) aimed to complement the altered policy of dispatching prefect (守令) during King Sejong's reign. Sejong, who actively engaged in direct interactions with his subjects through practices such as meeting officials in rotation (輪 對) and classic lecture (經筵), met prefect (守令) in person to confirm their qualities. Throughout Sejong's reign, active recognition of prefect (守令) transpired over 19 years, and this recognition persisted under later kings, leading to changes in the appointment process. Conversely, efforts to appoint government officials evaluated as excellent as prefect (守令) resulted in an increased number of prefect (守令) from successful candidate of liberal arts examination (文科). 수령을 통한 지방통치는 고려와 조선 지방제도의 유사점과 차이점이 동시에 드러나는 지점이다. 본고는 조선 세종대 수령 인견(引見) 확대에 주목해 수령 인사 방식 변화의 의미를 살펴보고자 했다. 세종대 수령 인견 확대는 우수한 자질을 갖춘 수령을 통해 지장에도 안정적으로 ‘왕화(王化)’를 실천하려는 의도를 담고 있었다. 이것은 고려 말 이래로 이어진 수령 자질 문제를 해결하려는 방향성은 유지하면서도 동시에 질적으로 다른 방식으로 수령 자질 문제를 해결하려는 시도였다. 고려의 군현제를 이어받은 조선은 고려와 마찬가지로 수령의 자질 미달 문제를 해결해야 했다. 세종대에는 우수하다고 평가받는 관원을 수령으로 파견하고 이들을 통해 안정적으로 지방을 통치하려는 정책이 이전 시기보다 강하게 추진되었다. 세종은 즉위 초부터 부민고소금지법을 시행해 수령의 군현 통치 안정성을 높이고자 했다. 또한 중앙 관원 사이에 만연한 수령직 회피를 타파하기 위해 수령육기법, 수령직 회피자 서용 금지법, 경외관순환제를 실시해 중앙 관원을 수령으로 파견하는 정책을 재위 기간 꾸준히 추진하였다. 이런 세종대 변화한 수령 파견 정책을 보완하는 것이 수령 인견 확대였다. 수령 인견을 확대하는 세종 7년(1425)은 부민고소금지법의 부작용이 대두되던 시점이었다. 수령의 자질을 점검할 필요가 있었고, 윤대·경연과 같이 신하와의 직접적인 대면을 넓혀가던 세종은 수령도 직접 만나보고 자질을 확인했다. 세종 재위 동안 19년에 걸쳐 수령 인견이 활발히 시행되었고, 수령 인견은 후대 왕들에 의해서도 유지되어 수령 부임 절차에도 변화를 가져왔다. 한편 우수하다고 평가받는 관원을 수령으로 파견하려는 시도는 문과 출신 수령의 증가로 이어지기도 했다.

어류가두리 양식장의 물질수지 산정

심보람,김형철,윤상필,홍석진,정우성,강성찬 한국수산과학회 2023 한국수산과학회지 Vol.56 No.4

This study was conducted to better understand the impact of marine fish farming by estimating mass balances of carbon and nitrogen. According to the results, 94.55% of carbon and 95.66% of nitrogen inputs were from the feed supplied in the farm. Of the total carbon emissions in the farm, 47.28% was due to fish respiration, which was subsequently released into seawater. Advection and diffusion in the farm contributed to 30.29% of the carbon released. In the case of nitrogen, 50.70% of the nitrogen released into the seawater was produced by fish excreta, and 31.37% was advected and diffused into the system. The sedimentary environment received 3.82% and 3.10% of the carbon and nitrogen released from the farm, respectively. The fish feed used for healthy growth contained 11.64% carbon and 9.17% nitrogen. Since the feed type was floating pellets, the load released into the sedimentary environment was relatively lower than that released into the marine environment. These findings suggest that the identification of an optimal fish feed that respects fish physiology and preserves a healthy ecology is critical for the future of aquaculture. Furthermore, ecosystem-based aquaculture systems that decrease environmental burden, while endeavoring to improve environmental health, are required.

필리핀 의료보장제도 현황과 과제 - 보편적 건강보장을 중심으로

심보람 건강보험심사평가원 2018 HIRA 정책동향 Vol.12 No.3

코로나19 발생의 지역사회 위험요인 분석

심보람,박명배 한국보건행정학회 2022 보건행정학회지 Vol.32 No.1

Background: There are regional variations in the incidence of coronavirus disease 2019 (COVID-19), which means that some regionsare more exposed to the risk of COVID-19 than others. Therefore, this study aims to investigate regional variations in the incidenceof COVID-19 in Korea and identify risk factors associated with the incidence of COVID-19 using community-level data. Methods: This study was conducted at the districts (si·gun ·gu) level in Korea. Data of COVID-19 incidence by districts were collectedfrom the official website of each province. Data was also obtained from the Korean Statistical Information Service and the CommunityHealth Survey; socio-demographic factor, transmission pathway, healthcare resource, and factor in response to COVID-19. Community risk factors that drive the incidence of COVID-19 were selected using a least absolute shrinkage and selection operatorregression. Results: As of June 2021, the incidence of COVID-19 differed by more than 80 times between districts. Among the candidate factors,sex ratio, population aged 20–29, local financial independence, population density, diabetes prevalence, and failure to comply withthe quarantine rules were significantly associated with COVID-19 incidence. Conclusion: This study suggests setting COVID-19 quarantine policy and allocating resources, considering the community riskfactors. Protecting vulnerable groups should be a high priority for these policies.

디지털 치료기기의 건강보험 적용방안

심보람,주진한,김현정,김병수 건강보험심사평가원 심사평가연구소 2022 연구보고서 Vol.2022 No.0

This study was performed to prepare for the coverage of Digital Therapeutics (DTx) as a benefit under National Health Insurance (NHI) of the Republic of Korea. To this end, the study first examines the characteristics of DTx and then discusses how to incorporate DTx into the existing benefit listing procedure and pricing method. As part of this study, the researchers reviewed DTx-related benefit policies in countries such as the US, UK, and Germany, which have prior experience of introducing insurance coverage of DTx, and gathered the opinions of stakeholders in the DTx field in Korea by conducting one-on-one in-depth interviews (IDI). The key results of this study are presented below. ○ First, this study defined DTx that is eligible for coverage under NHI as prescribed DTx, which is used according to a physician's prescription. In addition, since DTx is managed by the Ministry of Food and Drug Safety (MFDS) as a medical device, it would likewise be appropriate for DTx to be classified as a non-pharmaceutical benefit (a medical procedure or medical supply) under NHI. Moreover, given that there is minimal intervention by a physician during the use of DTx and continued management of each device is necessary, reimbursement for DTx should be provided separately as a medical supply rather than indirectly as part of a medical procedure. ○ Second, considering the fast pace of technological advances for DTx, it would be appropriate for DTx to be subject to the Innovative Health Technology Assessment track in the New Health Technology Assessment (nHTA) stage. Furthermore, the level of clinical evidence required for approval of DTx by the MFDS is higher than that required for other health technologies and DTx is expected to improve the efficiency of the healthcare system in the long-term. Accordingly, this study proposes a way of supporting the use of DTx by temporarily listing DTx that has been selected for Innovative Health Technology Assessment as an NHI benefit. ○ Third, since the permanent listing of DTx as an NHI benefit could affect the health of the entire Korean population, it is crucial that the safety and efficacy of DTx is evaluated against stringent criteria. In particular, the importance of demonstrating the clinical value of DTx through comparisons with existing benefits has been emphasized. ○ Fourth, the reimbursement for DTx is proposed to be based on the price of the DTx product and the medical fee for the prescribing physician’s service. This study suggests setting a price ceiling for DTx by applying a costing method based on the function points of software. Since this method arrives at a price based on the size and complexity of software functions, it essentially has similar aims as the existing value-based pricing in NHS. In addition, while a physician's efforts related to DTx were considered to be included in the scope of basic consultation fees, the cost of initial consultation and training on DTx use, which would be provided by non-physician staff, should be compensated separately. The results of this study are presented in consideration of the early stages of incorporating DTx into the NHI system, without any DTx listed as NHI benefits. Therefore, it is crucial to improve the system in a flexible manner in the future by building on the policy experience gained through the process of coverage decision-making and the outcome of using DTx in real-world clinical contexts. In particular, although this study proposed including DTx in the existing benefit category of medical supplies for the time being, it may become more appropriate in the future to create a separate listing system for the digital health field, including DTx, considering its potential for growth and sustainability. Keeping this in mind, all relevant stakeholders, including the medical community, patients, industry, and government, should come together and continue to seek the most appropriate option for the Korean context.