Earticle

연구목적: 본 연구는 재난 안전 사각지대에 있는 소규모의 민간 건축물을 대상으로 건축물의 위험징후를 분석하고 계측기술을 개발하기 위한 건축물 모니터링 시스템 설치 방안을 제시하는 것을 목적으로 한다. 연구방법: 건축물 위험거동의 원인, 모니터링 계측 기기의 구성요소, 계측기기 설치 위치, 관리 방안 등 을 제시한다. 연구결과: 계측기기는 필수적으로 가속도센서, 기울기센서, 자이로센서, GPS 등이 포함 된다. 계측장치는 기둥의 높이와 단면적을 고려해야 한다. 결론: 본 연구의 결과는 소규모 민간 건축물 에서 발생할 수 있는 건축물 붕괴로부터 발생하는 재난을 대비하여 재난 안전 역량 강화를 할 수 있다.

Purpose: The purpose of this study is to analyze the danger signs of buildings and present a plan to install a building monitoring system to develop measurement technology for small private buildings in the blind spot of disaster safety. Method: The cause of building risk behavior, components of monitoring measuring equipment, location of measuring equipment installation, management plan, etc. are presented. Result: Measuring instruments essentially include acceleration sensors, tilt sensors, gyro sensors, GPS, etc. The measuring instrument should take into account the height and cross-sectional area of the pillar. Conclusion: The results of this study can strengthen disaster safety capabilities in preparation for disasters arising from building collapses that may occur in small private buildings.

With the rising reliance on market estimation through customer analysis in customer-centered marketing, there is a rapid increase in the amount of personal data owned by corporations. There has been a corresponding rise in the customers" interest in personal information protection, and the problem of personal information leakage has risen as a serious issue. The purpose of this research is to develop a diagnosis model for personal information protection that is suited to our country"s corporate environment, and on this basis, to present diagnostic instruments that can be applied to domestic corporations. This diagnosis model is a structural equation model that schematizes the degree of synthetic effect that administration factors and estimation items have on the protection of personal information owned by corporations. We develop the model- consisting of the administration factors for personal information protection and the measurement items of each factor- using the development method of standardized structural equation model. We then present a tool through which the administration factors and estimation items verified through this model can be used in the diagnosis for personal information protection in corporations. This diagnostic tool can be utilized as a useful instrument to prevent in advance the leakage of personal information in corporations.

Purpose: This study was aimed to evaluate the methodological issues and comprehensiveness of workplace bullying instruments and to suggest a taxonomy of psychological abuse. Methods: Nineteen instruments applied in health care organizations and 469 questionnaire items mainly regarding psychological abuse were collected through a literature review. Three researchers classified the questionnaire items according to a “taxonomy of psychological abuse in the workplace.” Results: Many instruments of workplace bullying were developed in the 2000s using a reflective measurement model, but their psychometric property was not sufficient and the measurement model is questioned. Based on the questionnaire items, the “taxonomy of psychological abuse in the workplace” was modified by adding two new subcategories (unachievable work and unfair treatment) and clarifying some operational definitions. According to the modified taxonomy of 11 (sub)categories, the reviewed instruments assessed 6.5 (sub)categories on average. No instrument measured all (sub)categories. Category 4.2 (disrespect, humiliation, and rejection of the person) was measured in all instruments, followed by Categories 5 (professional discredit and denigration) and 1.2 (social isolation) behaviors. Conclusion: The current instruments are not comprehensive enough. It is suggested that the modified taxonomy is verified and guide more reliable and inclusive instruments in the future. Furthermore, a formative measurement model, which defines a bullying as an inventory of different types of behaviors, should be used.

Purpose: The purpose of this study was to evaluate studies on the measurement properties of selfreported instruments. Method: This descriptive review included studies on measurement properties that were reported in Asian Nursing Research over a five-year period from 2016 to September 2020. Nine key measurement properties were reviewed for each study: content validity, structural validity, internal consistency, crosscultural validity/measurement invariance, reliability, measurement error, criterion validity, hypothesestesting construct validity, and responsiveness. Results: The most commonly applied measurement properties were structural validity and internal consistency. However, structural validity using confirmatory factor analysis or item response theory/ Rasch analysis needs to be rigorously analyzed and interpreted. None of the studies assessed measurement error and responsiveness. Conclusion: It is recommended for nursing researchers to assess measurement properties beyond structural validity and internal consistency using more rigorous methodologies.

The bronze bells and the stone chimes are the specific musical instruments of court music. Originated from the ancient history of China, they were included in the Bát âm 八音(Eight Timbers) orchestra which was performed in the Chinese royal court. Since Nhã nhạc 雅樂 (Elegant music) was introduced to Vietnam in the XVth century, the bronze bells and the stone chimes were imported to Vietnam together with the other instruments of Bát âm (Eight Timbers) orchestra. When Vietnamese court music declined along with feudalism, these instruments were not longer performed, pieces of them have been displayed in the museum. For preserving Vietnamese Nhã nhạc which was recognized as a world heritage by Unesco, a thorough research on these two instruments has been done, then a trans-national project between Hue Monuments Conservation Center of Vietnam and National Gugak Center of South Korea was undertaken, resulting in the reconstruction and revitalization of these royal musical instruments. This essay will show the path that the work has gone through. Firstly, this research will provide a brief overview of the origin, history and the scale of bronze bells and stone chimes. It will then reveal the current condition of the remaining bells and chimes which have been carefully examined. Finally, with the proposal for the restoration of the instruments, the research is concluded on how the restoration process was actually conducted.

최근 치과에서 사용되는 10종의 폴리머 기구에 대한 세포독성을 평가하기 위하여 L-929 세포를 이용한 MTT 시험을 시행하였다. 검체를 4g 당 20mL의 비율로 제조한 37℃의 RPMI 1640 용액에서 24시간 동안 용출한 후 식품 의약품안전처 고시 제2020-12호 의료기기 생물학적 안전에 관한 공통기준규격에 따라 검체 용출액과 공시험액, 음성 및 양성대조를 사용하여, 37℃, 5% CO2 Incubator에서 24시간 배양하여 ELISA reader로 판정한 결과, Intraoral camera는 용출물 농도 약 50%에서 약 70% 이상의 세포 생존율을 나타냈나 Plastic impression tray, 3D printing tweezer, Impression disposable syringe, Dental floss holder, Hand implant scaler, Surgical retractor, Oral scanner tip, Dental mirror, Water pick tip은 모두 용출물 농도 100%에서 70% 이상의 세포 생존율로 세포 독성을 나타내지 않아 구강점막에 직접 접촉하여 사용이 가능한 기구로 평가되었다.

In order to assess the cell toxicity of 10 instruments made of polymers, the MTT assay which utilizes the L-929 cell was selected. Specimens were eluted at a temperature of 37°C for 24 hours at a rate of 4g per 20mL, RPMI 1640, and then was positively and negatively contrasted with a control test solution, in accordance with the Notification No. 2020-12 Protocols of Medical Apparatus Biological Safety from the Ministry of Drug and Food Safety. As a result of 24 hours of incubation in 37°C, 5% CO2 Incubator and assessment using an ELISA reader, the results of Intraoral camera indiciated a cellular viability of more than 70% at a 50% eluate. But, the Plastic impression tray, 3D printing tweezer, Impression disposable syringe, Dental floss holder, Hand implant scaler, Surgical retractor, Oral scanner tip, Dental mirror, and the Water pick tip all reported a cellular viability of more than 70% at a 100% eluate, which indicates that do not exhibit cytotoxicity, thus allowing it to be used in contact with the mucous membrane of the oral cavity.

Forest fire is one of the major disasters occurring in Nepal causing huge loss to the ecosystem, people and economy. They are mainly caused due to different anthropogenic activities. In Nepal, the forest fires occur during the dry season mainly from March to May. Nepal has roughly 29.5 percent forest area that are prone to forest fires and it is estimated that about 375 thousand hectares of forest were burned over one and half decade from 2000-2014. The forest fire risk is higher in the Terai and Siwalik regions than in any other region. To prevent and mitigate the forests fire incidences, the Government of Nepal has formulated and executed different policy instruments. In this regard, this paper aims to review the implementation of policies, strategies, Acts and regulations related to forest fire management at different levels of governance. Although federal and provincial governments’ different policy instruments have considered forest fire and its management, these are not effectively implemented. It is not prioritized in terms of resource allocation, institutional capacity building, disaster preparedness and early warning. In addition, there are unclear and overlapping roles and responsibilities among three tiers of governments to effectively implement the policy provisions. Considering the consequences of the forest fire, governments at different levels need to devise an effective mechanism involving all stakeholders for implementing preventive and curative activities, strengthen institutions and build the capacity of human resources, and increase the level of resource allocation to implement the provisions of various legal and policy instruments.

전자통신 기술의 응용에 따라서 전자상거래는 전세계적으로 유례를 찾아볼 수 없는 속도로 급격히 발전하고 있다. 국제 전자 상거래의 순조로운 발전을 위하여 UNCITRAL은 일련의 법률을 제정하였다. 대표적으로 전자상거래모델법, 전자서명모델법 및 전자통신사용에 관한 국제조약 등을 예로 들 수 있다. 주목해야 할 것은, 전자상거래모델법이나 전자서명모델법 등은 법적 구속력을 갖고 있지 않은 단순한 권고적 성격이 강하다. 또한 전자통신사용에 관한 국제조약은 공약 형식으로 제정한 것이긴 한데, 현재까지 이 조약에 서명한 18개 국가(중국과 한국 포함하여)중 이 조약을 비준한 국가는 단 한 국가도 없다. 그러므로 이 조약은 여전히 효력을 발휘하지 못하고 있다. 이 밖에 중국 전자상거래 발전을 촉진시키기 위해 제정된 중국합동법은 전자 합동 계약 체결의 문제에 대해 원칙적 규정을 만들어 내었을 뿐만 아니라 전자상거래와 관련하여 문제가 되는 전자서명법의 구체적인 모범 규칙을 공포하였다. 이에 본 논문은 전자상거래에 관한 국제적인 입법의 진행과 함께 중국의 진행상황을 정리한 후 몇가지 문제점들을 분석하고자 한다. 첫째는 전자상거래모델법과 전자서명모델법이 국제관례의 성질을 가지고 있는지, 전자적 방법으로 거래하는 당사자가 위에서 상술한 모델법으로 전자상거래에 관한 분쟁을 해결하는 법률로서 이용될 수 있는가 하는 점이다. 두번째는 국제계약에서 전자적 통신의 사용에 관한 UN협약에 국제물품매매계약에 관한 UN협약이 그 초안으로 간주될 수 있는가도 문제된다. 국제계약에서 전자적 통신의 사용에 관한 UN협약이 서로 다른 국가의 거래당사자 간의 서명과 실행을 통한 계약체결의 범위를 그 영업지위에 따라 제한하는 것이 지나치게 좁은 것이 아닌가 하는점이다. 또 이러한 규정의 적용이 동조약 제20조와 상호 모순된다는 비판도 제기된다. 마지막으로 중국 전자상거래법이 가지는 특징을 국제조약과 비교하여 검토하고자 한다. 이를 통하여 국제적·국내적 전자상거래의 입법의 발전 방향을 도모하고자 하는 것이다.

随着电子通讯技术的应用，电子商务正在以前所未有的速度在全球范围内迅猛发展。为了推动国际电子商务的顺利开展，联合国国际贸易法委员会制定了一系列法律文件，例如，《关于电脑记录法律价值的建议》、《电子商务示范法》、《电子签名示范法》、《国际合同使用电子通信公约》。值得注意的是，前三个文件不具有法律约束力，只是建议性文件。而第四个文件则以公约形式制定，但由于到目前为止该公约的18个签字国（包括中国和韩国）没有一个批准该公约，因此，该公约还仍然处于未生效状态。此外，为了促进中国电子商务的发展，中国《合同法》不仅对电子合同的订立问题做出了原则性规定，而且还颁布了专门规范电子商务问题的《电子签名法》。在对国际国内电子商务立法进行梳理后，本文重点分析了如下问题：第一，《电子商务示范法》以及《电子签名示范法》是否具备国际惯例的性质，电子合同当事人是否可以将上述示范法作为解决合同争议的法律适用法？第二，《国际合同使用电子通信公约》是否应该以仅规范国际货物买卖合同的《联合国国际货物销售合同公约》作为起草的蓝本？《国际合同使用电子通信公约》适用的国际合同范围仅限于营业地位于不同国家的当事人之间签署或履行的合同是否过于狭窄？这一适用范围的规定是否与公约第20条的规定相矛盾？第三，中国电子商务立法具有哪些特点？通过上述分析，笔者旨在澄清国际国内电子商务立法的发展方向。

지난 몇 년간 글로벌 지속 가능 금융이 급속히 성장하면서 외부적으로는 지속 가능 금융을 표방하면서 실제로는 그에 걸맞는 투자전략을 실행하지 않은 그린워싱에 대한 국제적 관심이 높아지고 있다. 실제로 투자자문사가 투자 프로세스에 포함하는 ESG 요인에 관한 정보를 정 확하게 공시하지 않거나 ESG 투자방침이나 절차에 미비가 있었다고 하여 미국 SEC가 제재금 을 부과하는 사례도 발생하고 있다. 자산운용사 및 투자자문사가 ESG 평가를 적정하게 실시하고 실효성을 높이기 위해서는 투자 처로부터의 ESG 관련 정보가 필수적이다. 지속 가능 금융 부문의 그린워싱은 투자자의 신뢰 뿐만 아니라 금융시장의 신뢰성 저하를 초래하기 때문이다. 본 논고에서는 선행하여 그린워싱(green washing) 규제에 나서고 있는 EU SFDR, 미국 SEC 규 칙 제정안, 일본 금융청의 감독지침, 국내 ESG 펀드 공시기준을 비교 분석하여 그 유사점과 차이를 분명히 하고 ESG 투자의 핵심 수단인 ESG 투자상품에서 발생하는 그린워싱의 문제점 에 대한 개선방안을 제시했다.

Purpose : As sustainable finance grows as major trend in capital markets worldwide and the risk of greenwashing increases, we have sought to develop sustainable disclosure standards and countermeasures against misselling. Research design, data, methodology : In terms of regulatory consistency, we compared and analyzed the EU SFDR, US SEC rule-making proposal, Japanese Financial Services Agency's supervisory guidelines, and domestic ESG fund disclosure standards. Results : While sustainable finance brings socio-economic benefits in response to climate change, it brings about the problem of greenwashing. Conclusions : In order to secure investor reliability due to the uncertainty in the concept of sustainable finance, it is necessary to introduce quantitative criteria in addition to qualitative criteria as a clear criterion for identifying greenwashing.

20세기 초 이후 한국에서 시작된 오선보 표기를 쓰게 되면서 국악 연주자들이 음악을 가르치고 작곡하고 연주하는 방식에 많은 영향이 있었다. 기보법에 대한 음악교육은 악보가 기록되는 방식뿐 아니라 작곡가와 연주자의 음악 인지 방식에도 영향을 주게 된다. 현대 거의 모든 작곡에는 오선보가 사용되고 있다. 때로는 한국음악에 맞게 변형된 방식으로 쓰이거나 혹은 서양의 예술음악 표기에 통용되는 방식으로 쓰이기도 해서 그 세부적인 방식은 다양하다. 오선보에 기반한 작품이 점차 많아지고 제도적으로 오선보에 기반한 훈련을 받은 국악 연주자들이 많아지면서 오선보를 사용한 작품과 연주를 통한 음악문화가 만들어져 왔다. 그러나 오선보를 일반적으로 사용해 온 것은 오선보를 대체할 수 없는 새로운 기보법이 고안되지 않았기 때문이라고 볼 수 있으며, 한국음악의 역사적인 기보법을 토대로 한 표기로 대체해야 할 필요성에 대한 논의가 있기도 하다. 이 논문에서는 국악 연주자들을 위해 현대에 작곡된 예술 음악에서 사용하고 있는 기보법을 고찰하였으며, 오선보에 기반하여 작곡된 작품, 그리고 오선보 기보를 대신해서 다른 방식으로 기보하려는 시도를 한 작품 등을 분석하였다. 작곡가의 작품과 작곡가가 선택한 기보법은 그 작곡가가 어떤 교육을 받았는지를 보여준다고 할 수 있으며, 또한 기보법은 연주자가 공연을 할 때 음악을 어떻게 해석하는지에 영향을 미친다. 여러 세대의 동서양 작곡가의 작품에 쓰인 기보법 분석을 통해 이 논문에서는 전통적인 국악 기보법 체계가 현대음악 작곡 기보에 반영된 다양한 예를 비교하고 분석하고자 하였다. 본고의 분석을 통해 역사적인 국악 기보법의 요소를 현대에 창작되는 작품에 적용할 때 오선보의 제한점을 극복할 수 있는 대안이 무엇일지 적극적으로 모색되어야 할 것이며, 그렇게 될 때 음악적으로도 보다 표현이 풍부히 이루어지는 경지에 이를 수 있으리라고 주장하고자 한다. 이를 위해서는 국내외 작곡가, 그리고 국악 연주자들 모두에게 전통적인 국악기보법에 대한 교육이 이루어져야 할 것이며, 이러한 교육 환경의 변화가 이루어질 때 국악 연주자들과 작곡가, 그리고 국악에 관심이 있는 외국 작곡가들 모두에게 궁극적인 영향을 미칠 수 있으리라고 생각한다.

The 20th century shift to Western five-line staff (oseonbo) notation enormously impacted the way music for gugak players is taught, composed, disseminated, and performed. The education of music notation affects not only the way a score is written, or whether a score is written, but the very mode of musical cognition for composers and performers alike. Virtually all contemporary compositions make use of the Western 5-line staff, whether relatively unmodified, or varied according to conventions of cosmopolitan art music or gugak transcription methods. The shift to oseonbo-based archives and institutionally-based training created a musical culture in which most gugak musicians began to function with oseonbo as their musical mother tongue. The near absence of contemporary art music scores which either develop new notational methods or base their innovations on historical Korean practices is symptomatic of a general preference toward oseonbo notation that has increasingly replaced the need for familiarity with historical notation techniques. This study explores notational strategies currently employed in modern art music for gugak musicians. It focuses first on oseonbo-based music, and finally on music which attempts to avoid or otherwise mitigate oseonbo notation. I begin my discussion is with a piece by Hwang Byung-ki which reveals a radical disconnect in the notational education of 20th century gugak musicians. After this, I explore daegum works by several composers, and point out ways in which education affects composition, and notation affects performance psychology. The touchstone in this section is the daegum sanjo composed by Seo Yong-seok, and differences in musical training and notational specificity are analyzed closely. By way of several types of Korean “melodic line score” (garakseon akbo) and an obscure late-19th century gagok notation (supahyeong akbo), I finally discuss two theatrical experimental compositions: one by Kang Sukhi and a recent work of my own. These pieces aim at a greater degree of performer freedom than usually allowed in oseonbo, and exist at the intersection of oral and literate transmission methods. Throughout the whole, I touch on traditional Korean music notation systems as a point of comparison and an explanation for certain creative phenomena. With these examples I hope to suggest that a rich and virtually unexplored territory can be reached through adapting elements of historical Korean notation to contemporary creative works, and actively seeking alternatives to various restrictions of the oseonbo staff. But neither composers nor performers can adequately explore what they are ignorant of, and so music education must be adapted if more widespread awareness and interest in historical Korean notation is desired. Steps may be most convincingly taken by a change in the educational environment of both gugak musicians, and Korean or foreign composers interested in gugak music.

This paper investigated policies that drive the sustainable management of Ivorian forest which disappear at an annual rate of 250000 hectares. Based on an inter-temporal model for optimum allocation of forest land to three competing uses, the article found that sustainability depends on the incentive structure, of which forest taxes and fees are a key, though obviously not the sole, component. The study proposed to increase the area fee level by accounting for environmental externalities generated by forest harvesters and farmers. The paper showed that the area fee is a decreasing function of the forest natural rate of regeneration and the reconversion rate of agricultural surfaces. Finally, at the given forest natural rate of regeneration and the reconversion rate of agricultural surfaces, the model argued that the area fee need to be progressive (arithmetic progression) in the context of ecological equilibrium break while it should remain constant in normal situation.

Purpose: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. Methods: For this study, 632 elders were selected from community?based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale(KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale(EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale(25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's ?. Sensitivity, specificity and area under the curve(AUC) of ROC were measured to see validity with long?term care insurance grade as a gold standard. Results: The Cronbach's ? was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. Conclusion: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.

Purpose: This study was undertaken to identify which delirium screening instrument would be more useful in clinical practice. Methods: Data were collected from 118 nurses from six hospitals in five provinces in Korea. For the delirium screening three instruments were compared: NEECHAM Confusion Scale (NEECHAM), Nursing Delirium Screening Scale (Nu-DESC), Delirium Observation Scale (DOS). The MMSE-K was used for concurrent validity. The nurse subjects were surveyed as to the practical clinical value of each instrument. Cronbach's α coefficient and Kuder-Richardson 20 were used to confirm the reliability. Results: The range of three scales reliability was .70~.82 and the range of correlation coefficient was .63~.82 with MMSE-K. For sensitivity of NEECHAM, Nu-DESC and DOS was 1.00, 1.00 and 0.81 respectively and specificity NEECHAM, Nu-DESC and DOS was 0.88, 0.89 and 0.89 respectively. Nurses rated the practical use of the DOS scale as significantly easier to use than the NEECHAM and Nu-DESC. Conclusion: NEECHAM, Nu-DESC and DOS scales were acceptable in terms of reliability, validity, sensitivity and specificity. However, nurses rated the DOS scale as easier scale to use and had more relevance to their practice.

본 논문은 중앙은행의 통화량 조절수단으로서 재할인의존도가 초래하는 인플레 이션 편의를 추정하였다. Kim and Kim(2007)은 흔히 통화량 조절수단으로서 무 차별적으로 취급되는 공개시장조작과 재할인정책이 관료적 입장에서 보면 큰 차 이가 있을 수 있다는 점에 착안하여, 각국의 재할인의존도가 그 나라 중앙은행의 재량권과 관련이 있음을 보인 바 있다. 본 논문은 이를 연장하여 재할인의존도가 높을수록 그 재량적 속성으로 인해 통화량의 변동성이 커지고, 이때 가격의 하방 경직성이 작용하여 인플레이션 편의가 발생함을 국제자료를 통해 검증하였다. 이 러한 연구는 중앙은행이 외부적 압력으로부터의 독립과 마찬가지로 내부의 관료 적 유인으로부터의 독립 역시 함께 고려되어야 한다는 점에서 중앙은행 독립성에 대해 시사하는 점이 있으리라 사료된다.

This paper estimated the inflation bias of the discount windows as a monetary instrument. Kim and Kim(2007) showed that there is a significant difference between the open market operations and discount windows, which are often treated as ‘indifferent’ in the economics textbooks, from the bureaucratic perspective of the central bank, and proved that central bank’s dependence on the discount windows is related to its discretionary power over the monetary policy. This paper extends Kim and Kim (2007) and shows that higher dependence causes larger monetary fluctuation, which under the downward rigidity of the price level results in inflation bias. This finding will provide a beneficial implication for establishing the meaningful independence of the central bank.

건강보험의 재정전망을 낙관적 전망(복지부 계획)과 중립적 전망의 두 가지 시나리오에 의해 추계해 본 결과 어느 쪽도 2006년까지 재정적자를 면하기 어려운 것으로 예상되며 별도의 재정대책이 없이 현재와 같은 추세로 간다면 건강보험은 수년내 또다시 재정파탄의 가능성이 있는 것으로 사료된다. 장기적 재정안정을 위해 크게 두 가지 종류의 방안이 거론될 수 있는데, 하나는 약가인하나 수가통제와 같이 재정지출을 출발부터 줄이는 방법이고, 다른 하나는 건강보험의 목적적 가치인 의료이용의 형평성을 견지하면서 거시 경제적 차원에서 재정지출의 크기를 조절하는 장치로서 제도화하는 것이다. 위의 두 가지 방안, 즉 의료전달상의 미시적 효율과 거시적 재정조정장치가 동시에 추구되고 작동되면서 건강보험제도는 원래의 목적을 상실하지 않으면서 장기적 재정안정을 기할 수 있을 것으로 판단된다. 건강보험의 장기 재정안정은 재정안정을 위한 구조적 틀의 구성이 중요하다. 의료비 및 보험급여 증가요인들은 지불보상제, 전달체계, 의료의 공공성, 그리고 각종 지침(진료, 처방, 고가장비 등)의 사용이라는 네 가지의 매개체를 통하여 의료비 증가로 이어지게 된다. 따라서 이들 네 가지 매개체를 정책적으로 잘 관리함으로써 장기재정안정의 제도적 기전을 마련할 수 있다. 구체적으로는 건강보험제도를 통해 의료이용의 적절성 및 형평성이란 정책목표를 어느 정도 달성한 상황에서, 이런 정책 목표를 훼손시키지 않으면서 거시적 효율성 달성을 위해 한 걸음 더 전진할 수 있는 좋은 대안으로 총액예산제를 들 수 있다.

The purpose of this paper is to analyze long-term financial prospects of the national health insurance(NHI) and to suggest health policy instruments for financial stabilization of the Korean NHI. The financial crisis in the NHI is still on debate. The current deficit in the income statement of the NHI was increased by more than 870 billion won during 2002, which resulted in a total deficit of 2.6 trillion won. Based on two scenarios of optimistic and neutral assumptions, this paper predicted financial balance for the year 2003-2006. All possible predictions show a huge deficit in financial balance of the NHI until the end of 2006. Therefore the NHI is, without a new health reform plan, destined to be in a bankruptcy by the year 2006. Experiences in advanced countries show that the most effective health policy reform to cope with financial crisis is considered to be a change in payment system, a shift from the current fee-for-service to a global budget system. According to our analysis, a global budget system coupled with pharmaceutical price control, health care delivery system, clinical guideline, public health resources is the key variable to establish an efficient and equitable health care system in terms of both micro and macro level.

본 연구는 모래놀이치료 과정 중 제작되는 모래놀이 작품에 등장한 악기의 상징성을 살펴보고자 하였다. 철학과 예술에서 인식되며 표현되었던 상징(Symbol)은 심리학적 개념으로 사용되면서 심리치료에서 광범위하게 연구되어 왔다. 상징의 의미와 치료적 영향은 모래놀이치료에서도 중요한 연구주제가 되어왔다. 악기는 성경 및 동서양의 신화와 민담 등에서 치유와 치료, 감정의 표현, 물과 공기처럼 흐르는 여성성의 특성 및 조화의 균형, 질서 등 다양한 상징성을 내포하고 있다. 본 연구는 모래놀이 작품에 등장한 악기가 어떻게 악기의 다양하고 다층적인 상징성을 표현하는지에 대해 사례를 통해 살펴보고자 하는데 그 목적이 있다. 연구 결과 모래놀이 작품에 등장하는 악기는 치유, 감정, 욕망, 죽음 혹은 퇴행, 여성성, 조화 등 다양한 상징적 의미를 내포하고 있었다.

This study aimed to examine the symbolism of musical instruments appearing in sandplay works produced during sandplay therapy. Symbols began to be recognized and explored in philosophy and art, and have been widely studied in psychotherapy as they have been used as psychological concepts. The meaning and therapeutic influence of symbols have also been an important research topic in sandplay therapy. Musical instruments contain various symbolisms such as healing and treatment, expression of emotions, characteristics of femininity flowing like water and air, balance of harmony, and order in the Bible and Eastern and Western myths and folk tales. The purpose of this study is to examine how musical instruments appearing in sandplay works express their diverse and multilayered symbolism through cases. The results of the study showed that musical instruments appearing in sandplay works contained various symbolic meanings such as healing, emotions, desire, death or regression, femininity and harmony.