치과 보조 인력과 치과위생사-미국의 제도 비교 (Dental Assistant and Dental Hygienist-comparison with U.S.)
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- 대한치위생과학회지
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- 제6권2호
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- pp.65-77
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- 2023
연구배경: 치과계 특히 치과 의원들은 최근 수년간 보조 인력의 부족을 호소하고 있는 반면 치위생계에서는 미국 치과위생사와 같이 고유의 업무를 어느 정도 독자적으로 수행할 수 있는 구강 위생 전문가의 역할을 추구하고 있어 이러한 업무 범위의 조정과 치과 보조 인력의 양성에 대한 전반적인 논의가 절실하다. 연구방법: 이러한 논의에서 자주 언급되는 미국의 치과위생사와 치과 보조원제도에 대하여 미국 치과의사 협회(ADA), 미국 치과위생사 협회(ADHA), 미국 치과위생사 국가시험위원회(NBDHE), 미국 치과 보조원 협회 (ADAA), 미국 치과 보조원 국가시험위원회(DANB)에서 제공하는 면허취득을 위한 교육요건, 업무영역 등을 조사 분석하였다. 연구결과: 미국은 각 주별 제도가 서로 다르지만 일반적으로 치과위생사는 치위생 교육을 이수할 수 있는 기초 학습 능력 시험을 통과한 후에 2~3년의 전문학사 과정을 수료하고, NBDHE(National Board Dental Hygiene Examination)를 통해 면허를 취득한다. 이후, 주로 환자 검사, 구강 위생 관리 및 예방 처치와 관련된 업무를 수행한다. 치과 보조원(Dental Assitant)은 9~11개월 정도의 교육과정을 마친 후 기본적인 면허(General Chairside Assisting, GC) 취득을 위한 면허시험에 응시할 수 있고, 추가적인 업무를 위해서는 해당 업무에 대한 주별 자격시험 통과, 교육 이수 또는 학위취득, 일정 시간 및 기간 이상의 임상 경험 등이 요구된다. 결론: 우리나라의 의료 기사법과 시행령에서 지정하는 치과위생사의 업무 범위는 미국의 치과위생사와 치과 보조원의 업무를 모두 포함하고 있는데, 현재의 치과 보조 인력 부족을 해소하기 위해 미국과 같은 치과 보조원 제도를 도입한다면 이러한 업무 범위에 대한 조정과 구강 위생 관리 및 예방 업무에서의 치과위생사의 역할 확대 등의 제도적인 보완이 필요하고 이에 대한 구체적인 논의가 필요하다.
The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t=3.95, p<0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t=1.93, p<0.05), ‘I know that my baby wants most of the times’(t=2.75, p<0.01), ‘When the baby cries, 1 can tell what she/he wants’(t=2.10, p<0.05), ‘I have confidence in my ability to care for the baby’(t=3.72, p<0.01), ‘I trust my own judement in deciding how to care for the baby’(t=1.96, p<0.05), ‘I feel that I know my baby and what to do for him /her’(t=2.44, p<0.01), ‘I am concerned about being able to meet the baby's needs’(t=2.87, p<0.01), ‘I know what my baby likes and dislikes’(t=3.26, p<0.01), ‘I don't know to care for the baby as well as I should’(t=2.07, p<0.05), and ‘I am unsure about whether I give enough attention to the baby’(t=3.04, p<0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=3.95, p<0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t=2.31, p<0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t=2.29, p<0.05), ‘I enjoy taking care of the baby’(t=2.4g, p<0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t=2.87, P<0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t=2.51, p<0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t=2.43, p<0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=2.31, p<0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r=0.57, p<0.01)
강판 표면 결함은 강판의 품질과 가격을 결정하는 중요한 요인 중 하나로, 많은 철강 업체는 그동안 검사자의 육안으로 강판 표면 결함을 확인해왔다. 그러나 시각에 의존한 검사는 통상 30% 이상의 판단 오류가 발생함에 따라 검사 신뢰도가 낮은 문제점을 갖고 있다. 따라서 본 연구는 Simultaneous MTS (S-MTS) 알고리즘을 적용하여 보다 지능적이고 높은 정확도를 갖는 새로운 강판 표면 결함 진단 시스템을 제안하였다. S-MTS 알고리즘은 단일 클래스 분류에는 효과적이지만 다중 클래스 분류에서 정확도가 떨어지는 기존 마할라노비스 다구찌시스템 알고리즘(Mahalanobis Taguchi System; MTS)의 문제점을 해결한 새로운 알고리즘이다. 강판 표면 결함 진단은 대표적인 다중 클래스 분류 문제에 해당하므로, 강판 표면 결함 진단 시스템 구축을 위해 본 연구에서는 S-MTS 알고리즘을 채택하였다. 강판 표면 결함 진단 시스템 개발은 S-MTS 알고리즘에 따라 다음과 같이 진행하였다. 첫째, 각 강판 표면 결함 별로 개별적인 참조 그룹 마할라노비스 공간(Mahalanobis Space; MS)을 구축하였다. 둘째, 구축된 참조 그룹 MS를 기반으로 비교 그룹 마할라노비스 거리(Mahalanobis Distance; MD)를 계산한 후 최소 MD를 갖는 강판 표면 결함을 비교 그룹의 강판 표면 결함으로 판단하였다. 셋째, 강판 표면 결함을 분류하는 데 있어 결함 간의 차이점을 명확하게 해주는 예측 능력이 높은 변수를 파악하였다. 넷째, 예측 능력이 높은 변수만을 이용해 강판 표면 결함 분류를 재수행함으로써 최종적인 강판 표면 결함 진단 시스템을 구축한다. 이와 같은 과정을 통해 구축한 S-MTS 기반 강판 표면 결함 진단 시스템의 정확도는 90.79%로, 이는 기존 검사 방법에 비해 매우 높은 정확도를 갖는 유용한 방법임을 보여준다. 추후 연구에서는 본 연구를 통해 개발된 시스템을 현장 적용하여, 실제 효과성을 검증할 필요가 있다.
The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai(古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai' viewed treatments as the base, which was the view of most doctors in the Edo period. However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up'(兼收並蓄) was the same as the 'Kao Zheng Pai'. Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷). Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡). Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows. First Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方)' and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan(導水瑣言)", "Jiao Chiang Fang Yi Je(蕉窗方意解)" and "Yi Xue Sho(醫學說)". Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshimasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong Jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言)". Third, Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao Jing(神農本草經)", the main text for herbal medicine, "Ming Tang Jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei Jing(皇帝內經)" and "Nan Jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong Zong(中村中倧) and learned 'the old way'(古方) from Yoshimasu Todo and got experience through Ouan Yue(川越) and Fu Jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) fmm famous teachers. Showhaku(倧伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and receives help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue Gu(小島學古) and Xi Duo Cun Kao(喜多村栲窻) and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衡心) and becomes a Zheng Shi(徵土), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) Jia Ren Qn Wang(嘉仁親王, later the 大正天皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the qualjty and quantity of his clinical skills. Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窻書影)", "Wu Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "Jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窻書影) he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking, In the first volume of "Shang Han Biang Shu(傷寒辨術)" and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.
인터넷의 발달로, 소비자들은 이커머스에서 손쉽게 상품 정보를 확인한다. 이때 활용되는 상품 리뷰는 사용자 경험을 토대로 작성되어 구매의사결정의 효율성을 높일 뿐만 아니라 상품 개발에 도움을 주기도 한다. 하지만, 방대한 양의 상품 리뷰에서 관심있는 평가차원의 세부내용을 파악하는 데에는 많은 시간과 노력이 소비된다. 예를 들어, 노트북을 구매하려는 소비자들은 성능, 무게, 디자인과 같은 평가차원에 대해 각 차원별로 비교 상품의 평가를 확인하고자 한다. 따라서 본 논문에서는 상품 리뷰에서 다차원 상품평가 점수를 자동적으로 생성하는 방안을 제안하고자 한다. 본 연구에서 제시하는 방안은 크게 2단계로 구성된다. 사전준비 단계와 개별상품평가 단계로, 대분류 상품군 리뷰를 토대로 사전에 생성된 차원분류모델과 감성분석모델이 개별상품의 리뷰를 분석하게 된다. 차원분류모델은 워드임베딩과 연관분석을 결합함으로써 기존 연구에서 차원과 단어들의 관련성을 찾기 위한 워드임베딩 방식이 문장 내 단어의 위치만을 본다는 한계를 보완한다. 감성분석모델은 정확한 극성 판단을 위해 구(phrase) 단위로 긍부정이 태깅된 학습데이터를 구성하여 CNN 모델을 생성한다. 이를 통해, 개별상품평가 단계에서는 구 단위의 리뷰에 준비된 모델들을 적용하고 평가차원별로 종합함으로써 다차원 평가점수를 얻을 수 있다. 본 논문의 실험에서는 대분류 상품군 리뷰 약 260,000건으로 평가모델을 구성하고, S사와 L사의 노트북 리뷰 각 1,011건과 1,062건을 실험데이터로 활용한다. 차원분류모델은 구로 분해한 개별상품 리뷰를 6개 평가차원으로 분류했고, 기존 워드임베딩 방식보다 연관분석을 결합한 모델의 정확도가 13.7% 증가했음을 볼 수 있었다. 감성분석모델은 문장보다 구 단위로 학습한 모델이 평가차원을 면밀히 분석함으로써 29.4% 더 높은 정확도를 보임을 확인했다. 본 연구를 통해 판매자, 소비자 모두가 상품의 다차원적 비교가 가능하다는 점에서 구매 및 상품 개발에 효율적인 의사결정을 기대할 수 있다.
The outline and characteristics of the important doctors of the 'Zhe Zhong Pai'(折衷派) are as follows. Part 1. In the late Edo(江戶) period The 'Zhe Zhong Pai', which tried to take the theory and clinical treatment of the 'Hou Shi Pai (後世派)' and the 'Gu Fang Pai (古方派)' and get their strong points to make treatments perfect, appeared. Their point was 'The main part is the art of the ancients, The latter prescriptions are to be used'(以古法爲主, 後世方爲用) and the "Shang Han Lun(傷寒論)" was revered for its treatments but in actual use it was not kept at that. As mentioned above The 'Zhe Zhong Pai ' viewed treatments as the base, which was the view of most doctors in the Edo period, However, the reason the 'Zhe Zhong Pai' is not valued as much as the 'Gu Fang Pai' by medical history books in Japan is because the 'Zhe Zhong Pai' does not have the substantiation or uniqueness of the 'Gu Fang Pai', and also because the view of 'gather as well as store up' was the same as the 'Kao Zheng Pai', Moreover, the 'compromise'(折衷) point of view was from taking in both Chinese and western medical knowledge systems(漢蘭折衷), Generally the pioneer of the 'Zhe Zhong Pai' is seen as Mochizuki Rokumon(望月鹿門) and after that was Fukui Futei(福井楓亭), Wadato Kaku(和田東郭), Yamada Seichin(山田正珍) and Taki Motohiro(多紀元簡), Part 2. The lives of Wada Tokaku(和田東郭), Nakagame Kinkei(中神琴溪), Nei Teng Xi Zhe(內藤希哲), the important doctors of the 'Zhe Zhong Pai', are as follows First. Wada Tokaku(和田東郭, 1743-1803) was born when the 'Hou Shi Pai' was already declining and the 'Gu Fang Pai' was flourishing and learned medicine from a 'Hou Shi Pai' doctor, Hu Tian Xu Shan(戶田旭山) and a 'Gu Fang Pai' doctor, Yoshimasu Todo(吉益東洞). He was not hindered by 'the old ways(古方), and did not lean towards 'the new ways(後世方)' and formed a way of compromise that 'looked at hardness and softness as the same'(剛柔相摩) by setting 'the cure of the disease' as the base, and said that to cure diseases 'the old way' must be used, but 'the new way' was necessary to supplement its shortcomings. His works include "Dao Shui Suo Yan", "Jiao Chiang Fang Yi Je" and "Yi Xue Sho(醫學說)" Second. Nakagame Kinkei(中神琴溪, 1744-1833) was famous for leaving Yoshirnasu Todo(吉益東洞) and changing to the 'Zhe Zhong Pai', and in his early years used qing fen(輕粉) to cure geisha(妓女) of syphilis. His argument was "the "Shang Han Lun" must be revered but needs to be adapted", "Zhong jing can be made into a follower but I cannot become his follower", "the later medical texts such as "Ru Men Shi Qin(儒門事親)" should only be used for its prescriptions and not its theories". His works include "Shang Han Lun Yue Yan(傷寒論約言) Third. Nei Teng Xi Zhe(內藤希哲, 1701-1735) learned medicine from Qing Shui Xian Sheng(淸水先生) and went out to Edo. In his book "Yi Jing Jie Huo Lun(醫經解惑論)" he tells of how he went from 'learning'(學) to 'skepticism'(惑) and how skepticism made him learn in 'the six skepticisms'(六惑). In the latter years Xi Zhe(希哲) combines the "Shen Nong Ben Cao jing(神農本草經)", the main text for herbal medicine, "Ming Tang jing(明堂經)" of accupuncture, basic theory texts "Huang Dui Nei jing(黃帝內徑)" and "Nan jing(難經)" with the "Shang Han Za Bing Lun", a book that the 'Gu Fang Pai' saw as opposing to the rest, and became 'an expert of five scriptures'(五經一貫). Part 3. Asada Showhaku(淺田宗伯, 1815-1894) started medicine at Zhong Cun Zhong(中村中倧) and learned 'the old way'(古方) from Yoshirnasu Todo and got experience through Chuan Yue(川越) and Fu jing(福井) and received teachings in texts, history and Wang Yangmin's principles(陽明學) from famous teachers. Showhaku(宗伯) meets a medical official of the makufu(幕府), Ben Kang Zong Yuan(本康宗圓), and recieves help from the 3 great doctors of the Edo period, Taki Motokato(多紀元堅), Xiao Dao Xue GU(小島學古) and Xi Duo Cun Kao Chuang and further develops his arts. At 47 he diagnoses the general Jia Mao(家茂) with 'heart failure from beriberi'(脚氣衝心) and becomes a Zheng Shi(徵I), at 51 he cures a minister from France and received a present from Napoleon, at 65 he becomes the court physician and saves Ming Gong(明宮) jia Ren Qn Wang(嘉仁親王, later the 大正犬皇) from bodily convulsions and becomes 'the vassal of merit who saved the national polity(國體)' At the 7th year of the Meiji(明治) he becomes the 2nd owner of Wen Zhi She(溫知社) and takes part in the 'kampo continuation movement'. In his latter years he saw 14000 patients a year, so we can estimate the quality and quantity of his clinical skills Showhaku(宗伯) wrote over 80 books including the "Ju Chuang Shu Ying(橘窓書影)", "WU Wu Yao Shi Fang Han(勿誤藥室方函)", "Shang Han Biang Shu(傷寒辨術)", "jing Qi Shen Lun(精氣神論)", "Hunag Guo Ming Yi Chuan(皇國名醫傳)" and the "Xian Jhe Yi Hua(先哲醫話)". Especially in the "Ju Chuang Shu Ying(橘窓書影)" he says "the old theories are the main, and the new prescriptions are to be used"(以古法爲主, 後世方爲用), stating the 'Zhe Zhong Pai' way of thinking. In the first volume of "Shung Han Biang Shu(傷寒辨術) and "Za Bing Lun Shi(雜病論識)", 'Zong Ping'(總評), He discerns the parts that are not Zhang Zhong Jing's writings and emphasizes his theories and practical uses.
온라인 소비자는 쇼핑 웹사이트에서 특정 제품군이나 브랜드에 속한 제품들을 둘러보고 구매를 진행할 수 있고, 혹은 단순히 넓은 범위의 탐색 반경을 보이며 여러 페이지들을 돌아보다 구매를 진행하지 않고 이탈할 수 있다. 이러한 온라인 소비자의 행동과 구매에 관련된 연구는 꾸준히 진행되어왔으며, 실무에서도 소비자들의 행동 데이터를 바탕으로 한 서비스 및 어플리케이션이 개발되고 있다. 최근에는 빅데이터 기술의 발달로 소비자 개인 단위의 맞춤화 전략 및 추천 시스템이 활용되고 있으며 사용자의 쇼핑 경험을 최적화하기 위한 시도가 진행되고 있다. 하지만 이와 같은 시도에도 온라인 소비자가 실제로 웹사이트를 방문해 제품 구매 단계까지 전환될 확률은 매우 낮은 실정이다. 이는 온라인 소비자들이 단지 제품 구매를 위해 웹사이트를 방문하는 것이 아니라 그들의 쇼핑 동기 및 목적에 따라 웹사이트를 다르게 활용하고 탐색하기 때문이다. 따라서 단지 구매가 진행되는 방문 외에도 다양한 방문 형태를 분석하는 것은 온라인 소비자들의 행동을 이해하는데 중요하다고 할 수 있다. 이러한 관점에서 본 연구에서는 온라인 소비자의 탐색 행동의 다양성과 복잡성을 설명하기 위해 실제 E-commerce 기업의 클릭스트림 데이터를 기반으로 세션 단위의 클러스터링 분석을 진행해 탐색 행동을 유형화하였다. 이를 통해 각 유형별로 상세 단위의 탐색 행동과 구매 여부가 차이가 있음을 확인하였다. 또한 소비자 개인이 여러 방문에 걸친 일련의 탐색 유형에 대한 패턴을 분석하기 위해 순차 패턴 마이닝 기법을 활용하였으며, 같은 기간 내에 제품 구매까지 완료한 소비자와 구매를 진행하지 않은 채 방문만 진행한 소비자들의 탐색패턴에 대한 차이를 확인할 수 있었다. 본 연구의 시사점은 대규모의 클릭스트림 데이터를 활용해 온라인 소비자의 탐색 유형을 분석하고 이에 대한 패턴을 분석해 구매 과정 상의 행동을 데이터 기반으로 설명하였다는 점에 있다. 또한 온라인 소매 기업은 다양한 형태의 탐색 유형에 맞는 마케팅 전략 및 추천을 통해 구매 전환 개선을 시도할 수 있으며, 소비자의 탐색 패턴의 변화를 통해 전략의 효과를 평가할 수 있을 것이다.
The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences (
1. The 'Kao Zheng Pai(考證派) comes from the 'Zhe Zhong Pai' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金娥), Yoshida Koton(吉田篁墩) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li '(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 1739
1.The 'Kao Zheng Pai'(考證派) comes from the 'Zhe Zhong Pai(折衷派)' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金峨), Yoshida Koton(古田篁墩