• 수면정신생리
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• 제8권1호
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• pp.37-44
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• 2001

목 적 : 최근 수면장애에 대한 3가지 진단 분류 체계가 발달하였다. 즉 국제 수면장애 분류(the International Classification of Sleep Disorder, ICSD), 정신장애의 진단 및 통계 편람 제 4 판(the Diagnostic and Statistical Manual, 4th edition, DSM-IV) 그리고 국제 질병 분류 제 10 판(the International Classification of Diseases, 10th edition, ICD-10)이다. 국내에는 이들 진단 체계간의 비교에 대한 자료가 거의 없다. 본 저자들은 수면 문제로 정신과에 의뢰된 환자를 DSM-IV와 ICSD에 따라 진단하고 이를 비교하여 그 차이를 비교하고자 하였다. 방 법 : 고려대학부속 안암병원에 입원 환자 중 수면장애로 정신과에 의뢰된 284명의 환자를 대상으로 ICSD를 숙수면장애에 대한 ICSD와 DSM-IV 진단 비교 44지하지 않은 정신과 전공의와 ICSD를 숙지한 정신과 전공의가 비구조화된 면담을 시행하고, DSM-IV와 ICSD의 진단 기준에 따라 임상적 진단을 하여 그 차이를 비교하였다. 결 과 : DSM-IV 진단 분류에는 "기타 정신장애 관련 불면증"(전체의 61.1%)과 "일반적인 의학적 상태로 인한 섬망"(26.8%)이 빈도가 가장 높았다. ICSD에서는 "신경과적 장애가 동반된 수면장애" (38.4%)와 "정신과적 장애가 동반된 수면장애" (33.1%)의 빈도가 가장 높았다. DSM-IV와 ICSD의 비교에서, DSM-IV에서 신체적 질환이나 정신과적 질환과 무관한 수면장애로 진단된 환자군은 대부분 ICSD와 일치하였고, 이들 중 DSM-IV의 "일차적 불면증"은 ICSD의 "정신생리적 불면증"과 "부적수면위생"으로 구분되었다. DSM-IV에서 신체적 질환이나 정신과적 질환에 의한 수면장애를 가진 269명 중 62명(23%)이 ICSD와 불일치하였고 이들 중 대부분이 ICSD에서 신체적 질환이나 정신과적 질환과 무관한 수면장애인 "부적수면위생", "환경성 수면장애", "적응성 수면장애" 그리고 "수면결핍장애" 등이었다. 결 론 : 본 연구에서 DSM-IV와 ICSD의 진단 체계가 많은 부분 일치하였으나, 간과할 수 없는 차이를 가지고 있음을 확인하였다. 이 차이는 수면장애에 대한 임상의의 태도를 반영한다. 즉, 수면장애에 대한 개념화와 원인에 대한 임상의의 이해 정도에 따라, 수면장애를 진단하지 못하거나 적절한 치료를 할 수 없다. 따라서 본 연구에서 나타난 DSM-IV와 ICSD에 대한 임상의의 이해 정도는 중요하다고 할 수 있다.

• 대한간호학회지
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• 제4권2호
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• pp.17-31
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• 1974

Today, over seventy five percent of nursing in Korea provide a psychiatric experience in the basic curriculum. The psychiatric affiliation presents numerous major problems of adjustment to the student. The Importance of positive attitude toward the nursing care of psychiatric patients is recognized by the nursing profession. I have fined out the unfavorable attitude of non collegiate nursing students toward psychiatric nursing affiliation by previous research. This study was undertaken in response to a felt need to explore the use of several devices which might yield information about attitudes toward psychiatric nursing as a basis for future planning of the program offered at a selected hospital. This study is designed to meet the following objectives; (1) In order to find out the expressed attitudes of fifty·three collegiate nursing students toward their psychiatric affiliation. (2) To compare responses given by selected group of collegiate and non collegiate nursing students to same questionnaire (3) To determine the relationship between the attitudes of nursing students toward psychiatric nursing and the type of instructions where experience was obtained. A questionnaire, a Korean translation of the "Psychiatric Nursing Attitude Questionnaire" by Moldered Elizabeth fletcher, was administered to fifty-three collegiate nursing students who had completed a four-week psychiatric affiliation in a S hospital psychiatric ward during May 7, 1973 to Dec. 16, 1973. - The questionnaire of 100 statements was administered in the following way; (1) Part Ⅰ, Preconceptions, was, given in individual conferences with each subject, during the first few days of their affiliation, and again during the final week of affiliation. The responses to Part I were oral. (2) Part Ⅱ, Expectations, Part Ⅲ, Personal Relations, Part Ⅳ, Personal Feelings, and Part V, Attitudes and Activities of Patients were given to all of the subjects in a group meeting during the second week of the affiliation, and again, during the fourth week at the termination of the affiliation. Responses to Parts Ⅱ, Ⅲ, Ⅳ·, and V, were written. Each of the 100 statements of the questionnaire was considered to be either Positive or Negative. A favorable response was assigned the positive value of 1 and an unfavorable response was assigned the Negative value of O. The coefficient of correlation was computed between the two sets of scores for the fifty-three nursing students, The mean score, the standard deviation, and the differences in the means on each of the five parts of the questionnaire were computed and the relationships calculated by at-test. The results of the study were as follows; 1. There was no significant correlation between the two sets of the scores for the fifty-three nursing students during the four-week psychiatric affiliation. (r= 0.36) 2. There was no significant difference in the mean scores between the first and final tests for any of the questionnaire. 3. The Part Ⅰ, Preconceptions, data indicated collegiate nursing students have positive attitudes in preconceptions than non collegiate nursing students and preconceptions toward the psychiatric affiliation which affect their psychiatric nursing experience. 4. The Part Ⅱ, Expectations, data indicated more appropriate expectations of collegiate nursing students related to pre psychiatric affiliation orientation and sufficient theory learning than non-collegiate nursing students. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part V, Attitudes and activities of patients, data indicated collegiate nursing students have more positive attitudes to the psychotic behavior of certain situations due to sufficient theory learning. 8. The data indicated collegiate·nursing students have more positive attitude than non-collegiate nursing students. 5. The Part Ⅲ, Personal relations, data indicated some students have negative attitudes in personal relations with normal people in respect to psychological security and social responsibilities. 6. The Part Ⅳ, Personal feelings, data indicated nursing students have psychological insecurity & inappropriateness. 7. The Part V, Attitudes and activities of patients, data indicated collegiate nursing students have more positive attitudes to the psychotic behavior of certain situations due to sufficient theory learning. 8. The data indicated collegiate·nursing students have more positive attitude than non-collegiate nursing students through psychiatric affiliation.

• 근관절건강학회지
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• 제2권1호
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• pp.17-40
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• 1995

Rheumatoid arthritis is the one of the chronic diseases, one of its major symptoms is a chronic pain. Despite developing medical treatment and surgical techniques, it is suggested that to control the pain is the goal of the treatment. But pain is an inner experience and even those closest to the patient cannot truly observe its progress or share in its suffering. The National Academy of Sciences Institute of Medicine's report on Pain and Disability concluded that there is no objective measure of pain-(exactly) no pain thermometer-nor can there ever be one, because the experience of pain is inseparable from personal perception and social influence such as culture. To explore chronic pain experience is to understand the process and property of the patient's perception of pain through the response to pain, the coping with pain, and the adaptation to pain. Therefore a qualitative study was conducted in order to gain an understanding of pain experience of patients with RA in korea. I used naturalistic inquiry as a research methodology, which had 5 axioms, the first is that realities are multiple, constructed, and holistic, the second is that knower and known are interactive, inseparable, the third is only time and context bound working hypotheses(idiographic statements) are possible, the forth is all entities are in a state of mutual simultaneous shaping, so that it is impossible to distinguish causes from effects and the last is that inquiry is value-bound. Purposive sampling was conducted as a sampling. 20 subjects who experienced pain over 10 years, lived in middle-sized city and big city in Korea, and 17 women and 3 men. The subject's age was from 32 to 62 (average 48.8), all were married, living with their spouse and children, except two-one divorced and the other widow before they became ill. I collected data using In depth structured interview. I had interviews two or three times with each subject, and the interviews were conducted at each subject's home. Each interview lasted about two hours an average. A recording was taken with the consent of the subject. I used inductive data analysis-such as unitizing and categorizing. unitizing is a process of coding, whereby raw data are systematically transformed and aggregated into units. Categorizing is a process wherby previously unitized data are organized into categories that provide descriptive or inferential information about the context or setting from which the units were derived. This process is used constant comparative method. The pain controlling process is composed of behavior of pain control. The behaviors of pain control are rearranging of ADL, hiddening role conflict, balancing treatment, and changing social relation. Rearranging of ADL includes diet management, sleep management, and the adjustment of daily life activities. The subjects try to rearrange their daily activities by modified style of motions, rearranging time span & range of activities, using auxillary facilities, and getting help in order to keep on the pace of daily life. Hiddening role conflict means to reduce conflicts between sick role and their role as a family member. In this process, the subjects use two modes, one is to control the pain complaints, and the other is to internalize the value which is to stay home is good for caring her children and being a good mother. To control pain complaints is done by 'enduring', 'understanding' the other family members, or making them undersood in order to reduce pain. Balancing treatment is composed of two aspects. One is to keep the pain within the endurable level, the other is to keep in touch with medical personnel in order to get the information of treatment and emotional support. Changing social relation is made by information seeking and sharing, formation of mutual support relation, and finally simplification of social relationships. The subjects simplify their social relationships by refraining from relations with someone who makes them physically and psychologically strained. In particular the subjects are apt to avoid contact with in-laws, and the change of relation to in-laws results in lessening the family boundary. In the course of this process, they confront the crisis of family confict result in family dissolution. This crisis is related to the threat of self-existence. Findings from this study contribute to understanding the chronic pain experience. To advance this study, we should compare this result with other cases in different cultural contexts. I think to interpret these results, korean cultural background should be considered. Especially the different family concept, more broader family members and kinship network, and the traditional medical knowledge influences patients' behavior.

• Journal of Nutrition and Health
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• 제52권6호
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• pp.581-592
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• 2019

본 연구는 에너지 섭취 급원에 따라 골격근육량과 에너지 섭취량 간의 연관성이 달라지는지 알아보기 위해 수행되었다. 본 연구는 2008 ~ 2010년도 국민건강영양조사 자료를 이용하여 30세 이상 한국 성인 7,922명을 대상으로 각 식품의 에너지섭취비율을 기반으로 식사패턴을 분류하고 각 식사패턴 군집 내에서 대상자들의 골격근육량과 에너지 섭취량 간의 연관성을 분석하였다. 대상자의 22가지 식품군의 에너지 섭취량을 기준으로 군집분석을 실시한 결과 남성과 여성 모두에서 '밀가루와 유지류 (Flour, Animal fat)', '흰 쌀 (White rice)', '건강혼합식 (Healthy mixed diet)' 3가지 식사패턴을 도출하였다. 그 중 '흰 쌀' 식사패턴에서 남성 (p < 0.0001)과 여성 (p < 0.0195) 모두 에너지 섭취량과 골격근육량의 연관성이 있었으며, 나머지 식사패턴에서는 근육량과 에너지 섭취량 간의 관련성이 통계적으로 유의하지 않았다. 본 연구의 결과에서 30대 이상 한국 성인들의 골격근육량의 변화와 에너지 섭취량 간에는 유의한 양적 연관성이 있으나 대상자가 주로 섭취하는 식사 형태에 따라 에너지 섭취와 골격근육량의 연관성이 다른 것을 알 수 있었다. 본 연구의 결과에 근거하여, 골격근육량과 연관된 에너지 섭취량의 변화 [14]는 쌀밥 위주의 식사를 하는 한국 성인에 특이적인 결과임을 추정할 수 있다. 이는 에너지 섭취량의 증가 없이도 군집에 속한 식품의 영양소 균형이 골격근육량 유지에 도움을 주는 다른 식사패턴 (예, 건강혼합식)과는 달리 쌀밥위주의 식사가 전형적인 한국인의 경우 전체적인 식사량의 확보도 골격근육 유지에 중요함을 제시하는 결과이며 쌀밥 위주의 식사를 하는 대상자들의 체중감량식단이나 근감소증 비율이 상대적으로 높은 노인들의 식사 지침에 응용할 수 있을 것으로 기대된다.

• 생태와환경
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• 제56권3호
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• pp.187-195
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• 2023

영산강의 상류에는 4개의 농업용 댐들이 축조되어 있으며 각 댐의 물은 경작지 관개용수로 거의 모두 공급되고 영산강 본류로 방류되지 않고 있다. 또한, 관개용수의 대부분도 사용 후에 영산강으로 회귀하지 않고 격리된 상태의 별도 용수간선을 통하여 영산강 하류까지 흘러가기 때문에 영산강 본류의 유량 부족 문제를 가중시키고 있다. 이러한 원인으로 영산강 유량의 71%가 하수처리수로 채워지는 결과를 초래하였으며 이에 따라 수질뿐 아니라 수생태 건강성도 우리나라 4대강 중 가장 열악한 실정이다. 따라서 본 연구에서는 영산강 수질개선을 위한 여러 가지 시나리오들을 오염삭감과 유량증대를 함께 고려하여 개발하였고 QUAL-MEV를 이용하여 각 시나리오의 장래수질을 예측·분석하였으며, 이러한 연구결과로부터 얻어진 결론은 다음과 같다. 1. 영산강의 수질개선은 오염삭감을 통해 그동안 꾸준히 시행되어 왔으나 이제 한계에 다다르고 있어 앞으로는 오염삭감만이 아니라 유량증대(해수담수화 포함) 방법이 함께 중점 추진되어야 하며, 이러한 경우에는 영산강 수질목표의 달성도 가능하다. 2. BOD는 오염삭감 그리고 T-P는 유량증대의 방법을 통해 크게 개선될 수 있다고 예측되었으므로 수질목표의 달성을 위해 오염삭감과 더불어 유량증대가 함께 도입된다면 이들 상호 간에는 시너지 효과가 크게 작용할 수 있을 것이다. 3. 그러나 유량증대사업의 원활한 추진을 위해서는 투자비용을 늘리는 것도 중요하겠으나 기존의 용수 이해관계자들간에 형성되어 있는 갈등 문제를 협의·해소키 위한 꾸준한 노력이 선행되어야 할 것이다. 4. 댐의 건설, 용수배분 조정 등 강우 유관형 유량증대 방법은 기후변화로 인해 강우가 오랜 기간 발생하지 않으면서 대가뭄이 지속될 경우에 적용의 효용성이 떨어지거나 상실될 수 있으므로 앞으로 비슷한 조건이라면 강우 무관형인 해수담수화시설을 유량증대사업 중 우선 설치대상으로 고려해야 할 것이다. 그 이유는 이러한 시설이 우리나라에서 새로 건설하기 어려운 댐의 용수확보 기능을 대체할 수 있고 대가뭄이 장기간 지속될 경우에 물관련 재해방지도 가능하여 기후변화의 적응시설로서 유용할 수 있기 때문이다.

• 대한간호학회지
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• 제8권1호
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• pp.16-42
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• 1978

This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.

• KDI Journal of Economic Policy
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• 제12권3호
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• pp.27-45
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• 1990

이촌향도형(離村向都型) 인구이동(人口移動) 농촌지역경제(農村地域經濟)에 미치는 영향(影響)에 관해 두가지 상반(相反)된 견해(見解)가 있다. 신고전학파적(新古典學派的) 낙관론(樂觀論) 따르면 이농현상(離農現象)은 농촌지역(農村地域)의 소득(所得)이나 후생수준(厚生水準)을 저해(沮害)하지 않는다고 보는 반면 Lipton (1980)은 그 반대의 견해(見解)를 취하고 있다. 본고(本稿)에서는 비교역재(非交易財)(nontraded goods)에 대한 국제무역이론(國濟貿易理論)과 화란병(和蘭病)(Dutch Disease)의 이론(理論)을 원용하여 농촌(農村)에서 도시(都市)로의 인구이동모형을 개발했다. 이 모형은 이농인구이동(離農人口移動)이 농촌지역(農村地域)의 소득(所得)과 후생수준(厚生水準)을 저해(沮害)한다는 점에서는 Lipton의 견해(見解)와 일치하나 소득(所得)을 감소(減少)시키는 요인들은 Lipton의 모형(模型)에서 지적(指摘)된 것들과는 다르다. 본고(本稿)는 이농현상(離農現象)이 농촌소득(農村所得)을 감소(減少)시키는 이유가 농업생산성(農業生産性)의 하락(下落) 때문이 아니라 농촌노동 및 소비인구의 격감으로 인한 농업부문(農業部門)의 이윤감소(利潤減少)와 농촌(農村) 서비스부문(部門)와 쇠퇴(衰退)때문이라고 주장한다. 1966, 1970, 1975, 1980 및 1985년의 한국인구(韓國人口)센서스 통계자료(統計資料)를 이용하여 주요가설(主要假說)들에 대해 실증분석(實證分析)을 한 결과 신고전학파(新古典學派)의 주장(主張)이나 Lipton의 견해(見解)보다 본(本) 연구모형(硏究模型)의 설명력(說明力)이 더 높은 것으로 밝혀졌다.