• 제목/요약/키워드: Modern medicine

검색결과 875건 처리시간 0.03초

고택의 의미와 가치 분석을 통한 공간치료 프로그램 연구 : 안동 권성백 고택을 중심으로 (A Study on the Spatial Therapy Program through the Analysis of the Meaning and Value of Old Houses : Focus on Kwon Seong-baek Old House in Andong)

  • 조정은;장창수;권기창
    • 지역과문화
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    • 제7권4호
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    • pp.49-68
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    • 2020
  • 현대인의 정신질환에 대한 보완의학 연구는 학문적 분야별로 이루어져 왔다. 심리치료, 미술치료, 문학치료, 무용치료 등이 그 중 하나지만 이러한 비통합적 연구를 현실에 적용하기는 극히 제한적이다. 약물치료 후 보완책을 모색하는 의료계와의 협업도 문제고, 이를 정책적으로 제도화하기는 더욱 어렵다. 이에 본 연구는 대부분의 치료 프로그램이 중시하는 공간의 가치를 연구해 공간 중심의 치료 패러다임으로의 전환을 제언하였다. 독일에서 발달해 국내에 유입된 통합문학치료학의 이론을 기저로 고찰하고 테트라시스템을 우리의 문화유산이도 한 고택 공간에 대입해 적용했다. 그리고 고택 공간의 특성을 치료 프로그램화 하는 방안을 샘플로 제시해 보았다. 안동시의 권성백 고택을 대표적인 공간으로 보고 분석해 보았다. 유사 사례로서 힐리언스 선마을, 독일의 크나이프 마을, 봉은사 템플스테이를 살펴보고 공간의 활용 실태를 파악하였다. 이에 고택 공간들을 테트라시스템으로 분석해 걷기, 시 쓰기, 풍욕, 편지 쓰기 등의 공간치료 프로그램을 제시하였다. 이는 공간의 장소화와 장소성을 프로그램에 접목하는 시초의 연구로서 의미가 크다 할 것이다.

중독(中毒) 현상의 도가철학적 해석 (On the Taoist Interpretation of Addiction)

  • 김백희
    • 대순사상논총
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    • 제47집
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    • pp.39-63
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    • 2023
  • 현대사회의 병리현상 중에서 매우 심각하게 문제를 야기하는 "중독(中毒)" 현상에 대한 도가철학적 해석과 해결 방안을 모색하는 것이 본고의 의도이다. 이를 위해 철학적 사유의 지평에서 중독을 관조는 법을 구명하였다. 질병은 고정불변의 실체를 지니는 존재자가 아니라 균형과 조화를 상실한 일종의 현상으로서 파악해야 한다. 이에 대한 치료는 해독약으로서의 약(藥)을 처방할 수 있다. 약 자체가 독약과 양약의 구분이 모호한 물질적 존재로서, 조화와 균형의 시각에서 약을 다루어야만 중독 현상의 해결에 유효할 수 있다. 중독 현상을 보는 도가철학의 관점은 만물의 개별자가 지니는 욕망의 일탈 또는 욕망의 과잉으로 빚어진 병리 현상이다. 개별자는 우주자연의 변화과정 속에 일시적으로 존재하는 과정적 존재일 뿐이다. 이런 도가적 세계관을 계승하는 유파로서의 한의철학이 있다. 도가적 한의철학의 지평에서 중독 현상은 마음의 조화와 균형을 잃는 것에서 온다. 해결의 방법도 마음의 혼란 상태[마(魔)]를 안정시키는 것에서 시작한다. 병리현상으로서의 중독은 실제로는 실체적 본질이 없다. 질병 현상은 삶의 어떤 계기나 인연에 의하여 조금씩 쌓여 견고하게 굳어진 일종의 일시적 현상일 뿐, 영원한 본질이 있는 악의 표상이 아니다. 이런 이치를 자각하는 순간 그런 병리현상에서 벗어날 수 있는 길이 열린다. 도가철학의 진단과 처방은 단호하다. 욕망의 일탈이 바로 병리현상을 일으킨다. 과유불급(過猶不及)이다. 과(過)와 불급(不及) 사이의 조화와 균형을 찾는 일이 중요하다. 그리하면 병리적 중독과 같은 모든 시름은 우주변화의 풍랑에 씻기어 간다.

만성 피부 질환으로 발생하는 스트레스 개선을 위한 호박, 작약, 타트체리 복합물의 효능 연구 (Study on the Efficacy of Paeonia Japonica, Cucurbita Moschata and Prunus Cerasus Complex Extract for Alleviating Stress Associated with Chronic Skin Conditions)

  • 박수진;김동희;곽기성;김현정
    • 한국응용과학기술학회지
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    • 제41권2호
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    • pp.459-471
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    • 2024
  • 현대사회에서 스트레스와 긴장감은 피할 수 없는 요인이다. 다양한 피부질환은 스트레스를 일으키는 중요한 요인으로 언급되고 있다. 피부질환을 가진 환자들은 수면상태가 원활하지 않아 전반적으로 수면 효율이 낮다. 또한 피부질환으로 인해 심리적 스트레스 수치가 높아지고, 이와 같은 과정은 반복적으로 발생하고 있다. 피부질환과 스트레스는 상호적으로 연관되어 있으며, psychodematology에 대한 연구가 증가하고 있다. 이에 본 연구에서는 피부질환을 저하 시킬 수 있는 호박, 작약, 타트체리 복합물을 활용하여 피부 각질 형성 세포에서 스트레스로 인한 만성 피부질환을 개선할 수 있는 소재를 개발하고 효능을 입증하고자 하였다. HaCaT 각질형성세포에 복합 추출물은 12.5, 25, 50, 100 ㎍/mL 농도 의존적으로 TNF-α, IL-1β, IL-6, MDC, TARC 발현량이 저해되었으며 특히 IL-1β의 경우, 100 ㎍/mL의 농도에서 40% 이상 저해하는 우수한 효능을 확인하였다. 또한 AQP-3, HA, filaggrin의 생성량 농도 의존적으로 유의미한 증가를 보이며 TNF-α/IFN-γ로 증가된 p-ERK, p-JNK, p-p38의 단백질 발현은 복합 추출물의 처리로 유의하게 감소시 키는 것으로 나타났다. 이를 통하여 해당 복합 추출물은 피부질환을 치료 및 예방할 수 있는 소재로서 활용가치가 있는 것으로 판단되며, 이는 피부질환과 스트레스 간의 상호 관계의 악영향을 낮춰 줄 것으로 판단된다.

노인복지시설(老人福祉施設)에 대한 대학생(大學生)의 의식(意識)과 관련요인(關聯要因) (An Awareness of Welfare Facility for the Elderly and It's Related Factors of College Students)

  • 좌윤택;남철현;박천만
    • 대한예방한의학회지
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    • 제2권1호
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    • pp.87-111
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    • 1998
  • For the newly approach of policy with the old aged era at hand, the result which examines the 1,200 students attending professional colleges and upward in three small-to-medium sized cities, for two months, from October 1, 1996 to November 30, in order to know the change of consciousness of the growing modern young intellectual age group is as follows. 1. The objects of survey consist of 72.1% of women, 40.4% of 20 to 21 age, 49.1% of atheists, and people from big cities and fishing and agrarian village occupy equally 40.2%. Concerning the long-termed residents, 49% of them dwell in big cities. In case of the parents' age is more than 55, 31.5% in fathers, and 10.9% in mothers. 2. The types of housing in which they desire to reside in their getting older are : 72.8% of them hope to live in individual houses, 16.6% in apartments or villas, and 3.4% in social welfare facilities. Out of respondents, compared with other groups, man rather than woman, those who are 20 to 21 age group and from fishing and agrarian villages and have over 7 family members and live with their parents have a higher preference for independent houses. 3. The districts in which they hope to live when they are old are : 41.6% of them, with the highest percent, hope to live in farming villages, the older they are, the more they hope to live in agricultural district, and women of 21 years and upward hope to live in big cities. On the other hand, the preferable degree for social welfare facilities is higher each in people who are 24 years and upward, buddhists, self-boarding students, and the more poorly they are off, the higher the percent is. 4. The types of preferable welfare facilities for the elderly are : 58.2% of them think silver towns desirable, 28.4% think the charged (or free) elderly welfare facilities. Compared with other groups, the percentage which prefer silver towns is higher in women, people from big cities, residents of main family, long-termed city residents, people with higher income, people having grandparents alive, and people who had experience of taking lectures on hygienics or social welfare. 5. 50.3% of the respondents insist that provision of living expenses against old age should be insured by social security system, and 42.8% by the elderly themselves. The percentage of the former shows higher in people of 21 years and upward, women, residents of fishing and agrarian villages, christians, people in more needy circumstances and people who have experience of using a medical institution. 6. Compared with other nations, 54.5% of the respondents have an opinion that elderly welfare and welfare work in Korea stays in insufficient level and most of them are women, people from farming village, residents of head family, people having younger parents and people being worse health condition, and they have a more positive attitude about the elderly welfare work. 7. 92.3% of the respondents answered that a national budget for the elderly welfare is scarce, and the percentage is higher in people who are older, residents of big cities, people in lower living condition and people in worse health condition. 8. 35.2% of the respondents answered that the proper cost of their old age must be over 220mi11ion. The more a family's total income is, the higher the percentage is. 9. The factors which have an effect on the preference of silver towns are sex(p<0.01, the type of the present residence(p<0.05), and a family's total income(p<0.05). 10. From the survey result of the above, we comes to the conclusion that, for the sake of welfare of the increasing elderly population, government authorities and parties concerned must exert their utmost for the elderly welfare by increasing a budget of it and establishing a number of facilities of the elderly welfare and silver towns located in fresh and comfortable villages. In addition, they have to set up a course of hygienics in all the colleges and instruct the contexts on hygienic welfare as well.

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파월국군장병의 고엽제 위해에 관한 예비적 역학조사 (A Preliminary Epidemiologic Study on Korean Veterans Exposed to Herbicides in Vietnam War)

  • 김정순;임현술;이홍복;이원영;박영주;김성수
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.711-734
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    • 1994
  • Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

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Structural Similarity Index 인자를 이용한 방사선 분할 조사간 환자 체위 변화의 자동화 검출능 평가: 초기 보고 (Feasibility of Automated Detection of Inter-fractional Deviation in Patient Positioning Using Structural Similarity Index: Preliminary Results)

  • 윤한빈;전호상;이자영;이주혜;남지호;박달;김원택;기용간;김동현
    • 한국의학물리학회지:의학물리
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    • 제26권4호
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    • pp.258-266
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    • 2015
  • 현대 방사선치료는 고선명 X선 투사영상을 이용하여 환자 및 종양의 위치를 확인하는 기술이 요구되지만, 3차원 영상 촬영을 위한 피폭량 및 영상정보의 급격한 증가는 환자에게 추가적인 부담이 될 수 있다. 본 연구에서는 영상의 구조 정보를 효과적으로 추출할 수 있는 Structural similarity (SSIM) 인자를 도입하여 매일 촬영하는 환자의 2차원 X선 영상간 차이를 자동 분석하여 환자의 위치 정확성의 검증 가능성을 제시하였다. 먼저 종양을 모사하기 위하여 구형 전산 팬텀의 크기와 위치를 변화시키면서 각각의 투사 영상을 시뮬레이션하고, SSIM 인자를 통해 영상 간 차이를 검출하여 분석하였다. 또한 12일간 매일 촬영한 방사선 치료 환자의 2차원 X선 영상들 간 차이를 동일한 방법으로 검출하였다. 그 결과 산출된 팬텀 변화에 따른 SSIM 값은 0.85~1 범위로, 관심영역(ROI)을 영상 전체가 아닌 팬텀으로 한정하였을 때는 0.006~1 범위로 나타나서 ROI 적용 시 민감도가 크게 상승하는 것을 확인하였다. 또한 임상 영상의 SSIM은 0.799~0.853 범위의 값을 나타냈으며 영상 간 차이가 SSIM 분포 상에 검출되는 것을 확인하였다. 본 연구결과는 소요 시간 및 피폭 등의 우려로 매일 사용하기 어려운 3차원 영상기법 대신 간단한 2차원 영상만을 이용하여 객관적이고 정량적인 환자 위치 정확성의 자동 평가 기법을 제공할 수 있을 것으로 기대된다.

아침대체 편의식 개발을 위한 전통음식의 조리방법과 문헌고찰 I(1400년대${\sim}$1945년대 고 조리서 속 미음과 미수, 고음류 분석) (Literary Investigation and Traditional Food Cooking Methods for the Development of a Breakfast Food Substitutefood I (Analysis of Mieum, Misu, and Goeum During $1400's{\sim}1945's$))

  • 복혜자
    • 한국식품조리과학회지
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    • 제23권6호
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    • pp.987-1002
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    • 2007
  • 조선시대 고조리서와 고문헌고찰을 통한 전통음식인 미음, 미수, 고음류의 조리방법은 다음과 같다. 미음류는 쌀과 잡곡류를 섞어 조리한 미음류 7종류와 견과류에 잡곡류와 한약재료 등을 섞어 조리한 미음류는 3종류이었다. 약초 등 한약 재료에 육류, 조류, 어패류 등을 섞어 조리한 미음류는 7종류로 총 17종류의 미음과 미수, 고음류 등이 분류되었다. 세부적인 조리방법은 다음과 같다. (1) 곡류를 이용한 미음으로 쌀과 조 등은 오랫동안 끓여 즙을 내 체에 받혀 소금간을 하였고, 율무, 수수 등은 수비한 가루를 끓이거나 물에 타 먹었다. (2) 인삼 등 한약재료 등은 오래 동안 끓여 성분이 용출되면 체에 밭여 액즙을 사용하였고 고기, 뼈, 어패류 등도 함께 오랫동안 푹 끓여 체에 받혀 즙으로 만들어 수시로 음료 마시듯이 이용하였다. 갈분, 율무 등은 수비한 가루로 묽게 끓였다. (3) 고기와 어패류를 이용한 미음으로는 고기와 어패류를 함께 푹 끓여 체에 받힌 후 묵은 간장으로 간을 하였으며, 뼈, 양, 도가니 등은 함께 만화로 오랫동안 끓여 체에 밭여 즙으로 짜거나 찹쌀이나 멥쌀로 함께 끓여 섞기도 하였다. 현대인들의 바쁜 일상에 일하면서 공부하면서 바로 먹을 수 있는 식사대체음식이 요구되는바 이에 전통음식이었던 미음, 미수, 고음류의 문헌고찰과 조리방법을 1차적인 연구로 시도하였다. 또한 고 조리서 속 전통음식을 재현한 문헌을 제시하였고 조리방법도 비교하였으며 전통음식을 조리과학적으로 실험한 연구동향을 살펴보았다. 후속 연구로 전통음식을 조리과학적인 실험연구로 전체적인 성분과 조리후의 영양 손실과 잔존여부, 실온상태에서의 보존료가 첨가되지 않은 기간동안의 부패 여부 등과 조리후의 항산화성 등을 실험하고 조리후의 관능평가를 거친 후 상품으로서의 식사대체음식 개발을 위한 기초연구자료로 삼고자 한다.

'낙태죄' 헌법재판소 헌법불합치 결정의 취지와 법률개정 방향 - 헌법재판소 2019. 4. 11. 선고 2017헌바127 전원재판부 결정에 따라 - (A Review on Constitutional Discordance Adjudication of the Constitutional Court to Total Ban on Abortion)

  • 이석배
    • 의료법학
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    • 제20권2호
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    • pp.3-39
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    • 2019
  • 헌법재판소가 2012년 8월 23일 낙태죄 규정을 합헌으로 결정한 이후에도 낙태죄 폐지에 대한 논란은 지속되어 왔다. 낙태죄의 존폐논란은 최근에만 일어난 일이 아니라 이미 형법제정 당시부터 있었던 것으로, 대한민국의 근대입법과정과 역사를 같이 한다. 당시 형법제정과정에서 낙태죄의 전면삭제를 주장하면서 수정안을 제출했던 의원들은 사회·경제적 적응사유를 핵심적인 제안이유로 제시하기도 하였다. 이후 개발독재기에도 낙태죄의 폐지가 논의되었으나, 이는 여성의 인권을 보장하기 위한 것이 아니라, 박정희 독재정권의 '산아제한', '가족계획'이라는 국책사업과 관련이 있었다. 이후 인공임신중절을 제한적으로나마 허용하는 「모자보건법」의 제정은 유신으로 국회가 해산된 후 입법권을 대신하게 된 비상국무회의에서 1973년 2월 8일 이루어졌고, 1973년 5월 10일부터 시행되었다. 그나마 일부라도 낙태의 합법화를 포함하는 「모자보건법」이 가능했던 배경은 당시 유신독재가 어떠한 이견도 허락하지 않았기 때문에, 종교계에서도 반대 의견을 표명하기 어려웠기 때문일 것으로 보인다. 이렇게 제정된 「모자보건법」은 지금까지 약간의 수정만을 거치며 그대로 유지되어왔다. 낙태죄 존폐론의 논거들도 형법제정 당시와 큰 차이 없이 그대로 평행선을 달려왔다고 볼 수 있다. 2012년 8월 23일 헌법재판소의 결정에서도 합헌의견과 위헌의견이 4:4로 팽팽하게 맞섰었다. 다만 헌법재판소의 위헌결정을 위한 정족수를 채우지 못하여 합헌으로 결정하였다. 이 낙태죄 폐지 논쟁은 이번 헌법재판소의 헌법불합치 결정으로 일단락되었고, 국회는 새로운 입법이라는 과제를 부담한다. 즉 국회는 적어도 2020년 12월 31일까지 개선입법을 이행하여야 하고, 그때까지 개선입법이 이루어지지 않으면 낙태죄조항들(「형법」 제269조제1항, 제270조제1항)은 2021년 1월 1일부터 효력을 상실한다. 따라서 아래에서 우선 형법상 낙태죄 규정에 대한 헌법재판소 헌법불합치 결정의 논거가 무엇인지를 살펴보고(II), 과거의 헌법재판소와 대법원의 논증구조와 어떠한 점에서 차이를 가지는지, 그리고 헌법재판소 헌법불합치 결정에서 나타난 쟁점을 무엇인지를 검토한 후(III), 헌법재판소가 제시한 기준에 따른 입법재량의 범위 안에서 입법방향과 이미 제출된 「형법」과 「모자보건법」의 개정안에 대하여 검토(IV)하였다.

비행시차와 일중리듬 (Jet Lag and Circadian Rhythms)

  • 김인
    • 수면정신생리
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    • 제4권1호
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    • pp.57-65
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    • 1997
  • 누구나 시차가 큰 여행을 할 때 몇일 간 비행시차증이라고 불리우는 증상을 경험하게 된다. 비행시차증은 수면박탈, 비행요인, 지연요인의 복합적인 원인으로 인해 생기는 하나의 증상군이라고 말할 수 있다. 특히 빠른 시차변화로 인한 생리적 지연효과(Jet lag)는 외적 비동조화, 내적 비동조화, 그리고 수면상실의 결과를 낳는다. 인간의 수면을 조절하는 기전에 있어 일중체계가 중요하다. 즉, 평균적인 수면-각성주기는 중심체온의 주기와 내적 비동조화가 일어나더라도 수면경향, 졸리움, 자발적 수면 기간, 그리고 렘수면 경향은 중심체온의 내인성 일중주기에 따라 통제된다. 수면의 구성요소중에서 서파수면은 중심체온의 주기보다는 수면시작시간에 따라 나타나며 이전에 깨어있었던 기간이 길수록 강력하게 나타난다. 따라서 수면은 일중체계와 항상성 기전의 상호작용으로 조절된다. 비행시차 후에 변화되는 수면양상을 이해하는데 있어 일중 체계 이외에 도항상성 기전을 고려하여야한다. 수면에 대한 일중리듬체계의 영향과 수면의 항상성 과정이 비행시차후 도착지에서의 수면양상을 설 명할 수 있을 것이다. 도착지에서의 적응은 통과한 시간대 수, 여행 방향, 일주기 리듬의 부조화에 적응 할 수 있는 개인별 능력에 따라 다르다. 도착지의 시간적 단서에 빨리 노출되어 일중체계의 위상반응곡선에 의한 재동조화를 촉진시키고 수면의 항상성 과정을 고려하여 도착지의 밤 이전까지 충분히 깨어 있는 것이 Jet Lag를 극복하고 적응하는 지름길일 것이다.

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농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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