• Journal of Nutrition and Health
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• 제56권6호
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• pp.683-701
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• 2023

본 연구는 우리나라 청소년의 성별과 신체활동 수준에 따른 식행동과 영양섭취 실태를 비교하기 위하여 제7기 국민건강영양조사의 2,3차년도 (2017-2018년) 자료를 분석하였다. 총 659명 중 남학생은 344명 (51.5%), 여학생은 315명 (48.5%)이며, 하루 60분 이상 신체활동 실천 빈도를 기준으로 '신체활동 많은 군' 57명 (8.9%), '신체활동 보통 군' 196명 (29.7%), '신체활동을 하지 않는 군' 406명 (61.4%)으로 구분하였다. 신체활동이 많은 군의 81.5%는 남학생, 신체활동이 없는 군의 59.9%는 여학생이었다. 신체활동을 많이 하는 청소년일수록 아침식사, 점심식사, 저녁식사 빈도가 높았다. 남학생의 35.5%는 '마른 편', 여학생의 38.9%는 '비만'으로 인식하였으며, 남학생의 20.2%는 '체중증가', 여학생의 48.6%는 '체중감량' 노력을 하였으며, 남학생의 근력운동 실시비율이 유의적으로 높았다. 신체활동에 따라서는 신체활동이 많은 군에서 주관적 건강상태를 좋다고 인식하는 경우가 67.8%로 유의하게 높았다. 신체활동이 많은 군에서 자신의 체형을 마른 편 또는 보통으로 높게 인식하는 반면 신체활동이 보통인 군과 없는 군에서는 비만으로 인식하고 있어 유의적인 차이를 보였다. 생화학적 특성은 콜레스테롤은 여학생이 공복혈당, 혈중 헤모글로빈, 헤마토크릿, 혈중 요소질소, 혈중 크레아틴은 남학생이 유의하게 높았다. 신체활동이 많은 청소년들의 혈중 중성지방과 콜레스테롤은 낮은 반면 혈중 헤모글로빈, 헤마토크릿은 유의적으로 높았다. 혈중 요소질소와 혈중 크레아틴은 신체활동을 하지 않는 군이 유의적으로 낮았다. 총 에너지 중 탄수화물: 단백질: 지방의 섭취비율은 모든 군이 적정 섭취비율 범위이었다. 신체활동을 하는 군의 에너지, 탄수화물, 단백질, 지방의 섭취량은 신체활동을 하지 않는 군보다 유의미하게 높았다. 신체활동을 하는 군의 비타민 B₁, 니아신의 섭취량이 유의적으로 높았다. 무기질은 신체활동이 많은 군의 칼슘, 인, 나트륨, 칼륨의 섭취량이 유의적으로 높았으며, 철의 섭취량은 신체활동이 보통인 군이 유의적으로 높았다. 이상의 결과, 성별에 따라 신체활동 수준의 차이를 보였으며, 규칙적인 신체활동은 청소년의 체질량지수, 식행동 및 영양소 섭취에 영향을 주었다. 따라서 학교 체육수업 참여를 통한 신체활동의 촉진과 청소년들이 흥미를 가지고 참여할 수 있는 다양한 스포츠 활동 프로그램의 개발과 운영이 필요하겠다.

• 한국비블리아학회지
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• 제34권4호
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• pp.303-329
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• 2023

본 연구는 국내 문헌정보학과 대학에서 수행되는 어린이청소년 문학 교육의 현황을 알아보고 개선 방안을 제시하기 위해 문헌정보학과의 학부와 대학원에 개설된 어린이청소년 문학 관련 교과목의 현황을 파악하고, 국내 대학 문헌정보학과에서 어린이청소년 문학 관련 교과목을 강의한 경험이 있는 교수자들을 대상으로 심층 면담과 설문조사를 진행하였다. 연구 결과에 따르면, 국내 문헌정보학과 대학 학부 과정에서는 평균 1.7개의 어린이청소년 문학 관련 교과목이 개설되어 있는데, 개설 과목이 1개 이하인 학교가 전체 대학의 36%이며, 학부와 대학원 모두 개설 과목이 대체로 '독서지도론'에 편중되어 있었다. 설문 응답자 29명 중 자신이 담당하는 어린이청소년 문학 관련 교과목에서 '어린이청소년 문학'에 관한 내용을 가르친다고 응답한 이는 24명(83%) 이었다. 교수자들이 수업에서 가장 많은 시간을 할애하는 장르는 그림책이었으며, 적은 시간을 할애하는 장르는 SF, 판타지, 만화 등 다양했다. 상대적으로 소홀한 장르가 있을 수밖에 없는 가장 큰 이유는 수업 시간이 부족하다는 것이었다. 부족한 수업 시간은 어린이청소년 문학을 가르치며 느끼는 가장 큰 어려움으로 지적되기도 했다. 설문 응답자 중에는 스스로 어린이청소년 문학에 대한 이해 역량을 갖고 있으면서도 어린이청소년 문학의 전문가가 아니라고 생각하는 이들이 일부 존재했는데, 면담 대상자들은 어린이청소년 문학과 관련한 문헌정보학 전공자의 강점을 스스로 인정하지 못하는 분위기를 안타까워했다. 면담 대상자 모두와 일부 설문 응답자들은 문헌정보학과에서의 어린이청소년 문학 교육이 현장 중심이어야 한다고 주장했다. 교수자들은 토론, 스토리텔링 실습, 리뷰 작성 등 다양한 교수 방법을 활용하여 학생들이 졸업 후 실제 도서관에서 어린이청소년 서비스를 제공할 때 도움이 되는 지식을 습득할 수 있게 하기 위해 노력하고 있었다.

• 대한원격탐사학회지
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• 제39권6_1호
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• pp.1309-1320
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• 2023

모바일 기기의 기술 발전과 대중화는 어디서든 사용자의 위치를 확인할 수 있으며 인터넷을 사용할 수 있도록 발전되었다. 그러나 실내의 경우 인터넷은 끊김없이 사용할 수 있지만 global positioning system (GPS) 기능은 활용하기 어렵다. 실내 공공장소인 백화점, 박물관, 컨퍼런스장, 학교, 터널 등 GPS가 수신되지 않는 음영 지역에서 실시간 위치정보 제공의 필요성이 증가하고 있다. 이에 따라 최근의 실내 측위 기술은 랜드마크 데이터베이스를 구축하기 위해 light detection and ranging (LiDAR) 장비를 기반으로 연구가 증가하고 있다. 본 연구에서는 랜드마크 데이터베이스 구축의 접근성에 초점을 두어 모바일 기기를 기반으로 랜드마크를 촬영한 단일 이미지와 사전에 구축된 랜드마크 데이터베이스 정보를 이용하여 사용자의 위치를 추정하는 기법을 개발하고자 하였다. 첫 번째로, 랜드마크 데이터베이스를 구축하였다. 랜드마크를 촬영한 모바일 이미지만으로 사용자 위치를 추정하기 위해서는 모바일 이미지에서 랜드마크 검출이 필수적이고, 검출된 랜드마크에서 고정적인 성격을 가진 지점의 지상좌표 취득이 필수적이다. 두 번째 단계에서는 bag of words (BoW) 영상 검색 기술을 적용해 랜드마크 데이터베이스 중 모바일 이미지가 촬영한 랜드마크를 유사한 4위까지 검색하였다. 세 번째 단계에서는 scale invariant feature transform (SIFT) 특징점 추출 기법과 Homography random sample consensus (RANSAC)을 통해 검색된 4개의 후보 랜드마크들 중 가장 유사한 하나의 랜드마크를 선정하였고, 이때 임계값 설정을 통해 정합점 수를 기반으로 한 차례 더 필터링을 수행하였다. 네 번째 단계에서는 대응된 랜드마크와 모바일 이미지간의 Homography 행렬을 통해 랜드마크 이미지를 모바일 이미지에 투사하여 랜드마크의 영역과 코너(외곽선)점을 검출하였다. 마지막으로, 위치추정 기법을 통해 사용자의 위치를 추정하였다. 해당 기술의 성능을 분석한 결과, 랜드마크 검색 성능은 약 86%로 측정되었다. 위치추정 결과와 사용자의 실제 지상좌표를 비교한 결과, 약 0.56 m의 수평 위치 정확도를 갖는 것이 확인되어 별도의 고가 장비 없이 랜드마크 데이터베이스를 구축하여 모바일 영상으로 사용자 위치 추정이 가능한 것을 확인하였다.

• 문화기술의 융합
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• 제9권6호
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• pp.531-538
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• 2023

최근 많은 대학 수업이 교수자 중심의 수업에서 학습자 중심의 수업으로 변해가고 있고, 특히 4차 산업혁명시대에 적합한 인재를 양성하기 위해 대학은 대학 교육의 방향성을 새로 정립시키고자 노력하고 있다. 이를 위해 대학에서는 학생들에게 필요한 다양한 역량을 제시하고 각 역량별 효율적인 교육 방안에 대한 연구에 집중하고 있다. 그 가운데 창의력은 대학에서 학생들이 지녀야 할 무엇보다 중요한 역량으로 꼽힌다. 탁상적인 수업에서 벗어나 다양한 전공자들이 모여서 창의적인 팀 활동을 진행하면서 결과 도출을 하는 창의적 문제해결 기반 교과목을 개발하는 것은시대적 요구에 적합한 인재를 양성할 수 있는 유의미한 교과라고 판단된다. 따라서 본 연구는 창의적 문제해결 기반교과목을 개발하고 수업 진행 결과를 분석하는데 있다. 본 창의력 문제해결 기반 수업은 단계별 아이디어 개발을 위한 Action Learnin 수업으로 진행되는데, 창의력 아이디어 개발을 위한 이론강의를 시작으로 하여 이후에 Action Learnin 5단계로 구성된다. 본 수업에 활용된 액션 러닝의 과제는 형성된 그룹의 친밀도를 높이고, 그룹의 집단표현력을 높이기 위해 세라믹으로 표현하기와 공익광고 포스터 만들기, 개인의 아이디어를 병합하여 하나로 압축하는 능력을 기르기 위한 생활 속의 아이디어, 학교에 대한 관심도를 높이거나 지역사회를 이해하기 위한 학교 주변의 환경개선 프로그램, 마지막으로 다양한 주제로 UCC 만들기 등으로 구성되었다. 수업 전반에 실시되는 이론강의에서는 창의적인 문제해결을 위한 과학적 사고 (Scientific Thinking)에 대해 수업을 진행하였고, 이후에 순차적으로 설정된 그룹형 action learning 수업을 실시하였다. 본 Action Learnin 과정은, 개인 및 그룹형 Action Learnin을 시작으로 사회 연계형 Action Learnin으로 넓혀지면서 단계별로 점차 난이도를 높혀가며 심화학습이 되도록 유도하였다. 또한, 본 수업을 진행하면서 다각적인 창의력 수업을 최적화하였고, 창의적 문제해결 형 대학 강의의 다양한 활용예시를 소개함으로써 향후 본 교과목 학습활동을 활성화하는 데 도움을 주었다.

• 대순사상논총
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• 제48집
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• pp.305-335
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• 2024

7~8세기에 중국 불교는 가장 융성했고 주요한 종파들이 등장해 각기 다른 길을 갔다. 이러한 사실은 잇따라 저술된 여러 고승전과 그 체재의 성격 변화를 통해서도 드러났다. 6세기 초, 혜교(慧皎)는 중국에 불교가 전래된 이후의 역사를 담은 『고승전(高僧傳)』을 편찬했다. 이때 십과(十科)라는 체재를 마련했는데, 645년에 도선(道宣)은 이 십과를 기본틀로 삼아 『속고승전(續高僧傳)』을 편찬했다. 그러나 십과의 일부를 수정하고 보완함으로써 십과를 역사서에 걸맞은 체재로서 정형화했다. 『속고승전』 이후에는 십과를 변형한 체재를 갖춘 고승전들이 편찬되었다. 법장(法藏)은 『화엄경전기』(690년?)를 저술하면서 십과로 구성했으나, 과목들의 명칭과 의미가 화엄철학을 강조하는 쪽으로 크게 변했다. 이어 혜상(惠詳)은 『홍찬법화전(弘贊法華傳)』(706년?)을 편찬하면서 『고승전』과 『속고승전』의 십과를 바탕으로 새롭게 변형한 팔과(八科)를 갖추었고, 승상(僧詳)은 『화엄경전기』의 십과에 두 과목을 새로 추가한 십이과(十二科) 체재의 『법화전기(法華傳記)』(750년?)를 편찬했다. 두 고승전의 체재는 철학보다 신앙에 방점을 찍었다. 선종에서도 8세기 초부터 고승전이 잇달아 편찬되었다. 『전법보기(傳法寶紀)』(713년?), 『능가사자기(楞伽師資記)』(713년?), 『역대법보기(歷代法寶記)』(774년), 『보림전(寶林傳)』(801년) 등이 그것이다. 그런데 네 고승전의 체재는 이전과 전혀 달랐다. 어떠한 과목도 설정하지 않고, 스승에서 제자로 이어지는 계보를 세워 서술했다. 이는 선종이 경전에 의거하지 않고 수행자가 스스로 깨닫는 것을 요체로 하기 때문이다. 그리고 처음에는 중국의 조사들만 입전하다가 『보림전』에 이르러서는 붓다 및 가섭 이하 27명의 조사들을 계보에 포함해 역사화했다. 이 허구적인 계보는 선종이 번성하면서 종파적 우월성과 정통성을 확보할 필요에 따른 것이었다.

• 한국학교ㆍ지역보건교육학회지
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• 제25권2호
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• pp.27-44
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• 2024

목적: 본 연구는 청소년의 생활습관과 흡연경험의 연관성을 알아보고 영향요인을 파악하여 청소년 흡연 예방을 위한 기초자료 제공하고자 하였다. 방법: 청소년건강행태조사 제17차(2021년) 자료를 활용한 2차 자료 분석으로 설계하였다. 연구대상은 796개 학교 54,848명의 자료를 사용하였으며 연구변수는 일반적특성, 흡연유무와 생활습관인 식습관, 신체활동습관, 수면습관, 스트레스인지정도를 사용하였다. 분석방법으로는 연구대상의 일반적 특성은 빈도분석, 흡연유무에 따른 일반적특성과 생활습관의 차이는 빈도분석과 Pearson Chis-square 검정을 실시하였다. 생활습관이 흡연경험에 미치는 영향요인을 알아보기 위해 다항 로지스틱 회귀분석을 실시하였다. 모든 분석은 IBM SPSS Statistics 28을 이용하였고 p<0.05인 경우 통계적으로 유의하다고 판단하였다. 결과: 일반적 특성에서 흡연경험이 있는 그룹에서 흡연경험이 없는 그룹보다 남학생이 더 많았다(67.4% : 50.1%)(p<0.001). 흡연경험 유무에 따른 생활습관의 차이를 분석한 결과 흡연경험이 있는 그룹에서 아침식사를 0일 하는 경우(27.7%), 과일섭취를 0번하는 경우(17.8%), 패스트푸드를 매일 3번이상 먹는 경우(0.9%)가 더 많았다(p<.001). 흡연경험 유무에 따른 신체활동습관은 흡연경험이 있는 그룹에서 60분 이상 숨이 찬 정도의 신체활동을 주 7회 하는 경우(8.4%), 고강도 신체활동을 주 5일 이상 하는 경우가(18.7%)가 더 많았다(p<.001). 수면을 통해 피로회복 정도는 흡연경험이 있는 그룹에서 전혀 충분하지 않다(21.6%)와 평상시 스트레스를 느끼는 정도가 아주 심한 경우(17.2%)가 흡연경험이 있는 그룹에서 더 많았다(p<.001). 생활습관과 흡연과의 연관성을 분석한 결과, 아침식사를 0일 하는 경우가 매일 하는 경우 보다 흡연가능성이 증가하였으며(OR=1.759, p<.001), 과일섭취를 0번 섭취하는 경우가 매일 3번 이상 섭취하는 경우보다 흡연경험 가능성이 증가하였다(OR=1.921, p<.001). 패스트푸드 섭취를 0번 하는 경우는 매일 3번 이상하는 경우보다 흡연경험 가능성이 감소하였다(OR=0.206, p<.001). 수면으로 피로회복정도가 충분한 경우는 충분하지 않는 경우보다 흡연경험 가능성이 감소하였으며(OR=0.458, p<.001), 스트레스를 가장 많이 느끼는 경우는 스트레스를 느끼지 않는 경우보다 흡연경험 가능성이 증가하였다(OR=1.260, p<.05). 결론: 청소년의 생활습관은 흡연경험과 연관성이 있음을 알 수 있었다. 이를 통해 청소년의 흡연 예방을 위한 정책 및 프로그램 개발 시 흡연행위 뿐만아니라 생활습관을 고려하여 다각적인 측면으로 교육 및 지도하는 방안을 모색할 수 있을 것이다. 이에 본 연구가 건강하고 올바른 생활습관 개선을 통한 청소년의 흡연 예방을 위한 기초자료로 활용될 수 있기를 기대한다.

• 대한간호학회지
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• 제3권1호
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• 대한한의학원전학회지
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• 제20권4호
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• pp.211-250
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• 2007

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${\sim}$1798) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai, Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 1749${\sim}$1787) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論) and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯) 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai 's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋司"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue", "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Rits(森立之 1807${\sim}$ 1885) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken and later became a pupil of Shou Gu Yi Zhai, a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("神農本草經"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"(神農本草經) and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"("枳園隨筆") that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"("說文解字") to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據). Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬 1804${\sim}$1876) learned scriptures and ancient texts from confucian scholar Asaka Gonsai, and learned medicine from his father Huai Yaun(槐園). He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi" and "Lao Yi Zhi Yan" but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 912-955) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 1755-1810) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi" and "Jin Qui Yao Lue Ji Yi" are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng" is a collection of essays on research. Also there are the "Su Wen Shi"("素問識"), "Ling Shu Shi"("靈樞識"), and the "Guan lu Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 1789-1827), and his works include works of research such as "Nan Jing Shu Jeng"("難經疏證"), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"("疾雅"), "Ming Yi Gong An"("名醫公案"), and "Yi Ji Kao"("醫籍考"). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 1789-1827), Yuan Jian(元堅 1795-1857) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(樂匙). He left about 15 texts, including "Su Wen Shao Shi"("素間紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"(傷寒廣要), and "Zhen Fu Yao Jue"("該腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(失數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', 'the founding of Ji Shou Guan and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai ' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

• 동국한의학연구소논문집
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• 제10권
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• pp.1-40
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• 2008

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 $1745{\sim}1798$) 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 $1739{\sim}1798$) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan(躋壽館) mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken(伊澤蘭軒) taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai(澀江抽齋), Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 $1749{\sim}1787$) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論") and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯). 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken(伊澤蘭軒) and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋詞"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue"("金匱要略"), "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Ritsi(森立之 $1807{\sim}1885$) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken(伊澤蘭軒) and later became a pupil of Shou Gu Yi Zhai(狩谷掖齋), a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"("神農本草經") and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"(枳園隨筆) that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"(說文解字) to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據), Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬, $1804{\sim}1876$) learned scriptures and ancient texts from confucian scholar Asaka Gonsai(安積艮齋), and learned medicine from his father Huai Yaun(槐園), He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju"("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi"("金匱要略疏義") and "Lao Yi Zhi Yan"(老醫巵言) but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 $912{\sim}955$) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 $1755{\sim}1810$) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi"("傷寒論輯義") and "Jin Qui Yao Lue Ji Yi"("金匱要略輯義") are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng"("醫勝") is a collection of essays on research. Also there are the "Su Wen Shi"(素問識), "Ling Shu Shi"("靈樞識"), and the "Guan Ju Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 $1789{\sim}1827$), and his works include works of research such as "Nan Jing Shu Jeng"(難經疏證), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"(疾雅), "Ming Yi Gong An"(名醫公案), and "Yi Ji Kao"(醫籍考). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 $1789{\sim}1827$), Yuan Jian(元堅 $1795{\sim}1857$) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(禦匙). He left about 15 texts, including "Su Wen Shao Shi"("素問紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"("傷寒廣要"), and "Zhen Fu Yao Jue"("診腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(矢數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', the founding of Ji Shou Guan(躋壽館) and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

• 농촌의학ㆍ지역보건
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• 제1권1호
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• pp.5-9
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• 1976

The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.