고도난청아(高度難聽兒)에 대(對)한 잔존청력(殘存聽力) (A Study on Residual Hearing of Hearing Impaired Children)
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- Journal of Preventive Medicine and Public Health
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- 제6권1호
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- pp.51-63
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- 1973
고도난청아(高度難聽兒)에 대(對)한 잔존청력(殘存聽力)을 조사(調査)하기 위(爲)하여 1973년(年) 3월(月) 10일(日)부터 동년(同年) 11월(月) 28일(日)까지 한사대(韓社大) 부속(附屬) 농학교(聾學校) 재학생(在學生) 207명(名)(초등(初等) 138명(名), 중등(中等) 47명(名), 고등(高等) 22명(名)), 즉(卽) 남(男) 135명(名), 여(女) 72명(名)을 대상(對象)으로 문진(問診)을 통(通)한 사회의학적(社會醫學的) 배경조사(背景調査)와 특수교육연구소(特殊敎育硏究所) 방음실(防音室)에서 AS-105형(型) 진단용(診斷用) TRIO 청력측정기(聽力測定器)에 의(依)한 청력검사결과(聽力檢査結果), 다음과 같은 성적(成績)을 얻었으므로 이에 보고(報告)하는 바이다. (1) 의무교육(義務敎育)은 초등교육(初等敎育)의 취학률(就學率)도 정상아(正常兒)에 있어서와 달리 난청출현율(難聽出現率)에 비례(比例)하여 고도난청아(高度難聽兒)에 있어서는 여자(女子)쪽이 현저(顯著)히 낮은 경향(傾向)이었고, 상분학교(上粉學校)(중(中),고(高))에 진학(進學)할수록 더욱 심(甚)한 격차(隔差)를 보였다. (2) 적령기(適齡期)(초등(初等) 만(滿) 6세(歲), 중등(中等) 12세(歲), 고등(高等) 15세(歲))에 입학(入學)한 학생(學生)은 11.3%, 학령기(學齡期)(초(初) 6세(歲)
In china, six bibliographies of offical historical books are evaluated at the most important things among the systematically-editing bibliographies. These bibliographies would be usful to study the orign of classical sciences and their development, bibliographic research of Chinese classics, bibliographic judgement on genuine books, titles, authors, volumes. They could be refered to research into graving, correcting, and existence of ancient books. therefore, these bibliographies would be applied to estimation the phase of scientific and cultural development. The study of these bibliographies has been not yet made in Korea. This thesis lays its importance on the background of their appearance, their classification norms, organizing system of their catalogue, and comparison between their difference. 1. Editing and compiling of Chilyak (칠약) by Liu Chin (유흠) and official histories played an important role of entering an apperance of historical book's bibliographies. Chilyak has been lost. However, its classification and compiling system of classical books would be traced by Hansoyemunji(한서예문지) of which basic system is similar to Chilyak. It classified books according to their scientific characteristic. If a few books didn't have their own categories, they were combined by the circles parallel to the books' characteristic. With the books classified under the same scientific characteristic, they were again divided into the scientific schools or structures. It also arranged the same kinds of books according to the chronology. The some books wi th duplicate subjects were classified multiplely by their duplicate subject. 2. Ssu-ma Chon's (사마천) The Historical Records (Saki, 사기) and Pan Ku's (반고) The History of the Former Han Dynasty (Hanso, 한서) has also took effects on appearance of historical books' bibliographies. Covering overall history, Saki was structured by the five parts: The basic annals(본기), the chronological tables (표), the documents (서), the hereditary houses (세가), biographies (열전). The basic annals dealt with kings and courts' affairs according to the chronology. The chronological tables was the records of the annals. The documents described overall the social and cultural systems. The hereditary houses recorded courts' meritorious officials and public figures. The biographies showed exemplars of seventy peoples selected by their social status. Pan Ku(반구)'s The History of the Former Han Dynasty(한서) deserved to be called the prototype for the offical histories after Saki's (사기; The Historical Records) apperance. Although it modelled on Saki, it had set up its own cataloguing system. It was organized by four parts; the basic annals (본기), the chronological tables (표), treatises(지), biographies (열전). The documents in the Hanso(한서) was converted into treatises(지). The hereditary houses and biographies were merged. For the first time, the treatise with The Yemunji could operate function for historical bibliographies. 3. There were six historical bibliographies: Hansoyemunji(한서예문지), Susokyongjeokji (수서경적지), Kudangsokyongjeokji(구당서경적지), Shindangsoyemunji (신당서예문지), Songsayemunji (송사예문지), Myongsayemunji (명사예문지). 1) Modelling on Liu Chin's Chilyak except Chipryak(집략), Hansoyemunji divided the characteristic of the books and documents into six parts: Yukrye(육예), Cheja(제자), Shibu(시부), Pyongsoh(병서), Susul(수술), Pangki(방기). Under six parts, there were thirty eight orders in Hansoyemunji. To its own classification, Hansoyemunji applied the Chilyak's theory of classification that the books or documents were managed according to characteristic of sciences, the difference of schools, the organization of sentences. However the overlapped subjects were deleted and unified into one. The books included into an unsuitable subject were corrected and converted into another. The Hansoyemunji consisted of main preface (Taesoh 대서), minor preface (Sosoh 소서) , the general preface (Chongso 총서). It also recorded the introduction of books and documents, the origin of sciences, the outline of subjects, and the establishment of orders. The books classified by the subject had title, author, and volumes. They were rearranged by titles and the chronological publication year. Sometimes author was the first access point to catalogue the books. If it was necessary for the books to take footnotes, detail notes were formed. The Volume number written consecutively to order and subject could clarify the quantity of books. 2) Refering to Classfication System by Seven Norms (칠분법) and Classification System by Four Norms(사분법), Susokyongjeokji(수서경적지) had accomplished the classification by four norms. In fact, its classification largely imitated Wanhyosoh(완효서)'s Chilrok(칠록), Susokyongjeokji's system of classification consisted of four parts-Kyung(경), Sa(사), Cha(자), Chip(칩). The four parts were divided into 40 orders. Its appendix was again divided into two parts, Buddihism and Taiosm. Under the two parts there were fifteen orders. Totally Susokyongjeokji was made of six parts and fifty five orders. In comparison with Hansoyemunji(한서예문지), it clearly showed the conception of Kyung, Sa, Cha, Chip. Especially it deserved to be paid attention that Hansoyemunji laied history off Chunchu(춘추) and removed history to Sabu(사부). However Chabu(사부) put many contrary subjects such as Cheja(제자), Kiye(기예), Sulsu(술수), Sosol(소설) into the same boundary, which committed errors insufficient theoretical basis. Anothor demerit of Susokyongjeokji was that it dealt with Taiosm scriptures and Buddism scriptures at the appendix because they were considered as quasi-religion. Its compilation of bibliographical facts consisted of main preface(Taesoh 대서), minor preface(Sosoh 소서), general preface (Chongsoh 총서), postscript (Husoh 후서). Its bibliological facts mainly focused on the titles. Its recorded authors' birth date and their position. It wrote the lost and existence of books consecutive to total number of books, which revealed total of the lost books in Su Dynasty. 3) Modelling on the basis of Kokumsorok(고분서록) and Naewaekyongrok(내외경록), Kudangsokyongjeokji(구당서경적지) had four parts and fourty five orders. It was estimated as the important role of establishing basic frame of classification by four norms in classification theory's history. However it had also its own limit. Editing and compling orders of Kudangsokyongjeokji had been not progressively changed. Its orders imitated by and large Susokyongjeokji. In Its system of organizing catalogue, with its minor preface and general preface deleting, Kudangsokyongjeokji by titles after orders sometimes broke out confusion because of unclear boundaries between orders. 4) Shindangsoyemunji(신당서예문지), adding 28,469 books to Kudangsokyongjeokji, recorded 82,384 books which were divided by four parts and fourty four orders. In comparison with Kudangkyongjeokj, Sindangsoyemunji corrected unclear order's norm. It merged the analogical norms four orders (for instance, Kohun 고훈 and Sohakryu 소학류) and seperated the different norms four orders (for example, Hyokyong 효경 and Noneuhryu 논어류, Chamwi 참위 and Kyonghaeryu 경해류, Pyonryon 편년 and Wisaryu 위사류). Recording kings' behaviors and speeches (Kikochuryu 기거주류) in the historical parts induced the concept of specfication category. For the first time, part of Chipbu (집부) set up the order of classification norm for historical and literatural books and documents (Munsaryu 문사류). Its editing and compiling had been more simplified than Kudangsokyongjeokji. Introduction was written at first part of bibliographies. Appendants except bibliographic items such subject, author, title, volume number, total were omitted. 5) Songsayemunji(송사예문지) were edited in the basis of combining Puksong(북송) and Namsong(남송), depending on Sabukuksayemunji(사부국사예문지). Generally Songsayemunji had lost a lot of bibliographical facts of many books. They were duplicated and wrongly classified books because it committed an error of the incorrectly annalistic editing. Particularly Namsong showed more open these defaults. Songsayemunji didin't include the books published since the king Youngchong(영종). Its system of classification was more better controlled. Chamwiryu(참위류) in the part of Kyongbu(경부) was omitted. In the part of history(Sabu 사부), recordings of kings' behaviors and speeches more merged in the annals. Historical abstract documents (Sachoryu 사초류) were seperately arranged. In the part of Chabu(자부), Myongdangkyongmaekryu(명당경맥류) and Euisulryu(의술류) were combined. Ohangryu(오행류) were laied off Shikuryu(시구류). In the part of Chipbu(집부), historical and literatural books (Munsaryu 문사류) were independentely arranged. There were the renamed orders; from Wisa(위사) to Paesa(패사), Chapsa (잡사) to Pyolsa(열사), Chapchonki(잡전기) to Chonki(전기), Ryusoh(류서) to Ryusa(류서). Introduction had only main preface. The books of each subject catalogued by title, the volume number, and author and arranged mainly by authors. Annotations were written consecutively after title and the volume number. In the afternote the number of not-treated books were revealed. Difference from Singdangsohyemunji(신당서예문지) were that the concept and boundary of orders became more clearer. It also wrote the number of books consecutive to main subject. 6) Modelling on Chonkyongdangsomok (경당서목), Myongsayemunji(명사예문지) was compiled in the basis of books and documents published in the Ming Danasty. In classification system, Myongsayemunji partly merged and the seperated some orders for it. It also deleted and renamed some of orders. In case of necessity, combining of orders' norm was occured particulary in the part of Sabu(사부) and Chabu(자부). Therefore these merging of orders norm didn't offer sufficient theretical background. For example, such demerits were seen in the case that historical books edited by annals were combined with offical historical ones which were differently compiled and edited from the former. In the part of Chabu(자부), it broke out another confusion that Pubga(법가), Meongga(명가), Mukga(묵가), Chonghweongka's(종횡가) thoughts were classified in the Chapka(잡가). Scriptures of Taiosim and Buddhism were seperated from each other. There were some deleted books such as Mokrokryu(목록류), Paesaryu(패사류) in the part of history (Sabu 사부) and Chosaryu(초사류) in the part of Chipbu(집부). The some in the each orders had been renamed. Imitating compiling system of Songsayemunji(송사예문지), with reffering to its differ-ence, Myongsayemunji(명사예문지) wrote the review and the change of the books by author. The number of not-treated books didn't appear at the total. It also deleted the total following main subject.
Just before the Korean War, the total number of the North Korean troops was 198,380, while that of the ROK(Republic of Korea) army troops 105,752. That is, the total number of the ROK army troops at that time was 53.3% of the total number of the North Korean army. As of December 2008, the total number of the North Korean troops is estimated to be 1,190,000, while that of the ROK troops is 655,000, so the ROK army maintains 55.04% of the total number of the North Korean troops. If the ROK army continues to reduce its troops according to [Military Reform Plan 2020], the total number of its troops will be 517,000 m 2020. If North Korea maintains the current status(l,190,000 troops), the number of the ROK troops will be 43.4% of the North Korean army. In terms of units, just before the Korean War, the number of the ROK army divisions and regiments was 80% and 44.8% of North Korean army. As of December 2008, North Korea maintains 86 divisions and 69 regiments. Compared to the North Korean army, the ROK army maintains 46 Divisions (53.4% of North Korean army) and 15 regiments (21.3% of North Korean army). If the ROK army continue to reduce the military units according to [Military Reform Plan 2020], the number of ROK army divisions will be 28(13 Active Division, 4 Mobilization Divisions and 11 Local Reserve Divisions), while that of the North Korean army will be 86 in 2020. In that case, the number of divisions of the ROK army will be 32.5% of North Korean army. During the Korean war, North Korea suddenly invaded the Republic of Korea and occupied its capital 3 days after the war began. At that time, the ROK army maintained 80% of army divisions, compared to the North Korean army. The lesson to be learned from this is that, if the ROK army is forced to disperse its divisions because of the simultaneous invasion of North Korea and attack of guerrillas in home front areas, the Republic of Korea can be in a serious military danger, even though it maintains 80% of military divisions of North Korea. If the ROK army promotes the plans in [Military Reform Plan 2020], the number of military units of the ROK army will be 32.5% of that of the North Korean army. This ratio is 2.4 times lower than that of the time when the Korean war began, and in this case, 90% of total military power should be placed in the DMZ area. If 90% of military power is placed in the DMZ area, few troops will be left for the defense of home front. In addition, if the ROK army continues to reduce the troops, it can allow North Korea to have asymmetrical superiority in military force and it will eventually exert negative influence on the stability and peace of the Korean peninsular. On the other hand, it should be reminded that, during the Korean War, the Republic of Korea was attacked by North Korea, though it kept 53.3% of troops, compared to North Korea. It should also be reminded that, as of 2008, the ROK army is defending its territory with the troops 55.04% of North Korea. Moreover, the national defense is assisted by 25,120 troops of the US Forces in Korea. In case the total number of the ROK troops falls below 43.4% of the North Korean army, it may cause social unrest about the national security and may lead North Korea's misjudgement. Besides, according to Lanchester strategy, the party with weaker military power (60% compared to the party with stronger military power) has the 4.1% of winning possibility. Therefore, if we consider the fact that the total number of the ROK army troops is 55.04% of that of the North Korean army, the winning possibility of the ROK army is not higher than 4.1%. If the total number of ROK troops is reduced to 43.4% of that of North Korea, the winning possibility will be lower and the military operations will be in critically difficult situation. [Military Reform Plan 2020] rums at the reduction of troops and units of the ground forces under the policy of 'select few'. However, the problem is that the financial support to achieve this goal is not secured. Therefore, the promotion of [Military Reform Plan 2020] may cause the weakening of military defence power in 2020. Some advanced countries such as Japan, UK, Germany, and France have promoted the policy of 'select few'. However, what is to be noted is that the national security situation of those countries is much different from that of Korea. With the collapse of the Soviet Unions and European communist countries, the military threat of those European advanced countries has almost disappeared. In addition, the threats those advanced countries are facing are not wars in national level, but terrorism in international level. To cope with the threats like terrorism, large scaled army trops would not be necessary. So those advanced European countries can promote the policy of 'select few'. In line with this, those European countries put their focuses on the development of military sections that deal with non-military operations and protection from unspecified enemies. That is, those countries are promoting the policy of 'select few', because they found that the policy is suitable for their national security environment. Moreover, since they are pursuing common interest under the European Union(EU) and they can form an allied force under NATO, it is natural that they are pursing the 'select few' policy. At present, NATO maintains the larger number of troops(2,446,000) than Russia(l,027,000) to prepare for the potential threat of Russia. The situation of japan is also much different from that of Korea. As a country composed of islands, its prime military focus is put on the maritime defense. Accordingly, the development of ground force is given secondary focus. The japanese government promotes the policy to develop technology-concentrated small size navy and air-forces, instead of maintaining large-scaled ground force. In addition, because of the 'Peace Constitution' that was enacted just after the end of World War II, japan cannot maintain troops more than 240,000. With the limited number of troops (240,000), japan has no choice but to promote the policy of 'select few'. However, the situation of Korea is much different from the situations of those countries. The Republic of Korea is facing the threat of the North Korean Army that aims at keeping a large-scale military force. In addition, the countries surrounding Korea are also super powers containing strong military forces. Therefore, to cope with the actual threat of present and unspecified threat of future, the importance of maintaining a carefully calculated large-scale military force cannot be denied. Furthermore, when considering the fact that Korea is in a peninsular, the Republic of Korea must take it into consideration the tradition of continental countries' to maintain large-scale military powers. Since the Korean War, the ROK army has developed the technology-force combined military system, maintaining proper number of troops and units and pursuing 'select few' policy at the same time. This has been promoted with the consideration of military situation in the Koran peninsular and the cooperation of ROK-US combined forces. This kind of unique military system that cannot be found in other countries can be said to be an insightful one for the preparation for the actual threat of North Korea and the conflicts between continental countries and maritime countries. In addition, this kind of technology-force combined military system has enabled us to keep peace in Korea. Therefore, it would be desirable to maintain this technology-force combined military system until the reunification of the Korean peninsular. Furthermore, it is to be pointed out that blindly following the 'select few' policy of advanced countries is not a good option, because it is ignoring the military strategic situation of the Korean peninsular. If the Republic of Korea pursues the reduction of troops and units radically without consideration of the threat of North Korea and surrounding countries, it could be a significant strategic mistake. In addition, the ROK army should keep an eye on the fact the European advanced countries and Japan that are not facing direct military threats are spending more defense expenditures than Korea. If the ROK army reduces military power without proper alternatives, it would exert a negative effect on the stable economic development of Korea and peaceful reunification of the Korean peninsular. Therefore, the desirable option would be to focus on the development of quality of forces, maintaining proper size and number of troops and units under the technology-force combined military system. The tableau above shows that the advanced countries like the UK, Germany, Italy, and Austria spend more defense expenditure per person than the Republic of Korea, although they do not face actual military threats, and that they keep achieving better economic progress than the countries that spend less defense expenditure. Therefore, it would be necessary to adopt the merits of the defense systems of those advanced countries. As we have examined, it would be desirable to maintain the current size and number of troops and units, to promote 'select few' policy with increased defense expenditure, and to strengthen the technology-force combined military system. On the basis of firm national security, the Republic of Korea can develop efficient policies for reunification and prosperity, and jump into the status of advanced countries. Therefore, the plans to reduce troops and units in [Military Reform Plan 2020] should be reexamined. If it is difficult for the ROK army to maintain its size of 655,000 troops because of low birth rate, the plans to establish the prompt mobilization force or to adopt drafting system should be considered for the maintenance of proper number of troops and units. From now on, the Republic of Korean government should develop plans to keep peace as well as to prepare unexpected changes in the Korean peninsular. For the achievement of these missions, some options can be considered. The first one is to maintain the same size of military troops and units as North Korea. The second one is to maintain the same level of military power as North Korea in terms of military force index. The third one is to maintain the same level of military power as North Korea, with the combination of the prompt mobilization force and the troops in active service under the system of technology-force combined military system. At present, it would be not possible for the ROK army to maintain such a large-size military force as North Korea (1,190,000 troops and 86 units). So it would be rational to maintain almost the same level of military force as North Korea with the combination of the troops on the active list and the prompt mobilization forces. In other words, with the combination of the troops in active service (60%) and the prompt mobilization force (40%), the ROK army should develop the strategies to harmonize technology and forces. The Korean government should also be prepared for the strategic flexibility of USFK, the possibility of American policy change about the location of foreign army, radical unexpected changes in North Korea, the emergence of potential threat, surrounding countries' demand for Korean force for the maintenance of regional stability, and demand for international cooperation against terrorism. For this, it is necessary to develop new approaches toward the proper number and size of troops and units. For instance, to prepare for radical unexpected political or military changes in North Korea, the Republic of Korea should have plans to protect a large number of refugees, to control arms and people, to maintain social security, and to keep orders in North Korea. From the experiences of other countries, it is estimated that 115,000 to 230,000 troops, plus ten thousands of police are required to stabilize the North Korean society, in the case radical unexpected military or political change happens in North Korea. In addition, if the Republic of Korea should perform the release of hostages, control of mass destruction weapons, and suppress the internal wars in North Korea, it should send 460,000 troops to North Korea. Moreover, if the Republic of Korea wants to stop the attack of North Korea and flow of refugees in DMZ area, at least 600,000 troops would be required. In sum, even if the ROK army maintains 600,000 troops, it may need additional 460,000 troops to prepare for unexpected radical changes in North Korea. For this, it is necessary to establish the prompt mobilization force whose size and number are almost the same as the troops in active service. In case the ROK army keeps 650,000 troops, the proper number of the prompt mobilization force would be 460,000 to 500,000.
One of the important tasks for new parents. especially mothers, is to establish warm, mutually affirming interpersonal relationships with the new baby in the family, with the purpose of promoting the healthy development of the child and the wellbeing of the whole family. Nurses assess the quality of the behavioral characteristics of the maternal-infant interaction. This study examined the relationships between primiparas pereptions of their delivery experience and their maternal infant interaction. It compared to delivery experience of mothers having a normal vaginal delivery with those having a casearean section. The purpose was to explore the relationships between the mother's perceptions of her delivery experience with her maternal infant interaction. The aim was to contribute to the development of theoretical understanding on which to base care toward promoting the quality of maternal-infant interaction. Data were collected directly by the investigator and a trained associate from Dec. 1, 1987 to March 8, 1988. Subjects were 3 random sample of 62 mothers, 32 who had a normal vaginal delivery and 30 who had a non-elective cesarean section (but without other perinatal complications) at three general hospitals in Seoul. Instruments used were the Stainton Parent -infant Interaction Scale(1981) and the Marut and Mercer Perception of Birth Scale(1979). The first observations were made in the delivery room (for vaginally delivered mothers only), followed by day 1, day 2, day 3, and 2 weeks, 4 weeks, 6 weeks and 8 weeks after birth, for a total of 7-8 contacts(Cesarean section mothers were observed on days 4 and 5 but the data not used for analysis). Observations in the hospital were made during the hour prior to scheduled feedings. The infant was placed beside the mother. Later contacts were made at home. Data analysis was done by computer using as SPSS program and indulded X² test, paired t-test, t-test, and Pearson Correlation coefficient ; the results were as follows. 1. Mothers who had a normal vaginal delivery tended to perceive the delivery experience more positively than cesarean section mothers(p＝0.002). The finding supported the hypothesis I that perception of delivery would vary according to the method of delivery. Mothers' perceptions of birth were classified into three dimensions, labor, delivery and the bady. There was a significantly different and positive perception by the vaginally delivered mothers to the delivery experience(p＝0.000) but no differences for labor or the bady according to the delivery method(p＝0.096, p＝0.389), 2. Mothers who had a normal vaginal delivery had higher average maternal-infant interaction scores(p＝0.029) than mothers who had a cesarean section. There were similar higher scores for the 1st day(p＝0.042), 2nd day (p＝0.009), and the 3rd day(p＝0.006) after delivery but not for later times. The findings supported the hypothesis Ⅱ that there would be differences in maternal-infant interaction for mothers having vaginal and cesarean section deliveries. However these differences deccreased section deliveries. However these differences decreased over time . by eight weeks the scores for vaginal delivery mothers averaged 8.1 and for cesarean section mothers, 7.9. 3. The more highly positive the pereption of the delivery experience, the higher the maternal-infant interaction score for all subjects(F＝.3206, p＝.006). The findings supported the hypothesis Ⅲ that there would be correlations between perceptions of delivery and maternal-infant interaction. The maternal infant interaction was highest when the perception of the bady and deliery was positive(r＝.4363, p＝.000, r＝.2881, p＝.012). No correlations between perceptions of labor and maternal-infant interaction were found(p＝0.062). 4. The daily maternal-infant interaction score for the initial contact after birth to 8 weeks postpartum had the lowest average score 5.20 and the highest 7.98(in a range of 0-10). This subjects group of mothers needed nursing intervention to promote their maternal- infant interaction. The daily scores for the maternal-infant over the period of eight weeks. However, there were significantly different increases in maternal-infant interaction only from the first to second day(p＝0.000) and from the fourth to sixth weeks after birth(P＝0.000). 5. When the eight items of maternal-infant interaction were evaluated separately, “Expresses feelings about her role as mother” had the highest average score, 1.64(ina range of 0-3)and “Speaks to baby” the lowest, 0.9. All items, with the possible exception of “Expresses feelings about her role as mother”, suggested the subjects' need of nursing intervention to promote maternal-infant interaction. 6. There were positive correlations between certain general charateristis, namely, both a higher economic status(p＝0.002) and breast feeding(p＝0.202) and maternal - infant interaction. There were positive correlations between a mother's confidence in her role as a mother and the perception of the birth experience(p＝0.004). For mothers who had a cesarean section, a positive perception of the birth experience was related to the duration of her marriage(p＝0.010), a wanted pregnancy (P＝0.030) and her confidence in her role as a mother(p＝0.000). Pereptions of birth for mothers who had a normal vaginal delivery were positive than those for mothers who had a cesarean section. The level of maternalinfant interaction for mothers delivered vaginally was higher than for cesarean section mothers. The relationship between perception of birth and materanalinfant interaction was confirmed. Cesarean section has an impact on the mother's perceived experience of birth which, in turn, is positively related to maternal-infant in turn, is positively related to maternal-infant interaction. Nursing intervention to enhance maternal-infant interaction should begin in prenatal classes with an exploration of the potential impact of cesarean section on the perceptions of the birth experience and continue throughout the perinatal and post-natal periods to promote the mother's ability to control with this crisis experience and to mobilize social support. Nursing should help transform a relatively negatively perceived experience into an accepted, positively perceived and self affirming experience which enhances the maternal-infant relationship.
The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and
본 연구는 국민영양관리를 위한 전문 인력 중장기 수급전망을 통하여 영양사 인력수급정책에 필요한 기초 자료와 정책방향을 제시하는데 그 목적이 있다. 이를 위하여 영양사의 면허등록인력, 사망자, 해외이주자, 취업직종 등 공급실태를 조사 분석하였다. 이 분석결과를 토대로 영양사 인력의 중장기 수급추계와 정책방향을 제시하였다. 영양사의 실태분석을 위해서 보건복지가족부의 영양사 면허등록인력, 행정안전부의 주민등록자료 및 건강보험공단의 건강보험 자격 자료를 수집하여 분석하였고, 영양사 인력 공급 추계방법으로는 기초추계유형 하에서 유입유출방법과 인구학적인 방법을 사용하였고, 수요추계방법으로는 인구, 국민총생산액 (GDP) 그리고 외국의 기준을 적용하는 비 (ratio)의 방법을 적용하였다. 본 연구결과에 따르면, 2025년까지 영양사 수급불균형정도와 방향은 영양사 수요추계방법에 따라 다소 다르게 전망된다. 먼저 인구 비 (ratio)를 적용한 수요추계에서 단순인구를 적용한 수요 추계치는 우리나라와 같이 저출산 현상이 지속되는 국가에서는 향후 국민건강영양수요의 변화를 반영하지 못하기 때문에 적절하지 않다고 판단된다. 따라서 인구 비를 적용해야 하는 경우 연령별 가중치가 적용된 보정된 인구수를 적용하는 것이 타당하다. 이 방법에 의한 수요추계치와 공급추계치를 비교하면 수요에 비해서 공급이 다소 많아서 2010년에 1,634명에서 2025년에 2,076명으로 영양사가 공급과잉 될 것으로 전망되지만, 수급 불균형 규모가 10%내외에 있기 때문에 큰 문제가 되지 않을 것으로 전망된다. 뿐만 아니라 향후 소득증가에 따른 건강수준 향상에 대한 요구와 만성질환자 증가 등에 따른 식이영양의 중요성으로 영양사 수요는 증가하리라 판단되기 때문에 수급불균형은 큰 문제가 되지 않을 것으로 판단된다. 국내총생산 (GDP)의 비 (ratio)를 적용한 방법과 관련하여, 국내총생산이 원화 (￦)와 달러화 ($)로 표시된 것에 따라 수급불균형의 규모가 다소 달라지는 것으로 나타났다. 원화로 표시된 국내총생산의 비를 적용하여 추계한 수요와 비교하면 10% 내외의 수급불균형이 발생하고, 달러화로 표시된 국내총생산의 비를 적용한 수요추계치와 비교하면 영양사 공급과잉규모가 증가하다가 2020년 이후 부터 공급과잉의 규모가 감소한다. 국내총생산 (GDP)을 적용한 수요추계치와 공급추계치를 비교하면 전반적으로 공급과잉현상이 나타날 것으로 전망되지만, 노령화 및 만성질환자의 증가에 따른 식이영양의 수요의 증가로 영양사의 수요가 증가할 것으로 판단되어 국내총생산의 비를 적용한 시나리오 하에서도 영양사의 수급불균형은 크게 문제가 되지 않을 것으로 판단된다. 외국의 영양사 비를 적용한 시나리오와 관련하여, 공급추계치를 미국의 영양사 기준을 적용하여 추계한 우리나라 영양사 수요추계치와 비교하면, 시나리오에 상관없이 우리나라 영양사 수요는 2025년까지 공급과잉으로 전망된다. 그러나 유럽의 영양사 기준을 적용했을 때는 시나리오에 따라 수급전망이 달라진다. 유럽의 '시나리오 1'을 기준으로 하면 공급과잉 현상이 발생하지만 '시나리오 2'를 기준으로 하면 공급부족현상이 발생한다. 외국의 기준을 적용한 수급추계결과에 대해서는 국가 간 영양사의 역할 및 기능 등이 다소 다를 수 있기 때문에 신중하게 접근해야 한다. 우리나라 영양사인력은 다소 과잉공급이 전망되지만 노령화 및 만성질환자의 증가에 따른 식이영양 수요의 증가와 병원 분야의 임상영양사의 수요의 증가로 영양사의 수요가 증가할 것으로 판단되어 영양사 공급과잉은 큰 문제가 될 것으로 보이지는 않는다. 그러나 우리나라의 영양사 자격요건은 지나치게 열려있으며 이는 영양사인력의 자질에도 영향을 미치고 있는 실정이다. 따라서 향후 영양사 면허자격과 합격요건을 강화하여 영양사 배출 인력의 자질 향상과 적정수급을 유지하는 방향의 정책이 요구된다.
I investigated actual conditions of smoking of teenagers who were randomly chosen middle and high school students. 1. Juvenile smoking 1) Parents' opinions of juvenile smoking Most parents do not want their children to smoke after growth : 88.6% of fathers (middle school students: 88.9%, high school students: 88.4%) and 95.1% of mothers (middle school students: 93.4%, high school students :95.5%). 2) Teenagers' opinions of smoking after growth The rate of students who will smoke after growth is 10.8% (middle school students: 12.0%, high school students: 9.9%): students in agricultural areas show the higher rate than those in cities. 3) Parents' opinions of their children's smoking now 1.5% of fathers want their children to smoke now (middle school students: 1.3%, high school students: 1.6%) and 1.1% of mothers do (middle school students: 0.6%, high school students: 1.5%). This shows that most parents do not want their children to smoke now. 4) Students' opinions of their friends' smoking now Students who want their friends smoke now cover 7.8% (middle school students: 7.1%, high school students: 8.4%). This rates are higher than those of parents shown in (3). And more high school students and more girl students gave the positive reponse than middle school boy and girl students, respectively. 5) Students' views of smoking "Look like an adult" covers the rate of 4.0% (boy: 7.8%, girl:3.6%) 6.7% of middle school students have this view, while 3.7% of high school students have. 16.1% of students had an experience of smoking during the last one year (boy: 29.9%, girl: 8.6%): this shows that the rate of the boy students is more than 3 times greater than that of the girl students and high students who experienced smoking last year covers 20.2%, while middle school students shows 10.9%. 6) Actual conditions of students' smoking The present rate of students' smoking is 22.4% (boy:38.3%, girl:13.8%): the rate of boy students is greater than that of girl students. Students who smoke more than pack of cigarettes a day cover 8.2% (boy: 17.5%, girl: 3.2%): 5.2% of middle school students (boy:11.4%, girl: 2.1%) smoke more than one pack while 10.7% of high school students do (boy:21.5%, girl: 4.2%). This shows that the rate of boy students' smoking is greater than that of girl students' smoking. 7) The rate of smoking of students' parents 75.4% of fathers (city: 74.5%, agricultural area:75.9%) smoke: and more than a half (62.4%) smoke more than a pack cigarettes a day. On the other hand, the rate of smoking mothers is 5.2%(city: 4.3%, agricultural area: 7.3%): the rate is higher in agricultural areas. 8) Opinions of smoking population in the future 61.4% of students answered that smoking population will increase, while 27.0% have the opinion that smoking population will decrease. 2. Opinions of the effects of smoking on health 1) Have you heard that smokers are likely to suffer from tuberclosis? 78.3% of students said yes (boy: 80.8%, girl: 76.4%): it is shown that the rate of boys is greater than that of girls. 2) Have you heard that smokers are likely to get out of endurance? 76.6% of students (boy: 69.3%, girl: 49.7%) answered yes: it is shown that the rate of boys is greater than that of girls. 3) Have you heard that heart-beats get fast when one smokes? 32.5% of students (boy: 35.5%, girl: 30.9%) answered yes: 32.2% in cities(boy: 33.0%, girl: 31.8%) and 33.5% in agricultural areas(boy: 41.8%, girl: 28.8%): and 28.7% middle students and 35.5% of high school students answered yes. 4) Have you heard that smokers are likely to have heart-diseases? 35.1% of students (boy: 34.0%, girl: 34.1%) answered yes: 35.3% in cities (boy: 37.2%, girl: 34.2%) and 36.7% in agricultural areas (boy: 39.0%, girl: 33.9%): 34.8% of middle school students and 35.4% of high school students. 5) Have you heard that smokers are likely to have a lung cancer? 91.4% of students (boy: 93.2%, girl: 89.9%) answered yes: 90.35% in cities and 94.2% in agricultural areas. 6) Have you heard that the life of smokers gets shorter? 94.3% of students (boy:94.6%, girl: 92.2%) answered yes. 7) Have you heard that pregnant smokers will deliver a baby with low birth weight? 29.6% of students (boy: 29.8%, girl: 29.4%) answered yes: the rates of boys and girls almost the same. 8) Have you heard that one feels calm when one smokes? 80.1% of students (boy: 81.8%, girl: 79.2%) answered yes: boys and girls showed almost the same rate. 3. Preventive measures Smoking people continued to increase all over the world because smoking not only mitigated emotional uneasiness such as loneliness, nervousness and so on, but also could be very helpful from the social perspective. This was so because they did not consider harmful effects of smoking on health, and victims. However, because any -one can have physical disorders caused by smoking, people should always keep in mind the following preventive measures. 1) Doctors or teachers should set an example of giving up smoking. Informing patients or students of harmful effects of smoking to persuade their family and relatives not to smoke. 2) Through mass media like newspapers, periodicals or broadcasting, to make people know harmful effects of smoking and not smoke. 3) To prohibit selling teenagers cigarette by law. 4) To prohibit smoking in public places like work places, offices, lecture rooms, recreation rooms, buses, trains and so on. 5) To decrease the rate of life insurance for non-smokers as in foreign countries and to give a warming of the harmful effects on cigarette packets or ads.
Purpose: This study evaluated the manpower planning of dental technicians. Methods: Methods : Survey was conducted regarding subject's general characteristics, characteristics of dental technician's occupational view and working conditions, and reason to enter into branches of the public health enter. The survey sample consisted of 323 dental technicians (221 male/ 102 female). Survey was conducted for one month from August 1 to September 1 in 2010. Following results were obtained. Results: 1. Regarding general characteristics of the subjects, there was a slight male predilection with 68.4%. Subjects in their 40s occupied the highest proportion of 32.2%. Majority of subjects worked in the big cities (71.5%). Favored working places were dental laboratory (57.6%) and dental hospital or dental clinic (19.5%). Although no position is available in the public sector such as public health center or health care civil servant, 9.3% preferred working in the public health center. Public sector is more favored than 2-year technical colleges or dental supply and equipment companies. In respect to education, 57% of the subjects graduated college. 67.8% were married. Subjects who specialize in the porcelain or all-ceramic were 57.9%. With regard to current position, head of the dental laboratory was most common. 2. Following occupation characteristics were found. Economic reason took the highest proportion when deciding their occupation (39.9%) followed by gaining social experience (36.5%). Majority of the subjects (76.5%) wanted to work as dental technicians until their retirement. 71.5% pursuit to become a manager of the dental laboratory. 76.1% agreed on opening a dental technician position in the public health center. Regarding an authority to lead developing the dental technician position in the public sector, majority of the subject chose ministry of health and welfare (35.6%) and Korean dental technologist association (34.7%). Employment (average, 30%) and turnover rate (average, 36.5%) of dental technology college graduates ranged from 40% to 60%. Most important factors for the employment were practical experience (41.2%) and competency (34.4%). With regard to job satisfaction, so-so as 46.7% and satisfactory was 42.7% 3. In respect to the reason for opening a position in the public health center, 'It is needed to continue denture rogram for elderly patients' obtained the highest score (4.14 point). 'Institutional devices are required to open a position for dental technicians as a public healthcare provider' received high score (4.11 point). 4. Concerning the working conditions, 'professional knowledge is required' received the highest score (4.23) followed by 'too short maternity and parental leave' (4.21). 5. Relationship between general characteristics of the subjects and favor of working in the public health center was investigated. Significant differences were found according to the current and favored working area, favored occupation, education level, marital status, and specialty. Working in the public health center was favored by following subjects: working in mid- or small-sized cities (4.16 point, p<0.05); PhD degree-holder (4.59 point, p<0.01). 6. Among general characteristics of the subjects, significant difference of working conditions was found in the following factors: gender; working areas; favored working areas; favored working positions, and education level. Majority of subjects favored working in big cities and currently work in big cities although satisfaction was comparatively low (3.75 score). 7. Future plan to work in public health center was evaluated according to occupational characteristics. Subject's intention to work in the public healthcare center was significantly affected by opening of dental technician position, leading authority, average turnover rate, and factors affecting employment. Working in the public health care center was favored by the following subjects: Dental technicians who actively supported opening of the dental technician position (4.34 point, p<0.001); subjects who thought the Korean dental technologist association is responsible for the opening of positions in the public sector (4.26 point, p<0.001); and subjects who thought that attitude and character are important for the employment (p<0.001). 8. Concerning difference of working conditions according to the occupational characteristics, significant difference was demonstrated by factors such as a reason to choose to be a dental technician, work plan, pursuing position, responsible authority, average employment rate, and job satisfaction. High standard of working conditions was required in subjects who selected to be a dental technician for the leisure time after work (s.05 point, p<0.01), who planted to work until their marriage (4.25 point, p<0.001), and who pursuit to be a manager (3.98, p<0.05). 9. In respect to influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.068 and age affected the working condition with significant difference according to the pvalue. 10. Regarding influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.335 and work plan, opening of dental technician position in the public sector, and responsible authority had significant influence over the subject's intention to work in the public health center according to the p-value. 11. With regard to the influence of general characteristics on the advancement to public health centers, the coefficient of determination (R2) was 0.091 and reason to choose to be a dental technician, work plan, and responsible authority significantly affected subject's working conditions. Conclusion: Korean society is becoming a super-aged society according to several statistics. As aged population is rapidly increasing, national health insurance plans to cover denture for senior citizen over 75 years old from 2012. Therefore, dental technicians are urgently needed in the public health centers all over the nation. Many subjects in this study planed to work until their retirement and recognized dental technician's expertise. Ministry of health and welfare and Korean dental technologist association should co-operate each other to prepare foundation and institutional devices for dental technicians to advance into the public health center. This will improve oral health of the population. This study showed urgency of medical facilities and services which meets increasing number of aged population and welfare of the population.
오늘날의 시장 경제는 소비자 중심으로 빠르게 변모하고 있다. 이는 점점 가속화 되어가는 소비자의 생활수준과 교육수준의 향상, 다양한 대중매체를 통한 구매자의 상품에 대한 접근의 용이성에 기인한다. 다양한 선택의 대안 속에서 자신의 가치를 만족시킬 수 있는 상품을 선택할 수 있는 소비자 중심의 시장 경제체제는 소비자의 소득수준의 증가와 전 국민 의료보험의 실시로 인한 의료 수요확대를 통해 의료분야에서도 그 두각을 나타내고 있다. 최근 우리나라의 의료계는 의료기관의 수 및 의료 인력의 증가로 인해 경쟁이 강화되고 있는 실정이고, 이러한 경쟁 강화를 통해 소비자의 시장 선택의 폭은 넓어지게 되었다. 이런 시점에 소비자의 입장에서 본 의료서비스에 있어서의 고객만족도에 영향을 미치는 요인, 서비스의 문제점, 개선점에 대한 조사와 연구는 필요 불가결하다고 하겠다. 이 연구는 2006년 1월 23일부터 4월 15일 까지 서울시에 소재한 연세대학교 치과병원에 내원한 환자 784명을 대상으로 진행되었으며 구조화된 설문지를 이용하여 자기기입식 방법으로 자료를 수집하여 이를 분석하였다. 본 연구의 결과를 살펴보면 다음과 같다. 1. 응답자의 사회인구학적인 특성은 성별이나 결혼여부는 적절하게 표본이 추출 된 것으로 보이나 직업에서는 학생 및 대학(원)생, 내원이 유와 현재 받고 있는 치료에 있어서는 교정치료가 높은 비율로 나타났다. 2. 치과병원에 대한 전반적인 만족도는 전체의 74%가 높은 만족을 나타내었다. 3. 독립변수들 중 구체적 서비스 항목에 대해서는 '서비스시스템', '친절도', '설명', '대기시간설명', '예약시스템', '응급상황에의 대처', '치과진료경험의 풍부', '치과적 지식의 유무', '병원의 규모', '소독', '내부시설', '주차' 에 대한 만족도는 높게, '치료비', '치료 준비시간', '대기시간', '치료시간', '예약기간' 에 대한 만족도는 낮게 나타났다. 4. 독립변수들 간의 상관관계 분석을 실시하였고 이들 사이에는 높은 선형관계가 없었다. 5. 독립변수들과 종속변수 사이의 상호관련성을 평가하기 위한 프로빗 회귀분석 결과 총 34개의 독립변수 중에서 불편감 해소, 서비스 시스템, 친절도, 설명, 한 번 내원 시 치료시간, 예약시스템, 지식의 유무, 내부시설에 대한 만족도의 8개 독립변수가 유의수준 1%하에서 서로 높은 상호관련성을 보였다. 고객의 만족은 전적으로 고객의 주관적인 평가에 의존한다. 환자들의 욕구가 다양화되고 고급화되면서 의료서비스에 대한 기대수준이 높아지고 있기 때문에 이에 부합하는 서비스를 제공하는 것이 의료서비스의 고객인 환자를 만족시키는 필수 요건이 된다. 많은 의료기관이 환자를 중심으로 하여 고객만족을 위한 병원, 고객감동을 위한 병원이 되기 위하여 노력을 하고 있으며, 이는 치과의료 분야에 있어서도 적용되고 있는 현실이다. 내원환자들의 만족도를 향상시키기 위해서는 이 연구의 결과를 기초로 한 새로운 병원 경영 전략의 수립과 그로 인한 의료 서비스의 질 향상으로 고객이 만족하는 양질의 의료서비스를 제공하는 노력이 필요하리라 여겨진다.
21세기 첨단기술을 활용하고 있는 테러집단들이 앞으로 활용할 가능성이 높은 방법 중의 하나가 바로 사이버테러이다. 현실에서는 상상만으로 가능한 일이 사이버 공간에서는 실제로 가능한 경우가 많다. 손쉬운 예로 병원에 입원 중인 요인들의 전산기록 중 혈액형 한 글자만을 임의로 변경하여도 주요 인물에게 타격을 주어 상대편의 체제전복에 영향을 줄 수 있다. 이와 같이 테러분자들이 사이버테러를 선호하는 이유는 다른 물리적인 테러수단 보다 적은 비용으로 큰 효과를 거둘 수 있기 때문이다. 폭탄설치나 인질납치 보다 사이버 테러리스트들은 인터넷으로 언제 어디서나 공격 대상에 침투할 수 있다. 1999년 4월 26일 발생했던 CIH 대란은 여러모로 시사하는 바가 크다. 대만의 대학생이 뚜렷한 목적 없이 만들었던 몇 줄짜리 바이러스 프로그램이 인터넷을 통해 기하급수적으로 퍼져 국내에서만 30만대의 PC를 손상시켰고, 수리비와 데이터 복구에 소요된 비용만 20억원 이상이 소요된 것으로 확인되었다. 전세계적으로 피해액은 무려 2억 5000만 달러로 추정된다. 이와 같은 사이버테러의 위험성에도 불구하고, 국내 사이트의 상당수가 보안조치에 허술한 것으로 알려져 있다. 심지어는 수백만명 이상의 회원이 가입한 사이트를 운영하고 있는 회사마저도 보안조치에는 소홀한 경우가 많다. 사이버테러에 대한 전국가적인 대비가 필요한 때이다. 이러한 맥락에서 본 연구에서는 우리나라 사이버 안전체계의 실태를 법률과 제도적인 시각에서 분석하고, 아울러 개선전략을 제시하였다. 본 연구에서는 제시한 연구결과를 압축하여 제시하면 다음과 같다. 첫째, 현재 우리나라에서는 사이버위기를 국가차원에서 체계적으로 관리할 수 있는 제도와 구체적 방법 절차가 정립되어 있지 않아 테러 등 각종 위기상황 발생시 국가안보와 국익에 중대할 위험과 막대한 손해를 끼칠 우려가 높다. 따라서 사이버공격을 사전에 탐지하여 위기발생 가능성을 조기에 차단하며 위기발생시 국가의 역량을 결집하여 정부와 민간이 참여한 종합적인 국가대응체계를 구축하기 위해서는 법률 제정이 필요하다. 둘째, 국가차원의 사이버 안전의 효율적인 수행을 위해서는 국가사회 전반의 국가 사이버 안전의 기준과 새로운 모범을 제시하는 한편, 각 부처 및 국가사회의 구성요소들에 대해 국가 사이버 안전관리 정책을 집행할 수 있는 국가 사이버 안전관리 조직체계를 구축하는 것이 요구된다. 법률 및 추진체계 등을 통합 정비하여 정보보호 법률 제도 운영의 일관성을 확보함으로써 각종 정보보호 위협에 보다 효과적으로 대응할 수 있을 것이다. 즉 정부는 국가 사이버 안전관리에 관한 주요 정책의 심의 및 기획 조정, 통합된 국가 사이버 위기관리의 기능을 수행하기 위하여 현행 '국가사이버안전센터'의 기능을 확대 강화하는 것이 필요하다. 특히, 국가 사이버 위기와 관련된 정보의 종합적 수집, 분석, 처리의 종합적 기능을 수행하고 각 정보 및 공공 기관을 통할하며 민간부문과의 협조체계를 구축하는 것이 요구된다. 자율적 정보보호 수준제고를 위해 행정기관 공공기관의 정보보호관리체계(ISMS) 인증 제도를 확대하고 행정기관의 정보보호제품 도입 간소화 및 사용 촉진을 위해 행정정보보호용 시스템 선정 및 이용 규정을 신설 주요정보기반으로 지정된 정보기반 운영자, 정보공유 분석센터 등의 침해정보 공유 활성화 규정을 신설 및 정비함으로써 사이버침해로부터 국가 사회 주요시설을 효과적으로 보호할 수 있을 것이다. 끝으로 정부와 민간부분이 공동으로 참여하는 국가차원의 종합적인 대응체계를 구축하여 사이버공격을 사전에 탐지하여 사이버위기 발생 가능성을 조기에 차단하며 위기 발생 시 국가의 역량을 결집하여 신속히 대응할 수 있도록 해야 한다.