• 제목/요약/키워드: school doctor

검색결과 507건 처리시간 0.026초

안전한 진료환경 구축을 위한 정책 개선과제 (A Review of Improvements for Providing Safe and Secure Environments for Medical Treatment)

  • 최아름;김성은;백경희
    • 보건행정학회지
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    • 제29권2호
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    • pp.105-111
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    • 2019
  • On December 31, 2018, an incident occurred where a doctor was attacked and killed by a patient carrying a lethal weapon in the outpatients' clinic of the psychiatric department of a tertiary general hospital. The suspect was diagnosed with bipolar affective disorder (manic depressive disorder) and has been hospitalized and cared for in the psychiatric ward of this hospital. This incident illustrates the necessity of more active cures and therapeutic intervention for mental patients with intellectual developmental disorders who require treatment considering the fact that a radical outcome has been caused by such a patient. However, on the other hand, there is also a need for an approach and analysis from the perspective of crime prevention for all medical departments. The reason for this is that even a tertiary general hospital equipped with the largest human resources, medical devices, facilities, and so forth, is susceptible to violence. As for illegal actions perpetrated against health and medical service personnel in medical institutions, such as verbal abuse, assault, injury, etc. there have neither been understanding shown for the current extent of damage in detail, nor discussions of active institutional improvement related to the seriousness of the act. It can be said that violence in the field of medical treatment is a realm requiring serious discussion and appropriate remedial actions. This is because when such incidents take place, if a patient who is supposed to get treatment from the damaged health care provider is in an urgent situation or on the waiting list of serious cases, he or she could suffer serious damage caused by deprivation of treatment opportunity, or secondary damage might be caused to the patient and/or a guardian who can hardly have an opportunity to take action. Accordingly, in this review, we would like to help create the necessary conditions for both health and medical service personnel and patients/guardians, respectively, to provide and receive medical treatment in a more secure environment. Therefore, objective assessment of the institution and issues relating to this aforementioned incident and general cases of violence occurring in medical institutions, and by suggesting legal and institutional improvements and solutions.

심장비대증 환자의 흉부 X선 영상에 대한 Inception V3 알고리즘의 분류 성능평가 (Evaluation of Classification Performance of Inception V3 Algorithm for Chest X-ray Images of Patients with Cardiomegaly)

  • 정우연;김정훈;박지은;김민정;이종민
    • 한국방사선학회논문지
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    • 제15권4호
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    • pp.455-461
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    • 2021
  • 심장비대증은 흉부 X선 영상에서 흔히 보이는 질병 중 하나이지만 조기에 발견을 하지 못하면 심각한 합병증을 유발할 수도 있다. 이러한 점을 고려하여 최근에는 여러 과학기술 분야의 발전으로 인공지능을 이용한 딥러닝 알고리즘을 의료에 접목시키는 영상 분석 연구들이 많이 진행되고 있다. 본 논문에서는 Inception V3 딥러닝 모델을 흉부 X선 영상을 이용하여 심장비대증의 분류에 유용한 모델인지 평가하고자 한다. 사용된 영상의 경우 총 1026장의 경북대학교병원 내 정상 심장 진단을 받은 환자와 심장비대증 진단을 받은 환자의 흉부 X선 영상을 사용하였다. 실험결과 Inception V3 딥러닝 모델의 심장비대증 유무에 따른 분류 정확도와 손실도 결과값은 각각 96.0%, 0.22%의 결과값을 나타내었다. 연구결과를 통해 Inception V3 딥러닝 모델은 흉부 영상 데이터의 특징 추출 및 분류에 있어 우수한 딥러닝 모델인 것을 알 수 있었다. Inception V3 딥러닝 모델의 경우 흉부 질환의 분류에 있어 유용한 딥러닝 모델이 될 것으로 판단되며 조금 더 다양한 의료 영상 데이터를 이용한 연구를 진행하여 이와 같은 우수한 연구결과를 얻게 된다면 향후 임상의의 진단 시 많은 도움을 줄 수 있을 것으로 사료된다.

독립운동가 신홍균 한의사에 대하여 (Korean independence activist Hong-Kyun Shin)

  • 이상화
    • 한국의사학회지
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    • 제35권2호
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    • pp.69-82
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    • 2022
  • Shin Hong-gyun was born on August 20, 1881. The second son of Shin Tae-geom (申泰儉) in Sangsang-ri, Sinbukcheong-myeon, Bukcheong-gun,Hamgyeongnam-do. His family had been practicing East Asian medicine as a family business. At that time, the families of East Asian doctors who passed the general examination of the Joseon Dynasty had been continuing the East Asian medicine business from generation to generation. Starting with exile in North Gando in 1911, he was located in Wangga-dong, 17 Doo-gu, Changbaek-hyeon. In 1915, he met General Choi Un-san in Bongo-dong, treated the soldiers suffering from cellulitis, and participated in the training process to prepare for the upcoming anti-Japanese war. However, because of a growing difference of opinion with General Choi Woon-san, Shin Hong-gyun left Bono-dong after a year and mets Sorae Kim Jung-geon and joined the founding of Wonjonggyo and Daejindan, an anti-Japanese armed group. It is said that Shin Hong-gyun established many schools in Korean villages destroyed by the Gyeongshin disaster and 14 schools were established under the names of Wonjonggyo and Daejin. After the Japanese established the puppet Manchukuo in 1931, the Manchurian Defense Forces were formed. Koreans and Chinese immigrants to Manchuria worked together to carry out a joint Korean-Chinese anti-Japanese operation towards the Japanese Empire. In 1933, 50 of the Daejindan members joined the Korean Independence Army, and among them, Shin Hong-gyun began to work as a medical doctor in earnest. During an ambush in Daejeonryeong Valley, he could not get a proper meal and, to make matters worse, got wet in the rainy season, so the situation was a challenge in various ways. At this time, Shin Hong-gyun showed his knowledge of herbal medicine, picked black wood ear mushrooms that grew wild in the mountains, washed them in rain water, and provided food to the independence fighters and relieved them of hunger. After the Battle of Daejeon-ryeong, the Japanese army's suppression of the independence forces intensified, and most of the independence fighters escaped from the Chinese army's encirclement and were scattered. Ahn Tae-jin and others led the remaining units and continued the anti-Japanese armed struggle in the forest areas of Yeongan, Aekmok, Mokneung, and Milsan.

병원서비스품질이 감정적 애착과 지각된 가치 및 고객만족도에 미치는 영향 (The Effect of Hospital Service Quality on Emotional Attachment, Perceived Value, and Customer Satisfaction)

  • 신경숙;안운석
    • 벤처혁신연구
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    • 제4권3호
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    • pp.49-67
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    • 2021
  • 본 연구는 병원고객의 만족도와 관련한 중요한 원인으로 제안될 수 있는 병원서비스품질과 감정적 애착, 지각된 가치가 어떠한 영향을 미치는지를 구조적으로 파악하고, 특히 병원서비스품질과 고객만족도 간의 관계에서 감정적 애착과 지각된 가치의 역할을 파악하였다. 이를 위해 중소병원을 찾는 고객을 대상으로 설문조사를 실시하여 수집한 자료로 구조방정식모형분석을 실시한 결과는 다음과 같다. 첫째, 고객이 느끼는 병원서비스품질은 감정적애착과 고객만 족도에 유의한 영향을 미쳤으며, 지각된 가치에는 유의한 영향을 미치지 못하였다. 둘째, 고객이 느낀 감정적 애착은 지각된가치와 고객만족도에 유의한 영향을 미쳤다. 셋째, 서비스품질과 고객만족도 간의 관계에서 고객이 느낀 감정적 애착은 유의한 매개효과를 가졌다. 이상의 결과를 통해 병원을 찾는 고객이 느끼는 서비스품질은 의사역량과 의료기술 역량에 대한 애착으로 이어져 이러한 애착에 의해 고객만족도가 높아지는 것을 확인하였다. 이 결과를 토대로 얻은 시사점은 다음과 같다. 즉, 병원을 찾은 고객들이 느끼는 서비스품질이 고객만족도로 이어지기 위해서는 무엇보다도 그들이 가질 수 있는 감정적 애착에 중점을 두고 서비스품질의 개선전략방안을 모색해야 한다는 것이다. 즉, 고객이 의사의 역량과 의료기술에 대한 역량에 대해 높은 신뢰를 가질 수 있도록 우수한 의료진과 의료기술을 구축해야 하며, 이러한 역량을 효과적으로 나타낼 수 있는 홍보전략을 수립해야 할 것이다. 이러한 노력에 의해 고객들은 의사와 의료기술에 대한 애착을 강하게 느끼게 됨으로써 병원에 대한 만족도가 제고될 수 있을 것이다.

Moire 영상을 이용한 근골격계 질환의 한의학적 진단에 관한 연구 (A Study on Oriental Medical Diagnosis of Musculoskeletal Disorders using Moire Image)

  • 이은경;유승현;이수경;강성호;한종민;정명수;천은주;송용선;이기남
    • 대한예방한의학회지
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    • 제4권2호
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    • pp.72-92
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    • 2000
  • This research has conducted studies on an Oriental medicine-based method of diagnosing of occupational musculoskeletal system diseases. This researcher has searched through existing relevant medical literature. Also, this researcher has worked on a moire topography using moire topography. In this course, this researcher has reached the following conclusion in relation to the possibility of using a moire topography as a diagnosing device of musculoskeletal system diseases under Oriental medicine . 1 The Western medicine outlines its criteria of screening occupational musculoskeletal system diseases as follows A. The occupational musculoskeletal diseases must clearly include one or more of the subjective symptoms characterized by pain, hypoesthesia dysaesthesia, anaesthesia. etc . B, There should be clinically admitted objective observations and diagnosis outlining that the disease concerned shows symptoms such as tenderness, induration. and edema that can appear with occupational musculoskeletal system diseases. dyscinesia should be admitted with the disease concerned, or there should be observations and diagnosis outlining that abnormality exists in electric muscular or nervous diagnosis and examination . C. It should be admitted that prior to the occurrence of symptoms or observations and diagnosis on musculoskeletal system-related diseases, a patient has been engaged in works with conditions requiring improper work posture or work movement. That is, this is an approach whereby they see abnormality in the musculoskeletal system come from material and structural defect, and adjust and control abnormality in the musculoskeletal system and secreta . 2. The Oriental medicines sees that a patient develops the pain of occupational musculoskeletal diseases as he cannot properly activate the flow of his life force and blood thus not only causing formation of lumps in the body and blocking the flow of life force and blood in some parts of the body. Hence, The Oriental medicine focuses on resolving the cause of weakening the flow of life force and blood, instead of taking material approach of correcting structural abnormality Furthermore , Oriental medicine sees that when muscle tension builds up, this presses blood vessels and nerves passing by, triggering circulation dyscrasia and neurological reaction and thus leading to lesion. Thus, instead of taking skeletal or neurophysiological approach. it seeks to fundamentally resolve the cause of the flow of the life force and blood in muscles not being activated. As a result Oriental medicine attributes the main cause of musculoskeletal system diseases to muscle tension and its build-up that stem from an individual's long formed chronicle habit and work environment. This approach considers not only the social structure aspect including companies owners and work environment that the existing methods have looked at, but also individual workers' responsibility and their environmental factors. Hence, this is a step forward method. 3 The diagnosis of musculoskeletal diseases under Oriental medicine is characterized by the fact that an Oriental medicine doctor uses not only photos taken by himself, but also various detection devices to gather information and pass comprehensive judgment on it. Thus, it is the core of diagnosis under Oriental medicine to develop diagnosing devices matching the characteristics of information to be induced and to interpret information so induced from the views of Oriental medicine. Diagnosis using diagnosing devices values the whole state of a patient and formal abnormality alike, and the whole balance and muscular state of a patient serves as the basis of diagnosis. Hence, this method, instead of depending on the information gathered from devices under Western medicine, requires devices that provide information on the whole state of a patient in addition to the local abnormality information that X-ray. CT, etc., can offer. This method sees muscle as the central part of the abnormality in the musculoskeletal system and thus requires diagnosing devices enabling the muscular state. 4. The diagnosing device using moire topography under Oriental medicine has advantages below and can be used for diagnosing musculoskeletal system diseases with industrial workers . First, the device can Provide information on the body in an unbalanced state. and thus identify the imbalance and difference of height in the left and right stature that a patient can not notice at normal times. Second, the device shows the twisting of muscles or induration regions in a contour map. This is not possible with existing shooting machines such as X-ray, CT, etc., thus differentiating itself from existing machines. Third, this device makes it possible for Oriental medicine to take its unique approach to the abnormality in the musculoskeletal system. Oriental medicine sees the state and imbalance state in muscles as major factors in determining the lesion of musculoskeletal system, and the device makes it possible to shoot the state of muscles in detail. In this respect, the device is significant. Fourth, the device has an advantage as non-aggression diagnosing device.

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가정과교사 문화의 특징과 발전 방안 (Characteristics and development plan of Home Economics teachers' culture)

  • 김승희;채정현
    • 한국가정과교육학회지
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    • 제30권2호
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    • pp.77-102
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    • 2018
  • 본 연구의 목적은 가정과교사 문화의 특징과 가정과교육 발전의 저해 요소를 밝힘으로써 가정과교사 문화의 발전 방안을 제시하는데 있다. 이를 위해 집중면접의 주제 분석법을 실행하였으며, 각 지역 가정교과연구회 또는 한국가정과교육학회 소속 석사과정 이상인 가정과교사 14명을 대상으로 이루어졌다. 응답 자료 분석을 위해 주제 분석법을 실행하였다. 본 연구의 결과는 다음과 같다. 첫째, 가정과교사들은 가정과교육의 철학을 정립한 후 가정교과가 청소년 개인과 가정, 그리고 사회를 이롭게 하는 실천비판교과라는 신념을 확고히 가지고 가정과수업을 통해서 청소년과 그들의 가정, 더 나아가 사회에 유익을 주는 교육을 실천하고 있었다. 둘째, 가정과교사들은 대학원에 진학하거나 가정교과연구회에 가입하여 수업 방법, 평가 방법, 업무 능력을 향상시키고, 수업을 공개하는 등 지속해서 전문성을 향상시키기 위해서 노력하는 문화를 형성하고 있었다. 셋째, 가정과교사들은 가정과교육 패러다임을 실천비판 패러다임으로 전환하여 실천적 문제 중심 수업을 실행해야 한다는 문화를 자리매김하였다. 또한, 그들은 세 행동체계(기술적 행동, 의사소통적 행동, 해방적 행동)를 순환적으로 적용하여 삶의 질과 가치를 향상시켜야 한다고 보았다. 넷째, 가정과교육의 발전을 저해하는 요소에는 교육제도와 사회적 인식이 있었다. 하지만 가정과교사들의 노력으로 가정과교육은 학생과 사회적 요구를 반영한 교육, 학생의 적성을 찾아주며 가정교과의 목표를 잘 살린 교육으로 자리 잡고 있었고, 이를 통해 가정과교사들은 학생들이 가정교과가 개인과 가정의 행복을 위해 꼭 필요한 교과라는 인식의 전환을 가져올 수 있다고 믿었다. 가정과교사문화의 발전방안으로 가정과교사들은 각 지역의 가정교과연구회에서는 더 많은 가정과교사들이 연구회에 참여하고 활동함으로써 발전할 수 있는 기회를 마련해야 한다고 하였다. 또한 지역의 가정교과연구회끼리 협력적 네트워크를 활성화하고 이를 이끌 수 있는 컨트롤타워가 필요하다고 했다. 한국가정과교육학회는 각 지역의 교과연구회의 중심점 역할이 되어서 다가올 교육 변화에 더욱 신속하고 조직적으로 움직여 적극적으로 대처함으로써 가정과교사들의 힘이 될 수 있어야 할 것이다. 마지막으로 참여자는 가정과교육의 변화를 위한 기초적 틀을 마련하기 위해 실천 비판적 가정과교사 양성이 필요하다고 했다. 이를 위해 가정과교사 양성과정에서 학생들이 더욱 깊이 있는 가정교과교육철학을 수강함으로써 가정교육학의 본질을 이해하고 정체성을 확립하여 유능하고 성숙한 가정과교사로서의 자질을 갖출 수 있을 것이다.

주의력결핍과잉행동장애 아동 어머니의 우울감, 양육 스트레스 및 양육 관련 태도가 양육 행동에 미치는 영향 (THE EFFECT OF ADHD CHILD MOTHER'S DEPRESSIVE MOOD, PARENTING STRESS, AND PARENTING RELATED ATTITUDE ON PARENTING BEHAVIOR)

  • 최윤영;조선미;홍성도;오은영;김지혜
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제13권1호
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    • pp.153-162
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    • 2002
  • 요 약:본 연구에서는 어머니의 우울감과 양육 스트레스, 양육 효능감 및 역기능적 사고 등 양육 관련 태도가 부모의 양육 행동에 미치는 영향을 살펴보았으며, 특히 주의력결핍과잉행동장애 아동 어머니를 중심으로 살펴보았다. 방 법:대상은 DSM-Ⅳ 진단 준거에 의한 정신과 전문의의 소견과 심리학적 진단 평가 하에 주의력결핍과잉 행동장애로 진단된 아동 31명의 어머니였고 연령 범위는 28세에서 44세였다. 비교 집단으로는 동일 연령대의 정상 아동 51명의 어머니를 대상으로 하였으며, 연령 범위는 32세에서 45세였다. 주의력결핍과잉행동장애 아동의 연령 범위는 6세에서 11세까지(남자 29명, 여자 2명)였고, 비교 집단은 선별 검사로 진단적 평가 척도(DRS)의 부모용과 교사용을 사용하여 주의력결핍과잉행동장애가 아닌 것으로 밝혀진 6세에서 11세까지의 아동(남자 21명, 여자 30명)이었다. 모든 아동의 어머니에게 우울감 및 양육 관련 태도를 측정하기 위해 부모용 질문지 배터리를 실시하였으며 Student's t-test와 상관 분석, 단계적, 위계적 회귀 분석을 실시하였다. 결 과:상관분석에서 강압적 양육 행동이 주의력결핍과잉행동장애 아동 부모에게서 높게 나타났고, 양육 관련 태도도 더욱 부정적인 결과를 보였으며 우울 역시 더 높게 보고되었다. 회귀 분석 결과, 어머니의 양육 스트레스, 역기능적 사고와 양육 효능감 그리고 어머니의 우울감은 강압적 양육행동의 50%를 유의미하게 예측하는 변인임이 밝혀졌는데, 어머니의 우울감이 강압적 양육 행동의 29%를 유의미하게 설명하고 있어, 우울감을 느끼는 경우 더욱 강압적 양육행동을 보일 수 있음이 시사되었다. 따라서 주의력결핍과잉행동장애 아동 부모의 경우, 아동의 증상이 양육 스트레스를 야기하고, 높은 역기능적 사고와 낮은 양육 효능감으로 더욱 우울감이 심화될 가능성이 높고 결국에는 아동에게 강압적 양육 행동을 나타내는 악순환이 나타나는 것으로 생각된다. 결 론:주의력결핍과잉행동장애 아동의 어머니의 경우, 높은 양육 스트레스와 낮은 양육 효능감 및 아동과의 관계에서의 역기능적 사고의 영향 뿐 아니라 부모 자신의 우울감이 강압적인 양육 행동에 영향을 미침을 시사한다. 따라서 부모의 강압적인 양육행동을 변화시키기 위해서는 주의력결핍과잉행동장애 아동 부모의 양육 스트레스, 아동에 대한 역기능적 사고 및 양육 효능감을 다루어야 할 뿐 아니라, 부모의 우울감을 치료 시 고려해야 할 것이다.

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간호학교육에서 기초의.과학 교과운영에 대한 연구 (A Study on the Current Status of the Curriculum Operation of the Basic Medical Sciences in Nursing Education)

  • 최명애;신기수
    • 대한간호학회지
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    • 제27권4호
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    • pp.975-987
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    • 1997
  • The purpose of this study was to investigate the current status of curriculum operation of the basic medical sciences in nursing education at college of nursing, department of nursing and junior college of nursing, ultimately to provide the basic data to improve a curriculum of basic medical science in nursing education. 78 professors who were in charge of basic medical science at 22 colleges of nursing and department of nursing, and 20 junior colleges of nursing responded the questionnaire consisted of 22 question items about the status of objectives, lectures, laboratory practice and characteristics of professors, and mailed to the author. The findings of this study were as follows : 1. The subjects of basic medical science were identified as physiology, anatomy, biochemistry, pathology, microbiology, pharmacology in the most colleges of nursing and junior colleges of nursing. 2 colleges of nursing and department of nursing(9.1%) and 19 junior colleges of nursing(95%) did not open biochemistry, 1 college of nursing and department of nursing(5%) did not open pathology and pharmacology. 2 Junior colleges of nursing(10%) did not open pharmacology, 1 junior college of nursing(5%) did not open pathology, the other 1 junior college of nursing did not open microbiology. 2. Credits of the subjects were ranged from 1 to 4. Lecture hours of one semester of physiology at school of nursing and junior college of nursing was average 103.6 and average 102.67, that of anatomy was average 127.1 and average 98, that of microbiology was average 109.7 and average 86.33, that of biochemistry was average 105, that of pathology was average 91 and average 94, that of pharmacology was average 86 and average 85.75. 3. Most of schools used 1 textbook for lectures, 3 school of nursing and department of nursing recommended references without using textbook, while all 36 junior colleges of nursing used textbooks. 4. 5 among 10 schools of nursing and department of nursing had a laboratory practice in physiology, 4 among 7 schools in anatomy, 4 among 6 schools in biochemistry, 2 among 6 schools in pathology 5 among 6 schools in microbiology. Not all the schools had a laboratory practice in pharmacology. 4 among 9 junior colleges of nursing had a laboratory practice in physiology. 1 among 4 schools in anatomy, 2 among 7 schools in microbiology. Not all the junior colleges of nursing had a laboratory practice in pathology and pharmacology. 11 among 20 colleges of nursing and department of nursing, 4 among 7 junior schools of nursing used a textbook of laboratory practice. 5. All the subjects at school of nursing and department of nursing responded that content of lectures and laboratory practices of basic medical science should be different from that of medical education, 34 junior schools of nursing responded that content of lecture of basic medical science in nursing education should be different from that of medical education. 33 junior schools of nursing responded that content of practice of basic medical science in nursing education should be different from that of medical education. 6. The final degree of 25 professors who were in charge of basic medical science were doctors of. medicine, that of 5 professors were masters of medicine, that of 5 were doctor of pharmacology, that of 2 were a master of pharmacology, that of 1 was physical science. The final degree of 8 professors who were in charge of basic medical science were masters of medicine, 7 doctors of medicine, 4 masters of nursing science, 4 masters of pharmacology, 2 doctors of nursing, 2 doctors of physical science, 2 doctors of pharmacology and 1 master of public health. 9 full professors, 13 associate professors, 11 assist ant professors, 3 full time instructors, and 6 part time instructors were in charge of basic medical science at college of nursing and department of nursing, 20 part time instructors, 8 associate professors, 6 assistant professors, and 2 full professors were in charge of has basic medical science at junior college of nursing. Based on these results, curriculum of basic medical science in nursing education should be reviewed deeply based on nursing model.

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첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구 (A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs)

  • 박용신;조병희;김호;이시백
    • 대한예방한의학회지
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    • 제7권1호
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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뇌성마비아 조기발견과 관련된 모자인자 (Maternal and Child Factors Associated with Early Detection of Cerebral Palsy)

  • 배성수;박정한
    • Journal of Preventive Medicine and Public Health
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    • 제20권2호
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    • pp.312-321
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    • 1987
  • 뇌성마비아의 조기 발견에 관련된 모자인자를 조사하기 위하여 1987년 2월부터 1987년 4월까지 대구 장애자 복지관, 대구대학교 부설재활원, 성바오로 어린이집, 그리고 부산 뇌성마비아복지회에 통원 또는 입원치료를 받고 있는 어린이 110명중 1980년 1월 1일 이후 출생자 74명 전원의 어머니를 대상으로 면담조사 하였다. 아버지의 학력과 이상 발견시기와는 아무런 상관관계가 없었으나 어머니의 학력이 대학졸업이상 일때가 고졸이하에 비해 어린이의 이상을 일찍 발견했고, 또 아버지의 직업이 전문직 또는 관리직일 때가 그 이외의 직업에 비해, 그리고 아버지의 월수입이 610,000원이상 일때가 600,000원 이하보다 더 일찍 발견하는 경향이었다. 첫째아이가 둘째아이 보다 그리고 부모의 나이가 34세 이하인 경우가 35세 이상인 경우에 비해 좀더 일찍 이상을 발견하는 경향을 보였다. 남아에서 여아에 비해 더 일찍 이상이 발견되었고 육아상담을 정기적으로 받은 어린이에서 정기적으로 받지 않은 어린이보다 더 일찍 이상이 발견되었는데 5% 유의수준에는 약간 못미쳤다. 연구대상아를 임신했을 때 산전관리를 7회이상 받았던 경우가 6회이하 받았던 경우에 비해 통계적으로 유의하게 일찍 어린이의 이상이 발견되었다. 처음으로 이상을 발견한 사람은 부모가 85.1%, 육아 상담을 정기적으로 받은 여부와는 관계없이 의사가 발견한 것은 2.7%였고 부모가 어린이의 이상을 발견하고 의사의 진단을 받았을때 36.5%에서 뇌성마비 진단을 받았고 나머지는관찰, 정상등으로 진단이 확실하지 않았다. 부모가 어린이의 이상을 발견하고 $2{\sim}3$개월 뒤에 의사의 진단을 받았고 진단후 전문적 치료를 시작할 때까지 방치했거나 물리치료, 한약, 침술 등을 받았다. 뇌성마비아의 조기 발견을 위해 의학교육과 임상수련과정에서 어린이의 발달을 평가하는 방법의 교육과 수련이 강화되어야 할 것이며 진단을 위한 전문인력의 양성이 필요한 것으로 생각된다. 또 부모들의 뇌성마비를 비롯한 각종 장애의 진단과 치료에 대한 인식을 높이기 위한 계몽교육이 필요하다.

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