• Title/Summary/Keyword: 수행 질

Search Result 3,131, Processing Time 0.041 seconds

Surgery Alone and Surgery Plus Postoperative Radiation Therapy for Patients with pT3N0 Non-small Cell Lung Cancer Invading the Chest Wall (흉벽을 침범한 pT3N0 비소세포폐암 환자에서 수술 단독과 수술 후 방사선치료)

  • 박영제;임도훈;김관민;김진국;심영목;안용찬
    • Journal of Chest Surgery
    • /
    • v.37 no.10
    • /
    • pp.845-855
    • /
    • 2004
  • Background: No general consensus has been available regarding the necessity of postoperative radiation therapy (PORT) and its optimal techniques in the patients with chest wall invasion (pT3cw) and node negative (N0) non-small cell lung cancer (NSCLC). We did retrospective analyses on the pT3cwN0 NSCLC patients who received PORT because of presumed inadequate resection margin on surgical findings. And we compared them with the pT3cwN0 NSCLC patients who did not received PORT during the same period. Material and Method: From Aug. of 1994 till June of 2002, 22 pT3cwN0 NSCLC patients received PORT-PORT (+) group- and 16 pT3cwN0 NSCLC patients had no PORT-PORT (-) group. The radiation target volume for PORT (+) group was confined to the tumor bed plus the immediate adjacent tissue only, and no regional lymphatics were included. The prognostic factors for all patients were analyzed and survival rates, failure patterns were compared with two groups. Result: Age, tumor size, depth of chest wall invasion, postoperative mobidities were greater in PORT (-) group than PORT (+) group. In PORT (-) group, four patients who were consulted for PORT did not receive the PORT because of self refusal (3 patients) and delay in the wound repair (1 patient). For all patients, overall survival (OS), disease-free survival (DFS), loco-regional recurrence-free survival (LRFS), and distant metastases-free survival (DMFS) rates at 5 years were 35.3%, 30.3%, 80.9%, 36.3%. In univariate and multivariate analysis, only PORT significantly affect the survival. The 5 year as rates were 43.3% in the PORT (+) group and 25.0% in PORT (-) group (p=0.03). DFS, LRFS, DMFS rates were 36.9%, 84.9%, 43.1 % in PORT (+) group and 18.8%, 79.4%, 21.9% in PORT(-) group respectively. Three patients in PORT (-) group died of intercurrent disease without the evidence of recurrence. Few suffered from acute and late radiation side effects, all of which were RTOG grade 2 or lower. Conclusion: The strategy of adding PORT to surgery to improve the probability not only of local control but also of survival could be justified, considering that local control was the most important component in the successful treatment of pT3cw NSCLC patients, especially when the resection margin was not adequate. Authors were successful in the marked reduction of the incidence as well as the severity of the acute and late side effects of PORT, without taking too high risk of the regional failures by eliminating the regional lymphatics from the radiation target volume.

Assessment of Nutrient Intakes of Lunch Meals for the Aged Customers at the Elderly Care Facilities Through Measuring Cooking Yield Factor and the Weighed Plate Waste (조리 중량 변화 계수 및 잔반계측법을 이용한 노인복지시설 이용자의 점심식사 영양섭취평가)

  • Chang, Hye-Ja;Yi, Na-Young;Kim, Tae-Hee
    • Journal of Nutrition and Health
    • /
    • v.42 no.7
    • /
    • pp.650-663
    • /
    • 2009
  • The purposes of this study were to investigate one portion size of menus served and to evaluate nutrient intake of lunch at three elderly care facility food services located in Seoul. A weighed plate method was employed to measure plate wastes and consumption of the menus served. Yield factors were calculated from cooking experiments based on standardized recipes, and were used to evaluate nutrient intake. One hundred elderly participated in this study for measuring plate waste and were asked to complete questionnaire. Nutrient analyses for the served and consumed meal were performed using CAN program. The yield factors of rice dishes after cooking are 2.4 regardless of rice dish types, 1.58 for thick soups, 0.60 to 0.70 for meat dishes, and 1.0 to 1.25 branched vegetable. Average consumption quantity of dishes were 235.97 g for rice, 248.53 g for soup, 72.83 g for meat dishes, 39.80 g for vegetables and 28.36 g for Kimchi. On average the food waste rate is 14.0%, indicating the second highest plate waste percentage of Kimchi (26.2%), and meat/fish dish (17.3%). The evaluation results of NAR (Nutrition Adequacy Ratio) showed that iron (0.12), calcium (0.64), riboflavin (0.80), and folic acid (0.97) were less than 1.0 in both male and female elderly groups, indicating significant differences of NAR among three facilities. Compared to the 1/3 Dietary Reference Intake (DRIs) for the elderly groups, nutrient intake analysis demonstrated that calcium (100%) and iron (100%), followed by riboflavin, vitamin A, and Vitamin B6 did not met of the 1/3 EAR (Estimated Average Requirement). For the nutritious meal management, a professional dietitian should be placed at the elderly care center to develop standardized recipes in consideration of yield factors and the elderly's health and nutrition status.

Characteristics and Distribution Pattern of Carbonate Rock Resources in Kangwon Area: The Gabsan Formation around the Mt. Gachang Area, Chungbuk, Korea (강원 지역에 분포하는 석회석 자원의 특성과 부존환경: 충북 가창산 지역의 갑산층을 중심으로)

  • Park, Soo-In;Lee, Hee-Kwon;Lee, Sang-Hun
    • Journal of the Korean earth science society
    • /
    • v.21 no.4
    • /
    • pp.437-448
    • /
    • 2000
  • The Middle Carboniferous Gabsan Formation is distributed in the Cheongrim area of southern Yeongwol and the Mt. Gachang area of Chungbuk Province. This study was carried out to investigate the lithological characters and geochemical composition of the limestones and to find out controlling structures of the limestones of the formation. The limestones of the Gabsan Formation are characterized by the light gray to light brown in color and fine and dense textures. The limestone grains are composed of crinoid fragments, small foraminfers, fusulinids, gastropods, ostracods, etc. Due to the recrystallization, some limestones consist of fine crystalline calcites. The chemical analysis of limestones of the formation was conducted to find out the contents of CaO, MgO, Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$. The content of CaO ranges from 49.78-60.63% and the content of MgO ranges from 0.74 to 4.63% The contents of Al$_2$O$_3$ and Fe$_2$O$_3$ are 0.02-0.55% and 0.02${\sim}$0.84% , respectively. The content of SiO$_2$ varies from 1.55 to 4.80%, but some samples contain more than 6.0%. The limestones of the formation can be grouped into two according to the CaO content: One is a group of which CaO content ranges from 49.78 to 56.26% and the other is a group of which CaO content varies from 59.36 to 60.38%. In the first group, the contents of Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$ range very irregularly according to the CaO content. In the second group, the values of MgO, Al$_2$O$_3$, Fe$_2$O$_3$ and SiO$_2$ are nearly same. Detailed structural analysis of mesoscopic structures and microstructures indicates the five phase of deformation in the study area. The first phase of deformation(D$_1$) is characterized by regional scale isoclinal folds, and bedding parallel S$_1$ axial plane foliation which is locally developed in the mudstone and sandstone. Based on the observations of microstructures, S$_1$ foliations appear to be developed by grain preferred orientation accompanying pressure-solution. During second phase of deformation, outcrop scale E-W trending folds with associated foliations and lineations are developed. Microstructural observations indicate that crenulation foliations were formed by pressure-solution, grain boundary sliding and grain rotation. NNW and SSE trending outcrop scale folds, axial plane foliations, crenulation foliations, crenulation lineations, intersection lineations are developed during the third phase of deformation. On the microscale F$_3$ fold, axial plane foliations which are formed by pressure solution are well developed. Fourth phase of deformation is characterized by map scale NNW trending folds. The pre-existing planar and linear structures are reoriented by F$_4$ folds. Fifth phase of deformation developed joints and faults. The distribution pattern of the limestones is mostly controlled by F$_1$ and F$_4$ folds.

  • PDF

Assessment Study on Educational Programs for the Gifted Students in Mathematics (영재학급에서의 수학영재프로그램 평가에 관한 연구)

  • Kim, Jung-Hyun;Whang, Woo-Hyung
    • Communications of Mathematical Education
    • /
    • v.24 no.1
    • /
    • pp.235-257
    • /
    • 2010
  • Contemporary belief is that the creative talented can create new knowledge and lead national development, so lots of countries in the world have interest in Gifted Education. As we well know, U.S.A., England, Russia, Germany, Australia, Israel, and Singapore enforce related laws in Gifted Education to offer Gifted Classes, and our government has also created an Improvement Act in January, 2000 and Enforcement Ordinance for Gifted Improvement Act was also announced in April, 2002. Through this initiation Gifted Education can be possible. Enforcement Ordinance was revised in October, 2008. The main purpose of this revision was to expand the opportunity of Gifted Education to students with special education needs. One of these programs is, the opportunity of Gifted Education to be offered to lots of the Gifted by establishing Special Classes at each school. Also, it is important that the quality of Gifted Education should be combined with the expansion of opportunity for the Gifted. Social opinion is that it will be reckless only to expand the opportunity for the Gifted Education, therefore, assessment on the Teaching and Learning Program for the Gifted is indispensible. In this study, 3 middle schools were selected for the Teaching and Learning Programs in mathematics. Each 1st Grade was reviewed and analyzed through comparative tables between Regular and Gifted Education Programs. Also reviewed was the content of what should be taught, and programs were evaluated on assessment standards which were revised and modified from the present teaching and learning programs in mathematics. Below, research issues were set up to assess the formation of content areas and appropriateness for Teaching and Learning Programs for the Gifted in mathematics. A. Is the formation of special class content areas complying with the 7th national curriculum? 1. Which content areas of regular curriculum is applied in this program? 2. Among Enrichment and Selection in Curriculum for the Gifted, which one is applied in this programs? 3. Are the content areas organized and performed properly? B. Are the Programs for the Gifted appropriate? 1. Are the Educational goals of the Programs aligned with that of Gifted Education in mathematics? 2. Does the content of each program reflect characteristics of mathematical Gifted students and express their mathematical talents? 3. Are Teaching and Learning models and methods diverse enough to express their talents? 4. Can the assessment on each program reflect the Learning goals and content, and enhance Gifted students' thinking ability? The conclusions are as follows: First, the best contents to be taught to the mathematical Gifted were found to be the Numeration, Arithmetic, Geometry, Measurement, Probability, Statistics, Letter and Expression. Also, Enrichment area and Selection area within the curriculum for the Gifted were offered in many ways so that their Giftedness could be fully enhanced. Second, the educational goals of Teaching and Learning Programs for the mathematical Gifted students were in accordance with the directions of mathematical education and philosophy. Also, it reflected that their research ability was successful in reaching the educational goals of improving creativity, thinking ability, problem-solving ability, all of which are required in the set curriculum. In order to accomplish the goals, visualization, symbolization, phasing and exploring strategies were used effectively. Many different of lecturing types, cooperative learning, discovery learning were applied to accomplish the Teaching and Learning model goals. For Teaching and Learning activities, various strategies and models were used to express the students' talents. These activities included experiments, exploration, application, estimation, guess, discussion (conjecture and refutation) reconsideration and so on. There were no mention to the students about evaluation and paper exams. While the program activities were being performed, educational goals and assessment methods were reflected, that is, products, performance assessment, and portfolio were mainly used rather than just paper assessment.

Color-related Query Processing for Intelligent E-Commerce Search (지능형 검색엔진을 위한 색상 질의 처리 방안)

  • Hong, Jung A;Koo, Kyo Jung;Cha, Ji Won;Seo, Ah Jeong;Yeo, Un Yeong;Kim, Jong Woo
    • Journal of Intelligence and Information Systems
    • /
    • v.25 no.1
    • /
    • pp.109-125
    • /
    • 2019
  • As interest on intelligent search engines increases, various studies have been conducted to extract and utilize the features related to products intelligencely. In particular, when users search for goods in e-commerce search engines, the 'color' of a product is an important feature that describes the product. Therefore, it is necessary to deal with the synonyms of color terms in order to produce accurate results to user's color-related queries. Previous studies have suggested dictionary-based approach to process synonyms for color features. However, the dictionary-based approach has a limitation that it cannot handle unregistered color-related terms in user queries. In order to overcome the limitation of the conventional methods, this research proposes a model which extracts RGB values from an internet search engine in real time, and outputs similar color names based on designated color information. At first, a color term dictionary was constructed which includes color names and R, G, B values of each color from Korean color standard digital palette program and the Wikipedia color list for the basic color search. The dictionary has been made more robust by adding 138 color names converted from English color names to foreign words in Korean, and with corresponding RGB values. Therefore, the fininal color dictionary includes a total of 671 color names and corresponding RGB values. The method proposed in this research starts by searching for a specific color which a user searched for. Then, the presence of the searched color in the built-in color dictionary is checked. If there exists the color in the dictionary, the RGB values of the color in the dictioanry are used as reference values of the retrieved color. If the searched color does not exist in the dictionary, the top-5 Google image search results of the searched color are crawled and average RGB values are extracted in certain middle area of each image. To extract the RGB values in images, a variety of different ways was attempted since there are limits to simply obtain the average of the RGB values of the center area of images. As a result, clustering RGB values in image's certain area and making average value of the cluster with the highest density as the reference values showed the best performance. Based on the reference RGB values of the searched color, the RGB values of all the colors in the color dictionary constructed aforetime are compared. Then a color list is created with colors within the range of ${\pm}50$ for each R value, G value, and B value. Finally, using the Euclidean distance between the above results and the reference RGB values of the searched color, the color with the highest similarity from up to five colors becomes the final outcome. In order to evaluate the usefulness of the proposed method, we performed an experiment. In the experiment, 300 color names and corresponding color RGB values by the questionnaires were obtained. They are used to compare the RGB values obtained from four different methods including the proposed method. The average euclidean distance of CIE-Lab using our method was about 13.85, which showed a relatively low distance compared to 3088 for the case using synonym dictionary only and 30.38 for the case using the dictionary with Korean synonym website WordNet. The case which didn't use clustering method of the proposed method showed 13.88 of average euclidean distance, which implies the DBSCAN clustering of the proposed method can reduce the Euclidean distance. This research suggests a new color synonym processing method based on RGB values that combines the dictionary method with the real time synonym processing method for new color names. This method enables to get rid of the limit of the dictionary-based approach which is a conventional synonym processing method. This research can contribute to improve the intelligence of e-commerce search systems especially on the color searching feature.

The Origin of Radioactive Elements Found in Groundwater Within the Chiaksan Gneiss Complex: Focusing on the Relationship with Minerals of the Surrounding Geology (치악산 편마암 복합체에 분포하는 지하수 내 함유된 방사성 원소의 기원: 주변 지질을 구성하는 광물과의 연관성을 중심으로)

  • Kim, Hyeong-Gyu;Lee, Sang-Woo;Kim, Soon-Oh;Jeong, Do-Hwan;Kim, Moon-Su;Kim, Hyun-Koo;Jeong, Jong Ok
    • Korean Journal of Mineralogy and Petrology
    • /
    • v.35 no.2
    • /
    • pp.153-168
    • /
    • 2022
  • Petrological and mineralogical analyses were conducted to identify minerals containing radioactive elements (uranium) in the Chiaksan gneiss complex and to confirm their association with the surrounding groundwater. Fourteen minerals were identified through the microscopic and electron microscopy (SEMEDS) investigation. The principal minerals included plagioclase, biotite, quartz, alkali feldspar, chlorite, and calcite. Minor minerals were sphene, allanite, apatite, zircon, thorite, titanite, pyrite, and galena. A small amount of thorite was observed in the size of ~1 mm within macrocrystalline allanite. Allanite, which includes a large amount of rare earth elements, appeared in three distinctive patterns. The results of the EPMA analyses indicated that macrocrystalline allanite had higher elemental contents of TiO2~1.70 wt.%, Ce2O3~11.86 wt.%, FeO ~13.31 wt.%, MgO ~0.90 wt.% and ThO2 ~1.06 wt.% with the lowest average content of Al2O3 17.35 ± 2.15 wt.% (n = 7), CaO 12.13 ± 1.81 wt.% (n = 7). An allanite existing at the edge of the sphenes encompassing titanites had a higher element content of Al2O3 ~24.00 wt.%, Nd2O3 ~5.10 wt.%, Sm2O3~0.66 wt.%, Dy2O3~0.86 wt.% and Y2O3~1.38 wt.% with the lowest average content of TiO2 0.35 ± 0.21 wt.% (n = 11), Ce2O3 5.25 ± 1.03 wt.% (n = 11), FeO 9.84 ± 0.26 wt.% (n = 11), MgO 0.12 ± 0.05 wt.% (n = 11), and La2O3 1.49 ± 0.29 wt.% (n = 11). Allanites in a matrix of parental rocks exhibited intermediate values between the two elemental compositions mentioned above. None of the uranium-rich minerals were observed in the migmatitic gneiss within the study area. Consequently, the origin of uranium in the groundwater was not associated with the geology of the surrounding environment, but our investigation proved the existence of abundant allanites containing significant amounts of radioactive thorium and rare earth elements.

Characteristics of Vegetation Structure of Burned Area in Mt. Geombong, Samcheok-si, Kangwon-do (강원도 삼척 검봉산 일대 산불 피해복원지 식생 구조 특성)

  • Sung, Jung Won;Shim, Yun Jin;Lee, Kyeong Cheol;Kweon, Hyeong keun;Kang, Won Seok;Chung, You Kyung;Lee, Chae Rim;Byun, Se Min
    • Journal of Practical Agriculture & Fisheries Research
    • /
    • v.24 no.3
    • /
    • pp.15-24
    • /
    • 2022
  • In 2000, a total of 23,794ha of forest was lost due to the East Coast forest fire, and about 70% of the damaged area was concentrated in Samcheok. In 2001, artificial restoration and natural restoration were implemented in the damaged area. This study was conducted to understand the current vegetation structure 21 years after the restoration of forest fire damage in the Samcheok, Gumbong Mountain area. As a result of classifying the vegetation community, it was divided into three communities: Quercus variabilis-Pinus densiflora community, Pinus densiflora-Quercus mongolica community, and Pinus thunbergii community. Quercus variabilis, Pinus densiflora, and Pinus thunbergii planted in the artificial restoration site were found to continue to grow as dominant species in the local vegetation after restoration. As for the species diversity index of the community, the Quercus variabilis-Pinus densiflora community dominated by deciduous broad-leaf trees showed the highest, and the coniferous forest Pinus thunbergii community showed the lowest. Vegetation in areas affected by forest fires is greatly affected by reforestation tree species, and 21 years later, it has shown a tendency to recover to the forest type before forest fire. In order to establish DataBase for effective restoration and to prepare monitoring data, it is necessary to construct data through continuous vegetation survey on the areas affected by forest fires.

Occurrence and Chemical Composition of Ti-bearing Minerals from Drilling Core (No.04-1) at Gubong Au-Ag Deposit Area, Republic of Korea (구봉 금-은 광상일대 시추코아(04-1)에서 산출되는 함 티타늄 광물들의 산상과 화학조성)

  • Bong Chul Yoo
    • Korean Journal of Mineralogy and Petrology
    • /
    • v.36 no.3
    • /
    • pp.185-197
    • /
    • 2023
  • The Gubong Au-Ag deposit consists of eight lens-shaped quartz veins. These veins have filled fractures along fault zones within Precambrian metasedimentary rock. This has been one of the largest deposits in Korea, and is geologically a mix of orogenic-type and intrusion-related types. Korea Mining Promotion Corporation drilled into a quartz vein (referred to as the No. 6 vein) with a width of 0.9 m and a grade of 27.9 g/t Au at a depth of -728 ML by drilling (No. 90-12) in the southern site of the deposit, To further investigate the potential redevelopment of the No. 6 vein, another drilling (No. 04-1) was carried out in 2004. In 2004, samples (wallrock, wallrock alteration and quartz vein) were collected from the No. 04-1 drilling core site to study the occurrence and chemical composition of Ti-bearing minerals (ilmenite, rutile). Rutile from mineralized zone at a depth of -275 ML occur minerals including K-feldspar, biotite, quartz, calcite, chlorite, pyrite in wallrock alteration zone. Ilmenite and rutile from ore vein (No. 6 vein) at a depth of -779 ML occur minerals including white mica, chlorite, apatite, zircon, quartz, calcite, pyrrhotite, pyrite in wallrock alteration zone and quartz vein. Based on mineral assemblage, rutile was formed by hydrothermal alteration (chloritization) of Ti-rich biotite in the wallrock. Chemical composition of ilmenite has maximum values of 0.09 wt.% (HfO2), 0.39 wt.% (V2O3) and 0.54 wt.% (BaO). Comparing the chemical composition of rutile at a depth -275 ML and -779 ML, Rutile at a depth of -779 ML is higher contents (WO3, FeO and BaO) than rutile at a depth of -275 ML. The substitutions of rutile at a depth of -275 ML and -779 ML are as followed : rutile at a depth of -275 ML Ba2+ + Al3+ + Hf4+ + (Nb5+, Ta5+) ↔ 3Ti4+ + Fe2+, 2V4+ + (W5+, Ta5+, Nb5+) ↔ 2Ti4+ + Al3+ + (Fe2+, Ba2+), Al3+ + V4++ (Nb5+, Ta5+) ↔ 2Ti4+ + 2Fe2+, rutile at a depth of -779 ML 2 (Fe2+, Ba2+) + Al3+ + (W5+, Nb5+, Ta5+) ↔ 2Ti4+ + (V4+, Hf4+), Fe2+ + Al3+ + Hf 4+ + (W5+, Nb5+, Ta5+) ↔ 2Ti4+ + V4+ + Ba2+, respectively. Based on these data and chemical composition of rutiles from orogenic-type deposits, rutiles from Gubong deposit was formed in a relatively oxidizing environment than the rutile from orogenictype deposits (Unsan deposit, Kori Kollo deposit, Big Bell deposit, Meguma gold-bearing quartz vein).

Philosophical Stances for Future Nursing Education (미래를 향한 간호교육이념)

  • Hong Yeo Shin
    • The Korean Nurse
    • /
    • v.20 no.4 s.112
    • /
    • pp.27-38
    • /
    • 1981
  • 오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.

  • PDF

Management and Use of Oral History Archives on Forced Mobilization -Centering on oral history archives collected by the Truth Commission on Forced Mobilization under the Japanese Imperialism Republic of Korea- (강제동원 구술자료의 관리와 활용 -일제강점하강제동원피해진상규명위원회 소장 구술자료를 중심으로-)

  • Kwon, Mi-Hyun
    • The Korean Journal of Archival Studies
    • /
    • no.16
    • /
    • pp.303-339
    • /
    • 2007
  • "The damage incurred from forced mobilization under the Japanese Imperialism" means the life, physical, and property damage suffered by those who were forced to lead a life as soldiers, civilians attached to the military, laborers, and comfort women forcibly mobilized by the Japanese Imperialists during the period between the Manchurian Incident and the Pacific War. Up to the present time, every effort to restore the history on such a compulsory mobilization-borne damage has been made by the damaged parties, bereaved families, civil organizations, and academic circles concerned; as a result, on March 5, 2004, Disclosure act of Forced Mobilization under the Japanese Imperialism[part of it was partially revised on May 17, 2007]was officially established and proclaimed. On the basis of this law, the Truth Commission on Forced Mobilization under the Japanese Imperialism Republic of Korea[Compulsory Mobilization Commission hence after] was launched under the jurisdiction of the Prime Minister on November 10, 2004. Since February 1, 2005, this organ has begun its work with the aim of looking into the real aspects of damage incurred from compulsory mobilization under the Japanese Imperialism, by which making the historical truth open to the world. The major business of this organ is to receive the damage report and investigation of the reported damage[examination of the alleged victims and bereaved families, and decision-making], receipt of the application for the fact-finding & fact finding; fact finding and matters impossible to make judgment; correction of a family register subsequent to the damage judgement; collection & analysis of data concerning compulsory mobilization at home and from abroad and writing up of a report; exhumation of the remains, remains saving, their repatriation, and building project for historical records hall and museum & memorial place, etc. The Truth Commission on Compulsory Mobilization has dug out and collected a variety of records to meet the examination of the damage and fact finding business. As is often the case with other history of damage, the records which had already been made open to the public or have been newly dug out usually have their limits to ascertaining of the diverse historical context involved in compulsory mobilization in their quantity or quality. Of course, there may happen a case where the interested parties' story can fill the vacancy of records or has its foundational value more than its related record itself. The Truth Commission on Compulsory mobilization generated a variety of oral history records through oral interviews with the alleged damage-suffered survivors and puts those data to use for examination business, attempting to make use of those data for public use while managing those on a systematic method. The Truth Commission on compulsory mobilization-possessed oral history archives were generated based on a drastic planning from the beginning of their generation, and induced digital medium-based production of those data while bearing the conveniences of their management and usage in mind from the stage of production. In addition, in order to surpass the limits of the oral history archives produced in the process of the investigating process, this organ conducted several special training sessions for the interviewees and let the interviewees leave their real context in time of their oral testimony in an interview journal. The Truth Commission on compulsory mobilization isn't equipped with an extra records management system for the management of the collected archives. The digital archives are generated through the management system of the real aspects of damage and electronic approval system, and they plays a role in registering and searching the produced, collected, and contributed records. The oral history archives are registered at the digital archive and preserved together with real records. The collected oral history archives are technically classified at the same time of their registration and given a proper number for registration, classification, and keeping. The Truth Commission on compulsory mobilization has continued its publication of oral history archives collection for the positive use of them and is also planning on producing an image-based matters. The oral history archives collected by this organ are produced, managed and used in as positive a way as possible surpassing the limits produced in the process of investigation business and budgetary deficits as well as the absence of records management system, etc. as the form of time-limit structure. The accumulated oral history archives, if a historical records hall and museum should be built as regulated in Disclosure act of forced mobilization, would be more systematically managed and used for the public users.