• Title/Summary/Keyword: Neglected Children

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Precise Position Monitoring System for Infant Interaction Analysis (영유아 상호작용 분석을 위한 정밀위치 모니터링 시스템)

  • Park, Hyoung-Keun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.21-26
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    • 2019
  • This paper constructs a real-time monitoring system that can identify the individual positions of infants and their proximity to other infants using an Internet of Things (IoT)-based nameplate. The system consists of a precision location tracking module, a data transmission system for calculating gateway location information, a service platform server, and a data analysis processing module considering the development of infants and young children. The purpose of this study is to extract information about how infants interact with each other. The information gathered through this system can be used as important information to improve the peer relations of all infants and toddlers, from neglected infants to infants with no social development problems, to more popular infants. It is possible, based on the proximity information between infants and toddlers, that the teacher can identify positive interactions or negative interactions, and can educate infants on how to improve their peer relationships. These results can be used for consultation with parents, and the information collected through this system can be used as a database to establish a system for improving the relationships between infants and toddlers.

Age Group-Specific Improvement of Vertebral Scoliosis after the Surgical Release of Congenital Muscular Torticollis

  • Jong Min Choi;Seong Hoon Seol;Jae Hyun Kim;Chan Min Chung;Myong Chul Park
    • Archives of Plastic Surgery
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    • v.51 no.1
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    • pp.72-79
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    • 2024
  • Background Congenital muscular torticollis (CMT) is a common musculoskeletal disorder in children. Secondary scoliosis can occur in patients with CMT; however, the extent of inclination and improvement of scoliosis after surgical correction of CMT have not been adequately studied. In this study, we aimed to evaluate and measure the improvement in vertebral tilting after surgical correction according to age at the time of surgery. Methods Between June 2007 and January 2020, 831 patients with CMT underwent sternocleidomastoid release. Among them, 426 patients were enrolled, and their medical records were retrospectively reviewed. Ultimately, 210 patients available for radiological evaluation and analysis were enrolled in this study. The patients were divided into four groups according to age at the time of surgery to determine the relationship between age and changes in scoliosis. Results Our findings showed an improvement in scoliosis in all age groups after surgery. The results for follow-up after 1 year confirmed long-term improvement in vertebral tilting. The degree of improvement in scoliosis was significantly higher in the younger age group than in patients aged 18 years or older. Conclusion The effect of surgical release on scoliosis was significant in all age groups. The findings of this study suggest that CMT should be corrected before the age of 3 years to ensure an optimal surgical mitigation of scoliosis. Furthermore, in cases of neglected CMT, surgical release should be actively attempted because there is significant improvement.

Peer Relationship Problems in Relation to Children's Peer Status (아동의 또래지위에 따른 교우관계문제)

  • Jeong, Seong-Cheol;Hong, Sang-Hwang;Kim, Jong-Mee
    • The Korean Journal of Elementary Counseling
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    • v.10 no.2
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    • pp.167-184
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    • 2011
  • This study has investigated how five peer status groups that were selected by a social skills scale exhibit different peer relationship problems by means of averages, standard deviations, and profile analysis. Social skills scale developed by Yi-Hwan Ahn(2007) and the inventory of peer relationships by Hae-Won Jung(2007) were administered to 551 fifth and sixth graders in 9 elementary schools located in Gyungnam province, and averages and standard deviations of 5 peer status groups' peer relationship problems were explored. Also in order to see if differences exist among 8 sub-scales in the inventory of peer relationships according to the peer status, an average profile of scores was represented by a graph and multivariate analysis was carried out. The main results of the study are as follows. First, statistical analysis of 551 cases included in the study showed the children were distributed into the Average group(319, 57.9%), the Popular group(111, 29.1%), the Rejected group(70, 12.9%), the Controversial group(41, 7.4%), and the Neglected group(10, 1.8%), in that order. Second, as a result of comparing average scores for each measure in the inventory of peer relationships according to the peer status group, a significant difference was found to exist according to a child's peer status. The Popular group showed the lowest scores in Too Controlling, Hard to be Supportive, the Cold, and Non-Assertive among the 5 peer status groups whereas the Rejected group showed the highest scores in Social Avoidant, Non-Assertive, and Too Responsible. Third, marked differences according to the peer status group were found. The Popular group showed the lowest profile among the peer status groups whereas the Rejected group had the highest profile. In the sub-scales of the peer relationship problems, the Rejected children showed a significantly higher level of Socially Avoidant and Non-Assertiveness in comparison to the Popular children, which implies the Popular children group has lower levels of peer relationship problems than the other groups.

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Survey on Children Toothbrushing Teaching Guidance with Child Care Center Teachers (일부 보육교사의 유아 칫솔질 지도에 관한 실태조사)

  • Choi, Yong-Keum;Kim, Hee-Kyoung;Kim, Eun-Ju
    • Journal of dental hygiene science
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    • v.11 no.4
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    • pp.319-324
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    • 2011
  • This study aimed to investigate the current situation of toothbrushing guidance with child care teachers in day care facilities caring and managing infants and young children and to grasp problems neglected in using toothpaste and guiding toothbrushing to provide basic data for measures to cope with them. This study included 165 child care teachers or teachers of the kindergartens who agreed with its purpose. By excluding 10 questionnaires with omitted or conflicting answers, 156 ones were finally analyzed in this study. The correlation between education about oral health and toothbrushing guidance, the subjects with and without the experience of the education did not show any significant difference in time to encourage toothbrushing, behaviors of toothbrushing guidance, guidance on prevention of toothpaste intake and perception of an appropriate amount of toothpaste (p>0.05) while perception of the importance of oral health was significantly related with the education on oral health (p<0.05). Therefore, education system for specialists in oral health to offer a specific and systemic education and oral health education programs for child care teacher, are considered to be necessary.

Epidemiology of Pesticide Poisoning in Kyungpook (경북지방(慶北地方)의 농약중독(農藥中毒)에 대한 역학적(疫學的) 조사(調査))

  • Chung, Jong-Hak;Cho, Jae-Yeun
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.28-34
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    • 1983
  • In spite of the world-wide increase of incidence of pesticide poisoning due to greater use of pesticides, the epidemiological study of pesticide poisoning in Korea has been grossly neglected. The author gained access to the medical records for two year period (1981 through 1982) from local clinics, hospitals and health centers of Kyungpook area to investigate the status of the pesticide poisoning. During these two years, there were 1,618 cases of documented pesticide poisoning, of which in 1981 were 765 and in 1982 were 853. Those in the twenties decade of age was the most frequent and the male(70%) was more liable than the female (30%). In view of manner of poisoning, occupational poisoning was 27.8%, accidental 5.6%, and suicidal 66.6%. There are three distinct groups which make up the large majority of both fatal and nonfatal cases; young children who accidentally ingest pesticides, young to middle age adult who are occupationally poisoned, and middle age to older adults who suicidally ingest pesticides. The seasonal distribution of these poisonings disclosed the peak month to be July, with August next, followed by June and September. Only 11% of cases occurred during the three-month winter season of December to February. Thus pesticide caused poison- ing was primarily a summer and early fall occurrence. During these two years, average of 67 cases of poisoning was observed monthly. Of the pesticide poisoning documented, 49% were treated with poisoning patients from local clinic and 43% from hospital. The case fatality rate of occupational poisoning was 0.9%, accidental 5.6% and suicidal 20.3%. The mean overall case fatality rate was 14.1%. Annual incidence of pesticide poisoning was 25.4 per 100,000 population in the study area. There is a nationwide need for more reliable date on pesticide poisoning. This need can only grow more acute with the passage of time because of the increasing importance of pesticides as a cause of morbidity and mortality.

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Marital Status of Elderly: Does it Really Matter for Health? (노인의 결혼지위 점유에 따른 건강차이: 노년기 사회적 관계망의 매개효과를 중심으로)

  • Cha, Seung-Eun
    • 한국노년학
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    • v.27 no.2
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    • pp.371-392
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    • 2007
  • Marital status has drawn much attention as previous studies have been pointed it out as a key factor of health. Nonetheless, systematic studies on elderly marital status and health have been quite limited, for most researches have neglected the varying effects of marital status on health over the lifespan and mainly focused on midlife. This study, using nationwide survey on elderly population, attempts to discover the health differentials between widowed and married elderly and explain the differences though the structure and function of their social network. The results reveal that the magnitudes of marital status effects were differed by dimensions of health. The widowed were more likely to be unhappy than married, even after controlling the socio-demographic characteristics. In physical health, however, the health differences between widowed and married were less noticeable or disappeared, as sex, age and other structure factors were considered. Furthermore, the strength of social network factors affecting the physical and mental health of elderly turned out to be different between married and widowed: widowed were more likely than married to be affected by the contact with children and less likely to be affected by contact with friends/relatives. Such results had both positive and negative impact on physical and mental health of widowed. This may imply the difference in pathways of regulating health among the married and widowed elderly.

A Study on the Ambivalent Characteristic Displayed in Niki de Saint Phalle's Assemblages and Shooting Paintings by Looking Into Her Trauma (니키 드 생 팔의 트라우마를 통해 살펴본 아상블라주와 사격회화의 양면적 특성)

  • Yoo, Ka-Eun
    • The Journal of Art Theory & Practice
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    • no.6
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    • pp.77-99
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    • 2008
  • The purpose of this study is to show that the reason behind the ambivalent characteristic displayed in Niki de Saint Phalle's works is in her trauma and how such characteristic can be extracted from her works. During her creative years, Saint Phalle worked on various materials from different genres such as assemblages, shooting paintings, a series on Bride and Monster, 'Nana', 'Tarot Garden'and public sculptures. One commonality found among her various works is the ambivalent characteristic that contains contrasting elements simultaneously. Saint Phalle suffered a terrible psychological damage inflicted by her parents during her childhood. Specifically, she was sexually assaulted by her father and emotionally neglected by her mother, the trauma that affected her for the rest of her life. As a result, she came to develop extreme love- hate relationships with her parents and this became the main reason for the ambivalent characteristic displayed in her works. The love-hate relationship Saint Phalle developed can be identified through various researches done on the subject of the affect of sexual assault. It is common for incest victims to develop ambivalent feelings towards the perpetrator and Saint Phalle was no exception. Dissociation disorder and a snake well explain the trauma from her father. It is a generally accepted belief in the field of psychology that dissociation disorder commonly occurs to children who experience incest. And dissociation disorder is similar to the characteristic of ambivalence in the sense that a single entity contains more than two contrasting elements at the same time. In addition, the amputated doll objects used in her assemblages coincide with the expression of body detachment of people with dissociation disorder. These facts clearly indicate that the trauma from her father is showing through in her works. A snake is a subject matter that reflects the ambivalent tendency of Saint Phalle that resulted from her trauma. She remembers her father's rape as an image of a snake which is related to a phallic symbol in mythology or art reflecting her trauma. Moreover, she displays a similar pattern of ambivalent emotion like love and hate or fear towards a snake and her father. This is also confirmed by her portrayal of a snake as a monster or reversely as a creature with fundamental vitality in her works. The lack of affection from her mother can be explained by her mother's maternal deprivation. It appears that Saint Phalle's mother possessed all the causes for maternal deprivation such as maternal separation, personality disorder and inappropriate attitude towards child rearing. Especially, a study that shows mother's negative attitude towards child breeding tends to increase dissociation experience of children is another important evidence that supports Saint Phalle's dissociation tendency. These traces of Saint Phalle's trauma are clearly revealed in her assemblages and shooting paintings. The violent objects in her assemblages such as a hammer, razor, nail represent the rage and defensiveness towards her father. The objects such as fragments of broken plates of feminine patterns, pots and mirrors that her mother used symbolize the affection towards her mother. On the other hand, the destructed objects can be interpreted as her hate and resentment towards her mother. Shooting paintings contain her extreme fury and hate. Things such as acts of shooting and the image associated with blood after shooting are blunt expressions of her bursts of emotions. I have tried to define and classify the ambivalent characteristics shown in her assemblages and shooting paintings as hate, rage, violence, calm, love and pleasure according to the frame of Thanatos and Eros. Out of the six, hate, rage, violence and clam are associated with Thanatos while love and pleasure are associated with Eros and they correspondingly form an ambivalent structure. These ambivalent characteristics can be found in her assemblages and shooting paintings. The objects in her assemblages such as a razor, saw, hammer imply hate, rage, violence and the silence felt throughout her works represent calmness. And, as mentioned, the feminine objects can be seen as symbolizing love. In shooting paintings, hate, rage, violence can be found in the use of force and in the traces of watercolor after shooting, and a sense of pleasure in her feelings of catharsis after her shooting. Moreover, a shielded calmness can be found on the plywood all covered with plaster before the shooting. This study looked into the ambivalent characteristic of Saint Phalle's works by examining her trauma to find its correlation, and a meaning of this study can be found from the fact that it refocused the origin of Saint Phalle who is generally known as a feminist artist. Additionally, a meaning of the study can be found also from the fact that it examined the ambivalent characteristics of her works through a frame of Thanatos and Eros.

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A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment (지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例))

  • Sohn, Chang-Ho;Shin, Min-Sup;Hong, Kang-E;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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

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

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