• 디지털융복합연구
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• 제16권11호
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• pp.411-418
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• 2018

자폐성장애는 의학적인 조기 진단과 치료가 중요하고, 성인기에도 정기적으로 의학적 상태를 점검하는 것이 필요하다. 이 연구는 자폐성장애인에 대한 융복합적 접근을 위해 국민건강보험자료를 이용하여 자폐성장애인의 의료이용 경향과 추이 분석 및 시사점을 도출을 목적으로 하였다. 보건의료빅데이터개방시스템을 이용하여 2010년부터 2017년까지 자폐성장애인의 치료유병률, 의료이용 양상, 연령 구간에 따른 의료이용의 차이, 주 이용 의료기관 유형 및 소재지를 분석하였다. 연구결과 첫째, 자폐성 장애인의 2017년의 의료이용량은 2010년에 비해 50%이상 증가하였고 치료유병률은 79.1%로 추정되었으며, 향후 3년간 의료이용을 예측한 결과 지속적으로 증가하는 것으로 나타났다. 둘째, 자폐성 장애인의 의료이용은 연령구간에 따른 편차가 컸으며 특히 20세 이후에 의료이용량이 급감하였다. 셋째, 주로 이용하는 의료기관 유형은 의원급(45.6%)이었으며 서울(35.9%) 소재 의료기관을 주로 이용하는 것으로 나타났다. 이번 연구결과는 향후 정부의 자폐성장애관련 정책의 실효성 평가에 최소 기준점으로 활용할 수 있을 것이다. 그러나 자폐성 장애인의 치료유병률 향상 방안 및 연령별 의료이용량 차이의 원인 등에 대해 추가적인 연구가 필요하다.

• 한국병원경영학회지
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• 제6권2호
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• pp.70-85
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• 2001

This study has been conducted, on the reservation of specific examinations during seven months starting from June 1999 and ending December as the Group I for these of one stop service and as the Group II for those of existing direct reservation made by patients or patrons, to understand the differences between the two groups. The survey was extended to the patients visiting specific departments of K hospital with sample sizes of 154 for the Group I and 155 for the Group II. The findings of the survey are as follows: First, as the general characteristics of the sample, male patients account for 67% of the total and female patients 33%, with the former twice as large as the latter. The average age of the patients is 51, indicating relatively high level. By the geographical area of residence, metropolitan area is 80.7% and the other area 19.3%, showing most of the patients are from metropolitan area. The general characteristics do not have statistical significance between the Group I and the Group II(p>0.05). Second, regarding the ratio by the number of examinations, the Group I shows 37.0% for one examination and 63.0% for two examinations, while the Group IT indicates 30.3% for one examination and 69.7% for two examinations. The populations by the number of examinations do not have statistical difference between the two Groups(p>0.05). Third, regarding the time required for the reservation of examinations by the number of examinations, the Group I shows 9.8 minutes for one examination and 19.8 minutes for two examinations, with the average of 16.1 minutes. The Group IT indicates 19 minutes for one examinations and 25.7 minutes for two examinations, with the average of 23.7 minutes. Though the time required for the reservation by the number of examinations do not have statistical significance, the time required for the Group I was shortened. Fourth, regarding the time required for the reservation of examinations by the age range of patients, the Group I shows 21.7 minutes for 70-79 years of age, 17.5 minutes for 60-00 years of age, and 15.2 minutes for 30-39 years of age. The Group II indicates 27.2 minutes for 70-79 years of age, 26.3 minutes for 60-69 years of age, 24.4 minutes for 50-59 years of age, and 22.4 minutes for 30-39 years of age. The time required for the reservation gets longer as the age range moves up, and has statistical significance (p<0.05). Fifth, regarding the ratio by the range of time of required for reservation, the Group I shows 41.6% for 11-20 minutes, and 38.3% for 1-10 minutes, while the Group II indicates 43.9% for 11-20 minutes, 29% for 21-30 minutes, and 14.2% for 31-40 minutes. Statistical significance is revealed (p=0.001). Sixth, concerning the length of movement course by the number of examinations, the Group I shows 37 meters regardless of the number of examinations. The Group II indicates an average of 188 meters for one examination and 189 meters for two examinations, with the difference 151 meters between the Groups, and representing statistical significance (p=0.001). Based on the above findings. one-stop service contributes to the reduction of both the time and the movement course and therefore is considered to be beneficial to the patients, and the improve the efficiency of the hospitals in terms of the space and the time.

• 대한지리학회지
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• 제29권1호
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• pp.46-64
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• 1994

본 논문은 18세기에서 19세기에 이르는 전환기적 시기에 줄포만에서 행해진 자염을 소재로하여 당 지역의 역사지리적 경관복원을 시도해 본 것이다. 먼저 자염업의 성립배경과 관련해서 줄포만은 넓은 간석지를 근간으로 한 지형적 측면을 포함해 조석, 기후, 식생, 토 양 등 자연지리적 제 조건의 혜택하에 염업이 활성화 될 수 있었다. 사회경제적으로는 인구 증가, 농민층의 분해, 교환경제및 어업의 발달 등이 자염발달의 촉발요인이 되었다. 당시의 염장은 고부, 부안, 홍덕, 무장 등 4개 군현에 걸쳐 분포하였으며, 이 가운데 고부의 것은 월 경지인 부안면에 소재한 것으로 밝혀졌다. 그리고 본지역 자염의 기원지는 무장의 검당으로 비정하였다. 주요 제염설비에는 염막, 염전, 섯등, 염정, 염조, 염부 등이 있었고 실 작업에는 제염도구로 재래농기구가 동원되었다. 제염은 물때에 맞추어 행해지며 섯등굴착. 염토살포, 염밭갈이, 섯등구축, 염수회득, 자염의 과정을 거쳐 화염을 얻어내는 형태를 취하였다.

• 대한지리학회지
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• 제31권4호
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• pp.699-715
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• 1996

이 연구는 지리의 기본개념중의 하나인 '장소' 개념을 중심으로 하여, 이 개념의 사실인지측면과 가치판단측면이 어떻게 형성되는지 그리고 그것이 질적으로 구분되는 인지단계를 가지고 있는지를 밝히려고 하였다. 연구대상은 5세에서 14세에 이르는 도시 아동 및 학생으로 연령별로 남. 여 각각 100명, 총 200명이 선정되었다. 먼저 '장소' 개념의 사실인지측면은 입지감, 장소에 대한 지식, 지기적 영역감으로 3구분하고, 가치판단측면에서는 장소에 대한 감정, 장소에 대한 호기심, 장소에의 소속감으로 3구분하여 6가지의 하위내용영역을 중심으로 개념의 6가지 측면을 바탕으로 개념발달과정을 설명할 9개의 변수(준거이용 집, 학교, 동 입지시키기, 장소선호, 장소혐오, 장소호기심, 동 및 시 소속감, 장소 포 섭 관 계 인 식)를 사용하여 군집분석(Cluster analysis)을 실시하였다. 그 결과 본 연구에서는 장소개념의 발달과정이 다음과 같은 4단계로 나타남을 확인하였다. 1단계(5-7세): 장소개념의 6가지 측면 모두에서 낮은 수준을 보이는 학생들(군집 I)만이 있는 단계이다. 2단계(8-9새): 1단계의 주를 이루었던 모든 측면에서 낮은 인식수준을 보이는 학생들(군집 II)과 장소의 포섭관계, 집입지, 학교입지, 시에 대한 소속감, 장소에 대한 호기심의 측면에서 1단계의 학생집단보다 높은 수준을 보이는 학생들(군집 II)이 같은 비율로 나타나는 단계이다. 3단계(10세): 점이적인 단계로서 장소의 포섭관계, 집입지, 학교입지, 시에 대한 소속감, 장소에 대한 호기심의 측면에서 1단계의 학생보다 높은 수준을 보이는 학생들(집단 III)이 거의 대부분을 차지하는 단계이다. 4단계(11-14세): 군집 II 에 속하는 학생들이 일부가 있으나, 동입지 및 범위인지, 학교입지, 장소에 대한 선호, 장소호기심의 측면에서 군집 II보다 장소개념에 대한 인지수준이 높은 군집 III 에 속하는 학생들이 대부분을 차지하는 단계이다. 이를 통해볼 때, 유치원 2학년과 초등학교 1학년간에는 차이가 없으며, 더욱이 초등학교 5, 6학년과 중학교 1,2 학년간에는 차이가 거의 없는 것을 알 수 있다. 오히려 장소 개념의 발달에 있어서 중요한 변화를 가져오는 시기는 초등학교 2학년(8세), 4학년(10세), 5학년(11세)라고 할 수 있다. 결국 이 연구에서 확인된 5세-14세의 한국 도시 아동 및 학생에 있어서 장소 개념의 발달은 Piaget가 제시한 인지발달단계론에 따라 나타나고 있다고 하겠다. 즉 5세에서 7세에 이르는 전조작기의 전개념기와 7세-11.5세의 구체적 조작기, 그리고 11.5세의 형식적 조작기로 나아가면서 인지발달의 변화를 보이고 있다.

• 한국실내디자인학회논문집
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• 제19권6호
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• pp.206-213
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• 2010

This study, for church architectural amenities for the aged, with a base of 'laws on securing promotion of convenience for the disabled, aged, and pregnant women,' would like to propose improvement program after figuring out church worker (priest)'s willingness for amenities improvement, request of the aged church members, and level of request by different ages of the aged church members and total number of church members. The scope of geographical range for the study is limited to Northern side of Han River in Seoul and the churches with its own building having 500 to 3,000 people attending services, and implementation range, with a base of laws on promotion of convenience, separates specific items into mediation facility, interior facility, sanitary facility, and other facilities. The study selected 40 workers in church and 339 aged church members as subjects. As analysis method for the study, we have measured reliance level of questions by performing reliance test on each question, and performed frequency analysis in order to observe church worker's willingness to improve and request level of the aged church members. And, in order to find out the difference on opinion by the aged church members and total number of church members, we have performed "One way ANOVA," that verifies average difference. For evidence analysis we have verified all of them in attention level of p<.05, and for statistics analysis we have analyzed them using SPSSWIN 12.0 program. We are proposing improvement program based on study and analysis as next: First, since most of church workers have strong willingness to improve amenities we have learned that it is very optimistic to see improvements on church's amenities in the future. Second, since the aged church members' level of request was high on 3 of mediation facilities, elevators, and restrooms, it is desirable to improve mainly with these facilities. Third, the result on level of request for facilities based on the total number of church members revealed that the churches with 1,000-2,000 members have the highest level of request. Thus, we feel that the churches with 1,000-2,000 members should try harder to improve compared with churches with different number of members. Fourth, since the level of request on church amenities by different age group showed that the age group with 65-70 had the highest level of request on all facilities, except elevators, there are needs to apply the opinions of this age group more in depth based on this result.

• Asian Pacific Journal of Cancer Prevention
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• 제17권2호
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• pp.719-722
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• 2016

Background: Cholangiocarcinoma (CCA) is a serious health problem in Thailand, particularly in northeastern and northern regions, but epidemiological studies are scarce and the spatial distribution of CCA remains to be determined. A database for the population at risk is required for monitoring, surveillance and organization of home health care. This study aim was to geo-visually display the distribution of CCA in northeast Thailand, using a geographic information system and Google Earth. Materials and Methods: A cross-sectional survey was carried out in 9 sub-districts and 133 villages in Chum Phuang district, Nakhon Ratchasima province during June and October 2015. Data on demography, and the population at risk for CCA were combined with the points of villages, sub-district boundaries, district boundaries, and points of hospitals in districts, then fed into a geographical information system. After the conversion, all of the data were imported into Google Earth for geo-visualization. Results: A total of 11,960 from 83,096 population were included in this study. Females and male were 52.5%, and 47.8%, the age group 41-50 years old 33.3%. Individual risk for CCA was identifed and classified by using the Korat CCA verbal screening test as low (92.8%), followed by high risk (6.74%), and no (0.49%), respectively. Gender ($X^2$-test=1143.63, p-value= 0.001), age group ($X^2$-test==211.36, p-value=0.0001), and sub-district ($X^2$-test=1471.858, p-value=0.0001) were significantly associated with CCA risk. Spatial distribution of the population at risk for CCA in Chum Phuang district was viewed with Google Earth. Geo-visual display followed Layer 1: District, Layer 2: Sub-district, Layer 3: Number of low risk in village, Layer 4: Number of high risk in village, and Layer 5: Hospital in Chum Phuang District and their related catchment areas. Conclusions: We present the first risk geo-visual display of CCA in this rural community, which is important for spatial targeting of control efforts. Risk appears to be strongly associated with gender, age group, and sub-district. Therefor, spatial distribution is suitable for the use in the further monitoring, surveillance, and home health care for CCA.

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.455-460
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• 2014

Background: The purpose of the present study was to determine geographic clustering of breast cancer incidence in Kanagawa Prefecture, using cancer registry data. The study also aimed at examining the association between socio-economic factors and any identified cluster. Materials and Methods: Incidence data were collected for women who were first diagnosed with breast cancer during the period from January to December 2006 in Kanagawa. The data consisted of 2,326 incidence cases extracted from the total of 34,323 Kanagawa Cancer Registration data issued in 2011. To adjust for differences in age distribution, the standardized mortality ratio (SMR) and the standardized incidence ratio (SIR) of breast cancer were calculated for each of 56 municipalities (e.g., city, special ward, town, and village) in Kanagawa by an indirect method using Kanagawa female population data. Spatial scan statistics were used to detect any area of elevated risk as a cluster for breast cancer deaths and/or incidences. The Student t-test was performed to examine differences in socio-economic variables, viz, persons per household, total fertility rate, age at first marriage for women, and marriage rate, between cluster and other regions. Results: There was a statistically significant cluster of breast cancer incidence (p=0.001) composed of 11 municipalities in southeastern area of Kanagawa Prefecture, whose SIR was 35 percent higher than that of the remainder of Kanagawa Prefecture. In this cluster, average value of age at first-marriage for women was significantly higher than in the rest of Kanagawa (p=0.017). No statistically significant clusters of breast cancer deaths were detected (p=0.53). Conclusions: There was a statistically significant cluster of high breast cancer incidence in southeastern area of Kanagawa Prefecture. It was suggested that the cluster region was related to the tendency to marry later. This study methodology will be helpful in the analysis of geographical disparities in cancer deaths and incidence.

• Journal of Preventive Medicine and Public Health
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• 제39권1호
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• pp.30-38
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• 2006

Objectives: We examined whether the neighborhood socioeconomic position predicts the smoking rates after adjusting for individual socioeconomic position indicators. Methods: Data were obtained from the 2001 Seoul Health Indicators Survey. The neighborhood socioeconomic position was the residential distribution of the high class (power elites), as measured by the location quotients (LQ) for each administrative dong (district). A high LQ denotes a high neighborhood socioeconomic status. The individual socioeconomic position included education, occupation and income. Age-adjusted smoking rates according to the LQ level were computed with the direct method. The total number of subjects in this study (26,022 men and 28,007 women) was the reference. A multilevel logistic regression analysis was conducted with the individuals at the first level and the neighborhoods at the second level to estimate the odds ratios of smoking with 95% confidence intervals. Results: For men, the age-adjusted smoking rates increased with a decrease in the LQ. For women, the relationship between the age-adjusted smoking rate and the LQ was not clear. The odds of smoking for both genders were greater among those subjects with lower incomes and lower education. The manual occupational class had greater odds of smoking than the non-manual class for the males, while the odds ratio of smoking among females with a manual occupation tended to be lower than those females with a non-manual occupation. For the males, the LQ levels independently predicted smoking after adjustment for individual income. However, this relation between the LQ and smoking in males was explained by full adjustment for the individual socioeconomic position indicators (education, occupation and income). Conclusions: A low level of neighborhood socioeconomic position was associated with higher smoking rates among the men residing in Seoul. This association between the neighborhood socioeconomic position and smoking in men was explained by the individual socioeconomic position. Anti-smoking efforts to reduce geographical inequality in smoking should be directed at reducing the smoking rates between the individuals with different socioeconomic backgrounds in the metropolitan city of Seoul, South Korea.

• 대한지리학회지
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• 제39권1호
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• pp.27-44
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• 2004

소양강의 상류는 남한의 하천 중 태백산맥에 인접한 최북단의 하천으로 구조운동, 기후변화 등 한반도의 제4기 고환경을 연구하기에 유리한 지역이다. 본 연구는 소양강 상류에 분포한 58개 하안단구면의 분포 패턴, 지형면 특성, 퇴적물 분석과 함께 하천의 발달에 영향을 미친 고환경을 검토하였다. 하안단구는 가장 최근에 형성된 T1면에서 가장 오래된 T6면까지로 구분되며. 주로 곡류부 활주사면과 하천의 편안에 집중되어 있다. T1면에서 T6면으로 갈수록(시간이 경과할수록) 하안단구면의 개수는 줄어들고, 단구면의 평면적인 개석율은 높아지며, 경사도는 급해진다. 하천의 유로는 T2면 형성시기에 들어서 곡류 패턴이 더 강해진 것으로 보인다. 하안단구 역의 풍화각 두께는 오래된 하안단구면일수록 대체로 커지지만, 역층으로의 수분 및 산소 공급의 차이에 따라 변화가 나타난다. 퇴적 층서, 입도 분석. 화분 분석. 적색화 지수, 역 풍화각의 두께 측정 자료를 종합할 때, T5면의 형성 시기는 현재로부터 네번째 이전의 빙기인 MIS(Marine Oxygen Isotope Stage) 10시기일 가능성이 높으며, T2면은 간빙기를 한번 이상 겪은 MIS 6시기에 형성된 것으로 추정된다.

• 대한지리학회지
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• 제40권5호
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• pp.514-532
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• 2005

본 연구는 시간지리학 개념을 도입한 새로운 접근성 개념을 통해 공간적 근접성과 단일한 이동 행태를 전제하는 기존의 방법을 비판적으로 검토해보고자 한다. 이를 위해, 미국 Portland Metro 지역의 개인통행자료를 이용해 시공간적 접근성의 공간적 패턴과 근접성의 관계를 비교${\cdot}$분석하였다. 시간지리학의 시공간 프리즘 개념에 기반한 시공간적 접근성은 근접성 외에도 시공간 제약에 따른 다양한 이동성을 고려한 대안적 방법으로 최근 새롭게 주목받고 있다. 기존 방법은 접근성이 도시의 기능 중심성과 유사한 공간패턴을 보일 것으로 예상하지만, 연구결과는 접근성이 근접성보다는 개인의 시공간적 속성에 더 많은 영향을 받는다는 사실을 보여준다. 접근성은 CBD나 도시기회의 고밀도지역을 멀리 벗어난 지역에서 오히려 높게 나타났으며, 같은 지리적 특성을 공유하는 동일 지역이라 할지라도 성별에 따라 다르게 드러났다. 이는 접근성이 거주지뿐만 아니라 다른 공간적 축들(직장, 자녀의 탁아시설등)을 중심으로도 형성되며, 이에 따라 집에서 멀리 떨어진 곳의 도시 기회들이 집 주변의 도시기 회들보다 개인의 접근성에 더 큰 기여를 할 수 있다는 점을 시사한다.