• Journal of the Korean Society of Food Science and Nutrition
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• v.35 no.1
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• pp.68-77
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• 2006

This study was peformed to document the association between nutrient intakes, body mass index (BMI), waist/hip ratio (WHR), and a major risk factor for chronic diseases. A three-day dietary intake survey, using a 24 hour recall method, was obtained from 187 subjects aged 46 to 84 (mean age 65.3) living in Wando island area. The average daily mean energy intakes were 1869.0 kcal for male and 1943.9 kcal for female, respectively. Daily intakes of protein for male and female were 28.0 and 30.4 g, and those of fat were 31.5 and 28.51 g, respectively Carbohydrate dependency was decreased with age. Protein dependency was increased with age. The mean intakes of energy, protein, Vit. A, Vit. D, Vit. E, Ca, Zn did not meet Korean RDA for elderly. The level of serum triglyceride was higher in males than in females and showed the tendency to increase with age in both sexes, whereas HDL-cholesterol tended to decrease with age in both sexes. The levels of serum total-cholesterol and LDL-cholesterol were significantly higher in males than in females, particularly in the age of $46\~59$ (p<0.05). The level of atherogenic index (AI) was significantly higher in females than in males, particularly in the age of 80 and over (p<0.05) Based on these results, it is evident that people in island area did not consume enough nutrient. Specially, dietary intake of protein was not adequate. This study implies that triglyceride, total-cholesterol, LDL-cholesterol, AI were increased with increasing age, BMI and WHR.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• Journal of Biosystems Engineering
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• v.6 no.1
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• pp.28-38
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• 1981

A survey has been conducted to investigate the presents of breaks down and repair of power tiller for efficient use. Eight provinces were covered for this study. The results are summarized as follows. A. Frequency of breaks down. 1) Power tiller was breaken down 9.05 times a year and it represents a break down every 39.1 hours of use. High frequency of breaks down was found from the fuel and ignition system. For only these system, the number of breaks down were 2.02 and it represents 23.3% among total breaks down. It was followed by attachments, cylinder system, and traction device. 2) For the power tiller which was more than six years old, breaks down accured 37.7 hours of use and every 38.6 hours for the power tiller which was purchased in less than 2 years. 3) For the kerosene engine power tiller, breaks down occured every 36.8 hours of use, which is a higher value compared with diesel engine power tiller which break down every 42.8 hours of use. The 8HP kerosene engine power tiller showed higher frequency of break down compared with any other horse power tiller. 4) In October, the lowest frequency of break down was found with the value of once for every 51.5 hours of use, and it was followed by the frequency of break down in June. The more hours of use, the less breaks down was found. E. Repair place 1) 45.3% among total breaks down of power tiller was repaired by the owner, and 54.7% was repaired at repair shop. More power tiller were repaired at repair shop than by owner of power tiller. 2) The older the power tiller is, the higher percentage of repairing at the repair shop was found compared with the repairing by the owner. 3) Higher percentage of repairing by the owner was found for the diesel engine power tiller compared with the kerosene engine power tiller. It was 10 HP power tiller for the kerosene power tiller and 8 HP for the diesel engine power tiller. 4) 66.7% among total breaks down of steering device was repaired by the owner. It was the highest value compared with the percentage of repairing of any other parts of power tiller. The lowest percentage of repairing by owner was found for the attachments to the power tiller with the value of 26.5%. C. Cause of break down 1) Among the total breaks down of power tiller, 57.2% is caused by the old parts of power tiller with the value of 5.18 times break down a year and 34.7% was caused by the poor maintenance and over loading. 2) For the power tiller which was purchased in less than two years, more breaks down were caused by poor maintenance in comparison to the old parts of power tiller. 3) For the both 8-10 HP kerosene and diesel engine power tiller, the aspects of breaks down was almost the same. But for the 5 HP power tiller, more breaks down was caused by over loading in comparison to the old parts of power tiller. 4) For the cylinder system and traction device, most of the breaks down was caused by the old parts and for the fuel and ignition system, breaks down was caused mainly by the poor maintenance. D. Repair Cost 1) For each power tiller, repair cost was 34,509 won a year and it was 97 won for one hoar operation. 2) Repair cost of kerosene engine power tiller was 40,697 won a year, and it use 28,320 won for a diesel engine power tiller. 3) Average repair cost for one hour operation of kerosene engine power tiller was 103 won, and 86 won for a diesel engine power tiller. No differences were found between the horse power of engines. 4) Annual repair cost of cylinder system was 13,036 won which is the highest one compared with the repair cost of any other parts 362 won a year was required to repair the steering device, and it was the least among repair cost of parts. 5) Average cost for repairing the power tiller one time was 3,183 won. It was 10,598 won for a cylinder system and 1,006 won for a steering device of power tiller. E. Time requirement for repairing by owner. 1) Average time requirements for repairing the break down of a power tiller by owner himself was 8.36 hours, power tiller could not be used for operation for 93.58 hours a year due to the break down. 2) 21.3 hours were required for repairing by owner himself the break down of a power tiller which was more than 6 years old. This value is the highest one compared with the repairing time of power tiller which were purchased in different years. Due to the break down of the power tiller, it could not be used for operation annually 127.13 hours. 3) 10.66 hours were required for repairing by the owner himself a break down of a diesel engine power tiller and 6.48 hours for kerosene engine power tiller could not be used annually 99.14 hours for operation due to the break down and it was 88.67 hour for the diesel engine power tiller. 4) For both diesel and kerosene engine power tiller 8 HP power tiller required the least time for repairing by owner himself a break down compared with any other horse power tiller. It was 2.78 hours for kerosene engine power tiller and 8.25 hours fur diesel engine power tiller. 5) For the cylinder system of power tiller 32.02 hours were required for repairing a break down by the owner himself. Power tiller could not be used 39.30 hours a year due to the break down of the cylinder system.