• 제목/요약/키워드: 평가 기능

검색결과 8,630건 처리시간 0.045초

Effect of the Angle of Ventricular Septal Wall on Left Anterior Oblique View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 심실중격 각도에 따른 좌전사위상 변화에 대한 연구)

  • You, Yeon Wook;Lee, Chung Wun;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae;Bang, Ji-In;Lee, Soo Jin;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • 제20권1호
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    • pp.13-19
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    • 2016
  • Purpose In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (${\theta}$) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view. Materials and Methods From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (${\theta}$) between ventricular septum and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of ${\theta}$ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO ${\theta}$ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed. Results $Mean{\pm}SD$ of ${\theta}$ on total 253 patients was $37.0{\pm}8.5^{\circ}$. Among them, the patients whose difference between 45 and ${\theta}$ degrees were more than ${\pm}10$ degrees were 88 patients ($29.3{\pm}6.1^{\circ}$). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=62.0{\pm}6.6%$ vs. LVEF ${\theta}=64.0{\pm}5.6%$; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=66.7{\pm}7.2%$ vs. LVEF ${\theta}=69.0{\pm}6.4%$; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO ${\theta}$, there was no significant difference statistically. Conclusion We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO ${\theta}$ view.

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Influences of Forest Management Practices on pH and Electrical Conductivity in the Throughfall and Stemflow with the Abies holophylla and Pinus koraiensis Dominant Watershed (전나무림, 잣나무림 유역에서 수관통과우와 수간유하수의 수소이온농도 및 전기전도도에 미치는 산림시업의 영향)

  • Jeong, Yong-Ho;Kim, Kyong-Ha;Park, Jae-Hyeon
    • Korean Journal of Ecology and Environment
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    • 제35권1호통권97호
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    • pp.52-61
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    • 2002
  • This research was conducted to evaluate the effect of forest management practices on pH and electrical conductivity to get fundamental information on water purification capacity after forest operation. Rainfall, throughfall and stemflow were sampled at the study sites which consist of Abies holophylla and Pinus koraiensis in Gwangreung Experimental Forest for S months from May to November 1999. Mean pH of the throughfall of the beginning of the event was higher in management (thinning and pruning) sites of Abies holophylla and Pinus koraiensis stands than nonmanagement site of Abies holophylla and Pinus koraiensis stands. In addition, pH of the throughfall of the total amount of the event showed similar trends which are higher pH in the management sites compared with the non- management sites. This result indicates that managements such as thinning and pruning improve tree butler capacity of rainfall pH. According to the linear regression results, pH of the throughfall of the total amount of the event in non-management sites = 0.735${\times}$pH of the throughfall of the beginning of the event in non-management sites+1.849 ($R^2\;=\;0.82$) and pH of the throughfall of the total amount of the event in management sites= 0.863${\times}$pH of the throughfall of the beginning of the event in management sites +1.0242 ($R^2\;=\;0.87$). In case of stemflow pH, pH of the sternflow of the total amount of the event in non-management sites = 0.53${\times}$pH of the stemflow of the beginning of the event in non- management sites+2.7709 ($R^2\;=\;0.64$) and pH of the stemflow of the total amount of the event in management sites = 0.5854${\times}$pH of the stemflow of the beginning of the event in management sites+2.7045 ($R^2\;=\;0.65$). Electrical conductivity (EC) of the throughfall of the beginning and total amount of the event was highest in non- management site in Abies holophylla, followed by management sites in fsies Abies holophylla, non-management site in Pinus koraiensis, and management sites in Pinus koraiensis stands, respectively. According to the linear regression results, EC of the throughfall of the total amount of the event in non-managementsites = 0.4045${\times}$EC of the throughfall of the beginning of the event in non-management sites+26.766 ($R^2\;=\;0.69$) and EC of the throughfall of the total amount of the event in management sites = 0.6002${\times}$EC of the throughfall of the beginning of the event in management sites+8.0184 ($R^2\;=\;0.54$). In case of stemflow EC, EC of thestemflow of the total amount of the event in non-management sites = 0.6298${\times}$EC of the stemflow of the beginning of the event in non-management sites+11.582 ($R^2\;=\;0.72$) and pH of the stemflow of the total amount of the event in management sites =0.602${\times}$pH of the stemflow of the beginning of the event in management sites+20.783($R^2\;=\;0.49$).

The Experimental Study for Myocardial Preservation Effect of Ischemic Preconditioning (허혈성 전조건화 유발이 심근보호에 미치는 영향에 관한 실험적 연구)

  • 이종국;박일환;이상헌
    • Journal of Chest Surgery
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    • 제37권2호
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    • pp.119-130
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    • 2004
  • Decrease in cardiac function after open heart surgery is due to an ischemia induced myocardial damage during surgery, and ischemic preconditioning, a condition in which the myocardial damage does not accumulate after repeated episodes of ischemia but protects itself from damage after prolonged ischemia due to myocytes tolerating the ischemia, is known to diminish myocardial damage, which also helps the recovery of myocardium after reperfusion, and decreases incidences of arrythmia. Our study is performed to display the ischemic preconditioning and show the myocardial protective effect by applying cardioplegic solution to the heart removed from rat. Material and Method: Sprague-Dawley male rats were used, They were fixed on a modified isolated working heart model after cannulation. The reperfusion process was according to non-working and working heart methods and the working method was executed for 20 minutes in which the heart rate, aortic pressure, aortic flow and coronary flow were measured and recorded. The control group is the group which the extracted heart was fixed on the isolated working heart model, recovered by reperfusion 60 minutes after infusion and preserved in the cardioplegic solution 20 minutes after the working heart perfusion and aortic cross clamp, The thesis groups were divided into group I, which ischemic hearts that were hypoxia induced were perfused by cardioplegic solution and preserved for 60 minutes; group II, the cardioplegic solution was infused 45 seconds (II-1), 1 minutes (II-2), 3 minutes (II-3), after the ischemia induction, 20 minutes after working heart perfusion and aortic cross clamp; and group III, hearts were executed on working heart perfusion for 20 minutes and aortic cross clamp was performed for 45 seconds (III-1), 1minute (III-2), 3 minutes (III-3), reperfused for 2 minutes to recover the heart, and then aortic cross clamping was repeated for reperfusion, all the groups were compared based on hemodynamic performance after reperfusion of the heart after preservation for 60 minutes. Result: The recovery time until spontaneous heart beat was longer in groups I, II-3, III-2 and III-3 to control group (p<0.01). Group III-1 (p<0.05) had better results in terms of recovery in number of heart rates compared to control group, and recovered better compared to II-1 (p<0.05). The recovery of aortic blood pressure favored group III-1 (p<0.05) and had better outcomes compared with II-1 (p<0.01). Group III-1 also showed best results in terms of cardiac output (p<0.05) and group III-2 was better compared to II-2 (p<0.05). Group I (p<0.01) and II-3 (p<0.05) showed more cardiac edema than control group. Conclusion: When the effects of other organs are dismissed, protecting the heart by infusion of cardioplegic solution after enforcing ischemia for a short period of time before the onset of abnormal heart beats for preconditioning has a better recovery effect in the cardioplegic group with preconditioning compared to the cardioplegic solution itself. we believe that further study is needed to find a more effective method of preconditioning.

The Qualitiy Characteristics of Kimchi added Vinegar, Mustard and Leaf Vegetables (식초, 겨자, 잎채소를 첨가한 김치의 품질특성)

  • Pak, Hee-Ok;Sohn, Chun-Young
    • The Korean Journal of Food And Nutrition
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    • 제26권4호
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    • pp.841-849
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    • 2013
  • The aim of this study was to investigate the quality characteristics of Kimchi, prepared with seasoning fluid, vinegar, and mustard extract to inhibit the proliferation of microorganisms and extend the edible period during fermentation at $25^{\circ}C$. We also added perilla leaf, endive, and mustard leaf to Kimchi to improve the flavor. The pH of control Kimchi fluid over 1 day after Kimchi processing, was $5.40{\pm}0.01$ and that of the experimental groups in which vinegar and mustard extract were added was $4.51{\pm}0.01{\sim}4.52{\pm}0.01$, which was lower than that of the control. As the fermentation progresses, the pH of the control decreased rapidly and that of the experimental groups decreased slowly. The initial titratible acidity of the control was low and 3 days later reached $0.95{\pm}0.04$. However, that of the experimental groups was $0.42{\pm}0.01{\sim}0.43{\pm}0.02$ and 5 days later reached a level similar to that of the control. The salinities of the Kimchi juice of both the control and the experimental groups were $2.67{\pm}0.06{\sim}2.80{\pm}0.10$% after 1 day and decreased during fermentation. The amount of lactic acid bacteria of the control was $8.17{\pm}4.01{\times}10^8cfu/g$, 1 day after the Kimchi processing and that of the experimental groups was $2.70{\pm}2.08{\times}10^7{\sim}3.63{\pm}2.80{\times}10^7cfu/g$. After 3 days, these were $3.13{\pm}1.94{\times}10^{11}cfu/g$ and $2.47{\pm}2.23{\times}10^9{\sim}8.03{\pm}3.71{\times}10^9cfu/g$, respectively. According to the result of sensory evaluation, throughout the entire period of the experiment, all sensory items such as color, odor, taste, texture, and total acceptability of the experimental groups were better than those of the control group (p<0.05). Especially, Kimchi in which perilla leaf was added was the best. With the addition of vinegar and mustard extract to the Kimchi, microorganism proliferation was inhibited and the edible period was extended. The minerals, vitamins and antioxidants of leaf vegetables could therefore be obtained.

Diagnostic Accuracy of $^{99m}Tc$-DISIDA Scintigraphy in Biliary Atresia (선천성 담도폐쇄증에서 $^{99m}Tc$ DISIDA 신티그라피의 진단정확성)

  • Hyun, In-Young;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Chung, June-Key;Suh, Jung-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • 제28권3호
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    • pp.357-363
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    • 1994
  • We evaluated the diagnostic accuracy of $^{99m}Tc$-DISIDA scintigrauhy as a mean of differentiating biliary atresia from neonatal hepatitis. $^{99m}Tc$-DISIDA scintigraphy was visually interpreted by assessing the presence or absence of radioactivity in the intestine or gall bladder. In patients without intestinal radioactivity, we measured the hepatic retention index and the hepatic uptake index. The hepatic retention Index was expressed as the amount of change of liver activity from 5 minutes to 30 minutes postinjection. The hepatic uptake Index was graded visually with 5 minute images using the following scoring scheme : grade 0(normal hepatic uptake), grade 1(decreased hepatic uptake), grade 2(hepatic uptake equal to cardiac uptake), and grade 3(hepatic uptake less than cardiac uptake). Age, total bilirubin, and hepatic uptake index were compared between the biliary atresia and the neonatal hepatitis group, between neonatal hepatitis patients with and without intestinal radioactivity, and between the biliary atresia and neonatal hepatitis patients with absent intestinal radioactivity. The results were as follows ; 1) None of the 30 biliary atresia patients showed intestinal radioactivity, while 31/40 neonatal hepatitis patients showed intestinal radioactivity. The sensitivity, specificity, and accuracy of the presence of intestinal radioactivity ?or the diagnosis of biliary atresia was 100%, 78%, and 87%, respectively. 2) In patients with absent intestinal radioactivity the mean hepatic retention index was $1.5{\pm}0.6$ in the 16 biliary atresia patients, and $1.1{\pm}0.2$ in the 7 neonatal hepatitis patients(p<0.01). All 7 patients with hepatic retention index over 1.5 had biliary atresia. But there were 9 patients with biliary atresia below 1.5. 3) No significant differences were found in age, total bilirubin, or hepatic uptake Index between biliary atresia and neonatal hepatitis patients. However there were differences in age, total bilirubin, and hepatic uptake index between neonatal hepatitis patients with and without intestinal radioactivity. The hepatic uptake index was significantly lower, age was old, and total bilirubin was low in the group with intestinal radioactivity compared the group without intestinal radioactivity(p<0.05). Relation between total bilirubin and the hepatic uptake index was that total bilirubin was relatively low at normal hepatic uptake index in biliary atresia and neonatal hepatitis patients. 4) When hepatic uptake index and hepatic retention index were high it suggest that biliary atresia is more likely, considered relation between hepatic uptake Index and the hepatic retention index. Thus, we conclude that $^{99m}Tc$-DISIDA scintigraphy is accurate in the differential diagnosis of biliary atresia and neonatal hepatitis. In patients without intestinal radioactivity, the hepatic retention index and hepatic uptake index, along with the patient's age and total bilirubin level may supplement diagnosis and improve diagnostic accuracy.

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Analysis of Manganese Contents in 30 Korean Common Foods (한국인 상용식품 중 30종류 식품의 망간 함량 분석)

  • 최미경
    • Journal of the Korean Society of Food Science and Nutrition
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    • 제32권8호
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    • pp.1408-1413
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    • 2003
  • This study was conducted to analyze manganese contents of Korean common foods. Contents of manganese in 30 foods were analyzed by ICP spectrometer. And daily manganese intake through 30 common foods was calculated using analysis data of this study and daily food intakes cited from report on 1998 national health and nutrition survey. The average manganese contents of foods analyzed were 949.6 $\mu\textrm{g}$ for rice, 236.1 $\mu\textrm{g}$ for Korean chinese cabbage kimchi, 27.2 $\mu\textrm{g}$ for citrus fruit, 2.6 $\mu\textrm{g}$ for milk, 214.6 $\mu\textrm{g}$ for radish root, 40.0 $\mu\textrm{g}$ for apple, 60.4 $\mu\textrm{g}$ for persimmon, 13.9 $\mu\textrm{g}$ for pork, 9.5 $\mu\textrm{g}$ for beef, 638.3 $\mu\textrm{g}$ for soybean curd, 184.0 $\mu\textrm{g}$ for radish kimchi, 56.0 $\mu\textrm{g}$ for pear, 18.4 $\mu\textrm{g}$ for beer, 11.3 $\mu\textrm{g}$ for egg, 9.5 $\mu\textrm{g}$ for carbonated beverage, 345.0 $\mu\textrm{g}$ for bread, 50.7 $\mu\textrm{g}$ for soju, 270.3 $\mu\textrm{g}$ for potato, 236.1 $\mu\textrm{g}$ for sweet potato, 91.2 $\mu\textrm{g}$ for ramyeon, 32.5 $\mu\textrm{g}$ for onion, 68.0 $\mu\textrm{g}$ for nabak kimchi, 538.2 $\mu\textrm{g}$ for soybean sprout, 112.5 $\mu\textrm{g}$ for welsh onion, 336.7 $\mu\textrm{g}$ for rice cake, 589.9 $\mu\textrm{g}$ for Korean chinese cabbage, 430.4 $\mu\textrm{g}$ for somyeon, 144.3 $\mu\textrm{g}$ for pumpkin, 3.0 $\mu\textrm{g}$ for yoghurt, and 614.4 $\mu\textrm{g}$ for spinach per 100 g of each food. The daily manganese intake through 30 common foods of Koreans in 1998 was 3420.7 $\mu\textrm{g}$. Major sources of dietary manganese were rice, kimchi, and soybean curd. Especially, rice supplied 68.1% of total dietary manganese intake through 30 common foods. Further studies are required to establish database and RDA of manganese.

The Effect of Nasal BiPAP Ventilation in Acute Exacerbation of Chronic Obstructive Airway Disease (만성 기도폐쇄환자에서 급성 호흡 부전시 BiPAP 환기법의 치료 효과)

  • Cho, Young-Bok;Kim, Ki-Beom;Lee, Hak-Jun;Chung, Jin-Hong;Lee, Kwan-Ho;Lee, Hyun-Woo
    • Tuberculosis and Respiratory Diseases
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    • 제43권2호
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    • pp.190-200
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    • 1996
  • Background : Mechanical ventilation constitutes the last therapeutic method for acute respiratory failure when oxygen therapy and medical treatment fail to improve the respiratory status of the patient. This invasive ventilation, classically administered by endotracheal intubation or by tracheostomy, is associated with significant mortality and morbidity. Consequently, any less invasive method able to avoid the use of endotracheal ventilation would appear to be useful in high risk patient. Over recent years, the efficacy of nasal mask ventilation has been demonstrated in the treatment of chronic restrictive respiratory failure, particularly in patients with neuromuscular diseases. More recently, this method has been successfully used in the treatment of acute respiratory failure due to parenchymal disease. Method : We assessed the efficacy of Bilevel positive airway pressure(BiPAP) in the treatment of acute exacerbation of chronic obstructive pulmonary disease(COPD). This study prospectively evaluated the clinical effectiveness of a treatment schedule with positive pressure ventilation via nasal mask(Respironics BiPAP device) in 22 patients with acute exacerbations of COPD. Eleven patients with acute exacerbations of COPD were treated with nasal pressure support ventilation delivered via a nasal ventilatory support system plus standard treatment for 3 consecutive days. An additional 11 control patients were treated only with standard treatment. The standard treatment consisted of medical and oxygen therapy. The nasal BiPAP was delivered by a pressure support ventilator in spontaneous timed mode and at an inspiratory positive airway pressure $6-8cmH_2O$ and an expiratory positive airway pressure $3-4cmH_2O$. Patients were evaluated with physical examination(respiratory rate), modified Borg scale and arterial blood gas before and after the acute therapeutic intervention. Results : Pretreatment and after 3 days of treatment, mean $PaO_2$ was 56.3mmHg and 79.1mmHg (p<0.05) in BiPAP group and 56.9mmHg and 70.2mmHg (p<0.05) in conventional treatment (CT) group and $PaCO_2$ was 63.9mmHg and 56.9mmHg (p<0.05) in BiPAP group and 53mmHg and 52.8mmHg in CT group respectively. pH was 7.36 and 7.41 (p<0.05) in BiPAP group and 7.37 and 7.38 in cr group respectively. Pretreatment and after treatment, mean respiratory rate was 28 and 23 beats/min in BiPAP group and 25 and 20 beats/min in CT group respectively. Borg scale was 7.6 and 4.7 in BiPAP group and 6.4 and 3.8 in CT group respectively. There were significant differences between the two groups in changes of mean $PaO_2$, $PaCO_2$ and pH respectively. Conclusion: We conclude that short-term nasal pressure-support ventilation delivered via nasal BiPAP in the treatment of acute exacerbation of COPD, is an efficient mode of assisted ventilation for improving blood gas values and dyspnea sensation and may reduce the need for endotracheal intubation with mechanical ventilation.

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Role of Postoperative Conventional Radiation Therapy in the Management of Supratentorial Malignant Glioma - with respect to survival outcome and prognostic factors - (천막상부 악성 신경교종에서 수술 후 방사선 치료의 역할 - 생존율과 예후인자 분석 -)

  • Nam Taek Keun;Chung Woong Ki;Ahn Sung Ja;Nah Byung Sik
    • Radiation Oncology Journal
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    • 제16권4호
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    • pp.389-398
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    • 1998
  • Purpose : To evaluate the role of conventional postoperative adjuvant radiotherapy in the management of supratentorial malignant glioma and to determine favorable prognostic factors affecting survival. Materials and Methods : From Sep. 1985 to Mar. 1997, the number of eligible patients who received postoperative radiotherapy completely was 69. They ranged in age from 7 to 66 years (median, 47). Forty-two (61$\%$) patients were glioblastoma multiforme and the other 27 (39$\%$) were anaplastic astrocytoma. Twenty patients (29$\%$) had Karnofsky score equal or more than 80 preoperatively. Forty-three patients (62$\%$) had symptom duration equal or less than 3 months. Twenty-four patients (35$\%$) had gross total resection and forty patients(58$\%$) had partial resection, the remaining five patients (7$\%$) had biopsy only. Radiotherapy dose ranged from 50.4 Gy to 61.2 Gy (median, 55.8; mode, 59.4) with fraction size of 1 8 Gy-2.0 Gy for 33-83 days(median, 48) except three patients delivered 33, 36, 39 Gr, respectively with fraction size of 3.0 Gy due to poor postoperative performance status. Follow-up rate was 93$\%$ and median follow-up period was 14 months. Results : Overall survival rate at 2 and 3 years and median survival were 38$\%$, 20$\%$, and 16 months for entire patients; 67$\%$, 44$\%$, and 34 months for anaplastic astrocytoma; 18$\%$, 4$\%$, and 14 months for glioblastoma multiforme, respectively (p=0.0001). According to the extent of surgery, 3-year overall survival for gross total resection, partial resection, and biopsy only was 38$\%$, 11$\%$, and 0$\%$, respectively (p=0.02) The 3-year overall survival rates for patients age 40>, 40-59, and 60< were 52$\%$, 8$\%$, and 0$\%$, respectively (p=0.0007). For the variate of performance score 80< vs 80>, the 3-year survival rates were 53$\%$ and 9$\%$, respectively (p=0.008). On multivariate analysis including covariates of three surgical and age subgroups as above, pathology, extent of surgery and age were significant prognostic factors affecting overall survival. On another multivariate analysis with covariates of two surgical (total resection vs others) and two a9e (50> vs 50<) subgroups, then, pathology, extent of surgery and performance status were significant factors instead of age and 3-year cumulative survival rate for the five patients with these three favorable factors was 100$\%$ without serious sequela. Conclusion : We confirmed the role of postoperative conventional radiotherapy in the management of supratentorial malignant glioma by improving survival as compared with historical data of surgery only. Patients with anaplastic astrocytoma, good performance score, gross total resection and/or young age survived longest. Maximum surgical resection with acceptable preservation of neurologic function should be attempted in glioblastoma patients, especially in younger patients. But the survival of most globlastoma patients without favorable factors is still poor, so other active adjuvant treatment modalities should be tried or added rather than conventional radiation treatment alone in this subgroup.

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A Study on Perception and Attitudes of Health Workers Towards the Organization and Activities of Urban Health Centers (도시보건소 직원의 보건소 업무에 대한 인식 및 견해)

  • Lee, Jae-Mu;Kang, Pock-Soo;Lee, Kyeong-Soo;Kim, Cheon-Tae
    • Journal of Yeungnam Medical Science
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    • 제12권2호
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    • pp.347-365
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    • 1995
  • A survey was conducted to study perception and attitudes of health workers towards health center's activities and organization of health services, from August 15 to September 30, 1994. The study population was 310 health workers engaged in seven urban health centers in Taegu City area. A questionnaire method was used to collect data and response rate was 81.3 percent or 252 respondents. The following are summaries of findings: Profiles of study population: Health workers were predominantly female(62.3%); had college education(60.3%); and held medical and nursing positions(39.6%), technicians(30.6%) and public health/administrative positions(29.8%). Perceptions on health center's resources: Slightly more than a half(51.1%) of respondents expressed that physical facilities of the centers are inadequate; equipments needed are short(39.0%); human resource is inadequate(44.8%); and health budget allocated is insufficient(38.5%) to support the performance of health center's activities. Decentralization and health services: The majority revealed that the decentralization of government system would affect the future activities of health centers(51.9%) which may have to change. However, only one quarter of respondents(25.4%) seemed to view the decentralization positively as they expect that it would help perform health activities more effectively. The majority of the respondents(78.6%) insisted that the function and organization of the urban health centers should be changed. Target workload and job satisfaction: A large proportion (43.3%) of respondents felt that present target setting systems for various health activities are unrealistic in terms of community needs and health center's situation while only 11.1 percent responded it positively; the majority(57.5%) revealed that they need further training in professional fields to perform their job more effectively; more than one third(35.7%) expressed that they enjoy their professional autonomy in their job performance; and a considerable proportion (39.3%) said they are satisfied with their present work. Regarding the personnel management, more worker(47.3%) perceived it negatively than positive(11.5%) as most of workers seemed to think the personnel management practiced at the health centers is not fair or justly done. Health services rendered: Among health services rendered, health workers perceived the following services are most successfully delivered; they are, in order of importance, Tb control, curative services, and maternal and child health care. Such areas as health education, oral health, environmental sanitation, and integrated health services are needed to be strengthening. Regarding the community attitudes towards health workers, 41.3 percent of respondents think they are trusted by the community they serve. New areas of concern identified which must be included in future activities of health centers are, in order of priority, health care of elderly population, home health care, rehabilitation services, and such chronic diseases control programs as diabetes, hypertension, school health and mental health care. In conclusion, the study revealed that health workers seemed to have more negative perceptions and attitudes than positive ones towards organization and management of health services and activities performed by the urban health centers where they are engaged. More specifically, the majority of health workers studied revealed to have the following areas of health center's organization and management inadequate or insufficient to support effective performance of their health activities: Namely, physical facilities and equipments required are inadequate; human and financial resources are insufficient; personnel management is unsatisfactory; setting of service target system is unrealistic in terms of the community needs. However, respondents displayed a number of positive perceptions, particularly to those areas as further training needs and implementation of decentralization of government system which will bring more autonomy of local government as they perceived these change would bring the necessary changes to future activities of the health center. They also displayed positive perceptions in their job autonomy and have job satisfactions.

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Directions of Implementing Documentation Strategies for Local Regions (지역 기록화를 위한 도큐멘테이션 전략의 적용)

  • Seol, Moon-Won
    • The Korean Journal of Archival Studies
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    • 제26호
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    • pp.103-149
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    • 2010
  • Documentation strategy has been experimented in various subject areas and local regions since late 1980's when it was proposed as archival appraisal and selection methods by archival communities in the United States. Though it was criticized to be too ideal, it needs to shed new light on the potentialities of the strategy for documenting local regions in digital environment. The purpose of this study is to analyse the implementation issues of documentation strategy and to suggest the directions for documenting local regions of Korea through the application of the strategy. The documentation strategy which was developed more than twenty years ago in mostly western countries gives us some implications for documenting local regions even in current digital environments. They are as follows; Firstly, documentation strategy can enhance the value of archivists as well as archives in local regions because archivist should be active shaper of history rather than passive receiver of archives according to the strategy. It can also be a solution for overcoming poor conditions of local archives management in Korea. Secondly, the strategy can encourage cooperation between collecting institutions including museums, libraries, archives, cultural centers, history institutions, etc. in each local region. In the networked environment the cooperation can be achieved more effectively than in traditional environment where the heavy workload of cooperative institutions is needed. Thirdly, the strategy can facilitate solidarity of various groups in local region. According to the analysis of the strategy projects, it is essential to collect their knowledge, passion, and enthusiasm of related groups to effectively implement the strategy. It can also provide a methodology for minor groups of society to document their memories. This study suggests the directions of documenting local regions in consideration of current archival infrastructure of Korean as follows; Firstly, very selective and intensive documentation should be pursued rather than comprehensive one for documenting local regions. Though it is a very political problem to decide what subject has priority for documentation, interests of local community members as well as professional groups should be considered in the decision-making process seriously. Secondly, it is effective to plan integrated representation of local history in the distributed custody of local archives. It would be desirable to implement archival gateway for integrated search and representation of local archives regardless of the location of archives. Thirdly, it is necessary to try digital documentation using Web 2.0 technologies. Documentation strategy as the methodology of selecting and acquiring archives can not avoid subjectivity and prejudices of appraiser completely. To mitigate the problems, open documentation system should be prepared for reflecting different interests of different groups. Fourth, it is desirable to apply a conspectus model used in cooperative collection management of libraries to document local regions digitally. Conspectus can show existing documentation strength and future documentation intensity for each participating institution. Using this, documentation level of each subject area can be set up cooperatively and effectively in the local regions.