• Title/Summary/Keyword: Action with action observation

Search Result 197, Processing Time 0.028 seconds

Autoradiographic Studies on the Inhibitory Effect of Dibutyryl Cyclic AMP on Mouse Oocyte Maturation in Vitro (Dibutyryl Cyclic AMP가 생쥐여포난자의 성숙에 미치는 억제효과에 관한 자기방사법적 연구)

  • Choi, Choon-Keun
    • Applied Microscopy
    • /
    • v.7 no.1
    • /
    • pp.21-43
    • /
    • 1977
  • This experiment was undertaken in order to localize the labeled dbcAMP (dibutyryl cyclic AMP) in oocytes whose development has been suppressed by cold dbcAMP for 6 or 19 hours in vitro. Mouse oocytes were obtained from the ovaries of 3-4 week old A strain female mice, by puncturing the Graafian follicles in the modified Krebs-Ringer bicarbonate salt solution under the dissecting microscope. Those oocytes which have intact germinal vesicle were cultured in the basic culture medium supplemented with 0.4% bovine serum albumin (BSA). Cultivation of the oocytes was carried out in a microtube developed by Cho (1974). The cultures were then incubated in a humidified 5% $CO_2$ incubator maintained at $37^{\circ}C$ for 6 or 19 hours (Donahue, 1968). DbcAMP was added to culture medium for a final concentration of 100ug/ml, and $^3H-dbc$ AMP (specific activity 13 Ci/mM) for a final concentration of $40{\mu}Ci/ml$ was also added to the medium. For electron microscopic autoradiography, those oocytes recovered from the culture were washed with phosphate buffer (pH 7.4), and immediately prefixed in a 2.5% glutaraldehyde overnight and postfixed for 2 hours at $4 ^{\circ}C$ in 1% osmium tetroxide in phosphate buffer with pH 7.4 (Palade, 1952). After fixation, the materials were dehydrated in graded alcohol series and embedded in Epon 812 mixture based on the standard procedures (Luft, 1961). The thin sections $600-700{\AA}$ thick were mounted on the grids of 200 meshes. The grids containing sections were coated with a nuclear emulsion Kodak NTB-3 and stored in a cold dark box (at $4^{\circ}C$) for 3 weeks. After exposure, the samples were developed with Kodak D-19 and stained with uranyl acetate and lead citrate. Routine observation was made with Hitachi HU-11E electron microsocope. The results of the observation were as followings: 1. It was found that the labeled dbcAMP penetrated the egg plasma membrane and dispersed at random in the cytoplasm. 2. It was also observed that most of the labeled dbcAMP was attached to microfibrillar lattices portion of the oocyte cytoplasm. There fore, it is presumed that the receptor of the dbcAMP is localized in the microfibrillar lattices of the oocyte. 3. It also seems that some other cell organells such as mitochondria, Golgi complex, cortical granules are not directly related to the action of the dbcAMP. 4. The labeled dbcAMP was neither observed in the membrane nor in the nucleus. Therefore, it seems that there is no relationship between the concentration of dbcAMP and the nuclear membranous permeability. 5. There was no difference in number of dbcAMP particles when oocytes were cultured for 6 hours and 19 hours. 6. However, it was observed that, in same of the oocytes suppressed in germinal vesicle by dbcAMP for 19 hours, cell organells were moved and concentrated to a small portion of the cytoplasm, and that the morphology of the organells greatly changed to an abnormal. form. Therefore, it is supposed that those oocytes were in the process of degeneration. From the above results, it is expected that dbcAMP penetrated the egg membrane and was bound to the receptor which seems to be located in the microfibrillar lattiees portion, and that this dbcAMP-receptor complex inhibited some enzyme system of the oocytes which are essential for the germinal vesicle breakdown.

  • PDF

A Study of the Evolving Process of Wealthy Major Donors' Sharing Lives in Korea (부유층의 기부과정에 관한 연구)

  • Kang, Chul-Hee;Kim, Mi-Ok
    • Korean Journal of Social Welfare
    • /
    • v.59 no.2
    • /
    • pp.5-38
    • /
    • 2007
  • This study attempts to develop a theory on the evolving process of wealthy major donors' sharing lives in Korea through a grounded theory approach. To conduct this study, the researchers have in-depth interviews with 11 exemplary wealthy major donors who have more than one million US dollars in his or her own asset and donate more than ten thousand US dollars annually. In data analysis, this study identifies 161 concepts on the evolving process of wealthy major donors' sharing lives; and the concepts are categorized with 33 sub-categories and 14 categories. In the paradigm model on the evolving process of wealthy major donors' sharing lives, it is identified that the central phenomenon, 'practicing sharing lives as noblesse oblige', is related with the causal conditions such as 'learning through memories and observation', 'realizing my duties', and 'emphasizing'; and the central phenomenon is related with the contingent conditions such as 'being sensitive to external evaluation', 'having limited information on giving', 'distrusting donation related environments'. The action/interactional sequences such as 'utilizing relationships' and 'strengthening active participation' are accomplished by moderating conditions such as 'having internal and external supports' and 'guiding by firm conviction'. It reveals that as a result, wealthy major donors enjoy the feeling of becoming a ideal and true wealthy person, establish sharing lives as firm and major parts of overall lives, and experience strong desires for better future and society. In this study, 'generous sharing that shares personal heritages and social benefits' is analyzed as a core category; it shows that sharing of wealthy major donors is related to the characteristics of generosity practice based on moral self-benefiting rather than complete altruistic characteristics or self-sacrificial characteristics. The process analysis reveals that it has the following stages: first, initial giving by exposure to causes or requests; second, routine practice of giving; third, evolution of practice of giving with gradual expansion in quantities and qualities; and fourth, living with giving. In the process, the following four types are identified: devoted wealthy donors for sharing, wealthy donors practicing sharing in daily life, wealthy donors practicing sharing with learning on external stimulus, and wealthy donors practicing sharing on empathy. Finally, this study discusses both meanings of identifying and developing a theory on the evolving process of wealthy major donors' sharing lives and implications of the research results in cultivating and developing potential wealthy major donors in Korea.

  • PDF

The International Civil Aviation Organization and Recent Developments of Air Law in a Changing Environment (변환기(變換期)에 있어서의 국제민간항공기구(國際民間航空機構)(ICAD)와 항공법(航空法) 발전(發展)의 최근(最近) 동향(動向))

  • Choi, Wan-Sik
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.4
    • /
    • pp.7-35
    • /
    • 1992
  • The expansion of air transport on a global scale with ever increasing traffic densities has brought about problems that must be solved through new multilateral mechanisms. Looking to the immediate future, air transport will require new forms of international cooperation in technical and economic areas. Air transport by its very nature should have been a counterforce to nationalism. Yet, the regulatory system in civil aviation is still as firmly rooted in the principle of national sovereignty as when it was first proclaimed at t-11e Paris Convention of 1919 and reaffirmed in the Chicago Convention. Sovereignty over the airspace has remained the cornerstone of relations between states in all respects of air transport. The importance of sovereignty over air space embodied in article 1 of the Chicago Conrenton also is responsible for restricting the authority of ICAO as an intergovernmental regulatory agency. The Orgenization, for all its extensive efforts, has only limited authority. ICAO sets standards but cannot enforce them; it devises solutions but cannot impose them. To implement its rules ICAO most rely not so much on legal requirements as on the goodwill of states. It has been forty-eight years since international community set the foundations of the international system in civil aviation action. Profound political, economic and technological changes have taken place in air transport. The Chicago Convention is living proof that staes can work together to make air transport a safe mode of travel. The law governing international civil auiation is principally based on international treaties and on other regulation agreed to by governments, for the most part through the mechanism of ICAO. The role of ICAO international standards and recommended practices and procedures dealing with a broad range of technical matters could hardly be overestimated. The organization's ability to develop these standards and procedures, to adapt them continuously to the rapid sate of change and development of air transport, should be particularly stressed. The role of ICAO in the area of the development of multilateral conventions on international air law has been successful but to a certain degree. From the modest starting-point of the Tokyo Convention, we have seen more adequate international instruments prepared within the scope of ICAO activities, adopted: the Hague Convention of 1970 for the suppression of Unlawful Seizure of Aircraft and the Montreal Convention of 1971 for the Suppression of Unlawful Acts against the Safety of Civil Aviation. The work of ICAO in the new domain of international law conventions concerning what has been loosely termed above as the criminal problems connected with international air transport, in particular the problem of armed aggression against aircraft, should be positively appreciated. But ICAO records in the domain of developing a uniform legal system of international carriage by air are rather disappointing. The problem of maintaining and developing the uniformity of this regulation exceeds the scope of interest and competence of governmental transport agencies. The expectations of mankind linked to it are too great to give up trying to restore the uniform legal system of international air carriage that would create proper conditions for its further growth. It appears that ICAO has, at present, a good opportunity for doing this. The hasty preparation of ICAO draft conventions should be definitely excluded. Every Preliminary draft convention ought to be sent to Governments of all member-States for consideration, So that they could in form ICAO in due time of their observation. The problom of harmonizing a uniform law of international air carriage with that of other branches of international transport should demand more and more of its attention. ICAO cooperation with other international arganization, especially these working in the field of international transport, should be strengthened. ICAO is supposed to act as a link and a mediator among, at times the conflicting interests of member States, serving the happiness and peace of all of the world. The transformation of the contemporary world of developing international relations, stimulated by steadily growing international cooperation in its various dimensions, political, economic, scientific, technological, social and cultural, continuously confronts ICAO with new task.

  • PDF

VIDEO GAME CULTURE AND INTERACTIVITY -An exploration of digital interactive media through a metaphorical approach to video game culture-

  • U, Tak
    • 한국게임학회지
    • /
    • v.6 no.1
    • /
    • pp.70-72
    • /
    • 2009
  • This research is focused on defining interaction within the context of digital media and creating a multi cultural definition of interactivity. The concept of multi digital culture and a definition of interaction in digital media have often been overlooked by other researchers and this has caused the emergence of many different notions on this issue. As a result of these varied notions of the concept, public confusion has arisen regarding interactivity. The main purpose of this research is to find a suitable multi definition of interaction through examining local digital culture. In order to analogise multi digital culture, the video game culture is employed as a metaphor to interpret local digital culture. The reason for this is that a specific national culture can be easily identified within the video game culture. Four countries, South Korea, Japan, the U.S. and the UK have been chosen for comparison purposes. Case study, questionnaire and publicly accessible video game related data, such as, video game charts, are used for formalising and analysing unique local digital culture. The Heyri POP UP IMAGE Festival, S. Korea, was also used as a pilot study, with some of the above research methods being employed to analyse South Korean digital culture. In relation to western cases, interview and questionnaire were primarily used. The data from the case countries was carefully compared and analysed and then it became the basis of a theory of multi definition of interaction in digital media. The case study employed the cultural metaphor for this research and in addition video game culture related questionnaires and interviews with experts of interactive art genre, regarding new notions of digital interaction were utilised. The survey was conducted simultaneously in the four different cultural case nations of this research. Twenty respondents from each case nation participated in the survey, in order to investigate firstly, the existence of 'local digital culture' and secondly, the trends and phenomena of 'digital culture' in these four different 'local digital cultural areas'. In terms of interviews with experts of the interactive art genre, these were focused on obtaining their understanding of contemporary digital culture in their research. Using gathered data from the observation of local digital culture, the basic theory of interaction and the terminology of interaction are reformed. Localised definitions of interaction on digital media, control based interaction and communication based interaction are presented, in order to identify a 'locality' in terms of various contemporary digital cultures. As a result of analysing digital culture, new definitions of 'multi definition of digital interaction' were formulated. As mentioned above, 'control' and 'communication' based interaction were initiated, based on 'user to media' relationships. Based on the degree of physical interaction, 'liminal' and 'transitive' interactions were initiated. Less physical digital interaction is named 'liminal' interaction and more physical digital interaction is named' transitive' interaction. These new definitions of interaction were applied to the real world examples of uses of digital interaction, such as, digital interactive installation artworks and video games. The newly defined meaning of digital interaction can be applied to analysing digital interactive installation artworks and possibly indicate their future development and the prospects of future electronic games. Three leading digital interactive artists were selected for this analysis and their works were studied in terms of the implementation of 'multi definition of digital interaction'. Throughout these processes, the meaning of 'communication' in digital interactive media was emphasised. Many of the selected artists' digital installations were focused on 'communication' or 'interaction between each user through digital media', rather than the concept of 'control' in digital interaction, otherwise termed, 'communication with digital media'. In their artworks, interaction between each audience was digitally engaged within the physical interactive environment which was created by the digital media. Both the audience's action and all the reaction throughout the interaction between the audiences, triggered the digital media' s reaction. This audience-audience-media interaction is the key to understanding the concept of 'communication' in physical digital media and it is the main interactive concept upon which the selected digital interactive installation artists for this research and many other artists from similar fields, are concentrating their efforts. In the case of the video game, a similar trend was noticed to that of digital interactive installations. Based on this research's 'multi definition of digital interaction', the video game has evolved from the early stage of being conventional game, which was focused on control based interaction, to the on-line game which was focused on communication based interaction, to physical interactive games, such as, Nintendo Wii, which are focused on more physical interaction and finally, the ubiquitous interactive game, which is mainly concentrated on the concept of 'communication' in physical digital interaction. It is possible that this evolution of the video game concept of interaction is comparable to the progress of digital interactive artworks. This view is based on the fact that both genres show evidence that they are developing in the direction of the concept of 'communication', in terms of physical digital interaction. The important emphasis of this research's results is 'locality' and 'communication' in physical digital interaction. The existence of different digital culture trends, which were assessed by the 'multi definition of digital interaction', can explain the concept of 'locality' in digital interaction. This meaning of 'locality' may assist in understanding contemporary digital culture and can reduce possible misunderstanding as regards 'local' digital culture. In the application of the concept of digital interaction to the field of either artworks or video games, it is possible to form the opinion that an innovative concept of physical digital interaction is 'communication' within this context. This concept and its applications can improve the potential of both digital interactive culture and technology.

  • PDF

The Cytological Study of the Experimental Middle Ear Effusion. (실험적 중이삼출액의 세포학적 고찰)

  • 심상열;문태용;윤강묵;박순일;박인용
    • Proceedings of the KOR-BRONCHOESO Conference
    • /
    • 1982.05a
    • /
    • pp.13.2-14
    • /
    • 1982
  • Otitis media with effusion, described first by Politzer (1867), is closely related with the function of auditory tube, but its etiology and pathogenesis are not clearly defined yet. There are many theories about its pathogenesis including hydrops ex vacuo theory which was most reliable nowadays. In this paper, using cats in experimental animals, hydrops ex vacuo theory was proved and cytological study of the effusion and light microscopic observation of the middle ear mucosa in otitis media with effusion were done. The results were as follows: 1) The effusion was found in all experimental groups after eighteen hours of the auditory tube obstruction. 2) In the cytological study of effusion by smear technic, Polymorpholeukocytes were dominant in earlier days but monoculear cells were soon increased and no eosinophils were found. 3) In the culture of the effusion, no bacteria was cultured. 4) By opeating microscope, hypertrophy of the middle ear mucosa observed especially in the fourteen days after auditory tube obstruction and effusion was most remarkable in the fourteen days, also. 5) By light microscopy, there were epithelial hyperplasia, proliferation of goblet cells, capillaries and infiltration of inflammatory cells which showed same distribution as smear technic.

  • PDF

Psychotherapist's Liability for Failure to Protect Third Person (정신질환자의 타해(他害)사고와 의료과오책임)

  • Son, Heung-Soo
    • The Korean Society of Law and Medicine
    • /
    • v.11 no.1
    • /
    • pp.331-393
    • /
    • 2010
  • Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

  • PDF

An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
    • /
    • v.20 no.1 s.21
    • /
    • pp.165-203
    • /
    • 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.

  • PDF