• Title/Summary/Keyword: Changes in roles

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The Effects of Environmental Dynamism on Supply Chain Commitment in the High-tech Industry: The Roles of Flexibility and Dependence (첨단산업의 환경동태성이 공급체인의 결속에 미치는 영향: 유연성과 의존성의 역할)

  • Kim, Sang-Deok;Ji, Seong-Goo
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.2
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    • pp.31-54
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    • 2007
  • The exchange between buyers and sellers in the industrial market is changing from short-term to long-term relationships. Long-term relationships are governed mainly by formal contracts or informal agreements, but many scholars are now asserting that controlling relationship by using formal contracts under environmental dynamism is inappropriate. In this case, partners will depend on each other's flexibility or interdependence. The former, flexibility, provides a general frame of reference, order, and standards against which to guide and assess appropriate behavior in dynamic and ambiguous situations, thus motivating the value-oriented performance goals shared between partners. It is based on social sacrifices, which can potentially minimize any opportunistic behaviors. The later, interdependence, means that each firm possesses a high level of dependence in an dynamic channel relationship. When interdependence is high in magnitude and symmetric, each firm enjoys a high level of power and the bonds between the firms should be reasonably strong. Strong shared power is likely to promote commitment because of the common interests, attention, and support found in such channel relationships. This study deals with environmental dynamism in high-tech industry. Firms in the high-tech industry regard it as a key success factor to successfully cope with environmental changes. However, due to the lack of studies dealing with environmental dynamism and supply chain commitment in the high-tech industry, it is very difficult to find effective strategies to cope with them. This paper presents the results of an empirical study on the relationship between environmental dynamism and supply chain commitment in the high-tech industry. We examined the effects of consumer, competitor, and technological dynamism on supply chain commitment. Additionally, we examined the moderating effects of flexibility and dependence of supply chains. This study was confined to the type of high-tech industry which has the characteristics of rapid technology change and short product lifecycle. Flexibility among the firms of this industry, having the characteristic of hard and fast growth, is more important here than among any other industry. Thus, a variety of environmental dynamism can affect a supply chain relationship. The industries targeted industries were electronic parts, metal product, computer, electric machine, automobile, and medical precision manufacturing industries. Data was collected as follows. During the survey, the researchers managed to obtain the list of parts suppliers of 2 companies, N and L, with an international competitiveness in the mobile phone manufacturing industry; and of the suppliers in a business relationship with S company, a semiconductor manufacturing company. They were asked to respond to the survey via telephone and e-mail. During the two month period of February-April 2006, we were able to collect data from 44 companies. The respondents were restricted to direct dealing authorities and subcontractor company (the supplier) staff with at least three months of dealing experience with a manufacture (an industrial material buyer). The measurement validation procedures included scale reliability; discriminant and convergent validity were used to validate measures. Also, the reliability measurements traditionally employed, such as the Cronbach's alpha, were used. All the reliabilities were greater than.70. A series of exploratory factor analyses was conducted. We conducted confirmatory factor analyses to assess the validity of our measurements. A series of chi-square difference tests were conducted so that the discriminant validity could be ensured. For each pair, we estimated two models-an unconstrained model and a constrained model-and compared the two model fits. All these tests supported discriminant validity. Also, all items loaded significantly on their respective constructs, providing support for convergent validity. We then examined composite reliability and average variance extracted (AVE). The composite reliability of each construct was greater than.70. The AVE of each construct was greater than.50. According to the multiple regression analysis, customer dynamism had a negative effect and competitor dynamism had a positive effect on a supplier's commitment. In addition, flexibility and dependence had significant moderating effects on customer and competitor dynamism. On the other hand, all hypotheses about technological dynamism had no significant effects on commitment. In other words, technological dynamism had no direct effect on supplier's commitment and was not moderated by the flexibility and dependence of the supply chain. This study makes its contribution in the point of view that this is a rare study on environmental dynamism and supply chain commitment in the field of high-tech industry. Especially, this study verified the effects of three sectors of environmental dynamism on supplier's commitment. Also, it empirically tested how the effects were moderated by flexibility and dependence. The results showed that flexibility and interdependence had a role to strengthen supplier's commitment under environmental dynamism in high-tech industry. Thus relationship managers in high-tech industry should make supply chain relationship flexible and interdependent. The limitations of the study are as follows; First, about the research setting, the study was conducted with high-tech industry, in which the direction of the change in the power balance of supply chain dyads is usually determined by manufacturers. So we have a difficulty with generalization. We need to control the power structure between partners in a future study. Secondly, about flexibility, we treated it throughout the paper as positive, but it can also be negative, i.e. violating an agreement or moving, but in the wrong direction, etc. Therefore we need to investigate the multi-dimensionality of flexibility in future research.

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Expression of Phospholipase C Isozymes in Human Lung Cancer Tissues (인체 폐암조직에서 Phospholipase C 동위효소의 발현양상)

  • Hwang, Sung-Chul;Mah, Kyung-Ae;Choi, So-Yeon;Oh, Yoon-Jung;Choi, Young-In;Kim, Deog-Ki;Lee, Hyung-Noh;Choi, Young-Hwa;Park, Kwang-Ju;Lee, Yi-Hyeong;Lee, Kyi-Beom;Ha, Mahn-Joon;Bae, Yoon-Su
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.310-322
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    • 2000
  • Background : Phospholipase C(PLC) plays an important role in cellular signal transduction and is thought to be critical in cellular growth, differentiation and transformation of certain malignancies. Two second messengers produced from the enzymatic action of PLC are diacylglycerol (DAG) and inositol 1, 4, 5-trisphosphate (IP3). These two second messengers are important in down stream signal activation of protein kinase C and intracellular calcium elevation. In addition, functional domains of the PLC isozymes, such as Src homology 2 (SH2) domain, Src homology 3 (SH3) domain, and pleckstrin homology (PH) domain play crucial roles in protein translocation, lipid membrane modificailon and intracellular memrane trafficking which occur during various mitogenic processes. We have previously reported the presence of PLC-${\gamma}1$, ${\gamma}2$, ${\beta}1$, ${\beta}3$, and ${\delta}1$ isozymes in normal human lung tissue and tyrosine-kinase-independent activation of phospholipase C-${\gamma}$ isozymes by tau protein and AHNAK. We had also found that the expression of AHNAK protein was markedly increased in various mstologic types of lung can∞r tissues as compared to the normallungs. However, the report concerning expression of various PLC isozymes in lung canærs and other lung diseases is lacking. Therefore, in this study we examined the expression of PLC isozymes in the paired surgical specimens taken from lung cancer patients. Methods : Surgically resected lung cancer tissue samples taken from thirty seven patients and their paired normal control lungs from the same patients, The expression of various PLC isozymes were studied. Western blot analysis of the tissue extracts for the PLC isozymes and immunohistochemistry was performed on typical samples for localization of the isozyme. Results : In 16 of 18 squamous cell carcinomas, the expression of PLC-${\gamma}1$ was increased. PLC-${\gamma}1$ was also found to be increased in all of 15 adenocarcinoma patients. In most of the non-small cell lung cancer tissues we had examined, expression of PLC-${\delta}1$ was decreased. However, the expression of PLC-${\delta}1$ was markedly increased in 3 adenocarcinomas and 3 squamous carcinomas. Although the numbers were small, in all 4 cases of small cell lung cancer tissues, the expression of PLC-${\delta}1$ was nearly absent. Conclusion : We found increased expression of PLC-${\gamma}1$ isozyme in lung cancer tissues. Results of this study, taken together with our earlier findings of AHNAK protein-a putative PLD-${\gamma}$, activator-over-expression, and the changes observed in PLC-${\delta}1$ in primary human lung cancers may provide a possible insight into the derranged calcium-inositol signaling pathways leading to the lung malignancies.

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A Study on the Influence of IT Education Service Quality on Educational Satisfaction, Work Application Intention, and Recommendation Intention: Focusing on the Moderating Effects of Learner Position and Participation Motivation (IT교육 서비스품질이 교육만족도, 현업적용의도 및 추천의도에 미치는 영향에 관한 연구: 학습자 직위 및 참여동기의 조절효과를 중심으로)

  • Kang, Ryeo-Eun;Yang, Sung-Byung
    • Journal of Intelligence and Information Systems
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    • v.23 no.4
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    • pp.169-196
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    • 2017
  • The fourth industrial revolution represents a revolutionary change in the business environment and its ecosystem, which is a fusion of Information Technology (IT) and other industries. In line with these recent changes, the Ministry of Employment and Labor of South Korea announced 'the Fourth Industrial Revolution Leader Training Program,' which includes five key support areas such as (1) smart manufacturing, (2) Internet of Things (IoT), (3) big data including Artificial Intelligence (AI), (4) information security, and (5) bio innovation. Based on this program, we can get a glimpse of the South Korean government's efforts and willingness to emit leading human resource with advanced IT knowledge in various fusion technology-related and newly emerging industries. On the other hand, in order to nurture excellent IT manpower in preparation for the fourth industrial revolution, the role of educational institutions capable of providing high quality IT education services is most of importance. However, these days, most IT educational institutions have had difficulties in providing customized IT education services that meet the needs of consumers (i.e., learners), without breaking away from the traditional framework of providing supplier-oriented education services. From previous studies, it has been found that the provision of customized education services centered on learners leads to high satisfaction of learners, and that higher satisfaction increases not only task performance and the possibility of business application but also learners' recommendation intention. However, since research has not yet been conducted in a comprehensive way that consider both antecedent and consequent factors of the learner's satisfaction, more empirical research on this is highly desirable. With the advent of the fourth industrial revolution, a rising interest in various convergence technologies utilizing information technology (IT) has brought with the growing realization of the important role played by IT-related education services. However, research on the role of IT education service quality in the context of IT education is relatively scarce in spite of the fact that research on general education service quality and satisfaction has been actively conducted in various contexts. In this study, therefore, the five dimensions of IT education service quality (i.e., tangibles, reliability, responsiveness, assurance, and empathy) are derived from the context of IT education, based on the SERVPERF model and related previous studies. In addition, the effects of these detailed IT education service quality factors on learners' educational satisfaction and their work application/recommendation intentions are examined. Furthermore, the moderating roles of learner position (i.e., practitioner group vs. manager group) and participation motivation (i.e., voluntary participation vs. involuntary participation) in relationships between IT education service quality factors and learners' educational satisfaction, work application intention, and recommendation intention are also investigated. In an analysis using the structural equation model (SEM) technique based on a questionnaire given to 203 participants of IT education programs in an 'M' IT educational institution in Seoul, South Korea, tangibles, reliability, and assurance were found to have a significant effect on educational satisfaction. This educational satisfaction was found to have a significant effect on both work application intention and recommendation intention. Moreover, it was discovered that learner position and participation motivation have a partial moderating impact on the relationship between IT education service quality factors and educational satisfaction. This study holds academic implications in that it is one of the first studies to apply the SERVPERF model (rather than the SERVQUAL model, which has been widely adopted by prior studies) is to demonstrate the influence of IT education service quality on learners' educational satisfaction, work application intention, and recommendation intention in an IT education environment. The results of this study are expected to provide practical guidance for IT education service providers who wish to enhance learners' educational satisfaction and service management efficiency.

Studies on Microbial and Enzymatic Actions during the Ripening Process of Salted Alaska Pollack Tripe (창난 젓갈의 숙성 과정 중 미생물 및 자기소화효소 작용에 관한 연구)

  • Chae, Soo-Kyu
    • The Korean Journal of Food And Nutrition
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    • v.24 no.3
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    • pp.340-349
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    • 2011
  • This study examined the roles of autolytic enzymes and microorganisms in the ripening process of salted Alaska pollack tripe made with various concentrations of salt i.e, 7.5% and 20% by weight. Salted Alaska pollack tripe treated with antibiotic agents for the inhibition of microbial growth and a control were prepared experimentally, and changes in chemical composition and viable cell counts were investigated, individually, during the ripening process. Just after the preparation of the low salt Alaska pollack tripe made with 7.5% salt, viable bacterial cells occurred at a level of $10^5$ CFU/g. In the control, bacterial counts increased rapidly to $10^7$ CFU/g by the 14th day of ripening. However, in the sample treated with antibiotic agents, counts were decreased to a level of $10^4$ CFU/g by the 3rd day of ripening and increased gradually to $10^6$ CFU/g by the 5th day of ripening, and then the same value was maintained there-after. Just after the preparation of the high salt Alaska pollack tripe made with 20% salt, viable bacterial cells occurred at a level of $10^3$ CFU/g. In both the samples treated with antibiotic agents and the control, bacterial counts decreased rapidly to $10^0$ CFU/g by the 45th day of ripening and increased gradually there-after. The content of amino type nitrogen was 76.3 mg% just after the preparation of the low salt Alaska pollack tripe made with 7.5% salt. Amino type nitrogen content was increased to 283.5 mg% by the 5th day of proper ripening in the control, but it was increased to 208.0 mg% in the sample treated with antibiotic agents. The difference in amino type nitrogen content was 75.5 mg/100 g. The content of amino type nitrogen was 57.2 mg% just after the preparation of the high salt Alaska pollack tripe made with 20% salt. Amino type nitrogen content was increased to 198.3 mg by the 60th day of proper ripening in the control, but it was increased to 162.0 mg% in the sample treated with the antibiotic agents. The difference in amino type nitrogen content was 36.3 mg/100 g. The contents of VBN and TMA-N were 102.1 mg% and 20.5 mg%, respectively, at the 7th day of ripening in the low salt Alaska pollack tripe made with 7.5% salt. The content of VBN was 60.0 mg% and TMA-N was not detected at the 21st day of ripening in the sample treated with antibiotic agents. The control sample was spoiled by the 7th day of ripening but the sample treated with antibiotic agents was not spoiled by the 21st day of ripening. On the other hand, VBN content was 37.2 mg% and TMA-N was not detected at the 90th day of ripening in the high salt Alaska pollack tripe made with 20% salt, and the control sample was not spoiled.

A Contemplation on Measures to Advance Logistics Centers (물류센터 선진화를 위한 발전 방안에 대한 소고)

  • Sun, Il-Suck;Lee, Won-Dong
    • Journal of Distribution Science
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    • v.9 no.1
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    • pp.17-27
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    • 2011
  • As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

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Changes in the Religious Topography of the Great Gwanghaegun: Policies towards Buddhism and the Affected Buddhist Community (광해군 대(代)의 종교지형 변동 - 불교정책과 불교계의 양상을 중심으로 -)

  • Lee, Jong-woo
    • Journal of the Daesoon Academy of Sciences
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    • v.36
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    • pp.227-266
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    • 2020
  • The purpose of this paper is to review the representative Buddhist policies enforced during the reign of Gwanghaegun (光海君), the 15th king of the Joseon Dynasty, and the aspects of the Buddhist community affected by them. Through this, the influence and dynamism of Buddhism during the reign of Gwanghaegun will be revealed. Some of the findings will run contrary to what is popularly known about Joseon Buddhism and the policy of Sungyueokbul (崇儒抑佛), 'Revering Confucianism and Supressing Buddhism.' During the Joseon Dynasty, Neo-Confucianism was taken as an ideological background, and consequently, Buddhism was ostracized by the ruling class who advocated the exclusion of heretical views. This also characterized King Gwanghaegun's reign during the Mid-Joseon Dynasty. In reality though, the ruling class held mixed opinions about Buddhism, and this influenced the Buddhist community in the Gwanghaegun Period. The military might of Japan demonstrated during the Japanese Invasion of Korea in 1592, led the ruling class to recognize Buddhism, and as a result, the status of Buddhism rose to a certain extent. Based on its elevated status and the aftermath of the Japanese Invasion of Korea, the Buddhist community engaged in social welfare activities inspired by the notion of requiting favors, and the Buddhist community gained recognition for providing relief services. As a result, the number of monks increased, and the economic situation improved as land ownership was granted to temples and monks. This is the means by which the Japanese Invasion of Korea influenced the Buddhist policies of the Gwanghaegun Period and changed the religious topography of Buddhism. During the reign of King Gwanghaegun, the ruling class regarded Buddhism as heretical, but offered posthumous titles to monks who engaged in meritorious services during the Japanese invasions of 1592~1598. Favorable and/or preferential treatment was also granted to some Buddhist monks. In addition, monks began to perform labor projects that demanded organizational and physical strength, such as those which related to national defense and architecture. However, throughout the Gwanghaegun Period, the monks were paid a certain amount of compensation for their labor, and the monks' responsibility for labor increased. This can be understood as a partial reconciliation with Buddhism or an acceptance of Buddhism rather than the suppression of Buddhism often presented by historians. As for policies which affected Buddhism, the Buddhist community showed signs of cooperation with the ruling class, the creation and reconstruction of temples, and the production of Buddhist art. Through close ties with the ruling class, Buddhism during the Gwanghaegun Period saw the Buddhist community actively responded policies that impacted Buddhism, and this allowed their religious orders to be maintained. In this way, it was also confirmed that the monk, Buhyu Seonsu (浮休 善修) and his disciple Byeogam Gakseong (碧巖 覺性), took up leadership roles in their Buddhist community. The Buddhist-aimed policies of Gwanghaegun were implemented against the backdrop of the Buddhist community, wherein the ruling class held mixed opinions regarding Buddhism. As such, both improvements and set backs for Buddhism could be observed during that time period. The ruling class actively utilized the organizational power of Buddhism for national defense and civil engineering after the Japanese invasions of 1592~1598. Out of gratitude, they implemented appropriate compensation for the Buddhists involved. The Buddhist community also responded to policies that affected them through exchanges with the ruling class. They succeeded in securing funds and support to repair and produce Buddhist temples and artworks. A thoughtful inspection of the policies towards and responses to Buddhism during the Gwanghaegun Period, shows that Buddhism actually enjoyed considerable organizational power and influence. This flies in the face of the general description of Joseon Buddhism as "Sungyueokbul (revering Confucianism and supressing Buddhism)."

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
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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.

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