Health Management and Services of School-Nurse in Special Schools (특수학교의 보건관리)
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- Journal of the Korean Society of School Health
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- v.4 no.2
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- pp.176-192
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- 1991
School nurses, in service of 102 special schools in Korea, were urveyed by mail questionnaires from February to March, 1991 and 77 of hem responded. Collected data were analyzed to establish the direction of health management in special school and to provide basic reference data for improving the quality of the management of school-nurses' services. The major findings are as follows: Out of special schools surveyed, 67.5% is private school and 83.2% is located in city. The average number of classes, students, and educational personnels per special school is 17.2, 194, and 28 respectively. The average age of school-nurses surveyed is 32.7. The proportion of graduates from the junior college and upward was 97.4%, the proportion of the married was 71.4%. Out of respondents, 71.4% has religion : 79.2% has past career in the fields of clinics or public health: 62.3% accompanishes independent services: 77.9% belongs to primary school. About 69% of nursing room in special schools surveyed is located at the first floor. Out of special school surveyed, 90.9% has no organization for school health programms: Only 18.2% entrusted everyone of school doctor, school dentist, and school pharmacists with school health. 46.8% of respondents didn't know about the annual budget for school health programmes. The average annual expenditure for school health programme per special school was 317,000F26. won and the purchase cost for medical supplies accounted for the larger part of them. The monthly average number of students utilizing school nursing room was 71 per school, annual utilization times of school nursing room was 4.4 per student and utilization due to injury was prevalent by 26.6% and there is some differences in using the school nursing room according to disabled area. Rate of referral to medical facilities was 1.4%. The leading reason of referral to medical facilities was high fever among those who have visual handicaps, fracture among those who have emotional disturbance, injury by trauma among others. Nine hundred fifty six students of students in special school surveyed have sufferd from epilepsy and prevalence rate of epilepsy was 6.4%. Only 22.6% of respondents replied that they had physical examination more than 2 times per year. Out of respnodents, 98.7% answered that they had health education and 67.1% of them ansered that they educated in a classroom, 98.7% of respondents emphasized need of sex education. Respondents put the most emphasis on the personal hygiene when they performed health education and they used broadcasting education in the area of visual handicaps, OHP or VTR in hearing handicaps, home correspondence or OHP VTR in other area importantly. About 47% of repondents answered that health education was the most difficult and they emphasized that definite guide on health management was requested. Respondents had self-confidence and high perfomance rate in most of school-nurses' services completely, but so they was not in area of evaluation of school health programmes, an examination of physical strength, evaluation of health education, management of school purification area, suture of wounds. In consideration of above findings, we may conclude that special education for school-nurse in special schools as well as improvement of definite guiding principles are requested to establish direction for health management in special schools and to improve the degree of quality for school-nurses' sevices in special schools.
Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.
For the purpose of establishing the systematized technical scheme of the cooperative rice cultivation which has most significant impact to improve rice productivity and the farm management, the author have studied the cultivation practices, and the variation of rice growth and yield between the cooperative rice cultivation and the individual rice cultivation at random selected 18 paddy fields. The author also have investigated through comparative method on the cultivation practices, management, organization and operation scheme of the two different rice cultivation methods at 460 paddy fields. The economic feasibility has been ana lysed and added in this report. The results obtained from this study are summarized as follows; 1. In the nursery, the average amount of fertilizer application, especially, phosphate and potassium, and the frequency of chemicals spray for the disease, insect and pest control at the cooperative rice cultivation are significantly higher than those of the individual rice cultivation. 2. The cultivation techniques of the cooperative rice farming after the transplanting can be characterized by a) the earlier transplanting of rice, b) the denser hills per unit area and the lesser number of seedlings per hill, c) the application of larger quantities of fertilizer including nitrogen, phosphate and potassium, d) more divided application of fertilizers, split doses of the nitrogen and potassium, e) the increased frequencies of the chemicals spray for the prevention of disease, insect and pest damages. 3. The rate of lodging in the cooperative rice cultivation was slightly higher than that of the individual rice cultivation, however, the losses of rice yield owing to the occurrence of rice stem borer and grass leaf roller in the cooperative rice cultivation were lower than that of the individual rice cultivation. 4. The culm length, panicle length, straw weight and grain-straw ratio are respectively higher at the cooperative rice cultivation, moreover, the higher variation of the above factors due to different localities of the paddy fields found at the individual rice cultivation. 5. The number of panicles, number of flowers per panicle and the weight of 1, 000 grains, those contributing components to the rice yield were significantly greater in the cooperative rice cultivation, however, not clear difference in the maturing rate was observed. The variation coefficient of the yield component in the cooperative cultivation showed lower than that or the individual rice cultivation. 6. The average yield of brown rice per 10 are in the cooperative rice cultivation obtained 459.0 kilograms while that of the individual rice cultivation brought 374.8 kilograms. The yield of brown rice in the cooperative rice cultivation increased 84.2 kilogram per 10 are over the individual rice cultivation. With lower variation coefficient of the brown rice yield in the cooperative rice cultivation, it can be said that uniformed higher yield could be obtained through the cooperative rice cultivation. 7. Highly significant positive correlations shown between the seeding date and the number of flowers per panicle, the chemical spray and the number of flowers per panicle, the transplanting date and the number of flowers per panicle, phosphate application and yield, potassium application and maturing rate, the split application of fertilizers and yield. Whilst the significant negative correlation was shown between the transplanting date and the maturing rate 8. The results of investigation from 480 paddy fields obtained through comparative method on the following items are identical in general with those obtained at 18 paddy fields: Application of fertilizers, chemical spray for the control of disease, insects and pests both in the nursery and the paddy field, transplanting date, transplanting density, split application of fertilizers and yield n the paddy fields. a) The number of rice varieties used in the cooperative rice cultivation were 13 varieties while the individual rice cultivation used 47 varieties. b) The cooperative rice cultivation has more successfully adopted improved cultivation techniques such as the practice of seed disinfection, adoption of recommended seeding amount, fall ploughing, application of red soil, introduction of power tillers, the rectangular-type transplanting, midsummer drainage and the periodical irrigation. 9. The following results were also obtained from the same investigation and they are: a) In the cooperative rice cultivation, the greater part of the important practices have been carried out through cooperative operation including seed disinfection, ploughing, application of red soil and compost, the control of disease, insects and pests, harvest, threshing and transportation of the products. b) The labor input to the nursery bed and water control in the cooperative rice cultivation was less than that of the individual rice cultivation while the higher rate of labor input was resulted in the red soil and compost application. 10. From the investigation on the organization and operation scheme of the cooperative rice cultivation, the following results were obtained: a) The size of cooperative rice cultivation farm was varied from. 3 ha to 7 ha and 5 ha farm. occupied 55.9 percent of the total farms. And a single cooperative farm was consisted of 10 to 20 plots of paddies. b) The educational back ground of the staff members involved in the cooperative rice cultivation was superior than that of the individual rice cultivation. c) All of the farmers who participated to the questionaires have responded that the cooperative rice cultivation could promise the increased rice yield mainly through the introduction of the improved method of fertilizer application and the effective control of diseases, insects and pests damages. And the majority of farmers were also in the opinion that preparation of the materials and labor input can be timely carried out and the labor requirement for the rice cultivation possibly be saved through the cooperative rice cultivation. d) The farmers who have expressed their wishes to continue and to make further development of the cooperative rice cultivation was 74.5 percent of total farmers participated to the questionaires. 11. From the analysis of economical feasibility on the two different methods of cultivation, the following results were obtained: a) The value of operation cost for the compost, chemical fertilizers, agricultural chemicals and labor input in the cooperative rice cultivation was respectively higher by 335 won, 199 won, 288 won and 303 won over the individual rice cultivation. However, the other production costs showed no distinct differences between the two cultivation methods. b) Although the total value of expenses for the fertilizers, agricultural chemicals, labor input and etc. in the cooperative rice cultivation were approximately doubled to the amount of the individual rice cultivation, the net income, substracted operation costs from the gross income, was obtained 24, 302 won in the cooperative rice cultivation and 20, 168 won was obtained from the individual rice cultivation. Thereby, it can be said that net income from the cooperative rice cultivation increased 4, 134 won over the individual rice cultivation. It was revealed in this study that the cooperative rice cultivation has not only contributed to increment of the farm income through higher yield but also showed as an effective means to introduce highly improved cultivation techniques to the farmers. It may also be concluded, therefore, the cooperative rice cultivation shall continuously renovate the rice production process of the farmers.