• Title/Summary/Keyword: Individual Communication

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A Study Meaning Analysis and Interpretation of Body Sign, Kiki Smith - On Pee Body - (키키 스미스 작품에서 신체기호의 의미 분석과 해석 - 를 중심으로 -)

  • Kim, Sung-Hee
    • Journal of Science of Art and Design
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    • v.10
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    • pp.5-50
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    • 2006
  • The terminology "human body" simply means a physical body but also more often, as an object in art works, carries symbolic concepts incorporating the whole history of human lives. Human body has been employed as an artistic object capturing physical body, delivering artist's idea expressing life indicators from different standpoints of times and places. This point of view about human body in art works has in fact rather short history since 1960's when modern thinking paradigm focusing upon rationality and reasoning has begun declining and on the contrary when the body used to be the servant of the mind and soul for a long time has begun attracting artist's attention as a real entity from the viewpoint of dichotomy. During the 1960's, frequent performances in Pop art and of Fluxus showed that the human body has been an important media for artistic communication after importance of body performances had been raised in Action painting in 1940's. The human body became a more determined media in body art works that had got into stride after Yves Kline's conceptual works applying body and its traces. These kinds of art works have continued and consolidated into the Feminism came into blossom in 1980's and into fragmentated and disembodied body art trend in 1990's. Through development of trends in body works, human body now might well be regarded as a clue provide from individual identity with implication over the world. This thesis is to analyse in semiotic way main works of Kiki Smith who is a representative artist devoting to Feminism and proposing extended significance of human body. In the analysis process of works done by two great artists with histrorical background of art trend in order to find and open an significance horizon of human body, semiotics and bodism are therefore perceived as pertinent and applied as basic tools. The first stage of analysis is to get the significances emerged in between expression part and contextual parts, which are separated structually from the most basic level. The study deals with body works furthermore in the way of structual cohesion of the expression and the context from the view of A J. Greimas' Structural Semantics and tried to build up a basic frame for the extended significances of human body. This thesis is, on the other hand, to attempt to contribute for extension of disembodied and fragmentated body discussed in the structural semantic frame earlier by Julia Kriesteva who delivers abjection concepts and phenomenology of Maurice Merleau-Ponty who enables to overview relationship between the body and the world from the viewpoint of Bodism, further into interpretation level. The other works are Kiki smith's that showed epics about death in mid-1980's, detailed humbleness of vulnerable human body exposed to dichotomy and fragmentation in 1990's and religion and mythology incorporating wouln healing in 2000's and henceforth. Through the analysis of Kiki Smith's representative work 'Pee body', it is verified and confirmed that fragmentated body showed beyond boundary gap of the human body and ultimately tends to imply human healing owing to divine maternity. Bodily symbols in Kiki Smith's are extended to the universal world to imply human life and death on the one hand and religion and mythology of human wound and divine healing one the other hand. This thesis through these process and results of analysis is in a broad context, to emphasize that human body as objectified text has a key indicator role to understand world as well as semiotic extension in art works in late 20th century so that we might confirm bodily symbol as a cultural context constitutes a section of contemporary visual arts.

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A study of $Smartpeg^{TM}'s$ lifetime according to sterilization for implant stability (임플랜트 안정성을 위한 자기공명막대의 소독방법에 따른 수명에 관한 연구)

  • Won, Ho-Yeon;Cho, In-Ho;Lee, Joon-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.42-52
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    • 2008
  • Purpose: Resonance Frequency Analysis(RFA) technique can be used as an effective method in measuring the implant stability and documenting the clinical results. This technique also determines how stable the implant is before performing a prosthetic practice. Having become one the guidelines of the implant therapy whose final objective is the immediate loading, the $Osstell^{TM}$ mentor is giving a lot of information to the clinicians recently. In this communication, experiments were performed to investigate how reliable the measured ISQ values by $Osstell^{TM}$ mentor are, and to see if those are also stable even after sterilization. As five objectives: 1) How stable measured ISQ values after fixation $Smartpeg^{TM}s$ for 400 times. 2) How stable measured ISQ values after 'attach-detach'$Smartpeg^{TM}'s$ for 400 times. 3) How stable measured ISQ values after clinical sterilization methods. 4) How stable measured ISQ values after repeatedly sterilization in autoclave for 10 times. 5) What is the critical temperature which is lost the magnetism of $Smartpeg^{TM}$. Materials and Methods: Clinical sterilization methods(Autoclave sterilization, Dentistar sterilization, Ultra violet sterilization, Vacuum dry unit sterilization, Boiling water sterilization, combined $H_{2}O_{2}$ and Alcohol sterilization).$Smartpeg^{TM}s$. D3 Block bone($3{\times}9{\times}2cm$). Osstem implant(${\emptyset}4.1$-10mm).$Osstell^{TM}$ mentor. Individual experiment was used 8 number of $Smartpeg^{TM}s$ and they had measured to ISQ values of before experiment and after experiment. Results: 1. The measured ISQ values did not change after fixation $Smartpeg^{TM}s$ for 400 times. 2. There was no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ for 400 times. 3. The measured ISQ values did not change after the usual clinical sterilization methods. 4. The measured ISQ values did not change after sterilization in autoclave for 10 times. 5. It was impossible to exactly measure the critical temperature which is lost the magnetism of $Smartpeg^{TM}s$. But, the results was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10 minute. Conclusion: The measured ISQ values showed insignificant differences in case of no changes in the magnetism of the $Smartpeg^{TM}s$. It seems that the $Smartpeg^{TM}s$ can be used repeatedly in every measurement if the original magnetisms of the $Smartpeg^{TM}s$ can be recognized. There seems to be no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ only if the screw pitches were unimpaired. The clinical sterilization methods seems acceptable because the result was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10minute.

Individual Thinking Style leads its Emotional Perception: Development of Web-style Design Evaluation Model and Recommendation Algorithm Depending on Consumer Regulatory Focus (사고가 시각을 바꾼다: 조절 초점에 따른 소비자 감성 기반 웹 스타일 평가 모형 및 추천 알고리즘 개발)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.24 no.4
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    • pp.171-196
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    • 2018
  • With the development of the web, two-way communication and evaluation became possible and marketing paradigms shifted. In order to meet the needs of consumers, web design trends are continuously responding to consumer feedback. As the web becomes more and more important, both academics and businesses are studying consumer emotions and satisfaction on the web. However, some consumer characteristics are not well considered. Demographic characteristics such as age and sex have been studied extensively, but few studies consider psychological characteristics such as regulatory focus (i.e., emotional regulation). In this study, we analyze the effect of web style on consumer emotion. Many studies analyze the relationship between the web and regulatory focus, but most concentrate on the purpose of web use, particularly motivation and information search, rather than on web style and design. The web communicates with users through visual elements. Because the human brain is influenced by all five senses, both design factors and emotional responses are important in the web environment. Therefore, in this study, we examine the relationship between consumer emotion and satisfaction and web style and design. Previous studies have considered the effects of web layout, structure, and color on emotions. In this study, however, we excluded these web components, in contrast to earlier studies, and analyzed the relationship between consumer satisfaction and emotional indexes of web-style only. To perform this analysis, we collected consumer surveys presenting 40 web style themes to 204 consumers. Each consumer evaluated four themes. The emotional adjectives evaluated by consumers were composed of 18 contrast pairs, and the upper emotional indexes were extracted through factor analysis. The emotional indexes were 'softness,' 'modernity,' 'clearness,' and 'jam.' Hypotheses were established based on the assumption that emotional indexes have different effects on consumer satisfaction. After the analysis, hypotheses 1, 2, and 3 were accepted and hypothesis 4 was rejected. While hypothesis 4 was rejected, its effect on consumer satisfaction was negative, not positive. This means that emotional indexes such as 'softness,' 'modernity,' and 'clearness' have a positive effect on consumer satisfaction. In other words, consumers prefer emotions that are soft, emotional, natural, rounded, dynamic, modern, elaborate, unique, bright, pure, and clear. 'Jam' has a negative effect on consumer satisfaction. It means, consumer prefer the emotion which is empty, plain, and simple. Regulatory focus shows differences in motivation and propensity in various domains. It is important to consider organizational behavior and decision making according to the regulatory focus tendency, and it affects not only political, cultural, ethical judgments and behavior but also broad psychological problems. Regulatory focus also differs from emotional response. Promotion focus responds more strongly to positive emotional responses. On the other hand, prevention focus has a strong response to negative emotions. Web style is a type of service, and consumer satisfaction is affected not only by cognitive evaluation but also by emotion. This emotional response depends on whether the consumer will benefit or harm himself. Therefore, it is necessary to confirm the difference of the consumer's emotional response according to the regulatory focus which is one of the characteristics and viewpoint of the consumers about the web style. After MMR analysis result, hypothesis 5.3 was accepted, and hypothesis 5.4 was rejected. But hypothesis 5.4 supported in the opposite direction to the hypothesis. After validation, we confirmed the mechanism of emotional response according to the tendency of regulatory focus. Using the results, we developed the structure of web-style recommendation system and recommend methods through regulatory focus. We classified the regulatory focus group in to three categories that promotion, grey, prevention. Then, we suggest web-style recommend method along the group. If we further develop this study, we expect that the existing regulatory focus theory can be extended not only to the motivational part but also to the emotional behavioral response according to the regulatory focus tendency. Moreover, we believe that it is possible to recommend web-style according to regulatory focus and emotional desire which consumers most prefer.

Development of Beauty Experience Pattern Map Based on Consumer Emotions: Focusing on Cosmetics (소비자 감성 기반 뷰티 경험 패턴 맵 개발: 화장품을 중심으로)

  • Seo, Bong-Goon;Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.25 no.1
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    • pp.179-196
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    • 2019
  • Recently, the "Smart Consumer" has been emerging. He or she is increasingly inclined to search for and purchase products by taking into account personal judgment or expert reviews rather than by relying on information delivered through manufacturers' advertising. This is especially true when purchasing cosmetics. Because cosmetics act directly on the skin, consumers respond seriously to dangerous chemical elements they contain or to skin problems they may cause. Above all, cosmetics should fit well with the purchaser's skin type. In addition, changes in global cosmetics consumer trends make it necessary to study this field. The desire to find one's own individualized cosmetics is being revealed to consumers around the world and is known as "Finding the Holy Grail." Many consumers show a deep interest in customized cosmetics with the cultural boom known as "K-Beauty" (an aspect of "Han-Ryu"), the growth of personal grooming, and the emergence of "self-culture" that includes "self-beauty" and "self-interior." These trends have led to the explosive popularity of cosmetics made in Korea in the Chinese and Southeast Asian markets. In order to meet the customized cosmetics needs of consumers, cosmetics manufacturers and related companies are responding by concentrating on delivering premium services through the convergence of ICT(Information, Communication and Technology). Despite the evolution of companies' responses regarding market trends toward customized cosmetics, there is no "Intelligent Data Platform" that deals holistically with consumers' skin condition experience and thus attaches emotions to products and services. To find the Holy Grail of customized cosmetics, it is important to acquire and analyze consumer data on what they want in order to address their experiences and emotions. The emotions consumers are addressing when purchasing cosmetics varies by their age, sex, skin type, and specific skin issues and influences what price is considered reasonable. Therefore, it is necessary to classify emotions regarding cosmetics by individual consumer. Because of its importance, consumer emotion analysis has been used for both services and products. Given the trends identified above, we judge that consumer emotion analysis can be used in our study. Therefore, we collected and indexed data on consumers' emotions regarding their cosmetics experiences focusing on consumers' language. We crawled the cosmetics emotion data from SNS (blog and Twitter) according to sales ranking ($1^{st}$ to $99^{th}$), focusing on the ample/serum category. A total of 357 emotional adjectives were collected, and we combined and abstracted similar or duplicate emotional adjectives. We conducted a "Consumer Sentiment Journey" workshop to build a "Consumer Sentiment Dictionary," and this resulted in a total of 76 emotional adjectives regarding cosmetics consumer experience. Using these 76 emotional adjectives, we performed clustering with the Self-Organizing Map (SOM) method. As a result of the analysis, we derived eight final clusters of cosmetics consumer sentiments. Using the vector values of each node for each cluster, the characteristics of each cluster were derived based on the top ten most frequently appearing consumer sentiments. Different characteristics were found in consumer sentiments in each cluster. We also developed a cosmetics experience pattern map. The study results confirmed that recommendation and classification systems that consider consumer emotions and sentiments are needed because each consumer differs in what he or she pursues and prefers. Furthermore, this study reaffirms that the application of emotion and sentiment analysis can be extended to various fields other than cosmetics, and it implies that consumer insights can be derived using these methods. They can be used not only to build a specialized sentiment dictionary using scientific processes and "Design Thinking Methodology," but we also expect that these methods can help us to understand consumers' psychological reactions and cognitive behaviors. If this study is further developed, we believe that it will be able to provide solutions based on consumer experience, and therefore that it can be developed as an aspect of marketing intelligence.

Self-Regulatory Mode Effects on Emotion and Customer's Response in Failed Services - Focusing on the moderate effect of attribution processing - (고객의 자기조절성향이 서비스 실패에 따른 부정적 감정과 고객반응에 미치는 영향 - 귀인과정에 따른 조정적 역할을 중심으로 -)

  • Sung, Hyung-Suk;Han, Sang-Lin
    • Asia Marketing Journal
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    • v.12 no.2
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    • pp.83-110
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    • 2010
  • Dissatisfied customers may express their dissatisfaction behaviorally. These behavioral responses may impact the firms' profitability. How do we model the impact of self regulatory orientation on emotions and subsequent customer behaviors? Obviously, the positive and negative emotions experienced in these situations will influence the overall degree of satisfaction or dissatisfaction with the service(Zeelenberg and Pieters 1999). Most likely, these specific emotions will also partly determine the subsequent behavior in relation to the service and service provider, such as the likelihood of complaining, the degree to which customers will switch or repurchase, and the extent of word of mouth communication they will engage in(Zeelenberg and Pieters 2004). This study investigates the antecedents, consequences of negative consumption emotion and the moderate effect of attribution processing in an integrated model(self regulatory mode → specific emotions → behavioral responses). We focused on the fact that regret and disappointment have effects on consumer behavior. Especially, There are essentially two approaches in this research: the valence based approach and the specific emotions approach. The authors indicate theoretically and show empirically that it matters to distinguish these approaches in services research. and The present studies examined the influence of two regulatory mode concerns(Locomotion orientation and Assessment orientation) with making comparisons on experiencing post decisional regret and disappointment(Pierro, Kruglanski, and Higgins 2006; Pierro et al. 2008). When contemplating a decision with a negative outcome, it was predicted that high (vs low) locomotion would induce more disappointment than regret, whereas high (vs low) assessment would induce more regret than disappointment. The validity of the measurement scales was also confirmed by evaluations provided by the participating respondents and an independent advisory panel; samples provided recommendations throughout the primary, exploratory phases of the study. The resulting goodness of fit statistics were RMR or RMSEA of 0.05, GFI and AGFI greater than 0.9, and a chi-square with a 175.11. The indicators of the each constructs were very good measures of variables and had high convergent validity as evidenced by the reliability with a more than 0.9. Some items were deleted leaving those that reflected the cognitive dimension of importance rather than the dimension. The indicators were very good measures and had convergent validity as evidenced by the reliability of 0.9. These results for all constructs indicate the measurement fits the sample data well and is adequate for use. The scale for each factor was set by fixing the factor loading to one of its indicator variables and then applying the maximum likelihood estimation method. The results of the analysis showed that directions of the effects in the model are ultimately supported by the theory underpinning the causal linkages of the model. This research proposed 6 hypotheses on 6 latent variables and tested through structural equation modeling. 6 alternative measurements were compared through statistical significance test of the paths of research model and the overall fitting level of structural equation model and the result was successful. Also, Locomotion orientation more positively influences disappointment when internal attribution is high than low and Assessment orientation more positively influences regret when external attribution is high than low. In sum, The results of our studies suggest that assessment and locomotion concerns, both as chronic individual predispositions and as situationally induced states, influence the amount of people's experienced regret and disappointment. These findings contribute to our understanding of regulatory mode, regret, and disappointment. In previous studies of regulatory mode, relatively little attention has been paid to the post actional evaluative phase of self regulation. The present findings indicate that assessment concerns and locomotion concerns are clearly distinct in this phase, with individuals higher in assessment delving more into possible alternatives to past actions and individuals higher in locomotion engaging less in such reflective thought. What this suggests is that, separate from decreasing the amount of counterfactual thinking per se, individuals with locomotion concerns want to move on, to get on with it. Regret is about the past and not the future. Thus, individuals with locomotion concerns are less likely to experience regret. The results supported our predictions. We discuss the implications of these findings for the nature of regret and disappointment from the perspective of their relation to regulatory mode. Also, self regulatory mode and the specific emotions(disappointment and regret) were assessed and their influence on customers' behavioral responses(inaction, word of mouth) was examined, using a sample of 275 customers. It was found that emotions have a direct impact on behavior over and above the effects of negative emotions and customer behavior. Hence, We argue against incorporating emotions such as regret and disappointment into a specific response measure and in favor of a specific emotions approach on self regulation. Implications for services marketing practice and theory are discussed.

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Roles of the Insulin-like Growth Factor System in the Reproductive Function;Uterine Connection (Insulin-like Growth Factor Systems의 생식기능에서의 역할;자궁편)

  • Lee, Chul-Young
    • Clinical and Experimental Reproductive Medicine
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    • v.23 no.3
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    • pp.247-268
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    • 1996
  • It has been known for a long time that gonadotropins and steroid hormones play a pivotal role in a series of reproductive biological phenomena including the maturation of ovarian follicles and oocytes, ovulation and implantation, maintenance of pregnancy and fetal growth & development, parturition and mammary development and lactation. Recent investigations, however, have elucidated that in addition to these classic hormones, multiple growth factors also are involved in these phenomena. Most growth factors in reproductive organs mediate the actions of gonadotropins and steroid hormones or synergize with them in an autocrine/paracrine manner. The insulin-like growth factor(IGF) system, which is one of the most actively investigated areas lately in the reproductive organs, has been found to have important roles in a wide gamut of reproductive phenomena. In the present communication, published literature pertaining to the intrauterine IGF system will be reviewed preceded by general information of the IGF system. The IGF family comprises of IGF-I & IGF-II ligands, two types of IGF receptors and six classes of IGF-binding proteins(IGFBPs) that are known to date. IGF-I and IGF-II peptides, which are structurally homologous to proinsulin, possess the insulin-like activity including the stimulatory effect of glucose and amino acid transport. Besides, IGFs as mitogens stimulate cell division, and also play a role in cellular differentiation and functions in a variety of cell lines. IGFs are expressed mainly in the liver and messenchymal cells, and act on almost all types of tissues in an autocrine/paracrine as well as endocrine mode. There are two types of IGF receptors. Type I IGF receptors, which are tyrosine kinase receptors having high-affinity for IGF-I and IGF-II, mediate almost all the IGF actions that are described above. Type II IGF receptors or IGF-II/mannose-6-phosphate receptors have two distinct binding sites; the IGF-II binding site exhibits a high affinity only for IGF-II. The principal role of the type II IGF receptor is to destroy IGF-II by targeting the ligand to the lysosome. IGFs in biological fluids are mostly bound to IGFBP. IGFBPs, in general, are IGF storage/carrier proteins or modulators of IGF actions; however, as for distinct roles for individual IGFBPs, only limited information is available. IGFBPs inhibit IGF actions under most in vitro situations, seemingly because affinities of IGFBPs for IGFs are greater than those of IGF receptors. How IGF is released from IGFBP to reach IGF receptors is not known; however, various IGFBP protease activities that are present in blood and interstitial fluids are believed to play an important role in the process of IGF release from the IGFBP. According to latest reports, there is evidence that under certain in vitro circumstances, IGFBP-1, -3, -5 have their own biological activities independent of the IGF. This may add another dimension of complexity of the already complicated IGF system. Messenger ribonucleic acids and proteins of the IGF family members are expressed in the uterine tissue and conceptus of the primates, rodents and farm animals to play important roles in growth and development of the uterus and fetus. Expression of the uterine IGF system is regulated by gonadal hormones and local regulatory substances with temporal and spatial specificities. Locally expressed IGFs and IGFBPs act on the uterine tissue in an autocrine/paracrine manner, or are secreted into the uterine lumen to participate in conceptus growth and development. Conceptus also expresses the IGF system beginning from the peri-implantation period. When an IGF family member is expressed in the conceptus, however, is determined by the presence or absence of maternally inherited mRNAs, genetic programming of the conceptus itself and an interaction with the maternal tissue. The site of IGF action also follows temporal (physiological status) and spatial specificities. These facts that expression of the IGF system is temporally and spatially regulated support indirectly a hypothesis that IGFs play a role in conceptus growth and development. Uterine and conceptus-derived IGFs stimulate cell division and differentiation, glucose and amino acid transport, general protein synthesis and the biosynthesis of mammotropic hormones including placental lactogen and prolactin, and also play a role in steroidogenesis. The suggested role for IGFs in conceptus growth and development has been proven by the result of IGF-I, IGF-II or IGF receptor gene disruption(targeting) of murine embryos by the homologous recombination technique. Mice carrying a null mutation for IGF-I and/or IGF-II or type I IGF receptor undergo delayed prenatal and postnatal growth and development with 30-60% normal weights at birth. Moreover, mice lacking the type I IGF receptor or IGF-I plus IGF-II die soon after birth. Intrauterine IGFBPs generally are believed to sequester IGF ligands within the uterus or to play a role of negative regulators of IGF actions by inhibiting IGF binding to cognate receptors. However, when it is taken into account that IGFBP-1 is expressed and secreted in primate uteri in amounts assessedly far exceeding those of local IGFs and that IGFBP-1 is one of the major secretory proteins of the primate decidua, the possibility that this IGFBP may have its own biological activity independent of IGF cannot be excluded. Evidently, elucidating the exact role of each IGFBP is an essential step into understanding the whole IGF system. As such, further research in this area is awaited with a lot of anticipation and attention.

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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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