• Journal of the Korean Institute of Landscape Architecture
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• v.43 no.1
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• pp.69-81
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• 2015

Under the premise that parks have been a performing field of welfare ideology that benefits the citizen from the past, the present study began with a basic question on what substance a park has and how it has worked. Therefore, this study tried to find out the theoretic background that can explain the roles of a park as an instrument for welfare, of which topic is currently being discussed, and examine how the ideology in the debate regarding welfare characteristics of parks are differentiated from those of social welfare. In addition, this study divided the process of development of parks defined by Galen Cranz in an attempt to view how welfare benefits offered by parks have changed in their development and looked into the roles and types of welfare functions that parks provided to the citizens under a certain social situation by period. Furthermore, the characteristics and development of the ideology underlying a welfare park were examined by function and element in its progression. The results of this study are as follows. The functions that parks have performed so far can be classified into three categories. First, they have a remedial function. Parks have given direct services to 'the socially disadvantaged' such as relief, fostering, and rehabilitation. Second, parks have played a preventive function. They aim to reinforce the functions of individual, family, group, and community. Third, they have exerted a developmental function. They function to promote change of society in a way for it to contribute to social development. Looking into the roles and functions of parks from the perspective of their beneficiary class and benefits, the following were discovered. First, the beneficiaries of welfare characteristics in parks have expanded to the general public from the poor class, and the benefits of parks have spread into the public including the underprivileged in a real sense. Second, the significance of welfare characteristics in parks has also changed from literal benefits to caring for basic human rights. Third, the purpose of welfare characteristics in parks has changed from providing minimal conditions to optimal conditions. At its beginning, the ideology of welfare in parks remained ideal, confining itself to their idealistic characteristics; but as time went on, they created several social benefits in response to various social demands, developing into a field where welfare ideology manifests and is realized in an active manner. Furthermore, it was witnessed that the parks and welfare of the present times are standing at the point of contact for participation and universal well-being. The present study reconsidered the meaning and value of parks from perspective of them as a provider of welfare benefits as well as examined how the welfare ideology of parks is connected to practice. By doing so, this study discovered the various roles, values, and ideology that parks should bear in the future. Therefore, this study is expected to be a good example for future research related to the topic.

• Journal of radiological science and technology
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• v.40 no.4
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• pp.633-638
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• 2017

The amount of radioactive waste has been rapidly increased with development of radiation treatment in medical field. Recently, it has been a common practice to use I-131 for thyroid cancer, F-18 for PET/CT and Tc-99m for diagnosis of nuclear medicine. All the wastes concerned have been disposed of by means of the self-disposal method, for example incineration, after storage enough to decay less than clearance level. IAEA proposed criteria for clearance level of waste which depends on the individual ($10{\mu}Sv/y$) and collective dose (1 man-Sv/y), and concentration of each nuclide (IAEA Safety Series No 111-P-1.1, 1992 and IAEA RS-G-1.7, 2004). In this study, specific radioactivity of radioactive waste contaminated with Re-186 was measured to confirm whether it meets the clearance level. Re-186 has long half life of 3.8 days relatively and emits beta and gamma radiation, therefore it can be applied in treatment and imaging purposes. The specific radioactivity of contaminated gloves weared by radiation workers was measured by MCA(Multi-channel Analyzer) which was calibrated by reference materials in accordance with the measuring procedure. As a result, comparison evaluation of decay storage period between the half-life which was calculated by attenuation curve based on real measurement and physical half-life was considered, and it is showed that the physical half-life is longer than induced half-life. Therefore, the storage period of radioactive waste for self-disposal may be curtailed in case of application of induced half-life. The result of this study will be proposed as ISO standard.

• The Journal of Art Theory & Practice
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• no.5
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• pp.43-80
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• 2007

PASKYULA was formed in September, 1923 through the union of artists involved in two art groups: Kim Ki-Jin, Kim Bok-Jin, Yeon Hak-Nyeon who had previously participated in the ToWolHoi, and Park Young-Hi, Lee Sang-Hwa, An Seok-Ju, former members of the BaeckJo. After its founding, the PASKYULA artists had been searching for the social function of art to reform the harsh reality of Minjung and the nation with criticism toward society as well as art world. Their art theory for MinJung could grow relatively ease in relation to changing social and political conditions in the early 1920s. In August, 1925, PASKYULA organized the Korea Artista Proletaria Federatio with the YeomGunSa, and laid the groundwork for Proletariat art movement which was regularized in the late 1920s. From PASKYULA up to the early state of KAPF, the theory of art advocated by Kim Bok-Jin and An Seok-Ju could be summarized as "art for MinJung". At that time, widely ranging discourses on MinJung, however, was spawned in art theory, because many intellectuals-including artists and writers-begun to pay more attention to MinJung, who emerged as one of the social forces after the Samil Independent Movement. Sometimes, MinJung was construed as the target of enlightenment from a negative viewpoint. On the other hand, several intellectuals under the influence of individualism asserted that the discussion itself on MinJung exerted an evil influence on art. In contrast of these cases, the PASKYULA artists including Kim Bok-Jin, An Seok-Ju perceived that MinJung had the potential to change society, and regarded them as "a creator of genuine civilization and art". In the PASKYULA artist's writings, the concept of MinJung was often overlapped with the meaning of the Choson nation suffering under colony. Although their concept of MinJung was transformed gradually into the proletariat as they were under the strong influence of socialism, it did not change that they grasped the realities of the whole Choson Peninsula through the proletarian consciousness. In the early state of PASKYULA, the methodology for social function of art was presented in a twofold manner. First of all, Kim Bok-Jin emphasized on the necessity of education to improve MinJung's way of life through art, and it was embodied by the organization of ToWol Art Workshop and public lecture. Also, he championed "the popularization of art", which was one of methods to distribute art to MinJung. According to the PASKYULA artists, art should be not art for art' sake but art for MinJung. That was why they advocated the convergence of art and MinJung's life. Especially Kim Bok-Jin affirmed a link between art and industry because he considered industry the field inextricably linked with MinJung's life. In this context, his idea could be read as the generalization and equalization within the framework of possession. Kim Bok-Jin thought that the social ramifications of capitalism deprived MinJung of their right to enjoy art, and emphasized the artist' social role to return the right to them. That is, the even distribution of art was mainly discussed than the contents of art in the half of 1920s. By 1925, the contents of art itself became an issue in the PASKYULA art theory, and it was based in realism. Kim Bok-Jin and An Seok-Ju insisted that art should be reflection of real life. At that time, realism acquired the representation of MinJung and the nation's realities not realistic style. In fact, the various Western art styles including Futurism, Constructivism, Cubism etc. were exploited in the PASKYULA's visual images. Western art, target of criticism on theory, was selectively adopted in the works which were produced by Kim Bok-Jin and An Seok-Ju. Kim Bok-Jin's MoonYeUnDong cover design was conceived of as the example in which Western art was adopted with it's ideology under the influence of MAVO, while Western art shown in An Seok-Ju's illustrations served as a decorative function in many cases. Especially, An Seok-Ju attempted the various styles of Western art simultaneously, which may be seen as representing that PASKYULA did not have a firm ideology for their style. Also, it can be read as showing his hasty zeal to overcome Western art rapidly. The wish to establish "art for MinJung" as soon as possible was accompanied with the will to jump over the all steps of Western art though it was superficial. This aspiration of PASKYULA was expressed through the mass media, which had the potential for communicating to MinJung. At this point, there was a significant disparity between PASKYULA and another art groups in the first half of 1920s. However, the PASKYULA's method on the basis of the mass media could not but have a certain limitation because of the medium's properties. Nevertheless, PASKYULA' attempts may be considered to be valuable in sense that they expended the boundaries of Korean modern art into the commercial art questioning the matter of the distribution for art.

• Korean Journal of Heritage: History & Science
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• v.53 no.4
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• pp.274-291
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• 2020

This year is the 50th anniversary of the adoption by UNESCO in 1970 of the Convention on the Means of Prohibiting and Preventing the Illicit Import, Export, and Transfer of Ownership of Cultural Property (the '1970 Convention'). Since its ratification of the 1970 Convention in 1983, the Republic of Korea has domestically implemented the Convention through its Cultural Heritage Protection Act, which was first enacted in 1962. This is a different form of implementation than is normally used for other UNESCO Conventions on cultural heritage, in that the Republic of Korea has recently adopted special acts to enforce the 2003 Convention for the Safeguarding of Intangible Cultural Heritage and the 1972 Convention concerning the Protection of the World Cultural and Natural Heritage. In addition, the 1970 Convention has been developed further through the introduction of new Operational Guidelines in 2015 for the concrete enforcement of the Convention, which has provided momentum for the Republic of Korea to analyze its current national legislation related to the 1970 Convention as well as consider its amendment in the future. Overall, the Cultural Heritage Protection Act of the Republic of Korea effectively reflects the duties of States Parties under the 1970 Convention. These include measures to introduce export certificates, prohibit the import of stolen cultural property, return other state parties' cultural property, and impose penalties or administrative sanctions in the event of any infringements. Indeed, the Republic of Korea's implementation of the 1970 Convention was introduced as an example of good practice at the Meeting of State Parties in 2019. However, changes in the illegal market for cultural property and development of relevant international law and measures imply that there still exists room for improvement concerning the legal implementation of the 1970 Convention at the national level. In particular, the Operational Guidelines recommend States Parties to adopt legal measures in two respects: detailed criteria for due diligence in assessing bona-fide purchasers, referring to the 1995 UNIDROIT Convention on Stolen or Illegally Exported Cultural Objects, and measures to address the emerging issue of illegal trade in cultural property on internet platforms. Amendment of the Cultural Heritage Protection Act and other relevant laws should be considered in order to duly reflect these issues. Taking that opportunity, concrete provisions to facilitate international cooperation in respect of the implementation of the 1970 Convention could be introduced as well. Such measures could be expected to strengthen the Republic of Korea's international legal cooperation to respond to the changing environment regarding illicit trafficking of cultural property and its restitution.

• (The) Research of the performance art and culture
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• no.43
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• pp.145-172
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• 2021

Shin Myung-soon's is based on the taboo 'bombing of the Han River Bridge'. The reality of the bombing of the Han River Bridge in 1950 and the shooting of Colonel Choi Chang-sik was known only as a word of mouth. At that time, the ruling class did not want to reveal the painful mistakes of the unfavorable war situation in the early days of the war and the false broadcasting of the president. The truth of the case, which was kept completely secret even to the bereaved family, could only be revealed after the regime change. After that, the bereaved family of Colonel Choi Chang-sik confirmed the innocence of the deceased through a request for retrial, and then the was born. However, the fate of was not so smooth. At the time, the performance officials vividly remember the difficulties they had with the text. Despite passing the pre-screening of the script, the performance was canceled just before the performance. The fact that the National Theater, officials from the Ministry of Culture and Education, and even military generals visited the practice room to stop the performance, on the contrary, was a testimony to the dangers of . It can be summarized as a crack in official history and a move to stop it. was later adapted into a special TV drama in 1981 and was first released to the public. This was a very meaningful step in terms of dealing with politically sensitive subjects on television, but the inconsistency of in the first place has largely disappeared. After that, in 1988, only after democracy entered the phase of appeasement, could be performed in its full form. In short, can be said to be an example of a process in which the history of the Korean War recorded from the standpoint of an established order and the counter-memory that crack it up are transformed according to the changes of the times and media.

• Journal of the Daesoon Academy of Sciences
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• v.46
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• pp.123-152
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• 2023

This paper will examine how the Avalokitesvara faith of India was restructured into the doctrines and practices related to the Sinicized version of the deity as Guanyin (觀音) Bodhisattva. Particular focus will be given to the Hangzhou area of China, when the Guanyin faith was still in the process of gaining establishment in China. In the Hangzhou area, Buddhist Orders grew significantly due to the wealth accumulated from commerce using canals and maritime trade, and the Chan (禪 typically known as Zen in English) Orders were particularly active during the Song Dynasty. Zhiyi (智顗), a prominent master from the Tiantai Order (天台宗), based his activities out of Hangzhou. He composed the text known as the Commentary on the Guanyin Petitioning Sutra (Qingguanyinjing-shu 請觀音經疏) based on a reinterpretation of a scripture related to Guanyin, and he systematized the Guanyin Repentance Ritual (Guanyin-chanfa 觀音懺法) by combining the Doctrines of Tiantai with the Guanyin faith. In addition, Ciyin Zunshi (慈雲遵式) reformulated that Guanyin Repentance Ritual into the Guanyin Petitioning Repentance Ritual (qing-guanyin-chan 請觀音懺) to make it into a common ritual that was more accessible to everyday people. The book, Records Regarding the Personal Conduct of the Chan Master Zhijue (zhijue-chanshi-zixing-lu 智覺禪師自行錄), which is written by Yongming Yanshou (永明延壽), a figure from the Fayan Order (法眼宗), one of the Chan Buddhist orders in the Hangzhou area during the Northern Song Dynasty, reveals the acceptance of the Guanyin faith as a daily practice within the 108 daily rituals (108事). In Chinese Buddhism, there were historical examples of monks being worshipped as incarnations of Guanyin Bodhisattva. An example of this includes iconography depicting Baozhi (寶誌), a figure from Jiliang (濟涼) who lived during the Southern Dynasties, as Ekādaśamukha (十一面觀音, Eleven-faced Guanyin Bodhisattva) in keeping with the belief that he was an incarnation of that deity. Monks of the Tiantai and Chan orders operating in the Hangzhou area actively utilized the transmission of Buddhist tales about Guanyin Bodhisattva as related to monks that exhibited miraculous powers (神異僧). This can be understood as a phenomenon demonstrating how Song Buddhism tried to attract more believers through the popularity of the Guanyin Faith.

• 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.

• Journal of agricultural medicine and community health
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• v.1 no.1
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• pp.5-9
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• 1976

The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

• Journal of Preventive Medicine and Public Health
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• v.5 no.1
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• pp.57-95
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• 1972

This study was conducted to assess the effectiveness of service by maternity aids concerning maternal and child health in improving simultaneously infant mortality, contraception and vital registration among expectant mothers in rural Korea, where there is less apportunity for maternal and child health care. It is unrealistic to expect to solve this problem in rural Korea through professional persons considering the situation of medical facilities and the socioeconomic condition of residents. So, we intended to adopt a system of services by maternity aids who were educated formally among indigenous women. After the women were trained in maternal and child health, contraception, and registration for a short period, they were assigned as a maternity aids to each village to help with various activities concerning maternal and child health, for example, registration of pregnant women, home visiting to check for complications, supplying of delivery kits, attendance at delivery, persuasion of contraception, and invitation for registration and so on. Mean-while, four researchers called on the maternity aids to collect materials concerning vital events, maternal child health, contraception and registration, and to give further instruction and supervision as the program proceeded. A. Changes of women's attitude by services of maternity aid. Now, we examined to what extent' such a service system to expectant mothers affected a change in attitude of women residing in the study area as compared to women of the control area. 1) In the birth and death places, there were no changes between last and present infants, in study or control area. 2) In regard to attendants at delivery, there were no changes except for a small percentage of attendance (8%) by maternity aid in study area. But, I expect that more maternity sids could be used as attendants at delivery if they would be trained further and if there was more explanation to the residents about such a service. 3) Considering the rate of utilization of sterilized delivery kit, I am sure that more than 90 percent would be used if the delivery kit were supplied in the proper time. There were significant differences in rates between the study and the control areas. 4) Taking into consideration the utilization rate of the clinic for prenatal care and well baby care, if suck facilities were installed, it would probably be well utilized. 5) In the contraception, the rate of approval was as high as 89 percent in study area as compared to 82 percent in the control area. 6) Considering the rate of pre-and post-partum acceptance on contraception were as much as 70 percent or more, if motivation to use contraception was given to them adequately, the government could reach the goals for family planning as planned. 7) In the vital registration, the rate of birth registration in the study area was some what improved compared to that of the control area, while the rate of death registration was not changed at all. Taking into account the fact that the rate of confirmation of vital events by maternity aids was remarkably high, if the registration system changed to a 'notification' system instead of formal registration ststem, it would be improved significantly compared to present system. B. Effect of the project Thus, with changes in the residents' attitude, was there a reduction in the infant death rate? 1) It is very difficult problem to compare the mortality of infants between last and present infants, because many women don't want to answer accurately about their dead children especially the infants that died within a few days after birth. In this study the data of present death comes from the maternity aides who followed up every pregnancy they had recorded to see what had happened. They seem to have very reliable information on what happened in first few weeks with follow up visitits to check out later changes. From these calculaton, when we compared the rate of infant death between last and present infant, there was remarkable reduction of death rate for present infant compare to that of last children, namely, the former was 30, while the latter 42. The figure is the lowest rate that I have ever heard. As the quality of data we could assess by comparing the causes of death. In the current death rate by communicable disease was much lower compare to the last child especially, tetanus cases and pneumonia. 2) Next, how many respondents used contraception after birth because of frequent contact with the maternity aid. In the registered cases, the respondents showed a tendency to practice contraception at an earlier age and with a small number of children. In a comparison of the rate of contraception between the study and the control area, the rate in the former was significantly higher than that of the latter. What is more, the proportion favoring smaller numbers of children and younger women rose in the study area as compared to the control area. 3) Regarding vital registration, though the rate of registration was gradually improved by efforts of maternity aid, it would be better to change the registration system. 4) In the crude birth rate, the rate in the study area was 22.2 while in the control area was 26.5. Natural increase rate showed 15.4 in the study area, while control area was 19.1. 5) In assessment of the efficiency of the maternity aids judging by the cost-effect viewpoint, the workers in the Medium area seemed to be more efficiency than those of other areas.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.51-64
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• 1997

The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.