• 제목/요약/키워드: Private Records

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Publication Report of the Asian-Australasian Journal of Animal Sciences over its History of 15 Years - A Review

  • Han, In K.
    • Asian-Australasian Journal of Animal Sciences
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    • 제15권1호
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    • pp.124-136
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    • 2002
  • As an official journal of the Asian-Australasian Association of Animal Production Societies (AAAP), the Asian-Australasian Journal of Animal Sciences (AJAS) was born in February 1987 and the first issue (Volume 1, Number 1) was published in March 1988 under the Editorship of Professor In K. Han (Korea). By the end of 2001, a total of 84 issues in 14 volumes and 1,761 papers in 11,462 pages had been published. In addition to these 14 volumes, a special issue entitled "Recent Advances in Animal Nutrition" (April, 2000) and 3 supplements entitled "Proceedings of the 9th AAAP Animal Science Congress" (July, 2000) were also published. Publication frequency has steadily increased from 4 issues in 1988, to 6 issues in 1997 and to 12 issues in 2000. The total number of pages per volume and the number of original or review papers published also increased. Some significant milestones in the history of the AJAS include that (1) it became a Science Citation Index (SCI) journal in 1997, (2) the impact factor of the journal improved from 0.257 in 1999 to 0.446 in 2000, (3) it became a monthly journal (12 issues per volume) in 2000, (4) it adopted an English editing system in 1999, and (5) it has been covered in "Current Contents/Agriculture, Biology and Environmental Science since 2000. The AJAS is subscribed by 842 individuals or institutions. Annual subscription fees of US$ 50 (Category B) or US$ 70 (Category A) for individuals and US$ 70 (Category B) or US$ 120 (Category A) for institutions are much less than the actual production costs of US$ 130. A list of the 1,761 papers published in AJAS, listed according to subject area, may be found in the AJAS homepage (http://www.ajas.snu.ac.kr) and a very well prepared "Editorial Policy with Guide for Authors" is available in the Appendix of this paper. With regard to the submission status of manuscripts from AAAP member countries, India (235), Korea (235) and Japan (198) have submitted the most manuscripts. On the other hand, Mongolia, Nepal, and Papua New Guinea have never submitted any articles. The average time required from submission of a manuscript to printing in the AJAS has been reduced from 11 months in 1997-2000 to 7.8 months in 2001. The average rejection rate of manuscripts was 35.3%, a percentage slightly higher than most leading animal science journals. The total number of scientific papers published in the AJAS by AAAP member countries during a 14-year period (1988-2001) was 1,333 papers (75.7%) and that by non- AAAP member countries was 428 papers (24.3%). Japanese animal scientists have published the largest number of papers (397), followed by Korea (275), India (160), Bangladesh (111), Pakistan (85), Australia (71), Malaysia (59), China (53), Thailand (53), and Indonesia (34). It is regrettable that the Philippines (15), Vietnam (10), New Zealand (8), Nepal (2), Mongolia (0) and Papua New Guinea (0) have not actively participated in publishing papers in the AJAS. It is also interesting to note that the top 5 countries (Bangladesh, India, Japan, Korea and Pakistan) have published 1,028 papers in total indicating 77% of the total papers being published by AAAP animal scientists from Vol. 1 to 14 of the AJAS. The largest number of papers were published in the ruminant nutrition section (591 papers-44.3%), followed by the non-ruminant nutrition section (251 papers-18.8%), the animal reproduction section (153 papers-11.5%) and the animal breeding section (115 papers-8.6%). The largest portion of AJAS manuscripts was reviewed by Korean editors (44.3%), followed by Japanese editors (18.1%), Australian editors (6.0%) and Chinese editors (5.6%). Editors from the rest of the AAAP member countries have reviewed slightly less than 5% of the total AJAS manuscripts. It was regrettably noticed that editorial members representing Nepal (66.7%), Mongolia (50.0%), India (35.7%), Pakistan (25.0%), Papua New Guinea (25.0%), Malaysia (22.8%) and New Zealand (21.5%) have failed to return many of the manuscripts requested to be reviewed by the Editor-in-Chief. Financial records show that Korea has contributed the largest portion of production costs (68.5%), followed by Japan (17.3%), China (8.3%), and Australia (3.5%). It was found that 6 AAAP member countries have contributed less than 1% of the total production costs (Bangladesh, India, Indonesia, Malaysia, Papua New Guinea and Thailand), and another 6 AAAP member countries (Mongolia, Nepal and Pakistan, Philippine and Vietnam) have never provided any financial contribution in the form of subscriptions, page charges or reprints. It should be pointed out that most AAAP member countries have published more papers than their financial input with the exception of Korea and China. For example, Japan has published 29.8% of the total papers published in AJAS by AAAP member countries. However, Japan has contributed only 17.3% of total income. Similar trends could also be found in the case of Australia, Bangladesh, India, Indonesia, Malaysia and Thailand. A total of 12 Asian young animal scientists (under 40 years of age) have been awarded the AJAS-Purina Outstanding Research Award which was initiated in 1990 with a donation of US$ 2,000-3,000 by Mr. K. Y. Kim, President of Agribrands Purina Korea Inc. In order to improve the impact factor (citation frequency) and the financial structure of the AJAS, (1) submission of more manuscripts of good quality should be encouraged, (2) subscription rate of all AAAP member countries, especially Category B member countries should be dramatically increased, (3) a page charge policy and reprint ordering system should be applied to all AAAP member countries, and (4) all AAAP countries, especially Category A member countries should share more of the financial burden (advertisement revenue or support from public or private sector).

병원 간호행정 개선을 위한 연구 (A Study for Improvement of Nursing Service Administration)

  • 박정호
    • 대한간호학회지
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    • 제3권1호
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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곡성 함허정(涵虛亭)의 경관짜임과 의미경관 (The Landscape Configuration and Semantic Landscape of Hamheo-pavilion in Gokseong)

  • 이현우;심우경;노재현;신상섭
    • 한국전통조경학회지
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    • 제33권1호
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    • pp.52-64
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    • 2015
  • 본 연구는 곡성 함허정(전남유형문화재 제160호)을 중심으로 '현장조사 문헌조사 인터뷰' 등의 연구방법을 토대로 연구대상 일원의 풍수형국과 경관짜임 및 조영의도 그리고 의미경관의 특성을 추적한 것이다. 함허정 일원의 입지 및 조망적 조영특성의 분석과 해석의 일환으로, 함허정 일원의 경관상에 드러난 호혜적 자연관과 경관짜임이 어떠한 형태 및 방식으로 표출되었는가를 구체적으로 밝힌 연구결과는 다음과 같이 축약된다. 첫째, 함허정은 심광형(沈光亨, 1510~1550)이 중종30년(1535)에 군촌(현(現). 전남 곡성군 입면 제월리)에 처소 및 강학을 위한 군지촌정사를 창건한 이후, 지근거리에 1543년 학문연구와 유식(遊息)을 위해 지은 누정이다. 함허정과 군지촌정사가 자리한 군촌마을은 순자강(섬진강)을 마주한 전형적인 배산임수 국면인데, 진산인 동악산은 소가 강가에 누워 한가로이 되새김질 하는 와우형(臥牛形)으로 해석되며, 함허정 일원은 목동(牧童)이 강가에서 피리를 부는 형국으로 와우(臥牛)가 적초(積草案, 풀더미)를 구비하여 평안과 풍요를 누릴 수 있는 길처로 회자된다. 특히, 함허정 뒷동산은 거북이 용궁으로 입수하는 혈맥으로 거북(또는 자라)의 등 위에 앉은 건물[구형(龜形)]이 함허정이며, 절벽 아래 남측의 하중암도(河中巖島)인 구암조대(龜巖釣臺)와 용암(龍巖)은 거북이 지향한 해중 신선경(海中 神仙景)으로 해석된다. 둘째, 함허정은 곡성8경의 제3경 순강청풍과 제9경 설산낙조(雪山落照)의 풍광시점장이면서, 곡성 입면8경의 제2경 함허순자와 제3경 천마귀암(天馬歸岩)의 풍광시점이기도 하다. 한편 음양접합과 같은 '산태극(山太極) 수태극(水太極)'으로 배열된 순자강5곡의 제4곡 경물로서 도학 및 성리학적 토포스로 본 초월적 풍경이자 감각적 투시를 통한 굽음의 미학으로 재생산되고 있다. 특히 비변사인방안지도(18C 중엽)와 옥과현지(1788년) 등에 순자강5곡 중 제2곡 합강정과 제4곡 호연정(함허정), 그리고 제3곡 무진정이 묘사되었음을 볼 때 순자강5곡 경물은 피안(彼岸)과 차안(此岸)의 세계를 넘나들며 선경세계로 귀의하는 장소정체성은 물론 조선후기 명소적 연계경관으로서의 지명도를 엿볼 수 있다. 셋째, 비워둠의 미학이 절묘하게 드러난 함허정은 상수리나무 굴참나무 소나무 등 노거수 수림경관, 구암조대와 용암, 첩석(疊石) 등 바위경관, 군촌마을 문화경관 등이 지근경(至近景)으로 펼쳐지고, 중경요소로 순자강 평호(平湖)와 마산봉, 고리봉 등이 산악경관으로 조망되며, 동쪽에서 서쪽으로 고리봉 마산봉 무등산 설산 등이 개방성 강한 $180^{\circ}$ 조망범위로 펼쳐진다. 특히 군지촌정사의 사랑채인 망서재(望瑞齋)의 당호는 "서석산(瑞石山)을 전망하는 집"이라는 뜻을 갖는데, 조산인 무등산과 설산을 앙경(仰景)하는 등 다채로운 차경(읍경(揖景), 환경(環景), 원근(遠近), 앙부경관(仰俯景觀))에 대한 조망지향적 의도가 중층적(中層的) 경관짜임을 통해 구현되고 있다. 넷째, 실존[주거(住居) 강학처(講學處)]과 이상향[누정(樓亭) 재실(齋室)]이 접합된 군지촌 정주환경의 살림집[제월당], 강학처[군지촌정사], 누정[함허정], 재실[구암사, 청송심씨 4현 배향] 및 묘역 등은 '생성-풍요-초월-회귀'로 이어지는 사대부들의 생애주기와 관련한 의미론적 연계경관으로 인식된다. 특히 함허정 관련 시문은 순자강 일대의 가경 예찬과 유유자적한 삶에 대한 호혜적 자연관 묘사가 주를 이루고 있음을 주지할 때, 함허정은 자연귀의와 안분지족의 요체이자 거점처이며, 수심양성(修心養性)하는 은일지소로서의 현학성이 형이상학적 의미경관으로 표출된다.

과시된 효심: 국립중앙박물관 소장 <인왕선영도(仁旺先塋圖)> 연구 (Showing Filial Piety: Ancestral Burial Ground on the Inwangsan Mountain at the National Museum of Korea)

  • 이재호
    • 미술자료
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    • 제96권
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    • pp.123-154
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    • 2019
  • 국립중앙박물관 소장 <인왕선영도(仁旺先塋圖)>(덕수5520)는 그림과 발문(跋文) 열 폭으로 이루어진 병풍으로, 작가는 조중묵(趙重黙)(1820~1894 이후), 주문자는 박경빈(朴景彬)(생몰년 미상), 발문을 쓴 사람은 홍선주(洪善疇)(생몰년 미상), 제작연대는 1868년이다. 국립중앙박물관은 낱장으로 보관되어 온 <인왕선영도>를 병풍으로 복원하고 특별전 '우리 강산을 그리다: 화가의 시선, 조선시대 실경산수화'에서 최초로 공개하였다. <인왕선영도>에는 오늘날 서울특별시 서대문구 홍제동과 홍은동을 아우르는 인왕산 서쪽 실경이 묘사되어있고 원경에는 북한산 연봉이 그려져 있다. 화면 속에는 인왕산(仁旺山), 추모현(追慕峴), 홍재원(弘濟院), 삼각산(三角山), 대남문(大南門), 미륵당(彌勒堂)이라는 지명이 표기되어있다. 이 지역을 나타낸 조선후기 지도와 비교해보면 지형 표현과 지명 표기에 유사성이 있다. 조중묵은 넓은 공간을 포착하기 위해 지도의 지리정보를 숙지하였을 것으로 추정된다. 실경의 현장을 답사한 결과, 조중묵은 각각의 경물을 과장하거나 생략하였고 수평의 화면에 나열식으로 조합하였음을 알 수 있었다. 조중묵은 남종화풍 정형산수에 뛰어났던 화가로, <인왕선영도>의 세부 표현에서 사왕파(四王派) 화풍의 영향을 찾을 수 있다. 19세기 도화서 화원들이 화보를 활용하여 가옥을 그리거나 토파에 호초점을 찍고 당분법(撞粉法)으로 꽃을 나타내는 등 장식적인 화풍을 구사한 경향도 부분적으로 나타난다. <인왕선영도>에는 바위를 짙은 먹으로 쓸어내리듯 붓질한 기법, 산세의 괴량감, 가로로 붓을 대어 단순하게 그린 소나무 등 18세기 정선(鄭敾)(1676~1759)의 개성적 양식도 가미되어있다. 조중묵은 인왕산 실경산수로 유명한 정선의 양식과 권위를 차용한 것으로 추정된다. 그러나 <인왕선영도>는 유기적 공간감과 현장의 인상이 잘 드러나지 않으며, 연폭 화면이라는 매체도 조중묵의 개인 양식과 잘 어울리지 않는다. <인왕선영도>는 발문의 텍스트와 화면의 이미지가 잘 조응하는 작품이다. 발문의 내용을 여섯 단락으로 나누어 보면 ①무덤의 주인공과 이장 경위, ②무덤의 입지와 풍수, ③묘제(墓祭)와 신이(神異)한 응답, ④무덤 관리에 대한 마을 사람들의 협력, ⑤병풍 제작의 동기인 박경빈의 효성과 수묘(守墓), ⑥발문을 쓴 의의로 파악된다. 이 가운데 화면에서 시각적으로 구현하기 용이한 ②의 내용은 화면에 충실하게 재현되었다. <인왕선영도> 제작의 직접적 동기인 ⑤를 보면 주문자 박경빈이 "무덤이 마치 새롭게 단장한 것 같이 눈에 완연하다."라 하여 <인왕선영도>에 만족했음을 알 수 있다. 경물 하나하나를 설명하듯 나열한 구도는 회화미는 떨어지더라도 무덤의 풍수지리를 전달하는 데는 더 적합했을 것으로 추정된다. 현존하는 상당수의 산도(山圖)는 18세기 이후 제작된 목판본 선영도로서, 족보와 문집에 수록된 경우가 많다. 16~17세기의 기록에서는 족자 선영도를 첨배(瞻拜)의 대상으로 삼은 사례를 찾을 수 있다. 선영도 첨배는 현실적으로 수묘(守墓)가 곤란할 때 이를 대신할 수 있는 의례로 인정되었다. 한효원(韓效元)(1468~1534), 조실구(曺實久)(1591~1658) 등이 선영도를 제작한 후 당대의 명사에게 서문을 요청하고 효심을 과시한 사례는 <인왕선영도>의 선구가 된 것으로 추정된다. <석정처사유거도(石亭處士幽居圖)>(개인 소장), <화개현구장도(花開縣舊莊圖)>(국립중앙박물관) 등은 선영도는 아니지만 계회도 형식의 족자이고 풍수를 도해했다는 점에서 17세기 선영도의 모습을 유추할 수 있는 자료가 된다. <인왕선영도>는 첨배라는 측면에서 초상화와도 의미가 비슷했다. 발문의 "부친의 기침소리를 직접 접하는 듯하고, 그 태도와 몸가짐을 눈으로 보는 듯하다."는 표현과 부친의 초상에 조석 문안을 올린 서효숙 고사에서 그 단초를 찾을 수 있다. 박경빈이 일반적인 선영도 형식이었던 족자나 목판화 대신 연폭 병풍의 실경산수화를 주문한 의도는 분명히 알기 어렵다. 19세기에는 민간에서도 사례(四禮) 의식에 다수의 병풍을 배설(排設)하였는데, 의례의 성격에 따라 그림의 주제를 반드시 구분하여 사용한 것은 아니었다. <인왕선영도> 또한 여러 의례에 두루 배설하거나 장식 병풍으로도 사용하기 위해서 선영 그림이라는 주제를 실경산수화 이미지 아래에 가렸을 가능성이 있다. 특히 <인왕선영도>의 핵심 소재인 무덤 봉분이 모호하게 처리된 것은 사산금표(四山禁標)의 금제 위반을 숨기기 위함일 가능성이 있다. <인왕선영도>에 묘사된 인왕산 서쪽 산기슭은 분묘 조성 금지구역이었다. 1832년에 금표 내에 몰래 쓴 묘를 적발하여 즉시 파내고 관련자를 엄히 처벌한 사례로 볼 때, 19세기 중엽까지도 사산금표 내의 분묘 금제는 효력을 발휘하고 있었던 것으로 추정된다. <인왕선영도>의 발문에는 장지를 얻기 위해 쏟은 정성이 상세하게 쓰여 있다. 장지조성에 마을사람들의 협조와 묵인이 필요했던 것은 금표 구역 내에 묘지를 조성하는 것이 부담스러운 일이었기 때문으로 볼 수 있다. <인왕선영도>와 비교 가능한 동시대 연폭 병풍의 실경산수화로 이한철(李漢喆)(1808~1880)이 그린 <석파정도(石坡亭圖)>(미국 로스앤젤레스카운티미술관)를 들 수 있다. <석파정도> 제작시기를 전후한 1861년에 이한철과 조중묵은 철종어진도사에 함께 참여하였으므로 조중묵이 이한철의 <석파정도> 제작 과정을 보았을 가능성은 상당히 높다. 조중묵이 몇 년 후 <인왕선영도>를 주문받았을 때 <석파정도>의 인상적인 연폭 실경산수를 본 경험이 반영되었을 가능성이 있다. 두 작품의 화풍 차이는 주문자의 취향과 제작 목적의 차이에서 비롯된 것으로 추정된다. <인왕선영도>는 실경산수화와 선영도의 중층적인 구조를 가지고 있어서 관람자의 지식수준과 주문자와의 친분, 관람에 들이는 시간에 따라 천차만별의 의미로 수용되었을 것이다. <인왕선영도>의 발문에는 무덤 주인의 이름과 자호, 본관이 일체 작성되지 않은 채 '박공(朴公)'이라고만 표기되어 있다. 주문자인 박경빈의 인적 사항도 파악할 수 없었으나 다만 관직에 나아가지 못한 가계를 미루어 볼 때 재력이 있음에도 지배계층으로 올라설 수 없는 신분적 한계를 지니고 있었음은 짐작할 수 있다. 발문을 쓴 홍선주 또한 사대부로 보기 어려우며, 『승정원일기』 기록에 나타나는 경아전 서리일 가능성이 있다. 박경빈은 상류 계층에 진입하고 싶은 욕망으로 보수적인 가치인 효(孝)를 강조하여 부친의 무덤을 명당으로 이전하고 <인왕선영도>를 제작하였을 것으로 추정된다. 그러나 <인왕선영도>는 금제위반 적발에 대한 우려, 병풍의 다목적성 등의 이유로 본래의 제작의도를 뚜렷하게 드러내지 못하고 모순적인 이미지가 되었다. 병풍이 제작된 지 47년 만에 각 폭이 분리된 채 미술상을 통해 이왕가미술관 소장품이 된 상황을 보더라도, 박경빈이 <인왕선영도>에서 꿈꾸었던 명당 발복과 가문의 신분상승은 이루어지지 못했던 것으로 생각된다.

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

  • 방숙;한성현;이정자;안문영;이인숙;김은실;김종호
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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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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