• Title/Summary/Keyword: Recommended Service

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A Dynamic Behavior Evaluation of the Curved Rail according to Lateral Spring Stiffness of Track System (궤도시스템의 횡탄성에 따른 곡선부 레일의 동적거동평가)

  • Kim, Bag-Jin;Choi, Jung-Youl;Chun, Dae-Sung;Eom, Mac;Kang, Yun-Suk;Park, Yong-Gul
    • Proceedings of the KSR Conference
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    • 2007.11a
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    • pp.517-528
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    • 2007
  • Domestic or international existing researches regarding rail damage factors are focused on laying, vehicle conditions, driving speed and driving habits and overlook characteristics of track structure (elasticity, maintenance etc). Also in ballast track, as there is no special lateral spring stiffness of track also called as ballast lateral resistance in concrete track, generally, existing study shows concrete track has 2 time shorter life cycle for rail replacement than ballast track due to abrasion. As a result of domestic concrete track design and operation performance review, concrete track elasticity is lower than track elasticity of ballast track resulting higher damage on rail and tracks. Generally, concrete track has advantage in track elasticity adjustment than ballast track and in case of Europe, in concrete track design, it is recommended to have same or higher performance range of vertical elastic stiffness of ballast track but domestically or internationally review on lateral spring stiffness of track is very minimal. Therefore, through analysis of service line track on site measurement and analysis on performance of maintenance, in this research, dynamic characteristic behaviors of commonly used ballast and concrete track are studied to infer elasticity of service line track and experimentally prove effects of track lateral spring stiffness that influence curved rail damage as well as correlation between track elasticity by track system and rail damage to propose importance of appropriate elastic stiffness level for concrete and ballast track.

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The Relationship Between Emotional Labor and Influence Factor in Dental Hygienist Who Work at Jeonla Provinces (전라남·북 지역에 근무하는 치과위생사의 감정노동과 관련요인)

  • Ahn, Kwon-Suk;Choi, Mi-Suk
    • Journal of dental hygiene science
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    • v.10 no.6
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    • pp.431-438
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    • 2010
  • This study was designed to identify the relationship between emotional labor and reaction factor(job satisfaction, fatigue), buffer factor(social support) among dental hygienist. The number of respondents was 50 who work in dental clinic and period of investigation was march 2010 through April 2010. A structured questionnaire was employed to evaluate the level of participants' sociodemographics, job-related factors, health-related behaviors, emotional labor and self-perceived fatigue, job satisfaction, social support. While the mean values of emotional labor were higher than thosewho work in hospital and lower than those who work in service employees. These results suggest that emotional labor was related to an increase in fatigue and strong correlation between involuntary emotional expression, self-perceived fatigue, job satisfaction, social support in dental hygienist. Multiple regression analysis has found that social support and no. of personnel were main factors that influence to the level of emotional labor in dental hygienist. The results of this study suggest that emotional labor was a determinant predictor of self perceived fatigue. Thus, a management program for emotional labor is strongly recommended for promotion of quality of life in dental hygienist and to improve dental service and competitiveness.

Salinity Monitoring of Soups of The Institutions Enrolled at Center for Children's Foodservice Management (어린이급식관리지원센터 등록 시설 국물음식의 염도 모니터링)

  • Park, Hyun Nae;Kim, Soon Mi
    • Journal of the East Asian Society of Dietary Life
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    • v.26 no.6
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    • pp.507-516
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    • 2016
  • The salinity of soups of institutions enrolled at the Center for Children's Foodservice Management was monitored to reduce sodium intake of children by continuously managing salinity of soups provided by children food service. Monitoring of salinity was conducted by a salinity meter (SB-1500H, HM digital) three times in 2016 by patrolling children's institutions for the instruction of public health. The average salinity of soups provided by total children's institution showed a significant decrease in salinity - $1^{st}$ 0.45%, $2^{nd}$ 0.41% and $3^{rd}$ 0.39% - as monitoring was proceeded (p<0.01). When salinity of soups was analyzed according to the type of children's institution, the salinity of national and public institutions showed no significant decrease. In contrast, the salinity of private institutions decreased significantly (p<0.05). Depending on the enrollment of the food service, there was no significant difference in average salinity of soups between large food services, which have over 50 children, and small food services, which have less than 50 children. However, all food services showed a salinity decrease from the $1^{st}$ monitoring to the $3^{rd}$ monitoring. Salinity according to the type of soup showed that salinity of clear soup, miso soup, and stew except beef soup decreased from the $1^{st}$ monitoring to $3^{rd}$ monitoring. However, there was no significant difference in salinity according to the type of soup which can be attributed to a large difference in salinity among the same type of soup. The individual soup showing the biggest difference between maximum and minimum salinity of soup was egg soup (0.62%), potato soup (0.54%), and mushroom soup (0.64%). The present average salinity of soup provided by children's institutions was less than 0.5% which is the recommended standard of the Ministry of Food and Drug Safety. However, the salinity of soups should be managed within a certain range including the minimum salinity regarding the taste education of children.

Estimation of Reference Crop Evapotranspiration Using Backpropagation Neural Network Model (역전파 신경망 모델을 이용한 기준 작물 증발산량 산정)

  • Kim, Minyoung;Choi, Yonghun;O'Shaughnessy, Susan;Colaizzi, Paul;Kim, Youngjin;Jeon, Jonggil;Lee, Sangbong
    • Journal of The Korean Society of Agricultural Engineers
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    • v.61 no.6
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    • pp.111-121
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    • 2019
  • Evapotranspiration (ET) of vegetation is one of the major components of the hydrologic cycle, and its accurate estimation is important for hydrologic water balance, irrigation management, crop yield simulation, and water resources planning and management. For agricultural crops, ET is often calculated in terms of a short or tall crop reference, such as well-watered, clipped grass (reference crop evapotranspiration, $ET_o$). The Penman-Monteith equation recommended by FAO (FAO 56-PM) has been accepted by researchers and practitioners, as the sole $ET_o$ method. However, its accuracy is contingent on high quality measurements of four meteorological variables, and its use has been limited by incomplete and/or inaccurate input data. Therefore, this study evaluated the applicability of Backpropagation Neural Network (BPNN) model for estimating $ET_o$ from less meteorological data than required by the FAO 56-PM. A total of six meteorological inputs, minimum temperature, average temperature, maximum temperature, relative humidity, wind speed and solar radiation, were divided into a series of input groups (a combination of one, two, three, four, five and six variables) and each combination of different meteorological dataset was evaluated for its level of accuracy in estimating $ET_o$. The overall findings of this study indicated that $ET_o$ could be reasonably estimated using less than all six meteorological data using BPNN. In addition, it was shown that the proper choice of neural network architecture could not only minimize the computational error, but also maximize the relationship between dependent and independent variables. The findings of this study would be of use in instances where data availability and/or accuracy are limited.

Requirement Analysis for Agricultural Meteorology Information Service Systems based on the Fourth Industrial Revolution Technologies (4차 산업혁명 기술에 기반한 농업 기상 정보 시스템의 요구도 분석)

  • Kim, Kwang Soo;Yoo, Byoung Hyun;Hyun, Shinwoo;Kang, DaeGyoon
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.21 no.3
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    • pp.175-186
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    • 2019
  • Efforts have been made to introduce the climate smart agriculture (CSA) for adaptation to future climate conditions, which would require collection and management of site specific meteorological data. The objectives of this study were to identify requirements for construction of agricultural meteorology information service system (AMISS) using technologies that lead to the fourth industrial revolution, e.g., internet of things (IoT), artificial intelligence, and cloud computing. The IoT sensors that require low cost and low operating current would be useful to organize wireless sensor network (WSN) for collection and analysis of weather measurement data, which would help assessment of productivity for an agricultural ecosystem. It would be recommended to extend the spatial extent of the WSN to a rural community, which would benefit a greater number of farms. It is preferred to create the big data for agricultural meteorology in order to produce and evaluate the site specific data in rural areas. The digital climate map can be improved using artificial intelligence such as deep neural networks. Furthermore, cloud computing and fog computing would help reduce costs and enhance the user experience of the AMISS. In addition, it would be advantageous to combine environmental data and farm management data, e.g., price data for the produce of interest. It would also be needed to develop a mobile application whose user interface could meet the needs of stakeholders. These fourth industrial revolution technologies would facilitate the development of the AMISS and wide application of the CSA.

Analytical method study for cephalexin with high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) applicable for residue studies in the whiteleg shrimp Litopenaeus vannamei (흰다리새우(Litopenaeus vannamei)에서 cephalexin의 잔류농도 연구를 위한 LC-MS/MS 분석법 연구)

  • Yang, Chan Yeong;Bae, Jun Sung;Lee, Chae Won;Jeong, Eun Ha;Lee, Ji-Hoon;Bak, Su-Jin;Choi, Sang-Hoon;Park, Kwan Ha
    • Journal of fish pathology
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    • v.34 no.1
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    • pp.71-80
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    • 2021
  • Cephalexin, a semi-synthetic cephalosporin antibiotic, has long been used in fish aquaculture in various countries under legal authorization. The drug is thus widely available for use in other aquatic species except fishes like the crustacean whiteleg shrimp. This study aims to develop a sensitive method for laboratory residue studies to adopt in withdrawal period determinations. Through repeated trials from the existing methods developed for other food animal tissues, it was possible to achieve a sensitive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. The results showed that at a concentration of 0.1 mg/kg, the recovery rate was 81.79%, and C.V. value was 8.2%, which meet the recovery rate and C.V. recommended by Codex guideline. After satisfactory validation of analytical procedures, applicability to the shrimp tissue was confirmed in experimentally cephalexin-treated whiteleg shrimp. As a result, most muscle samples were detected below the limit of quantification (0.05 mg/kg) after day 3, and most hepatopancreas samples were detected below the limit of quantification after day 14. In particular, the limit of quantification 0.05 ppm with the presently developed method suggests sufficient sensitive over the current legal maximum residue limit of 0.2 mg/kg set for fishes.

A Study on the Crime Prevention Design and Consumer Perception (CPTED) of Multi-Family Housing in China (중국 공동주택의 범죄 예방을 위한 디자인과 소비자의 인식에 관한 연구)

  • Kong, De Xin;Lee, Dong Hun;Park, Hae Rim
    • Journal of Service Research and Studies
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    • v.14 no.1
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    • pp.63-76
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    • 2024
  • Multi-family housing plays a crucial role as a living and experiencing space, and its environment has a direct impact on the well-being and stability of its residents. Therefore, Crime Prevention Design (CPTED) for multi-family housing is of utmost importance. However, crime-related data in China is not disclosed to the public because of its specificity, making it difficult for researchers to conduct further in-depth studies based on accurate crime data. As a result, the establishment and application of CPTED theory in terms of crime prevention is limited and delayed. This study aims to explore three aspects of CPTED in multi-family housing as perceived by home-buying consumers. It investigated consumer perception of the CPTED, the importance of each element and ways to increase awareness of CPTED in multifamily housing in order to effectively improve multifamily crime prevention design principles and further enhance public safety. This study examined the current state and future trends of CPTED in China by analyzing relevant research reports and literature, aiming to gain insights into the crime prevention awareness of Chinese homeowners. In addition, a survey was conducted on Chinese consumers to unravel the importance of CPTED and increase awareness of its various elements in multifamily-family. This study used a Likert scale and SPSS reliability analysis to determine the cognitive status of multi-family CPTED, the importance of each element, and proposed an improvement plan based on the analysis results. As this study was limited by the difficulty of implementation and the lack of validation of its practical effectiveness, it is recommended that future research needs to validate the effectiveness of crime prevention designs and produce more practical results. Furthermore, it is crucial to utilize this study to inform the implementation of security solutions that are tailored to the unique characteristics of each district. Additionally, it is important to offer guidance on how to enhance community safety by increasing residents' awareness of security through education and information dissemination. The author hopes that the representative multi-family CPTED awareness, the importance of each element, and plans for improvement shall be summarized from this study, and provide foundational data for the future development of CPTED based on the Chinese region.

Research Framework for International Franchising (국제프랜차이징 연구요소 및 연구방향)

  • Kim, Ju-Young;Lim, Young-Kyun;Shim, Jae-Duck
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.61-118
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    • 2008
  • The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.

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Surrogate Internet Shopping Malls: The Effects of Consumers' Perceived Risk and Product Evaluations on Country-of-Buying-Origin Image (망상대구점(网上代购店): 소비자감지풍험화산품평개대원산국형상적영향(消费者感知风险和产品评价对原产国形象的影响))

  • Lee, Hyun-Joung;Shin, So-Hyoun;Kim, Sang-Uk
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.208-218
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    • 2010
  • Internet has grown fast and become one of the most important retail channels now. Various types of Internet retailers, hereafter etailers, have been introduced so far and as one type of Internet shopping mall, 'surrogate Internet shopping mall' has been prosperous and attracting consumers in the domestic market. Surrogate Internet shopping mall is a unique type of etailer that globally purchases well-known brand goods that are not imported in the market, completes delivery in the favor of individual buyers, and collects fees for these specific services. The consumers, who are usually interested in purchasing high-end and unique but not eligible brands, have difficulties to purchase these items overseas directly from the retailers or brands in other countries due to worries of payment failure and no address available for their usually domestic only delivery. In Korea, both numbers of surrogate Internet shopping malls and the magnitude of sales have been growing rapidly up to more than 430 active malls and 500 billion Korean won in 2008 since the population of consumers who want this agent shopping service is also expending. This etail business concept is originated from 'surrogate-mediated purchase' and this type of shopping agent has existed in many different forms and also in wide ranges of context level for quite a long time. As marketers face their individual buyers' representatives instead of a direct contact with them in many occasions, the impact of surrogate shoppers on consumer's decision making has been enormously important and many scholars have explored various range of agent's impact on consumer's purchase decisions in marketing and psychology field. However, not much rigorous research in the Internet commerce has been conveyed yet. Moreover, since as one of the shopping agent surrogate Internet shopping malls specifically connect overseas brands or retailers to domestic consumers, one specific character of the mall's, image of surrogate buying country, where surrogate purchases are conducted in, may play an important role to form consumers' attitude and purchase intention toward products. Furthermore it also possibly affects various dimensions of perceived risk in consumer's information processing. However, though tremendous researches have been carried exploring the effects of diverse dimensions of country of origin, related studies in Internet context has been rarely executed. There have been some studies that prove the positive impact of country of origin on consumer's evaluations as one of information clues in product manufacture descriptions, yet studies detecting the relationship between country image of surrogate buying origin and product evaluations rarely undertaken regarding this specific mall type. Thus, the authors have found it well-worth investigating in this specific retail channel and explored systematic relationships among focal constructs and elaborated their different paths. The authors have proven that country image of surrogate buying origin in the mall, where surrogate malls purchase products in and brings them from for buyers, not only has a positive effect on consumers' product evaluations including attitude and purchase intention but also has a negative effect on all three dimensions of perceived risk: product-related risk, shipping-related risk, and post-purchase risk. Specifically among all the perceived risk, product-related risk which is arisen from high uncertainty of product performance is most affected (${\beta}$= -.30) by negative country image of surrogate buying origin, and also shipping-related risk (${\beta}$= -.18) and post-purchase risk (${\beta}$= -.15) get influenced in order. Its direct effects on product attitude (${\beta}$= .10) and purchase intention (${\beta}$= .14) are also secured. Each of perceived risk dimension is proven to have a negative effect on purchase intention through product attitude as a mediator (${\beta}$= -.57: product-related risk ${\rightarrow}$ product attitude; ${\beta}$= -.24: shipping-related risk ${\rightarrow}$ product attitude; ${\beta}$= -.44: post-purchase risk ${\rightarrow}$ product attitude) as well. From the additional analysis, the paths of consumers' information processing are shown to be different based on their levels of product knowledge. While novice consumers with low level of knowledge consider only perceived risk important, expert consumers with high level of knowledge take both the country image, where surrogate services are conducted in, and perceived risk seriously to build their attitudes and formulate decisions toward products more delicately and systematically, which is in line with previous studies. This study suggests several pieces of academic and practical advice. Precisely, country image of surrogate buying origin does affect on consumer's risk perceptions and behavioral consequences. Therefore a careful selection of surrogate buying origin is recommended. Furthermore, reducing consumers' risk level is required to blossom this new type of retail business whether its consumer are novices or experts. Additionally, since consumer take different paths of elaborating information based on their knowledge levels, sophisticated marketing approaches to each group of consumers are required. For novice buyers strong devices for risk mitigation are needed to induce them to form better attitudes and for experts selections of better and advanced countries as surrogate buying origins are advised while endorsement strategy for the site might work as a reliable information clue to all consumers to mitigate the barriers to purchase goods online. The authors have also explained that the study suffers from some limitations, including generalizability. In future studies, tests of and comparisons among different types of etailers with relevant constructs are recommended to broaden the findings.

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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