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Hepatoprotective Effects of the Extracts of Alnus japonica Leaf on Alcohol-Induced Liver Damage in HepG2/2E1 Cells (알코올로 유도된 간손상 모델 HepG2/2E1 세포에서 오리나무 잎 추출물의 간보호효과)

  • Bo-Ram Kim;Tae-Su Kim;Su Hui Seong;Seahee Han;Jin-Ho Kim;Chan Seo;Ha-Nul Lee;Sua Im;Jung Eun Kim;Ji Min Jung;Do-Yun Jeong;Kyung-Min Choi;Jin-Woo Jeong
    • Korean Journal of Plant Resources
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    • v.37 no.2
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    • pp.120-129
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    • 2024
  • Alcoholic liver disease (ALD) is a significant risk factor in the global disease burden. The stem bark of the Betulaceae plant Alnus japonica, which is indigenous to Korea, has been used as a popular folk medicine for hepatitis and cancer. However, the preventive effect of Alnus japonica leaf extracts on alcohol-related liver damage has not been investigated. The objective of this study was to investigate the hepatoprotective effects of the extracts of Alnus japonica leaf (AJL) against ethanol-induced liver damage in HepG2/2E1 cells. Treatment with AJL significantly prevented ethanol-induced cytotoxicity in HepG2/2E1 cells by reducing the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). This protective effect was likely associated with antioxidant potential of AJL, as evidenced by the attenuation of reactive oxygen species (ROS) and malondialdehyde (MDA) production and restoration of the depleted glutathione (GSH) levels in ethanol-induced HepG2/2E1 cells. Our findings suggest that FCC might be considered as a useful agent in the prevention of liver damage induced by oxidative stress by increasing the antioxidant defense mechanism.

Development of evaluation items for adolescents' dietary habits and nutritional practices reflecting eating behaviors and food environment (식행동, 식생활 환경을 반영한 청소년의 식생활·영양 실천 평가 항목 개발)

  • Jimin Lim;Hye Ji Seo;Jieun Oh
    • Journal of Nutrition and Health
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    • v.57 no.1
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    • pp.136-152
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    • 2024
  • Purpose: A comprehensive evaluation item was developed to assess adolescent dietary habits and nutritional practices, considering food intake, eating behaviors, and food culture, such as social support and food environment. Methods: The 59 candidate items of the evaluation checklist were obtained based on the results of the eighth Korea National Health and Nutrition Examination Survey data, Korea Dietary Reference Intakes, dietary guidelines for adolescents, Youth Risk Behavior Survey data, national nutrition policies and dietary guidelines, and literature reviews. Four hundred and three middle and high school students residing in metropolitan areas participated in a survey using the 58-item checklist, which was selected through expert evaluation and content validity ratio analysis. The construct validity of the assessment tool for the quality of adolescent diets was assessed by exploratory factor analyses to determine if the checklist items were organized properly and whether the responses to each item were distributed adequately. Results: The Bartlett sphericity test was significant for each area (p <0.001), and the eigen values were greater than one. The Kaiser-Meyer-Olkin and cumulative proportions by areas were food intake (0.765 and 56.8%, respectively), eating behaviors (0.544 and 64.8%, respectively), and food environment (0.699 and 62.4%, respectively). Twenty-two checklists were determined for the final evaluation items for the adolescents' dietary habits and nutritional practices and were categorized into three distinct factors: food intake (10 items), eating behaviors (4 items), and food environment (8 items). Conclusion: The evaluation items for adolescent dietary habits and nutritional practices is a useful checklist for easily and quickly assessing the dietary qualities and reflecting Korean adolescents and their food environmental factors related to a sustainable diet.

Macrobenthic Community Structure Along the Environmental Gradients of Ulsan Bay, Korea (울산만의 저서환경 구배에 따른 저서동물군집 구조)

  • Yoon, Sang-Pil;Jung, Rae-Hong;Kim, Youn-Jung;Kim, Seong-Gil;Choi, Min-Kyu;Lee, Won-Chan;Oh, Hyun-Taik;Hong, Sok-Jin
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.14 no.2
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    • pp.102-117
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    • 2009
  • This study was carried out to investigate the extent to which benthic environment of Ulsan Bay was disturbed by organic materials and trace metals from the megacity and industrial complex. Field survey for benthic environment and macroinvertebrate community was seasonally conducted from February to November 2006 at nine stations covering the inside and outside of the bay. TOC was on average 1.7% while four (As, Cu, Pb, Zn) out of seven trace metals measured exceeded the Effects Range Low (ERL) in most of the stations. Total number of species sampled was 199 and mean density was 4,578 ind./$m^2$, both of which were greatly dominated by the polychaetes. Dominant species were Aphelochaeta monilaris (22.6%), Ruditapes philippinarum (17.1%), Magelona japonica (12.2%), Lumbrineris longifolia (9.9%) and their distribution was ruled by the difference in the benthic environmental condition of each station. From the multivariate analyses, four stational groups were identified: northern part of the bay, middle and lower part of the bay, the intersection of Taewha River and Gosa stream and outside of the bay. As a result, the community heterogeneity of inner bay was much more greater than that of outer bay. SIMPER analysis showed that four groups were represented by R. philippinarum-Capitella capitata, A. monilaris-Balanoglossus carnosus, Sinocorophium sinensis-Cyathura higoensis and M. japonica-Ampharete arctica, respectively. Spatio-temporal changes of macroinvertebrate communities in Ulsan Bay were closely related to those of depth, mean grain size and organic content, and Zn was also a meaningful factor in that context.

Distribution and Remineralization Ratio of Inorganic Nutrients in the Divergence Zone($7^{\circ}{\sim}10.5^{\circ}N$), Northeastern Pacific (북동태평양 발산대 해역($7^{\circ}{\sim}10.5^{\circ}N$)의 무기영양염 분포와 재무기질화 비율)

  • Son, Ju-Won;Kim, Kyeong-Hong;Kim, Mi-Jin;Son, Seung-Kyu;Chi, Sang-Bum;Hwang, Keun-Choon;Park, Yong-Chul
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.13 no.3
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    • pp.178-189
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    • 2008
  • The distribution of inorganic nutrients and their remineralization ratio in the divergence zone ($7^{\circ}{\sim}10.5^{\circ}N$) of the northeastern Pacific were investigated from July 2003 to July 2007. A divergence zone along the boundary of the North Equatorial Counter Current (NECC) and North Equatorial Current (NEC) at $10^{\circ}N$ was observed in July 2007 when the La Nina event and divergence-related upwelling was strong. The mean depth of oligotrophic surface mixed layer in the divergence zone was 46, 61, and 30 m in July 2003, August 2005, and July 2007, respectively. Below the surface mixed layer, a nutricline was clearly observed. The depth integrated value of nitrate including nitrite (DIVn) in the upper layer($0{\sim}100$ m depth) ranged from 5.51 to 21.71 $gN/m^2$(mean 12.82 $gN/m^2$) in July 2003, from 5.62 to 8.46 $gN/m^2$ (mean 7.15 $gN/m^2$) in August 2005, and from 8.98 to 27.80 $gN/m^2$(mean 21.12 $gN/m^2$) in July 2007. The maximum DIVn was observed at the divergence zone. The distributions of phosphate(DIVp) and silicate(DIVsi) were similar to that of DIVn and the DIVn/DIVsi ratio was $0.87{\pm}0.11$ in the upper layer. The limiting nutrient for phytoplankton growth in the study area was identified as nitrogen(N/P ratio=14.6). The nitrate (including nitrite) concentrations were lower in the region mainly affected by NEC than in the region affected by NECC. The study area of low silicate concentrations was also considered to be Si-limiting environment. The remineralization ratios of nutrients were $P/N/-O_2=1/14.6{\pm}1.1/100.4{\pm}8.8(23.44{\leq}Sigma-{\theta}{\leq}26.38)$ in the study area. These ratios suggested remineralization process in the surface layer of divergence zone.

The Association of Dual Job on Dental Hygienists' Job Satisfaction (치과위생사의 직무만족도와 동시일자리(부업)의 관련성)

  • Mi-Sook Yoon;Go-eun Kim;Han-A Cho
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.51-64
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    • 2023
  • Background: This study was conducted to determine the association with dual jobbing on dental hygienists' job satisfaction and to identify the factors that lead to dual jobs. Methods: This study was an online survey of 110 currently employed dental hygienists conducted during the month of May 2022. To determine job satisfaction, we used the 20-item Korea-Minnesota Satisfaction Questionnaire (K-MSQ). Survey questions related to dual job were adapted and supplemented from the dual job survey instrument for dental hygienists to identify intention to dual job and future intention to dual job. Descriptive statistics, independent t-test, ANOVA and Scheffe's post hoc analysis, and multiple logistic regression were performed. Results: The dual job rate and future dual job rate of the participants in this study were about 27% and 47%, respectively. The means for Intrinsic job satisfaction, Extrinsic job satisfaction, and job satisfaction were 3.44, 3.15, and 3.36, respectively. It was statistically significant that extrinsic job satisfaction increased with increasing position, and intrinsic job satisfaction, extrinsic job satisfaction, and job satisfaction increased with increasing salary. Those currently working dual jobs cited "self-actualization" as a reason for doing so, and those who intended to work dual jobs in the future cited "not being paid enough in their primary job" as a reason. We found that a one-unit increase in intrinsic job satisfaction and job satisfaction increases the odds of future intention to dual job by about 1.07 and 1.05 times, respectively (p<0.05). Conclusion: This study confirmed the influence of dental hygienists' job satisfaction on intention to dual job and future intention to dual job, and self-actualization was found to be the main factor. Therefore, the consideration of dual jobs in the future will affect the improvement of dental hygienists as professionals and the reduction of turnover through better working conditions.

An Empirical Study on Influencing Factors of Venture Firm's CSR: Focusing on Slack Resources and Growth Strategy (벤처기업의 사회적책임(CSR)활동의 영향요인에 관한 연구: 기업의 여유자원과 성장전략을 중심으로)

  • Jang, Dong-Hyun;Yeon, Ju-Han;Kim, Chun-Kyu
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.3
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    • pp.27-40
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    • 2024
  • This study empirically derives the factors affecting the practice of corporate social responsibility (CSR) of venture firms in Korea from the perspective of Slack Resource Theory and the company's growth strategy, and provides implications for future expansion of venture firm's CSR activities. In Korea, venture firms have grown into important players in the national economy since the late 1990s through social contributions such as economic value creation, job creation, and technological development. As venture companies grow in status, positive relationships with stakeholders and responsibility for environmental and social values are required. Now, CSR is becoming an important strategic choice for SMEs and venture firms. However, until now, CSR-related academic research has mainly focused on large or listed corporations, and there is not much research on SMEs or venture firms. In particular, research on the factors that lead venture companies to make important business decisions of participating in CSR activities is not there yet. This study applied logistic multiple regression analysis using the '2023 Survey on Venture Firms' conducted by the Ministry of SMEs and Startups. As a result of this study, operating profit, which is an available resources of venture companies, and government support, which is a potential resource, have a positive impact on venture firms's CSR activities. Also, business relationships with large corporations and expectation for future cooperation also have a positive impact on CSR activities as the determinants. On the other hand, it was analyzed that in venture firms where ownership and management are not separated, the higher the CEO's shareholding ratio, the more negatively it affects CSR activities. This study contributes academically as the first empirical study on the determinants of CSR activities of venture firms in Korea and provides implications that government policy support and collaboration between large corporations and venture firms are important in order to expand CSR activities of venture firms.

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The Influence of Store Environment on Service Brand Personality and Repurchase Intention (점포의 물리적 환경이 서비스 브랜드 개성과 재구매의도에 미치는 영향)

  • Kim, Hyoung-Gil;Kim, Jung-Hee;Kim, Youn-Jeong
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.141-173
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    • 2007
  • The study examines how the environmental factors of store influence service brand personality and repurchase intention in the service environment. The service industry has been experiencing the intensified competition with the industry's continuous growth and the influence from rapid technological advancement. Under the circumstances, it has become ever more important for the brand competitiveness to be distinctively recognized against competition. A brand needs to be distinguished and differentiated from competing companies because they are all engaged in the similar environment of the service industry. The differentiation of brand achievement has become increasingly important to highlight certain brand functions to include emotional, self-expressive, and symbolic functions since the importance of such functions has been further emphasized in promoting consumption activities. That is the recent role of brand personality that has been emphasized in the service industry. In other words, customers now freely and actively express their personalities or egos in consumption activities, taking an important role in construction of a brand asset. Hence, the study suggests that it is necessary to disperse the recognition and acknowledgement that the maintenance of the existing customers contributes more to boost repurchase intention when it is compared to the efforts to create new customers, particularly in the service industry. Meanwhile, the store itself can offer a unique environment that may influence the consumer's purchase decision. Consumers interact with store environments in the process of,virtually, all household purchase they make (Sarel 1981). Thus, store environments may encourage customers to purchase. The roles that store environments play are to provide informational cues to customers about the store and goods and communicate messages to stimulate consumers' emotions. The store environments differentiate the store from competing stores and build a unique service brand personality. However, the existing studies related to brand in the service industry mostly concentrated on the relationship between the quality of service and customer satisfaction, and they are mostly generalized while the connective studies focused on brand personality. Such approaches show limitations and are insufficient to investigate on the relationship between store environment and brand personality in the service industry. Accordingly, the study intends to identify the level of contribution to the establishment of brand personality made by the store's physical environments that influence on the specific brand characteristics depending on the type of service. The study also intends to identify what kind of relationships with brand personality exists with brand personality while being influenced by store environments. In addition, the study intends to make meaningful suggestions to better direct marketing efforts by identifying whether a brand personality makes a positive influence to induce an intention for repurchase. For this study, the service industry is classified into four categories based on to the characteristics of service: experimental-emotional service, emotional -credible service, credible-functional service, and functional-experimental service. The type of business with the most frequent customer contact is determined for each service type and the enterprise with the highest brand value in each service sector based on the report made by the Korea Management Association. They are designated as the representative of each category. The selected representatives are a fast-food store (experimental-emotional service), a cinema house (emotional-credible service), a bank (credible-functional service), and discount store (functional-experimental service). The survey was conducted for the four selected brands to represent each service category among consumers who are experienced users of the designated stores in Seoul Metropolitan City and Gyeonggi province via written questionnaires in order to verify the suggested assumptions in the study. In particular, the survey adopted 15 scales, which represent each characteristic factor, among the 42 unique characteristics developed by Jennifer Aaker(1997) to assess the brand personality of each service brand. SPSS for Windows Release 12.0 and LISREL were used in the analysis of data verification. The methodology of the structural equation model was used for the study and the pivotal findings are as follows. 1) The environmental factors ware classified as design factors, ambient factors, and social factors. Therefore, the validity of measurement scale of Baker et al. (1994) was proved. 2) The service brand personalities were subdivided as sincerity, excitement, competence, sophistication, and ruggedness, which makes the use of the brand personality scales by Jennifer Aaker(1997) appropriate in the service industry as well. 3) One-way ANOVA analysis on the scales of store environment and service brand personality showed that there exist statistically significant differences in each service category. For example, the social factors were highest in discount stores, while the ambient factors and design factors were highest in fast-food stores. The discount stores were highest in the sincerity and excitement, while the highest point for banks was in the competence and ruggedness, and the highest point for fast-food stores was in the sophistication, The consumers will make a different respond to the physical environment of stores and service brand personality that are inherent to the corresponding service interface. Hence, the customers will make a different decision-making when dealing with different service categories. In this aspect, the relationships of variables in the proposed hypothesis appear to work in a different way depending on the exposed service category. 4) The store environment factors influenced on service brand personalities differently by category of service. The factors of store's physical environment are transferred to a brand and were verified to strengthen service brand personalities. In particular, the level of influence on the service brand personality by physical environment differs depending on service category or dimension, which indicates that there is a need to apply a different style of management to a different service category or dimension. It signifies that there needs to be a brand strategy established in order to positively influence the relationship with consumers by utilizing an appropriate brand personality factor depending on different characteristics by service category or dimension. 5) The service brand personalities influenced on the repurchase intention. Especially, the largest influence was made in the sophistication dimension of service brand personality scale; the unique and characteristically appropriate arrangement of physical environment will make customers stay in the service environment for a long time and will lead to give a positive influence on the repurchase intention. 6) The store environment factors influenced on the repurchase intention. Particularly, the largest influence was made on the social factors of store environment. The most intriguing finding is that the service factor among all other environment factors gives the biggest influence to the repurchase intention in most of all service types except fast-food stores. Such result indicates that the customers pay attention to how much the employees try to provide a quality service when they make an evaluation on the service brand. At the same time, it also indicates that the personal factor is directly transmitted to the construction of brand personality. The employees' attitude and behavior are the determinants to establish a service brand personality in the process of enhancing service interface. Hence, there should be a reinforced search for a method to efficiently manage the service staff who has a direct contact with customers in order to make an affirmative improvement of the customers' brand evaluation at the service interface. The findings suggest several managerial implications. 1) Results from the empirical study indicated that store environment factors have a strong positive impact on a service brand personality. To increase customers' repurchase intention of a service brand, the management is required to effectively manage store environment factors and create a friendly brand personality based on the corresponding service environment. 2) Mangers and researchers must understand and recognize that the store environment elements are important marketing tools, and that brand personality influences on consumers' repurchase intention. Based on such result of the study, a service brand could be utilized as an efficient measure to achieve a differentiation by enforcing the elements that are most influential among all other store environments for each service category. Therefore, brand personality established involving various store environments will further reinforce the relationship with customers through the elevated brand identification of which utilization to induce repurchase decision can be used as an entry barrier. 3) The study identified the store environment as a component of service brand personality for the store's effective communication with consumers. For this, all communication channels should be maintained with consistency and an integrated marketing communication should be executed to efficiently approach to a larger number of customers. Mangers and researchers must find strategies for aligning decisions about store environment elements with the retailers' marketing and store personality objectives. All ambient, design, and social factors need to be orchestrated so that consumers can take an appropriate store personality. In this study, the induced results from the previous studies were extended to the service industry so as to identify the customers' decision making process that leads to repurchase intention and a result similar to those of the previous studies. The findings suggested several theoretical and managerial implications. However, the situation that only one service brand served as the subject of analysis for each service category, and the situation that correlations among store environment elements were not identified, as well as the problem of representation in selection of samples should be considered and supplemented in the future when further studies are conducted. In addition, various antecedents and consequences of brand personality must be looked at in the aspect of the service environment for further research.

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A Study on the Relationship Between Online Community Characteristics and Loyalty : Focused on Mediating Roles of Self-Congruency, Consumer Experience, and Consumer to Consumer Interactivity (온라인 커뮤니티 특성과 충성도 간의 관계에 대한 연구: 자아일치성, 소비자 체험, 상호작용성의 매개적 역할을 중심으로)

  • Kim, Moon-Tae;Ock, Jung-Won
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.157-194
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    • 2008
  • The popularity of communities on the internet has captured the attention of marketing scholars and practitioners. By adapting to the culture of the internet, however, and providing consumer with the ability to interact with one another in addition to the company, businesses can build new and deeper relationships with customers. The economic potential of online communities has been discussed with much hope in the many popular papers. In contrast to this enthusiastic prognostications, empirical and practical evidence regarding the economic potential of the online community has shown a little different conclusion. To date, even communities with high levels of membership and vibrant social arenas have failed to build financial viability. In this perspective, this study investigates the role of various kinds of influencing factors to online community loyalty and basically suggests the framework that explains the process of building purchase loyalty. Even though the importance of building loyalty in an online environment has been emphasized from the marketing theorists and practitioners, there is no sufficient research conclusion about what is the process of building purchase loyalty and the most powerful factors that influence to it. In this study, the process of building purchase loyalty is divided into three levels; characteristics of community site such as content superiority, site vividness, navigation easiness, and customerization, the mediating variables such as self congruency, consumer experience, and consumer to consumer interactivity, and finally various factors about online community loyalty such as visit loyalty, affect, trust, and purchase loyalty are those things. And the findings of this research are as follows. First, consumer-to-consumer interactivity is an important factor to online community purchase loyalty and other loyalty factors. This means, in order to interact with other people more actively, many participants in online community have the willingness to buy some kinds of products such as music, content, avatar, and etc. From this perspective, marketers of online community have to create some online environments in order that consumers can easily interact with other consumers and make some site environments in order that consumer can feel experience in this site is interesting and self congruency is higher than at other community sites. It has been argued that giving consumers a good experience is vital in cyber space, and websites create an active (rather than passive) customer by their nature. Some researchers have tried to pin down the positive experience, with limited success and less empirical support. Web sites can provide a cognitively stimulating experience for the user. We define the online community experience as playfulness based on the past studies. Playfulness is created by the excitement generated through a website's content and measured using three descriptors Marketers can promote using and visiting online communities, which deliver a superior web experience, to influence their customers' attitudes and actions, encouraging high involvement with those communities. Specially, we suggest that transcendent customer experiences(TCEs) which have aspects of flow and/or peak experience, can generate lasting shifts in beliefs and attitudes including subjective self-transformation and facilitate strong consumer's ties to a online community. And we find that website success is closely related to positive website experiences: consumers will spend more time on the site, interacting with other users. As we can see figure 2, visit loyalty and consumer affect toward the online community site didn't directly influence to purchase loyalty. This implies that there may be a little different situations here in online community site compared to online shopping mall studies that shows close relations between revisit intention and purchase intention. There are so many alternative sites on web, consumers do not want to spend money to buy content and etc. In this sense, marketers of community websites must know consumers' affect toward online community site is not a last goal and important factor to influnece consumers' purchase. Third, building good content environment can be a really important marketing tool to create a competitive advantage in cyberspace. For example, Cyworld, Korea's number one community site shows distinctive superiority in the consumer evaluations of content characteristics such as content superiority, site vividness, and customerization. Particularly, comsumer evaluation about customerization was remarkably higher than the other sites. In this point, we can conclude that providing comsumers with good, unique and highly customized content will be urgent and important task directly and indirectly impacting to self congruency, consumer experience, c-to-c interactivity, and various loyalty factors of online community. By creating enjoyable, useful, and unique online community environments, online community portals such as Daum, Naver, and Cyworld are able to build customer loyalty to a degree that many of today's online marketer can only dream of these loyalty, in turn, generates strong economic returns. Another way to build good online community site is to provide consumers with an interactive, fun, experience-oriented or experiential Web site. Elements that can make a dot.com's Web site experiential include graphics, 3-D images, animation, video and audio capabilities. In addition, chat rooms and real-time customer service applications (which link site visitors directly to other visitors, or with company support personnel, respectively) are also being used to make web sites more interactive. Researchers note that online communities are increasingly incorporating such applications in their Web sites, in order to make consumers' online shopping experience more similar to that of an offline store. That is, if consumers are able to experience sensory stimulation (e.g. via 3-D images and audio sound), interact with other consumers (e.g., via chat rooms), and interact with sales or support people (e.g. via a real-time chat interface or e-mail), then they are likely to have a more positive dot.com experience, and develop a more positive image toward the online company itself). Analysts caution, however, that, while high quality graphics, animation and the like may create a fun experience for consumers, when heavily used, they can slow site navigation, resulting in frustrated consumers, who may never return to a site. Consequently, some analysts suggest that, at least with current technology, the rule-of-thumb is that less is more. That is, while graphics etc. can draw consumers to a site, they should be kept to a minimum, so as not to impact negatively on consumers' overall site experience.

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Problems in the Korean National Family Planning Program (한국가족계획사업(韓國家族計劃事業)의 문제점(問題點))

  • Hong, Jong-Kwan
    • Clinical and Experimental Reproductive Medicine
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    • v.2 no.2
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    • pp.27-36
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    • 1975
  • The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

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