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The Association Between Number of Remaining Teeth and Health-related Quality of Life(GOHAI) by Economic Activity Status in Elderly: Ninth Wave of the Korean Longitudinal Study of Ageing(KLoSA) (노인의 경제활동 상태에 따른 잔존치아수와 구강 건강관련 삶의 질(GOHAI)의 관련성: 고령화연구 패널조사 9차 자료를 이용하여)

  • Han-A Cho
    • Journal of Korean Dental Hygiene Science
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    • v.7 no.1
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    • pp.1-15
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    • 2024
  • Background: This study aims to determine the association between the number of remaining teeth and oral health-related quality of life according to economic activity status in elderly. Methods: Data from the 9th Korean Longitudinal Study of Ageing (KLoSA) were used to analyze 6,004 older adults aged 59 years and older. The number of remaining teeth was categorized as less than 20 and more than 20, and the Geriatric Oral Health Assessment Index (GOHAI) was used to measured the oral health-related quality of life of the elderly. Independent t-tests were performed to compare demographic, economic, sociodemographic, and health characteristics, as well as GOHAI scores, between economically active and inactive individuals. In the case of ANOVA analysis, Scheffe's post hoc analysis was performed to confirm statistical significance between groups. Linear regression analysis was conducted to determine the influence of the number of remaining teeth on GOHAI according to economic activity status. Results: Among the study population, 33.9% were economically active, which is approximately half the proportion of those were not economically active. The mean GOHAI scores were 43.32 and 40.15 for economically active and economically inactive individuals with 20 or more residual teeth, respectively (p<0.001). Simple linear regression analysis revealed that having more than 20 remaining teeth was associated with a statistically significant increase in GOHAI by approximately 4.56 times and 4.92 times compared to having fewer than 20 teeth for economically active and non-economically active individuals, respectively (p<0.001). Multiple linear regression analysis, adjusted for demographic, economic, sociodemographic, and health characteristics, showed that having more than 20 remaining teeth was associated with a statistically significant increase in GOHAI by approximately 3.62 and 2.97 times compared to having fewer than 20 teeth in economically active and non-economically active individuals, respectively (p<0.001). Conclusion: This study explored economic activity status as one of several approaches to enhance the oral health-related quality of life of the elderly. By using the number of remaining teeth as an indicator of oral health status. supporting economic activity could potentially improve both oral health and overall quality of life for older individuals. Such interventions may have positive effects on policy outcomes, including reducing economic inequality by promoting economic engagement among the elderly.

Effects of Adsorption and Decomposition on the Removal of Total Organic Carbon (TOC) in Oil Wastewater by Cellulose-based Pseudo Graphene and Persulfate (셀룰로오스 기반 유사-그래핀과 과황산염에 의한 압연류 폐수내 총유기탄소(TOC) 흡착 및 분해효과 연구)

  • Song-I Kim;Ji-Young Shin;Kyung-Chul Park;Jae-Kyu Yang;Dong-Su Kim
    • Journal of the Korea Organic Resources Recycling Association
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    • v.32 no.3
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    • pp.5-18
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    • 2024
  • Chemical oxygen demand (COD), an organic material measurement index, has a limit to the management of the total amount of all organic materials including non-degradable organic materials due to low oxidation rate. So total organic carbon (TOC) that can measure organic materials more accurately is introduced and used as a measurement index. Several environmental companies including company A in Gyeonggi-do dilute raw wastewater first and then treats it with chemicals. And an activated carbon is used at the rear stage to treat total organic carbon even though various treatment processes can be applied to reduce TOC in wastewater. There are some problems such as use of a lot of diluting water and generation of an excessive amount of sludge, so it is urgent to come up with an alternative plan. Therefore, in this study, an application experiment was conducted on two different methods for improving the TOC reduction efficiency of waste water from Company A. The first method is the evaluation of the substitution potential of powered activated carbon(PAC), an adsorbent currently used, by manufacturing cellulose-based graphene like carbon (CGLC). This first study showed that CGLC had about 10% higher TOC adsorption efficiency than commercial PAC, showing the possibility of being applied as an alternative adsorbent for PAC in water treatment sites. The second method relates to the removal of TOC by sulfate radials produced by persulfate (PS) activation. Two activation methods were applied: using CGLC and PAC as carbon-based catalyst and using the high temperature of wastewater for PS activation. As a result of using PAC and CGLC as PS activation materials, the TOC removal rate was lower than the adsorption amount of TOC by CGLC and PAC due to excessive chlorine ions present in the real wastewater. However, as a result of using the high water temperature (55~60℃) of the field wastewater for PS activation, it showed a much greater TOC removal efficiency than PAC alone, CGLC alone, and using a carbon-based catalyst for PS activation. When PS was injected more than 0.5%, it showed a TOC removal efficiency of 95% or more within 24 hr. In addition, when PS was injected more than 0.3%, the TOC concentration could be lowered to less than 75 ppm, which is the wastewater discharge standard applied to company A. When these results were summarized, raw wastewater of high temperature can be treated with a simple process of only adding of PS and discharged by treating TOC below the wastewater discharge standard applied to company A.

A Study on Nutritive Values and Salt Contents of Commercially Prepared Take-Out Boxed-Lunch In Korea (한국형 시판 도시락의 영양가 및 식염함량)

  • Kim, Bok-Hee;Lee, Eun-Wha;Kim, Won-Kyung;Lee, Yoon-Na;Kwak, Chung-Shil;Mo, Sumi
    • Journal of Nutrition and Health
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    • v.24 no.3
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    • pp.230-242
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    • 1991
  • This research was conducted on the 10 take-out boxed-lunches commercially prepared in the department stores. chain stores. and the public railroad trains in Korea. Sampling was conducted from February 1990 to March 1990. Nutritive values and sodium contents of the 10 boxed-lunch samples are summarized as follows : 1) The average weight(percentage) of the cooked rice and the side dishes were 304.6g(49.4) and 312.4(506%), respectively. The weight of these samples were significantly heavier than that of Japanese style boxed-lunches. 2) The average number of the side dishes was 12. The average numbers of food items classified by the five food groups were 6.1 in protein food group, 0.3 in calcium food group. 6.0 in vitamin and mineral food group. 1.5 in carbohydrate food group, and 1.5 in oil and fat food group. 3) They contained on the average 840.7kcal of energy, 38.9g of protein, 22.7g of fat, 120.4g of carbohydrate. 300.8mg of calcium. 410.8mg of phosphours, 6.61 mg of iron. 219.8 R.E. of vitamin A, 0.46mg of thiamin, 0.67mg of riboflavin, 10.5mg of niacin, 27.5mg of ascorbic acid. Thus. except vitamin t the content of all the nutrients were higher than the value of 1/3 of the RDA for adults. 4) The high priced group(group 2) had more protein, calcuim. iron and niacin contents than the cheaper group(group 1). Probably, it's because the group 2 had more animal foods than the group 1. 5) The average energy content per unit price(100 won) was 37.3kcal and the average protein content per unit price(100 won) was 1.64g. Korena style boxed-lunches had higher energy and protein contents per unit price than Japanese style, and the group 1 higher than the group 2. 6) The average energy Proportions of Protein, carbohydrate. and fat were 18.3%, 57.4%, and 24.3%, respectively. These proportions are good enough. 7) Frequency of cooking methods for the side dishes were found in the decreasing order : pan-frying, frying, braising, seasoning, kimchi, grilling, pickling, stir-frying, steaming and fermenting. Generally simple cooking methods were used, thus the menus were lack or varieties. 8) Frequency of colors for the side dishes were found in the decreasing order : red, brown. yellow, green, black, white. Too much red pepper was used. 9) The average capacity of the containers for the staples and the side dishes were 468.1ml and 590.6ml, respectively. And the containers could not keep the food items well seperated. 10) The average contensts of sodium and salt were 2.287mg and 5.76g, in the range of 1, 398mg to 3, 489mg and 3.53g to 8.80g, respectively. These are much higher values than the recommended amount of salt.

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Evaluation of CH4 Flux for Continuous Observation from Intertidal Flat Sediments in the Eoeun-ri, Taean-gun on the Mid-western Coast of Korea (서해안 태안 어은리 갯벌의 연속관측 메탄(CH4) 플럭스 특성 평가)

  • Lee, Jun-Ho;Rho, Kyoung Chan;Woo, Han Jun;Kang, Jeongwon;Jeong, Kap-Sik;Jang, Seok
    • Economic and Environmental Geology
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    • v.48 no.2
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    • pp.147-160
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    • 2015
  • In 2014, on 31 August and 1 September, the emissions of $CH_4$, $CO_2$, and $O_2$ gases were measured six times using the closed chamber method from exposed tidal flat sediments in the same position relative to the low point of the tidal cycle in the Eoeun-ri, Taean-gun, on the Mid-western Coast of Korea. The concentrations of $CH_4$ in the air sample collected in the chamber were measured using gas chromatography with an EG analyzer, model GS-23, within 6 hours of collection, and the other gases were measured in real time using a multi-gas monitor. The gas emission fluxes (source (+), and sink (-)) were calculated from a simple linear regression analysis of the changes in the concentrations over time. In order to see the surrounding parameters (water content, temperature, total organic carbon, average mean size of sediments, and the temperature of the inner chamber) were measured at the study site. On the first day, across three measurements during 5 hours 20 minutes, the observed $CO_2$ flux absorption was -137.00 to $-81.73mg/m^2/hr$, and the $O_2$ absorption, measured simultaneously, was -0.03 to $0.00mg/m^2/hr$. On the second day using an identical number of measurements, the $CO_2$ absorption was -20.43 to $-2.11mg/m^2/hr$, and the $O_2$ absorption -0.18 to $-0.14mg/m^2/hr$. The $CH_4$ absorption before low tide was $-0.02mg/m^2/hr$ (first day, Pearson correlation coefficient using the SPSS statistical analysis is -0.555(n=5, p=0.332, pronounced negative linear relationship)), and $-0.15mg/m^2/hr$ (second day, -0.915(n=5, p=0.030, strong negative linear relationship)) on both measurement days. The emitted flux after low tide on both measurement days reached a minimum of $+0.00mg/m^2/hr$ (+0.713(n=5, p=0.176, linear relationship which can be almost ignored)), and a maximum of $+0.03mg/m^2/hr$ (+0.194(n=5, p=0.754, weak positive linear relationship)) after low tide. However, the absolute values of the $CH_4$ fluxes were analyzed at different times. These results suggest that rate for $CH_4$ fluxes, even the same time and area, were influenced by changes in the tidal cycle characteristics of surface sediments for understanding their correlation with these gas emissions, and surrounding parameters such as physiochemical sediments conditions.

Mitral Valvuloplasty using New Mitral Strip (Mitracon^{(R)}$) (새로운 Strip (Mitracon^{(R)}$)을 이용한 승모판막 성형술)

  • Kang, Seong-Sik;Kim, Sang-Pil;Song, Meong-Gum
    • Journal of Chest Surgery
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    • v.41 no.3
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    • pp.320-328
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    • 2008
  • Background: Numerous surgical devices for mitral repair have been used in the past with good results. In this study we describe a simple annuloplasty technique with using a new device ($Mitracon^{(R)}$). The aim of this study was to assess its efficacy and surgical results with using $Mitracon^{(R)}$. Material and Method: From May 2003 to October 2005, 46 patients (21 women and 25 men (mean age of $51.4{\pm}17.8$ years) with mitral regurgitation from various causes were treated with either the $Mitracon^{(R)}$ (the $Mitracon^{(R)}$ group) or the Capentier Edward rigid ring (the CE group). The median follow-up duration was 18.9 months. Result: The mean grade of mitral regurgitation before and immediately after surgery in the $Mitracon^{(R)}$ group and the CE group decreased from $3.2{\pm}0.8$ to $0.6{\pm}0.7$ and $3.4{\pm}0.7$ to $0.3{\pm}0.5$, respectively. There were no significant changes in the ejection fraction either between the two groups or before and immediately after surgery. No deaths were seen in either group. Early postoperative echocardiography of all 46 patients showed only trivial mitral regurgitation or none at all. Echocardiography at a median of 18.9 months also showed no progression in mitral regurgitation. The mean grade of mitral regurgitation in the $Mitracon^{(R)}$ group at this time point decreased from $3.2{\pm}0.8$ to $0.8{\pm}0.7$ (p<0.05). The CE group also showed a similar degree of decrease from $3.4{\pm}0.7$ to $0.3{\pm}0.6$ (p<0.05). The mitral valve area in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.3{\pm}0.9cm^2$. The mitral valve area in the CE group was $2.7{\pm}0.6cm^2$. The mean mitral pressure gradient in the $Mitracon^{(R)}$ group at 1 year follow-up was $3.1{\pm}1.3$ mmHg. The mean pressure gradient in the CE group was $4.5{\pm}2.1$ mmHg, although any statistical significant difference for this between the groups was not reached. Conclusion: The present study showed the described technique to be safe and effective in the intermediate term. Because long term results are unavailable, a more extensive prospective randomized multicenter trial may be warranted to determine whether this procedure should be generally applied for repair of mitral valve disease.

Studies on the Functional Interrelation between the Vestibular Canals and the Extraocular Muscles (미로반규관(迷路半規管)과 외안근(外眼筋)의 기능적(機能的) 관계(關係)에 관(關)한 연구(硏究))

  • Kim, Jeh-Hyub
    • The Korean Journal of Physiology
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    • v.8 no.2
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    • pp.1-17
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    • 1974
  • This experiment was designed to explore the specific functional interrelations between the vestibular semicircular canals and the extraocular muscles which may disclose the neural organization, connecting the vestibular canals and each ocular motor nuclei in the brain system, for vestibuloocular reflex mechanism. In urethane anesthetized rabbits, a fine wire insulated except the cut cross section of its tip was inserted into the canals closely to the ampullary receptor organs through the minute holes provided on the osseous canal wall for monopolar stimulation of each canal nerve. All extraocular muscles of both eyes were ligated and cut at their insertio, and the isometric tension and EMG responses of the extraocular muscles to the vestibular canal nerve stimulation were recorded by means of a physiographic recorder. Upon stimulation of the semicircular canal nerve, direction if the eye movement was also observed. The experimental results were as follows. 1) Single canal nerve stimulation with high frequency square waves (240 cps, 0. 1 msec) caused excitation of three extraocular muscles and inhibition of remaining three muscles in the bilateral eyes; stimulation of any canal nerve of a unilateral labyrinth caused excitation (contraction) of the superior rectus, superior oblique and medial rectus muscles and inhibition (relaxation) of the inferior rectus, inferior oblique and lateral rectos muscles in the ipsilateral eye, and it caused the opposite events in the contralateral eye. 2) By the overlapped stimulation of triple canal nerves of a unilateral labyrinth, unidirectional (excitatory or inhibitory) summation of the individual canal effects on a given extraocular muscles was demonstrated, and this indicates that three different canals of a unilateral vestibular system exert similar effect on a given extraocular muscles. 3) Based on the above experimental evidences, a simple rule by which one can define the vestibular excitatory and inhibitory input sources to all the extraocular muscles is proposed; the superior rectus, superior oblique and medial rectus muscles receive excitatory impulses from the ipsilateral vestibular canals, and the inferior rectus, inferior oblique and lateral rectus muscles from the contralateral canals; the opposite relationship applies for vestibular inhibitory impulses to the extraocular muscles. 4) According to the specific direction of the eye movements induced by the individual canal nerve stimulation, an extraocutar muscle exerting major role (a muscle of primary contraction) and two muscles of synergistic contraction could be differentiated in both eyes. 5) When these experimental results were compared to the well known observations of Cohen et al. (1964) made in the cats, extraocular muscles of primary contraction were the same but those of synergistic contraction were partially different. Moreover, the oblique muscle responses to each canal nerve excitation appeared to be all identical. However, the responnes of horizontal (medial and lateral) and vertical (superior and inferior) rectus muscles showed considerable differences. By critical analysis of these data, the author was able to locate theoretical contradictions in the observations of Cohen et al. but not in the author's results. 6) An attempt was also made to compare the functional observation of this experiment to the morphological findings of Carpenter and his associates obtained by degeneration experiments in the monkeys, and it was able to find some significant coincidence between there two works of different approach. In summary, the author has demonstrated that the well known observations of Cohen et al. on the vestibulo-ocular interrelation contain important experimental errors which can he proved by theoretical evaluation and substantiated by a series of experiments. Based on such experimental evidences, a new rule is proposed to define the interrelation between the vestibular canals and the extraocular muscles.

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Estimation of SCS Runoff Curve Number and Hydrograph by Using Highly Detailed Soil Map(1:5,000) in a Small Watershed, Sosu-myeon, Goesan-gun (SCS-CN 산정을 위한 수치세부정밀토양도 활용과 괴산군 소수면 소유역의 물 유출량 평가)

  • Hong, Suk-Young;Jung, Kang-Ho;Choi, Chol-Uong;Jang, Min-Won;Kim, Yi-Hyun;Sonn, Yeon-Kyu;Ha, Sang-Keun
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.3
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    • pp.363-373
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    • 2010
  • "Curve number" (CN) indicates the runoff potential of an area. The US Soil Conservation Service (SCS)'s CN method is a simple, widely used, and efficient method for estimating the runoff from a rainfall event in a particular area, especially in ungauged basins. The use of soil maps requested from end-users was dominant up to about 80% of total use for estimating CN based rainfall-runoff. This study introduce the use of soil maps with respect to hydrologic and watershed management focused on hydrologic soil group and a case study resulted in assessing effective rainfall and runoff hydrograph based on SCS-CN method in a small watershed. The ratio of distribution areas for hydrologic soil group based on detailed soil map (1:25,000) of Korea were 42.2% (A), 29.4% (B), 18.5% (C), and 9.9% (D) for HSG 1995, and 35.1% (A), 15.7% (B), 5.5% (C), and 43.7% (D) for HSG 2006, respectively. The ratio of D group in HSG 2006 accounted for 43.7% of the total and 34.1% reclassified from A, B, and C groups of HSG 1995. Similarity between HSG 1995 and 2006 was about 55%. Our study area was located in Sosu-myeon, Goesan-gun including an approx. 44 $km^2$-catchment, Chungchungbuk-do. We used a digital elevation model (DEM) to delineate the catchments. The soils were classified into 4 hydrologic soil groups on the basis of measured infiltration rate and a model of the representative soils of the study area reported by Jung et al. 2006. Digital soil maps (1:5,000) were used for classifying hydrologic soil groups on the basis of soil series unit. Using high resolution satellite images, we delineated the boundary of each field or other parcel on computer screen, then surveyed the land use and cover in each. We calculated CN for each and used those data and a land use and cover map and a hydrologic soil map to estimate runoff. CN values, which are ranged from 0 (no runoff) to 100 (all precipitation runs off), of the catchment were 73 by HSG 1995 and 79 by HSG 2006, respectively. Each runoff response, peak runoff and time-to-peak, was examined using the SCS triangular synthetic unit hydrograph, and the results of HSG 2006 showed better agreement with the field observed data than those with use of HSG 1995.

Evaluation of the Image Quality According to the Pre-set Method in PET/CT Image (PET/CT 영상 획득 시 사전설정법 차이에 따른 영상 질 평가)

  • Park, Sun-Myung;Lee, Hyuk;Hong, Gun-Chul;Chung, Eun-Kyung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.41-46
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    • 2011
  • Purpose: The result of exam using an imaging device is very closely related with the image quality. Moreover, this image quality can be changed according to the condition of image acquisition and evaluation method. In this study, we evaluated the image quality according to the difference of pre-set method in PET/CT image. Materials & Methods: PET/CT Discovery STe16 (GE Healthcare, Milwaukee, USA), Chest PET phantom (Experiment 1) and 94 NEMA phantom (Experiment 2) were used. Phantom were filled with $^{18}F$-FDG maintaining hot sphere and background ratio to 4:1. In the case of experiment 1, we set the radio activity concentration on 3.5, 6.0, 8.6 kBq/mL. In the case of experiment 2, we set the radio activity concentration on 3.3, 5.5, 7.7, 9.9, 12.1, 16.5 kBq/mL. All experiments were performed with the time-set method for 2 minutes 30 seconds per frame and the count-set method with one hundred million counts in 3D mode after CT transmission scan. For the evaluation of the image quality, we compared each results by using the NECR and SNR. Results: In the experiment 1, both the NECR and SNR were increased as radioactivity concentration getting increased. The NECR was shown as 53.7, 66.9, 91.4. and SNR was shown as 7.9, 10.0, 11.7. Both the NECR and SNR were increased in time-set method. But the count-set method's pattern was not similar with the time-set method. The NECR was shown as 53.8, 69.1, 97.8, and SNR was shown as 14.1, 14.7 14.4. The SNR was not increased in count-set method. In experiment 2, results of both the NECR and SNR were shown as 45.1, 70.6, 95.3, 115.6, 134.6, 162.2 and 7.1, 8.8, 10.6, 11.5, 12.7, 14.0. These results were shown similar patten with the experiment 1. Moreover, when the count-set method was applied, the NECR was shown as 42.1, 67.3, 92.1, 112.2, 130.7, 158.7, and SNR was shown as 15.2, 15.9, 15.6, 15.4, 15.5, 14.9. The NECR was increased but SNR was not shown same pattern. Conclusion: Increment of administered radioactivity improves the quality of image unconcerned with the pre-set method. However, NECR was not influenced by increment of total acquisition counts through simple increasing scan duration without increment of administered activity. In case of count-set method, the SNR was shown similar value despite of increment of radioactivity. So, the administered activity is more important than the scan duration. And we have to consider that evaluation of image quality using only SNR may not be appropriate.

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Problems in the field of maternal and child health care and its improvement in rural Korea (우리나라 농촌(農村)의 모자보건(母子保健)의 문제점(問題點)과 개선방안(改善方案))

  • Lee, Sung-Kwan
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.29-36
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    • 1976
  • Introduction Recently, changes in the patterns and concepts of maternity care, in both developing and developed countries have been accelerating. An outstanding development in this field is the number of deliveries taking place in hospitals or maternity centers. In Korea, however, more than 90% of deliveries are carried out at home with the help of untrained relatives or even without helpers. It is estimated that less than 10% of deliveries are assisted by professional persons such as a physician or a midwife. Taking into account the shortage of professional person i11 rural Korea, it is difficult to expect widespread prenatal, postnatal, and delivery care by professional persons in the near future, It is unrealistic, therefore, to expect rapid development of MCH care by professional persons in rural Korea due to economic and sociological reasons. Given these conditions. it is reasonable that an educated village women could used as a "maternity aid", serving simple and technically easy roles in the MCH field, if we could give such a women incentive to do so. The midwife and physician are assigned difficult problems in the MCH field which could not be solved by the village worker. However, with the application of the village worker system, we could expect to improve maternal and child hoalth through the replacement of untrained relatives as birth attendants with educated and trained maternity aides. We hope that this system will be a way of improving MCH care, which is only one part of the general health services offered at the local health centre level. Problems of MCH in rural Korea The field of MCH is not only the weakest point in the medical field in our country hut it has also dropped behind other developing countries. Regarding the knowledge about pregnancy and delivery, a large proportion of our respondents reported having only a little knowledge, while 29% reported that they had "sufficient" knowledge. The average number of pregnancies among women residing in rural areas was 4.3 while the rate of women with 5 or more pregnancies among general women and women who terminated childbearing were 43 and 80% respectively. The rate of unwanted pregnancy among general women was 19.7%. The total rate for complications during pregnancy was 15.4%, toxemia being the major complication. The rate of pregnant women with chronic disease was 7%. Regarding the interval of pregnancy, the rates of pregnancy within 12 months and within 36 months after last delivery were 9 and 49% respectively. Induced abortion has been increasing in rural areas, being as high as 30-50% in some locations. The maternal death rate was shown 10 times higher than in developed countries (35/10,000 live births). Prenatal care Most women had no consultation with a physician during the prenatal period. Of those women who did have prenatal care, the majority (63%) received such care only 1 or 2 times throughout the entire period of pregnancy. Also, in 80% of these women the first visit Game after 4 months of gestation. Delivery conditions This field is lagging behind other public health problems in our country. Namely, more than 95% of the women deliveried their baby at home, and delivery attendance by a professional person occurred only 11% of the time. Attendance rate by laymen was 78% while those receiving no care at all was 16%. For instruments used to cut the umbilical corn, sterilized scissors were used by 19%, non-sterilized scissors by 63% and 16% used sickles. Regarding delivery sheets, the rate of use of clean sheets was only 10%, unclean sheets, vinyl and papers 72%, and without sheets, 18%. The main reason for not using a hospital as a place of delivery was that the women felt they did not need it as they had previously experience easy deliveries outside hospitals. Difficult delivery composed about 5% of the total. Child health The main food for infants (95%) was breast milk. Regarding weaning time, the rates within one year, up to one and half, two, three and more than three years were 28,43,60,81 and 91% respectively, and even after the next pregnancy still continued lactation. The vaccination of children is the only service for child health in rural Korea. As shown in the Table, the rates of all kinds of vaccination were very low and insufficient. Infant death rate was 42 per 1,000 live births. Most of the deaths were caused by preventable diseases. Death of infants within the neonatal period was 83% meaning that deaths from communicable diseases decreased remarkably after that time. Infant deaths which occurred without medical care was 52%. Methods of improvement in the MCH field 1. Through the activities of village health workers (VHW) to detect pregnant women by home visiting and. after registration. visiting once a month to observe any abnormalities in pregnant women. If they find warning signs of abnormalities. they refer them to the public health nurse or midwife. Sterilized delivery kits were distributed to the expected mother 2 weeks prior to expected date of delivery by the VHW. If a delivery was expected to be difficult, then the VHW took the mother to a physician or call a physician to help after birth, the VHW visits the mother and baby to confirm health and to recommend the baby be given proper vaccination. 2. Through the midwife or public health nurse (aid nurse) Examination of pregnant women who are referred by the VHW to confirm abnormalities and to treat them. If the midwife or aid nurse could not solve the problems, they refer the pregnant women to the OB-GY specialist. The midwife and PHN will attend in the cases of normal deliveries and they help in the birth. The PHN will conduct vaccination for all infants and children under 5, years old. 3. The Physician will help only in those cases referred to him by the PHN or VHW. However, the physician should examine all pregnant women at least three times during their pregnancy. First, the physician will identify the pregnancy and conduct general physical examination to confirm any chronic disease that might disturb the continuity of the pregnancy. Second, if the pregnant woman shows any abnormalities the physician must examine and treat. Third, at 9 or 10 months of gestation (after sitting of the baby) the physician should examine the position of the fetus and measure the pelvis to recommend institutional delivery of those who are expected to have a difficult delivery. And of course. the medical care of both the mother and the infants are responsible of the physician. Overall, large areas of the field of MCH would be served by the VHW, PHN, or midwife so the physician is needed only as a parttime worker.

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Interpreting Bounded Rationality in Business and Industrial Marketing Contexts: Executive Training Case Studies (집행관배훈안례연구(阐述工商业背景下的有限合理性):집행관배훈안례연구(执行官培训案例研究))

  • Woodside, Arch G.;Lai, Wen-Hsiang;Kim, Kyung-Hoon;Jung, Deuk-Keyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.49-61
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    • 2009
  • This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

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