• The Journal of Korean Medical History
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• v.14 no.2
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• pp.109-152
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• 2001

Throughout this paper, I adjusted the study of 'Qian Yi'(錢乙)'s Medical Thought, and the following is the summary. 1. 'Qian Yi' wrote 'Xiao Er Yao Zheng Zhi Jue'("小兒藥證直訣", edited by 誾季忠), and there were 'Shang Han Lun Zhi Wei'("傷寒論指微"), 'Ying Ru Lun', however those are loss of the record. 2. Qian Yi's 'Zhi Jue'("直訣") was influenced by 'Lu Xin Jing', yet if we compare the quality of 'Sheng Li, Byeng Li, Bang Jae'(生理, 病理, 方劑), 'Lu Xin Jing' cannot be the foundation of 'Zhi Jue'. He took over 'Nei Jing, Shang Han Lun, Jin Gui Yao Lue, Shen Long Ben Cao Jing, Tai Ping Sheng Hui Fang'("內經", "傷寒論", "金?要略", "神膿本草經", "太平聖惠方") and put them together to the direct clinical experiences of pediatrics. 3. There is no reference regarding the difficulties of pediatric diagnosis and diseases in 'Huang Di Nei Jing'("黃帝內經") Before 'Bei Song'(北宋), regardless of the lack of data related to pediatric diseases, 'Qian Yi' established the pediatric system in 'Xiao Er Yao Zheng Zhi Jue' for the first time. 4. In his diagnosis of the pediatric diseases, he 'Si Zhen He Can'(四診合參), also considered in the eye exam seriously. In addition, he closely combined 'Wu Zang Bian Zheng'(五臟辨證), and diagnosis the pediatric diseases. 5. 'Wu Zang Bian Zheng', what Qian established method was based on 'Zheng Ti Guan'(整體觀) in 'Huang Di Nei Jing'. It was based on clinical experiences and established the perspectives of 'Tian Ren Xiang Ying'(天人相應). First of all, he pinpointed 'Zhu Zheng'(主證) clearly. Secondly, he pinpointed the relationships to symptoms and then, he distinguished a generic character of 'Xu, Shi, Han, Re'(虛, 實, 寒, 熱). Finally, he made an induction from genealogical pediatric physiology. 6. 'Qian Yi' took a serious view of 'Ban Zhen'(斑疹), the inadequate field in those days. At that time, he criticized on the habituation of the misuse of medication. He treated separately which 'Ji Jing'(急驚) as 'Liang Xie'(凉瀉) and 'Man Jing'(慢驚) as 'Wen Bu'(溫補). He proposed 'Cong Gan Zhu Feng, Xin Zhu Jing'(從肝主風, 心主驚) theory and formulated 'Jing Feng'(驚風) theory as well. 7. As an opponent of a tendency to misusage of medicine, 'Qian Yi' made out a prescription with pliant medicine. He emphasized on the treatment to 'Gong Bu Shang Zheng, Bu Bu Zhi Xie, Xiao Bu Jian Shi'(攻不傷正, 補不滯邪, 消補兼施) because he had so lucid demonstration to 'Xu Shi Han Re'(虛實寒熱) of the five viscera in the field of 'Bang Yak'(方藥). 8. There were no pediatrics schools at that time, however, the pediatrics was being made up gradually by 'Jin Yuan Si Da Jia'(金元四大家) who was influenced by 'Qian Yi'. He raised an objection to medical treatment using pliant medicine. 'Qian Yi' applied 'Qu Xia'(驅下) treatment using 'Han Liang'(寒凉) medicine. 'Han Liang Pai'(寒凉派) is greatly influenced by Qian. 'Chen Wen Zhong'(陳文中) had a great impact on 'Han Liang Pai' who used a 'Zao Shu Wen Bu'(燥熟溫補) medicine for treatment. Since 'Song Jin'(宋金), he had a tremendous influence on pediatrics treating patients in both 'Han Wen'(寒溫) ways. 9. 'Qian Yi' had an influence on his medical thoughts on future generations, especially to 'Wan Quan'(萬全) of 'Ming Dai', 'Wu Tang'(吳塘) of 'Qing Dai'(淸代) and 'Yun Shu Jie'(?樹珏) of 'Min Guo'(民國). 'Wan Quan' is an advocate of 'You Yu, Bu Zu Zhi Shuo'(有餘, 不足之說)of 'Xiao Er Wu Zang'(小兒五臟) that he revealed Qian's 'Wu Zang Bian Zheng'(五臟辨證). 'Wu Tang' disclosed Qian's 'Xiao Er Ti Zhi Shuo'(小兒體質說) and 'Xiao Er Ke'(小兒科)'s 'Yong Yao Lun'(用藥論), therefore, he uncovered pediatric physiological characteristics through the advocate of Qian's 'Zang Fu Rou Ruo, Ji Gu Nen Qie, Yi Xu Yi Shi, Yi Han Yi Re' (臟腑柔弱, 肌骨嫩怯, 易虛易實, 易寒易熱). 'Yun Shu Jie' developed intrinsic relationships among time, symptom and 'Tian Ren Xiang Ying Guan'(天人相應觀), What 'Qian Yi' stated about them. And also, he developed Qian's 'Di Huang Wan'(地黃丸), 'Xie Qing Wan'(瀉靑丸), 'Yi Huang San'(益黃散) clinical usages as well. 10. Regarding Qian's 'Wu Zang Xu Shi'(五臟虛實), it has an influence on 'Zhang Yuan Su'(張元素)'s 'Zang Fu Bing Ji Bian Zheng'(臟腑病機辨證). 'Di Huang Wan', 'Xie Qing Wan', 'Xie Xin Tang'(瀉心湯), 'Yi Huang San', 'Xie Huang San'(瀉黃散) are the standard prescription of 'Wu Zang Bu Xie'(五臟補瀉). It is under the influence of Qian's treatment. Besides, 'Qian Yi' took a serious view of 'Xiao Er'(小兒)'s 'Pi Wei'(脾胃). 'Qian Yi' had an impact on 'Li Dong Yuan'(李東垣) one of the member of 'Bu Tu Pai'(補土派). 'Di Huang Wan', which placed great importance on 'Bu Yi Shen Yin'(補益腎陰), had a great impact on 'Da Bu Yin Wan'(大補陰丸) and 'Jin Yuan Si Da Jia' as well. 11. In a theory of Qian's 'Wu Zang Bian Zheng', though it had been stated clearly in 'Wu Zang Bian Zheng', but he neglected in 'Liu Fu Bian Zheng'(六腑辨證). In prescription field, The problem with the medicine is that it is either toxic or mineral, therefore, we are not able to use those medicine in a clinical testing at the present time.

• Journal of Nutrition and Health
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• v.53 no.3
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• pp.303-318
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• 2020

Purpose: This study examined the effects of nutritional education related to sugar in elementary school children on nutritional knowledge, attitude, and dietary behavior. Methods: A questionnaire survey on the knowledge, attitudes, and intake related to sugar was conducted on 572 students in grades 4-5, who were attending five elementary schools in Seoul and Gyeonggi-do. Results: Among the survey subjects, 270 (49.8%) were cognitive in education, and 302 (50.2%) were non-cognitive. The sugar-related knowledge score was 3.67 points in the cognitive education group, which was significantly higher than the 3.55 points in the non-cognitive group. The rate of checking the sugar content in the nutrition label was 31.2% in the cognitive education group, which was significantly higher than in the non-cognitive group, 15.4%. The cognitive education group had a higher intake frequency of unsweetened candy, jelly, and raw fruits, and higher sugar intake of unsweetened bread, white milk, and raw fruits than the non-cognitive group. In the case of the cognitive education group, the total knowledge score showed a positive correlation with the food behavior scores, and a negative correlation with the frequency of purchasing snacks after school, and the average sugar intake per day. In the cognitive education group only, the education of nutrition teachers was analyzed as a factor to reduce the total sugar intake. The cognitive group of sugar education tried to eat foods with a lower sugar content than the non-cognitive group, and nutrition education was an important factor affecting the sugar intake. Conclusion: To reduce the sugar intake of elementary school students, it will be necessary to practice oriented-nutrition education by nutrition teachers continuously. In addition, it is important to develop and disseminate various types of nutrition education materials related to sugar that can be utilized easily by nutrition teachers.

• Korea journal of population studies
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• v.19 no.1
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• pp.139-159
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• 1996

This study comparatively examines a causal model of employee attatchment which focuses on employee's organizational commitment and intent to stay with an organization. This study is based on two separate studies of employee attachment among teachers : the U.S. case of the Chicago Public Schools (CPS) and the South Korean case of the Seoul Educational District (SED). The main purpose of this study is to replicate in Korea the CPS study. A revised model based on the unique characteristics of Korean teachers is also developed and estimated. The Price Mueller model of employee attachment provides the basic theoretical framework for this study. It includes five general classes of variables : 1) employee responses to work variables : job satisfaction, commitment, and intent to stay; 2) psychological stress variables: role ambiguity, role conflict, work overload, and quality of students; 3) social structural variables: autonomy, routinization, distributive justice, and legitimacy; 4) economic structural variables: pay, job security, promotional opportunities, and job opportunities; and 5) work orientation variables : career commitment, normative commitment, work motivation, affectivity, work values, and met expectations. The data was collected through questionnaire survey and a sample of 649 secondary school teachers in Seoul, South Korea, was included in the final analysis. Covariance structure analysis (LISREL) was used to estimate the causal model. The results indicate that the endogenous variables of job satisfaction and commitment play a considerably less important role than in the U.S. model in mediating the effects of the exogenous variables on intent to stay, and the model fails to explain the majority of the variance in intent to stay. In addition, the new variables added to the revised Korean model do not bave significant effects on intent to stay. The structural characteristics of the employment relationship and labor markets associated with Korean teachers forced mobility and closed external markets - are largely accountable for the major differences between the Korean and the U.S. cases. The study suggests that conceptual and empirical work on what produces employee attachment under these structural constraints needs to receive more attention in future studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.2
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• pp.183-196
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• 2003

Objectives：The Purpose of this study is to investigate the reliability and validity of Korean Parent and Teacher Conners' Rating Scale. Methods：Randomly selected 1st to 6th graders of the two elementary schools(N=1044) in Anyang City participated in the study. Children diagnosed with ADHD(N=23) at the child and adolescent clinic at a university affiliated hospital were included in the study for the analysis of clinical validity of the scales. Parent and teacher completed Korean Conners' Rating Scale and Korean-ADHD Rating Scale(KARS). In addition, parents completed Korean-Children Behavior CheckList(K-CBCL). Descriptive statistics, t-test, and analysis of variance were performed. Results：Scores of Korean Conners' Parents Rating Scale were significantly correlated with those of Korean Conners Teacher Rating Scale. High internal consistency reliability were demonstrated in both parent and teacher rating scales. There were significant correlations among sub-scales of Conners' Rating Scales, K-CBCL and K-ARS. Factor analyses revealed that the K-CTRS had three-factor structure (Inattention-Passivity, Hyperactivity, Conduct Problem) and the K-CPRS had five-factor structure(Impulsive-Hyperactive, Conduct Problem I, Anxiety, Psychosomatic, Conduct Problem II). Conners' Rating Scales effectively distinguish children with ADHD from children without ADHD. Conclusion：Korean Parent and Teacher Conners' Rating Scales are valid and reliable instruments that are useful for screening and identifying childhood problem behaviors. Future studies are required with a larger number of sample sizes including adolescents from various geographic regions.

• Journal of radiological science and technology
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• v.6 no.1
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• pp.131-181
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• 1983

After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

• Journal of Korean Home Economics Education Association
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• v.18 no.1 s.39
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• pp.77-93
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• 2006

As our current society is increasingly demanding a Home Economics Education curriculum that projects the recent changes around us, in this study we hope to present which fundamental materials would be needed in Home Economics Education to satisfy the needs of learners in schools and to Provide actual practice and information crucial to live in the future society. A reform of the present Home Economics regime is needed, and as a result of critical analysis on the subject we found that it did not portray the plurality of family relations and cultures owing to the sudden changes in society, nor did it present an active curriculum that could be applied to the changes in social environments. This was partly because of the matter of establishing a proper academic identity of Home Economics Education, the matter of specializing curriculums and general methods of applying them, the academic conservatism in the field of Home Economics, and ineffectiveness of teacher reeducation as well as a lack of leadership on the part of administrative departments. The objective and content structure of Home Economics Education should be reformed to adjust to the current society by taking an approach focused on family and the consumer. In the family part, curriculums should include the formations of various family structures and home cultures to portray a more open concept of family, which should promote gender equality in matters of child upbringing and housework. From a humanitive perspective, Home Education should he dealing with the mediation and decision-making of individuals caught between social advancement and household functions. their communication skills in choosing and deciding, and furthermore their participation in their living communities which may present more material basis of critical scientific philosophies to be discussed in class. Additional themes such as sustainable consumption for earth environment and resource preservation and ways of application to rebuild our diminishing society must also be included in the education curriculum. We should look to find a more integrated approach to Home Economics Education rather than the present field based and specialized regime.

• Asia Marketing Journal
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• v.12 no.2
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• pp.27-52
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• 2010

It is not new that today's business organizations are expected to exhibit ethical and moral management and to carry out social responsibility as a good corporate citizen. Since South Korea emerged as a newly industrialized country during the 1980s, Korean corporations have become active in carrying out their social responsibility as a good corporate citizen to society. In spite of the short history of corporate social responsibility, Korean companies have actively participated in corporate philanthropy. Corporations' significant donations to various social causes, no-lay-off policies, corporate volunteerism and green marketing are evidences of their commitment to corporate citizenship. Corporate social responsibility is now an essential management practice whereby corporation can strengthen its sustainable value creation processes by enhancing the trust assets underlying the relationships between the business and the stakeholders. Much of the conceptual work in the area of corporate social responsibility(CSR) has originated from researches conducted in the management field. Carroll(1979) proposed that corporations have four types of social responsibilities: economic, legal, ethical and philanthropic responsibility. Most past research has investigated CSR and its impact on consumers' attitudes toward the corporations and corporate performances. Although there exists a large body of literature on how consumers perceive and respond to CSR, the majority of past studies were conducted in the United States. The stability and applicability of past findings need to be tested across different national/cultural settings, especially since corporate social responsibility is a reflection of implicit conformation with the expectations and criticism that society may have toward a corporation(Matten and Moon, 2004). In this study, we explored whether people in Korea perceive CSR of Korean corporations in the same four dimensions as done in the United States and what were the measurement items tapping each of these four dimensions. In order to investigate the dimensions of CSR and the measurement items for CSR perceived by Korean people, nine focus group interviews were conducted with several stakeholder groups(two with undergraduate students, two with graduate students, three with general consumers, and two with NGO groups). Scripts from the interviews revealed that the Korean stakeholders perceived four types of CSR which are the same as those proposed by Carroll(1979). However we found CSR issues unique to Korean corporations. For example for the economic responsibility, Korean people mentioned that the corporation needed to contribute to the economic development of the country by generating corporate profits. For the legal responsibility, Koreans included the "corporation need to follow the consumer protection law." For the ethical responsibility, they considered that the corporation needed to not promote false advertisement. In addition, Koreans thought that an ethical company should do transparent management. For the philanthropic responsibility, people in Korea thought that a corporation needed to return parts of its profits to the society for the betterment of society. The 28 items were developed based on the results of the nine focus group interviews, while considering the scale developed by Maignan and Ferrell(2001). Following the procedure proposed by Churchill(1979), we started by developing an item poll consisting of 28 items and purified the initial pool of items through exploratory, confirmatory factor analyses. 176 samples were sued for this analysis. Confirmatory factor analysis was performed on the 28 items in order to verify the underlying four factor structure. Study 1 provided new measurement items for tapping the Korean CSR dimensions, which can be useful for the future studies exploring the effects of CSR on Korean consumers' attitudes toward the corporations and corporate performances. And we found the CSR scale(17 items) has good reliability, discriminant validity and nomological validity. Economic Responsibility: "XYZ company continuously improves the quality of our products", "XYZ company has a procedure in place to respond to customer complaint", "XYZ company contributes to the economic development of our country by generating profits", "XYZ company is eager to hire people". Legal Responsibility: "XYZ company's products meet legal standards", "XYZ company seeks to comply with all laws regulating hiring and employee benefits", "XYZ company honors contractual obligations to its suppliers", "XYZ company's managers try to comply with the law related to the business operation". Ethical Responsibility: "XYZ company has a comprehensive code of conduct", "XYZ company does not promote a false or misleading advertisement", "XYZ company seems to conduct a transparent business", "XYZ company does a fair business with its suppliers or sub-contractors". Philanthropic Responsibility: "XYZ company encourages partnerships with local businesses and schools", "XYZ company supports sports and cultural activities", "XYZ company gives adequate contributions to charities considering its business size", "XYZ company encourages employees to support our community". Study 2 was condusted for comprehensive validity. 655 samples were used for this anlysis. Collected samples were tested by factor analysis and Crnbach's Alpha coefficiednts and were found to be satisfactory in terms of validity and reliability. Furthermore, fitness of the measurement model was tested by using conformatory factor analysis. χ²=880.73(df=160), GFI=0.891, AGFI=0.854, NFI=0.908, NNFI=0.913, RMR=0.059, RMESA=0.070. We hope that CSR scale could greatly facilitate research on Corporate social resposibility, it is by no means the final answer.

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

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