Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.
The Object of research was laid on the dry paddy field which had a low level of underground water, rather than on a paddy field with a high level of underground water. In the treatment of the clay paddy field before transplanting we employed 3 kinds of methods; deep plowing, development of cracks by drying the surface of the field under which pipe drain was built. This study was to find which one, among these three methods, is the most effective to let roots extend to deep zone and increase the yield of rice and at the same time, for trafficability of large scale machinery which will be introduced to the harvest, in the light of the earth bearing capacity in relation with underground drainage. In the treatments of plots, 1) the kyong plot was plowed 39 days before transplanting and dried, 2) the kyun plot was plowed again 2days before transplanting after plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying, 3) the kyunam plot was plowed again 2 days before transplanting after setting the drainage pipe and at the same time plowing 39 days before transplanting, leveling field surface in the saturation with water and developing the cracks by drying. Also each plot above had three different levels of soil depth, respectively; that is 15cm, 25cm, 35cm. The kyong plot with 15cm-depth was he control. The results obtained were as follows; 1. The kyunam plot showed a remarkably lager amount of water consumption by better underground drainage than the kyong and the kyun plot, and the kyong plot indicated a greater amount of water consumption than the kyun plot. Therefore the amount of available rainfall was decreased in the order of kyunam>kyong>kyun. The net duty of water decreased in the order of kyunam>kyong>kyun and its showed about 105cm in depth at the kyunam plot, about 70cm in depth at the kyong plot and about 45cm in depth at kyun plot, regardless of soil depth. 2. According to the tendency that the weight of the total root was effected by the maximum depth of the crack, it seemed that the root development was more affected by the depth of the crack than by only the crack itself. The weight of the total roots tended to increase as the depth of the crack got deeper and deeper, and the weight of the total roots was increased in the order of kyun<kyunam<kyong. 3. In the growing of the plant height, the difference did not appear at the beginning of growing(peak period of tillering) of any plot, But for the mid period of growing(ending period of tillering) to the period of young panicle formation, the deeper the depth of plot is, the more the growing goes down. On the contrary at the late period of growing, growth was more vigorous in the plot with deep depth than in the plot with shallow depth. Since the midperiod of growing, in the light of experimental treatment, the kyun plot was not better in growing than the other two plots and no remarkable defference was shown between the kyunam and the kyong plot, but the kyunam plot had the tendency of superiority in growing plant height. 4. As the depth of plot went deeper, the decreasing tendency was shown in the number of tillers through a whole period of growingi. When the above results were observed concering each plot of experimental treatment, the kyun plot was always smaller in the number of tiilers than the kyunam and the kvong plot, and the kyong plot was slightly larger than the kyunam plot in the number of tillers. 5. When each plot of the different experimental treatments was compared with the control plot(15-kyong), yield(weight of grains) was increased by 17% for the 35-kyong plot, by 10% for the 35-kyunam and yields for the other plots were less or nomore than the control plot. On the whole, as the depth of plot went deeper, yields for plots was increased in the order of kyong>kyunam>kyun. 1% of significance between the levels of depths and 5% of significance between the treatments were shown. 6. The depth of consumptive water which was more effective on the weight of grains is that of the last half period. When the depth of consumptive water was increased at the range of less than 2.7cm/day in the 15cm plot, 3.0cm/day in the 25cm plot and 3.3cm/day in the 35cm plot, the weight of grains was increased, and at the same time the weight of grains was increased as the depth of plot went deeper. The deeper plots was of advantage to the productivity at the same depth of consumptive water. 7. The increase in the weight of grains in propertion to the weighte of root showed a tendency to increase depending on the depth of plot at each plot of the same weight of roots. The weight of roots and grains together increasezd in the order of kyun>kyunam>kyong, considering each treatment of experimental plot. The weight of grains was in relation to the minimum water content ratio during the midperiod of surface drainage and the average earth temperature was mainly affected by the minimum water content ratio because it was relatively increased in proportion to the water content ratio(at less than 40%) 8. The weight ratio of straw to grain showed an increasing tendency at the plot of shallow depth and had a relation of an inversely exponental function to the weight of roots. At the same depth of plot except the 15cm plot, the weight ratio of straw to grain was increased in proportion to the depth of consumptive water. The weight of grains was increased as the depth of consumptive water was increased to some extent, but at the same time the weight of ratio of straw to grain was increased. 9. At a certain texture of soils the increase in the amount of the cracks depends on meteorological conditions, especially increase in amounts of pan evaporation. So if it rains during the progressing of field drying the cracks largely decrease. The amount of cracks of clay soil had relation of inversely exponental function to the water content ratio(at more than 25%). The maximum depth of crack kept generally a constant value at less than 30% of water content ratio. 10. The cone index showed the tendency that it was propertional to the amount of cracks within a certain limit but more or less inversely proportional over a certain limit. The water content ratio at the limit may be about 25%. 11. The increase in the cone index with the progressing of time after final surface drainage showed the tendency that it was proportional to the depth of consumptive water at the last half of growing period. Based on the same depth of if the cone index in the kyunam plot was much larger than in the other two plots and that in the kyong plot was much smaller than in the kyun plott, as long as the depth of plot was deeper, especially in the 35-kyong plot. 12. In the light of a situation where water content ratio of soil decreased and the cone index increased after final surface drainage the porogress of the field dryness was much more rapid in the kyunam plot than in the kyong plot and the kyun plot, especially slowest in the kyong plot. In the plot with deeper zone the progress was much slower. The progress requiring the value of the cone index,
This experiment was conducted to determine the influence of weed competition in sesame and the periods for weed control. Competition periods (days), for which sesame was seeded under transparent polyethylene film at May 15, were 10, 15, 30, 45, 60, 75, 90, and full growth season of sesame. Weed control periods (days), for which sesame was seeded under black polyethylene film at June 15, were 10, 15, 30, 45, 60, and full growth season of sesame. Dominant weeds were Ponulaca oleracea, Digitaria sanguinalis, Acalypha australis, L. Cyperus arnuricus, Arenaria aesrphllifolia, Cardamine flexucosa, Mollugo Stricta and Digitaria eschaemum. The number of weeds was maximum at the 30 days after planting. Broad leaf weeds were dominant than grass weeds, and then decreased the total number of weeds by the reason of major decrease of broad leaf weeds. However, the weight of weeds increased continuously. No weeds appeared until the 15 days after planting and the weight of broad leaf weeds was heavier than that of grass weeds until 45 days after planting. However, grass weeds were heavier than broad leaf weeds after 60 days after planting. The hazards of weeds on the growth and development appeared seriously from the 60 to 75 days after planting, but main yield reduction appeared from 30 days after planting. Therefore once more hand weeding should be practiced within 30 days after planting to minimize yield decrease. Serious hazards by weed growing appeared by removing black PE film after 15 to 30 days after planting in growth characteristics and 30 days later in grain yield. Leaf growth showed maximum from 45 to 60 days after planting and then decreased as compared with the continuous increase of stem and root in optimum planting, transparent PE film mulch and hand weeding. Leaf growth didn't show reducing in PE film mulch and weedy check but total weight of weeds increased and growth of sesame decreased as compared to PE film mulch and hand weeding. Leaf, stem and root growth of sesame, and weed weight under black PE film mulch showed same tendancy and lower growth of sesame as compared with optimum planting, transparent PE film mulch. Correlation between sesame yield and weeds weight were r =
In order to investigate the utilization probability of two years old laying hen for W.L. and R.I.R. breeds, carcass weight and percentage were examined and dried old chicken meat products were manufactured for experiments. The results obtained are as follows. 1. Average living body weight were 1,635.40g for the W.L. breeds and 2,289.29g for the R.I.R. breeds and percentage carcass and lean meat for the W.L. were 58.73% and 43.95%, for the R.I.R. 60.34%, 41.98%, respectively. 2. In constitution percentage of carcass on different parts for W.L. and R.I.R. breeds, head were 4.13% and 3.94%, wing 9.97% and 8.62%, breast 32.54% and 20.94%, back 11.35% and 9.75%, thigh 30.75% and 31.34%, hypordermic fat 11.37% and 17.34%, respectively. 3. In constitution percentage of lean meat on different parts for W.L. and R.I.R. breeds, head were 4.03% and 3.95%, wing 9.47% and 9.79%, breast 39.37% and 38.14%, back 11.24% and 9.40%, thigh 36.16% and 38.74%, respectively. 4. In chemical composition of old chicken meat for W.L. breed, moisture was 68.18%, crude protein 22.80%, crude fat 2.70%, extract 5.15% and crude ash 1.18% and for R.I.R. breed, moisture was 68.04%, crude protein 22.18%, crude fat 3.13%, extract 5.45% and crude ash 1.21%. 5. Weight loss in steaming for W.L. at
Brand has received much attention from considerable marketing research. When consumers consume product or services, they are exposed to a lot of brand related stimuli. These contain brand personality, brand experience, brand identity, brand communications and so on. A special kind of new crisis occasionally confronting companies' brand management today is the brand related rumor. An important influence on consumers' purchase decision making is the word-of-mouth spread by other consumers and most decisions are influenced by other's recommendations. In light of this influence, firms have reasonable reason to study and understand consumer-to-consumer communication such as brand rumor. The importance of brand rumor to marketers is increasing as the number of internet user and SNS(social network service) site grows. Due to the development of internet technology, people can spread rumors without the limitation of time, space and place. However relatively few studies have been published in marketing journals and little is known about brand rumors in the marketplace. The study of rumor has a long history in all major social science. But very few studies have dealt with the antecedents and consequences of any kind of brand rumor. Rumor has been generally described as a story or statement in general circulation without proper confirmation or certainty as to fact. And it also can be defined as an unconfirmed proposition, passed along from people to people. Rosnow(1991) claimed that rumors were transmitted because people needed to explain ambiguous and uncertain events and talking about them reduced associated anxiety. Especially negative rumors are believed to have the potential to devastate a company's reputation and relations with customers. From the perspective of marketer, negative rumors are considered harmful and extremely difficult to control in general. It is becoming a threat to a company's sustainability and sometimes leads to negative brand image and loss of customers. Thus there is a growing concern that these negative rumors can damage brands' reputations and lead them to financial disaster too. In this study we aimed to distinguish antecedents of brand rumor transmission and investigate the effects of brand rumor characteristics on rumor spread intention. We also found key components in personal acceptance of brand rumor. In contextualist perspective, we tried to unify the traditional psychological and sociological views. In this unified research approach we defined brand rumor's characteristics based on five major variables that had been found to influence the process of rumor spread intention. The five factors of usefulness, source credibility, message credibility, worry, and vividness, encompass multi level elements of brand rumor. We also selected product involvement as a control variable. To perform the empirical research, imaginary Korean 'Kimch' brand and related contamination rumor was created and proposed. Questionnaires were collected from 178 Korean samples. Data were collected from college students who have been experienced the focal product. College students were regarded as good subjects because they have a tendency to express their opinions in detail. PLS(partial least square) method was adopted to analyze the relations between variables in the equation model. The most widely adopted causal modeling method is LISREL. However it is poorly suited to deal with relatively small data samples and can yield not proper solutions in some cases. PLS has been developed to avoid some of these limitations and provide more reliable results. To test the reliability using SPSS 16 s/w, Cronbach alpha was examined and all the values were appropriate showing alpha values between .802 and .953. Subsequently, confirmatory factor analysis was conducted successfully. And structural equation modeling has been used to analyze the research model using smartPLS(ver. 2.0) s/w. Overall, R2 of adoption of rumor is .476 and R2 of intention of rumor transmission is .218. The overall model showed a satisfactory fit. The empirical results can be summarized as follows. According to the results, the variables of brand rumor characteristic such as source credibility, message credibility, worry, and vividness affect argument strength of rumor. And argument strength of rumor also affects rumor intention. On the other hand, the relationship between perceived usefulness and argument strength of rumor is not significant. The moderating effect of product involvement on the relations between argument strength of rumor and rumor W.O.M intention is not supported neither. Consequently this study suggests some managerial and academic implications. We consider some implications for corporate crisis management planning, PR and brand management. This results show marketers that rumor is a critical factor for managing strong brand assets. Also for researchers, brand rumor should become an important thesis of their interests to understand the relationship between consumer and brand. Recently many brand managers and marketers have focused on the short-term view. They just focused on strengthen the positive brand image. According to this study we suggested that effective brand management requires managing negative brand rumors with a long-term view of marketing decisions.
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.
Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.
Extracorporeal life support (ECLS) system is a device for respiratory and/or heart failure treatment, and there have been many trials for development and clinical application in the world. Currently, a non-pulsatile blood pump is a standard for ECLS system. Although a pulsatile blood pump is advantageous in physiologic aspects, high pressure generated in the circuits and resultant blood cell trauma remain major concerns which make one reluctant to use a pulsatile blood pump in artificial lung circuits containing a membrane oxygenator. The study was designed to evaluate the hypothesis that placement of a pressure-relieving compliance chamber between a pulsatile pump and a membrane oxygenator might reduce the above mentioned side effects while providing physiologic pulsatile blood flow. The study was performed in a canine model of oleic acid induced acute lung injury (N=16). The animals were divided into three groups according to the type of pump used and the presence of the compliance chamber, In group 1, a non-pulsatile centrifugal pump was used as a control (n=6). In group 2 (n=4), a single-pulsatile pump was used. In group 3 (n=6), a single-pulsatile pump equipped with a compliance chamber was used. The experimental model was a partial bypass between the right atrium and the aorta at a pump flow of 1.8∼2 L/min for 2 hours. The observed parameters were focused on hemodynamic changes, intra-circuit pressure, laboratory studies for blood profile, and the effect on blood cell trauma. In hemodynamics, the pulsatile group II & III generated higher arterial pulse pressure (47
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.
This study was conducted to evaluate the possibility of expanding the usage of whole crop silage from beef cattle and dairy cow to hogs and chickens. For this purpose, a crushing device was developed to crush whole crop silage. The crushed silage was sealed, and analyzed for its feed value. The silage varieties used for the experiment included Saessal barley and Geumgang wheat. Whole crop barley and wheat were crushed in the crushing system as a whole without separating stems, leaves, grains, etc.. When the crushed whole crop silages (CWCS) were analyzed, full grain, grains above 10 mm in size, grains 5~10 mm in size, and grains below 5 mm in size accounted for, 20%, 4%, 27%, and 49 %, respectively. In order to facilitate the fermentation of CWCS, inoculated some fermenter into each CWCS sample (barley or wheat). As control, another set of sample was not inoculated. Crude protein (CP), ether extract (EE), crude fiber (CF), neutral detergent fiber (NDF), acid detergent fiber (ADF), lignin, cellulose content, total digestible nutrient (TDN), and relative feed value (RFV) of fermenter-inoculated Saessal barley were 2.45 %, 1.61%, 8.95%, 16.94%, 9.52%, 1.01%, 8.51%, 81.38%, and 447.5%, respectively. The CP, EE, CF, NDF, ADF, lignin, cellulose content, TDN, and RFV in the other sample of Saessal barley without inoculation of fermenter were 2.57%, 1.62%, 9.61%, 18.25%, 10.13%, 1.10%, 9.04%, 80.90%, and 412.9%, respectively. The CP, EE, CF, NDF, ADF, lignin, cellulose content, TDN, and RFV of fermenter-inoculated Geumgang wheat sample were 2.43%, 1.27%, 10.99%, 19.49%, 11.23%, 1.46%, 9.77%, 80.03%, and 382.6%, respectively. The CP, EE, CF, NDF, ADF, lignin, cellulose content, TDN, RFV of the other set sample of Geumgang wheat sample without the inoculation of fermenter were 2.28%, 1.44%, 10.08%, 18.02%, 10.44%, 1.26%, 9.18%, 80.65%, and 416.9%, respectively. The TDN and RFV content in the fermenter-inoculated Saessal barley were 81.38% and 447.5%, respectively, while the one in the fermenter-inoculated Geumgang wheat were 80.03% and 382.6% respectively. When the feed value of whole crop barley and wheat silage without crushing process was compared to the feed value of whole crop barley and wheat silage made from crushing system, the latter appeared to be higher than the former. This could be due to the process of sealing the crushed silage which might have minimized air content between samples and shortened the golden period of fermentation. In conclusion, these results indicate that a crushing process might be needed to facilitate fermentation and improve the quality of silage when making whole crop silage.