• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

• Journal of Wetlands Research
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• v.15 no.4
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• pp.519-527
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• 2013

The Ministry of Environment of the Republic of Korea set up 'the $2^{nd}$ Fundamental Plan for Wetlands Conservation' to facilitate systematic surveys and management of various national wetlands and to promote sustainable conservation and use of those wetlands. The mid-term fundamental plan was established in accordance with the Article 5 of the Wetland Conservation Act, which spans 5 years from 2013 to 2017 and covers national wetlands including inland wetlands and coastal wetlands stated in the Act. The fundamental plan aims to promote the wise use of wetlands through establishing policies for sustainable conservation based on the assessment of implementation of the $1^{st}$ Fundamental Plan, setting up a scientific framework for establishment and implementation of national wetland policies by improving wetland survey systems and enhancing basis wetland data, improving the ecological health of wetlands and securing biodiversity conservation of wetlands by strengthening conservation and management system of national wetlands, and through raising public awareness and diversify education and promotion tools. The main objectives of the $2^{nd}$ Fundamental Plan is to revise the entire Wetland Conservation Act, to create a new monitoring system of national inland wetlands, to upgrade the national wetlands inventory, to reflect the 'Ecological Map' for promoting precautionary management of wetlands, to improve the 'Wetland Restoration and Management' system to build wetlands resilience, and to systematize the wise use of wetlands that benefits local people. As the Ministry of Environment plans to establish its other master plan for wetland conservation based on the $2^{nd}$ Fundamental Plan, this document introduces the $2^{nd}$ Fundamental Plan to stakeholder and wetland professions.

• Journal of Nutrition and Health
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• v.53 no.2
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• pp.203-214
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• 2020

Purpose: This study investigated customers' perception of a hygiene grade certification system for restaurants and this study also determined way to promote the application of the hygiene grade certification. Methods: A total of 315 customer responses were used for the data analysis. Statistical analyses were conducted using the SPSS program (ver. 23.0) for frequency analysis, χ²-tests, t-tests, analysis of variance, and Importance-Performance Analysis (IPA). Results: The composition of the respondents was 43.8% males and 56.2% females. The 73.3% lived with their families while 26.7% lived alone. Among those surveyed, 84.5% dine out at least once a week and 66.8% dine out during weekends evening. In addition, the most preferred types of restaurants were Korean restaurants (37.5%), delivery restaurants (14.6%), and Western restaurants (8.9%). Information about restaurant was most frequently obtained through Internet searches (54.0%). The average expenditure of eating-out per person was 15,483 Korean won, and the overall satisfaction averaged 3.58 out of 5 points. According to the results of IPA, the restaurant selection attributes that were priorities for improvement were the foods' taste and restroom cleanliness. In addition, 30.5% of respondents recognized the hygiene grade certification system for restaurants. The intention of dining at restaurants with a hygiene grade certification in the future was on average 4.02 out of 5 points. A total of 56.8% of respondents were willing to pay more for a restaurant with a hygiene grade certification. The average percentage of additional price was 6.02%. Conclusion: In order to apply and quickly disseminate the hygiene grade certification system all over the Korea, the study results suggest that relevant policy should be provided by the Korean government for certified restaurants along with the relevant education and promotion of the system to customers.

• Nutrition Research and Practice
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• v.4 no.3
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• pp.229-234
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• 2010

Recently, we found and analyzed vitamin $B_{12}$ in some Korean traditional plant foods which had not reported, yet. This study was to investigate vitamin $B_{12}$ intake and its dietary sources and the vitamin $B_{12}$ status in the very old elderly Koreans. We measured serum vitamin $B_{12}$ level and estimated the amounts of vitamin $B_{12}$ intake from different dietary sources in female elderly Koreans aged 85 and over who had consumed a relatively low animal traditional diet for the whole life. The average age of the subjects (n = 127) was 98.0 years (85-108 years). The assessment on energy and nutrient intake involved a one-day 24-hour recall, and serum vitamin $B_{12}$ concentration was measured by radioimmunoassay. Overall diet pattern was not different between the 85-99 yr-old group and centenarians, except centenarians were taking more dairy product. The average ratio of plant food to animal food consumption was 87.5:12.5 in weight. The average vitamin $B_{12}$ intake of our subjects was 3.2 ${\mu}g$, and 52.7% of subjects consumed under estimated average requirement, 2.0 ${\mu}g$/day. On dietary source, 67.3% of dietary vitamin $B_{12}$ was from meat, eggs and fishes and 30.6% was from plant foods, such as soybean-fermented foods, seaweeds, and kimchi. The average serum vitamin $B_{12}$ concentration was 450.5 pg/mL, and low serum vitamin $B_{12}$ (< 200 pg/mL) was found in 9.6% of subjects. Dietary vitamin $B_{12}$ intake was significantly lower in subjects with low serum vitamin $B_{12}$ (0.79 ${\mu}g$/day) than those with normal serum vitamin $B_{12}$ (3.47 ${\mu}g$/day). There were no significant difference in vitamin $B_{12}$ intake and its dietary sources and serum vitamin $B_{12}$ level between the 85-99 yr- old group and centenarians. In conclusion, several plant-origin foods including seaweed, soybean-fermented foods, and kimchi, may contribute significantly to good vitamin $B_{12}$ status in very old elderly Koreans.

• Korean Journal of Veterinary Service
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• v.25 no.2
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• pp.117-126
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• 2002

Contamination levels of pathogenic microorganisms in 145 cases of beef, which were distributed in Gwangju province, had been investigated in each distributed stage and also monitored by general bacterial count and E coli count index. General bacterial count of beef from the slaughterhouse was 10$^4$cfu/g less than the level of promotion(10 cfu/$\textrm{cm}^2$) and E coli count index was also under the level of 10$^2$cfu/$\textrm{cm}^2$ recommended level of the ministry of agriculture and forestry. Pathogenic microorganisms were detected from 23.2% of samples in the consumption stage, 12.5% in the slaughtering stage and 5.6% in the transporting and processing stage. Staphylococcus aureus was isolated in the largest number and its ratio was 9.0%, listeria monocytogenes 5.5% and salmonella spp 1.4%. There were no samples that bacteria had been detected dually. E coli O157:H7 and campylobacter jejuni were not isolated. In raw and chilled beef, isolation rate of pathogenic microorganisms were 13.3% and 16.5% each. Especially in raw beef, L monocytogenes was. isolated in 3 samples among 30 cases (10%) and S aureus in one sample (3.3%). According to a scale of meat store, isolation rates of pathogenic microorganisms were different. It was 28.6% in the small-scale meat store and 16.7% in the large-scale meat store each. Four cases (16.7%) of S aureus were isolated in the large-scale meat store and seven cases (20.0%) of L monocytogenes and 2 cases (5.7%) of salmonella spp were isolated in the small-scale meat store. S aureus was isolated in two places among 10 feeding facilities of the elementary school. This result shows that the sanitation of elementary school feeding facilities is so poor and more careful policy consideration is needed. Eleven strains of S aureus isolated showed ${\beta}$-hemolysis on blood agar, 1 strain ${\alpha}$-hemolysis, and 1 strain ${\gamma}$-hemolysis. Isolated strains of L monocytogenes were reconfirmed in 560 bp by PCR. Conclusively, these results show that the sanitary condition in the stages of slaughtering, transportation-processing and consumption influences the degree of pathogenic microorganisms contamination in beef severely It is necessary to apply thoroughly hazard analysis critical control point in a process of beef distribution and also to develop rapid test methods for microorganism diagnosis. This effort is very important for the supply of safe and clean meat from farm to table and helpful for the improvement of public health.

• Journal of Digital Convergence
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• v.15 no.8
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• pp.257-265
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• 2017

The purpose of this study was to investigate the degree of awareness of the concept of 'hospice palliative medical care' and decision of 'life-prolonging medical care' by the general public subjects. A survey was conducted on 346 participants and officials who participated in an event held in September 2016. As a result of the research, the subjects' responses results to the life-prolonging medical care decision showed that people with religion wanted natural death compared to people without religion, and had more active attitude toward decisions related to dignity death. Religion is an important factor that can influence perceptions of life and death, believing that afterlife is after death, so it is possible to take a more firm stance on the extension of meaningless life at the last minute. Therefore, in order to stabilize the hospice care and prescription medical decision law to the general public and to improve the quality of the death and the dignity of life, it is necessary to develop awareness through various educational programs in consideration of age, education level. In addition, education and promotion should be strengthened so that the general public can fully understand the knowledge of hospice palliative care and health care and government standardization and policies for hospice personnel and breeding programs will be urgent.

• The Journal of the Convergence on Culture Technology
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• v.2 no.2
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• pp.45-49
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• 2016

It may be summarized to four kinds of innovation through global convergence, and the convergence of adjacent areas according to mega-trends in medical services market and actively introduced ICT technologies, public and private partnership. Health care is no longer a local industry, it is becoming Global Convergence. In the case of developed countries, it is increased to income levels, the development of new medical technologies, while the increase in specialized medical services and need of aging population. It increases migration of foreign medical personnel, geographical proximity and choice of the best medical technology, regardless of the cost. The increasing demand for high quality yet relatively low foreign prices of medical services. Hospitals are especially spread of international certification such as the US JCI standards. Hospital exports are being evaluated and opened the way for the export industrialization as ICT convergence hospital that can be exported to the fusion-related technologies more efficiently. Current local hospital has already reached saturation, globalization of Korean hospital is being the time necessary. Thus, unlike a strategy for each country, as well as technology transfer it is also possible, such as total exports provided the building, medical equipment procurement, local medical personnel (doctors and nurses) selection and training, PR and marketing. In the current medical law and need to be revised prospectively maintained for publicity and abroad, there is a need for further legal dragons and actively support a more flexible policy on the application of national law overseas medical services.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.365-374
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• 2015

The goal of this study was 1) to compare the physical activity between the normal(NO) and obese (OB) group at baseline and 2) to investigate responses of the physical activity to a 24-week walking exercise program in both groups. A total of 29 middle-aged women was classified NO and OB group based on the BMI($25kg/m^2$). Walking exercise was designed to energy expenditure of 500 kcal per day, with a frequence of 3 days per week for 24 weeks. Body composition(Weight, BMI, BF(%), Hip, WHR) were measured at the baseline and after the walking exercise program(24 week). Physical activity were measured during 24 week for wellness convergence in the digital age. In conclusion, the current findings of this study indicate that 1) physical activity is not difference in both groups at baseline 2) 24-week walking exercise program is an effective means of improving physical activity in both NO and OB groups.

• Journal of Digital Convergence
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• v.11 no.1
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• pp.289-297
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• 2013

The destination of this study is a convenience sample of 301 people age 65 and older to use each one elderly welfare center D, M received a structured questionnaire for one-on-one interviews with the subjects to read all the questions and questionnaire was written. The depressed group and the normal group, identify the general characteristics, the ADL, and sleep, and the difference between the two groups, and relative risk were analyzed. The results of the study are as follows: Showed depressed group compared to normal group was the low level of ability to perform daily living, sleep well, not more than the ability to perform daily living, dressing, bowel and bladder management, and complained of the difficulty to perform instrumental activities of daily living ability of grooming, more difficult to appeal to public transportation, shopping. In conclusion, elderly health promotion strategy when you want to take into account whether or not the depression of the elderly will require the development of a variety of education and physical activity programs, and suggest the need for expanded research to determine the effectiveness.

• Journal of the Korean Society of Food Culture
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• v.3 no.4
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• pp.397-406
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• 1988

The changes in the dietary pattern of Koreans during the last one century and its consequences are summarized as follows; 1. Until the beginning of 20th century, Koreans used variety of cereals, vegetables and fruits for their staple food, but the variety has been largely reduced by the agricultural development and urbanized life style. 2. The well balanced traditional dietary pattern of Korean had been deeply deteriorated by the food shortage during the Japanese occupation and Korean war. 3. The deteriorated nutritional condition of Korean was not remedied by the restoration of traditional dietary pattern, but attempted to overcome it by the adoption of Western food habit. 4. The people were trained to eat milk and flour-meals during the starvation of Korean war, and it was continued after Korean war through the animal husbandry promotion policy. 5. The importation of food and feed cereals has been increased rapidly during the economic growth in 1970's and the food self-sufficiency droped below 50%. 6. In 1970's, the food supply pattern of Korean was restored to the level of early 1900, but the consumption of lipid increased extraordinarily. 7. The overconsumption of animal food and lipid continues in 1980's, and it coincides with the rapid increase in the occurence of food related degenerative deseases. 8. The establishment of Korean dietary goal which is based on the traditional dietary pattern is needed.