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Detection of Site Environment and Estimation of Stand Yield in Mixed Forests Using National Forest Inventory (국가산림자원조사를 이용한 혼효림의 입지환경 탐색 및 임분수확량 추정)

  • Seongyeop Jeong;Jongsu Yim;Sunjung Lee;Jungeun Song;Hyokeun Park;JungBin Lee;Kyujin Yeom;Yeongmo Son
    • Journal of Korean Society of Forest Science
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    • v.112 no.1
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    • pp.83-92
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    • 2023
  • This study was established to investigate the site environment of mixed forests in Korea and to estimate the growth and yield of stands using national forest resources inventory data. The growth of mixed forests was derived by applying the Chapman-Richards model with diameter at breast height (DBH), height, and cross-sectional area at breast height (BA), and the yield of mixed forests was derived by applying stepwise regression analysis with factors such as cross-sectional area at breast height, site index (SI), age, and standing tree density per ha. Mixed forests were found to be growing in various locations. By climate zone, more than half of them were distributed in the temperate central region. By altitude, about 62% were distributed at 101-400 m. The fitness indexes (FI) for the growth model of mixed forests, which is the independent variable of stand age, were 0.32 for the DBH estimation, 0.22 for the height estimation, and 0.18 for the basal area at breast height estimation, which were somewhat low. However, considering the graph and residual between the estimated and measured values of the estimation equation, the use of this estimation model is not expected to cause any particular problems. The yield prediction model of mixed forests was derived as follows: Stand volume =-162.6859+6.3434 ∙ BA+9.9214 ∙ SI+0.7271 ∙ Age, which is a step- by-step input of basal area at breast height (BA), site index (SI), and age among several growth factors, and the determination coefficient (R2) of the equation was about 96%. Using our optimal growth and yield prediction model, a makeshift stand yield table was created. This table of mixed forests was also used to derive the rotation of the highest production in volume.

The Relationship between Social Relations and Physical Activity in the Young-old and Old-old Elderly (전·후기 노인들의 사회적 관계와 신체활동 실천과의 관련성)

  • So Youn Jeon;Sok Goo Lee
    • Journal of agricultural medicine and community health
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    • v.48 no.2
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    • pp.103-117
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    • 2023
  • Objectives: This study aims to reveal the relationship between social relations and physical activity in the young-old and old-old elderly. Methods: Data from 2020 National survey of Older Koreans were used, and a total of 10,097 subjects over the age of 65 were included in analysis. The dependent variable was physical activity, and the independent variables were social relations barrier and motivational factors. x2-test and binary logistic regression were performed for data analysis. Results: The physical activity rate in the elderly were 40.8% in the young-old and 29.2% in the old-old. The socio-demographic characteristics affecting physical activity were the young-old elderly were sex, residential area, employment status and household income, and the old-old elderly were sex, age, residential area, education level and household income. The social relations barrier factors affecting physical activity were the young-old elderly were number of close friends, family care, exercise information search and video viewing, and the old-old elderly were household type, number of close friends, participation in exercise education, exercise information search and video viewing. The social relations motivational factors affecting physical activity were the young-old elderly were call with children/relative/friend, participation in sports activity, access time from home to parks, and the old-old elderly were call with children/relative/friend, participation in sports activity, satisfaction with green spaces. Conclusions: It was found that social relations barrier and motivational factors of the elderly are important factors to consider when developing physical activity promotion strategy, and there are also difference between the age of the elderly.

Association Between Structural and Functional Aspects of Social Networks and Health Promoting Behaviors: Focusing on Community-Dwelling Older Adults (사회적 관계망의 구조적, 기능적 측면과 건강증진행동과의 관계: 지역사회 거주 노인을 중심으로)

  • An, Hyunseo;Kim, Inhye;Yun, Sohyeon;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.12 no.4
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    • pp.81-96
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    • 2023
  • Objective : This study aimed to examine the association between the structural and functional aspects of social networks and health-promoting behaviors in community-dwelling older adults. Methods : Social networks based on structural and functional aspects and health-promoting behaviors by lifestyle were measured in 226 community-dwelling adults aged 65 years and over. To analyze the collected data, an independent t-test, one-way ANOVA, Pearson's correlation analysis, and hierarchical regression were performed. Results : The network size was the highest in the friend network, and the frequency of contact and social support was the highest in the non-living family network. Health-promoting behaviors were highest for activities of daily living and lowest for productive and social activities. All subfactors of social networks showed significant positive correlations with health-promoting behaviors. Hierarchical regression showed social support from neighbors as the variable with a significant effect on health-promoting behaviors; gender and depression were also influencing factors, and this model showed 37% explanatory power. Conclusion : To promote healthy behaviors of older adultsin the community, the development of health promotion programs and related policies considering social networks centering on social support from neighbors is required.

Customer Value Factors Influencing the Continuous Use Intention of Department Store Mobile Apps : Focusing on the Customer of Sinsegae Department Store (백화점 모바일 앱 지속 이용 의도에 영향을 미치는 고객 가치 요인 : 신세계 백화점 이용 고객을 중심으로 )

  • Kim, So-hyun;Choi, Chang-bum
    • Journal of Venture Innovation
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    • v.6 no.4
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    • pp.23-40
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    • 2023
  • This study examines the customer value factors affecting the intention to continue using the mobile app of department stores, which are traditional offline retailers, in the retail industry that is rapidly digitalizing and becoming mobile. This study clarifies multidimensional customer value in three dimensions; functional, convenience, and social. Functional value refers to the integrated channel, and consistent customer experience provided between channels in the omnichannel retail environment, while convenience value is the convenience of saving time and effort save while customers use a mobile app. Social value refers to the improvement of social approval or social self-concept occurring due to the use of products or services related to green marketing within the mobile app of the department store. The influence of each on the dependent variable, the mobile app's continuous use intention, was analyzed by using the three dimensions of customer value as independent variables. Data was collected from customers who have a history of using the mobile app of Shinsegae Department Store in Korea, and a confirmatory analysis was conducted using Smart PLS 4.0. The analysis results showed that all three dimensions of customer value; functional value, convenience value, and social value, had a positive (+) influence on customers' intention to continue using the mobile app, and the influence of functional value had the greatest impact. As functional value appears to be the most important influencing factor due to the omnichannel retail trend by advancement of technology, it suggests that it is important for department stores, and offline retailers, to provide integrated channels. This provides insights into the direction of customer-centered strategy formulation for activating department store mobile apps and suggests basic analytical data for customized services and marketing activities that department stores can effectively meet the changing expectations and demands of customers through new mobile channels rather than existing offline channels.

The Impact of Entrepreneurs' Cognitive Biases on Business Opportunity Evaluation Depending on Social Networks (기업가의 인지편향이 사회적 네트워크에 따라 사업 기회 평가에 미치는 영향)

  • Jang, Hyo Shik;Yang, Dong Woo
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.5
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    • pp.185-196
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    • 2023
  • This paper investigates the effects of entrepreneurs' cognitive biases on business opportunity evaluation, given their strong entrepreneurial spirit, which is characterized by innovation, proactivity, and risk-taking. When making decisions related to business activities, entrepreneurs typically make rational judgments based on their knowledge, experience, and the advice of external experts. However, in situations of extreme stress or when quick decisions are required, they often rely on heuristics based on their cognitive biases. In particular, we often see cases where entrepreneurs fail because they make decisions based on heuristics in the process of evaluating and selecting new business opportunities that are planned to guarantee the growth and sustainability of their companies. This study was conducted in response to the need for research to clarify the effects of entrepreneurs' cognitive biases on new business opportunity evaluation, given that the cognitive biases of entrepreneurs, which are formed by repeated successful experiences, can sometimes lead to business failure. Although there have been many studies on the effects of cognitive biases on entrepreneurship and opportunity evaluation among university students and general people who aspire to start a business, there have been few studies that have clarified the relationship between cognitive biases and social networks among entrepreneurs. In contrast to previous studies, this study conducted empirical surveys of entrepreneurs only, and also conducted research on the relationship with social networks. For the study, a survey was conducted using a parallel survey method using online mobile surveys and self-report questionnaires from 150 entrepreneurs of small and medium-sized enterprises. The results of the study showed that 'overconfidence' and 'illusion of control', among the independent variables of entrepreneurs' cognitive biases, had a statistically significant positive(+) effect on business opportunity evaluation. In addition, it was confirmed that the moderating variable, social network, moderates the effect of overconfidence on business opportunity evaluation. This study showed that entrepreneurs' cognitive biases play a role in the process of evaluating and selecting new business opportunities, and that social networks play a role in moderating the structural relationship between entrepreneurs' cognitive biases and business opportunity evaluation. This study is expected to be of great help not only to entrepreneurs, but also to entrepreneur education and policy making, by showing how entrepreneurs can use cognitive biases in a positive way and the influence of social networks.

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The Effect of Satisfaction Level with the University Entrepreneurship Education, Recognition of Support System, and Mentoring on the Entrepreneurial Intention: The Moderating Effect of Entrepreneurial Self-Efficacy (대학생의 창업교육 만족도와 창업지원제도인식, 창업멘토링이 창업의지에 미치는 영향: 창업효능감을 조절효과로)

  • Yu, Young Cheul;Lee, Won Il
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.2
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    • pp.187-200
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    • 2023
  • The purpose of this study is to examine how the start-up education, start-up support system, and start-up mentoring directly and indirectly conducted in universities affects entrepreneurial Intention, and to present programs and directions that can increase the possibility of start-up for college students. This study analyzed the effects of college students' satisfaction with university entrepreneurship education, awareness of the entrepreneurship support system, and entrepreneurship mentoring on entrepreneurial will, and then analyzed how entrepreneurship efficacy affects entrepreneurial will as a moderating effect. The recognition of the start-up support system was divided into the government start-up support policy and the university start-up support project, and start-up mentoring was divided into mentoring function (problem-solving function, networking function, communication function, motivation function) and mentor trust (cognitive trust, emotional trust). Regression analysis was performed on satisfaction with college entrepreneurship education, perception of entrepreneurship support system, entrepreneurship mentoring as independent variables, and willingness to entrepreneurship as dependent variables. In addition, entrepreneurship efficacy was designated as a moderating variable and analyzed. As a result of the study, first, it was found that satisfaction with start-up education had a positive (+) effect on college students' willingness to start a business. Second, among the start-up support systems, university start-up support projects were found to have a positive (+) effect on college students' willingness to start a business. Third, as a result of verifying whether entrepreneurial self-efficacy has a moderating effect on the relationship between college start-up support projects and college students' willingness to start a business while recognizing the start-up support system, it was found to have a moderating effect. The following implications can be derived based on the analysis results of this study. First, efforts to improve start-up education will be needed to increase the satisfaction of start-up education. Second, Through the operation of the start-up counseling center in the university, it will be possible to recognize the education system supported by the university, the university start-up support project that can carry out the indirect experience of start-up, and the government start-up support policy that supports funds. Third, It will be necessary to open a program that can provide start-up mentoring through connection with mentors in the start-up field, such as professors, employees, and senior start-ups in universities. Fourth, It is necessary to develop thorough education on the preparation process of start-ups, start-up special lectures where senior start-ups can indirectly experience the failure of start-ups, and programs for customized start-up education according to college students' major and individual tendencies.

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Changes in the Behavior of Healthcare Organizations Following the Introduction of Drug Utilization Review Evaluation Indicators in the Healthcare Quality Evaluation Grant Initiative (의료질평가지원금 제도의 의약품안전사용서비스 평가지표 도입에 따른 의료기관의 행태 변화)

  • Hyeon-Jeong Kim;Ki-Bong Yoo;Young-Joo Won;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.2
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    • pp.178-184
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    • 2024
  • Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

Studies on the Mechanical Properties of Weathered Granitic Soil -On the Elements of Shear Strength and Hardness- (화강암질풍화토(花崗岩質風化土)의 역학적(力學的) 성질(性質)에 관(關)한 연구(硏究) -전단강도(剪斷强度)의 영향요소(影響要素)와 견밀도(堅密度)에 대(對)하여-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.66 no.1
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    • pp.16-36
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    • 1984
  • It is very important in forestry to study the shear strength of weathered granitic soil, because the soil covers 66% of our country, and because the majority of land slides have been occured in the soil. In general, the causes of land slide can be classified both the external and internal factors. The external factors are known as vegetations, geography and climate, but internal factors are known as engineering properties originated from parent rocks and weathering. Soil engineering properties are controlled by the skeleton structure, texture, consistency, cohesion, permeability, water content, mineral components, porosity and density etc. of soils. And the effects of these internal factors on sliding down summarize as resistance, shear strength, against silding of soil mass. Shear strength basically depends upon effective stress, kinds of soils, density (void ratio), water content, the structure and arrangement of soil particles, among the properties. But these elements of shear strength work not all alone, but together. The purpose of this thesis is to clarify the characteristics of shear strength and the related elements, such as water content ($w_o$), void ratio($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$), and the interrelationship among related elements in order to decide the dominant element chiefly influencing on shear strength in natural/undisturbed state of weathered granitic soil, in addition to the characteristics of soil hardness of weathered granitic soil and root distribution of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands. For the characteristics of shear strength of weathered granitic soil and the related elements of shear strength, three sites were selected from Kwangju district. The outlines of sampling sites in the district were: average specific gravity, 2.63 ~ 2.79; average natural water content, 24.3 ~ 28.3%; average dry density, $1.31{\sim}1.43g/cm^3$, average void ratio, 0.93 ~ 1.001 ; cohesion, $ 0.2{\sim}0.75kg/cm^2$ ; angle of internal friction, $29^{\circ}{\sim}45^{\circ}$ ; soil texture, SL. The shear strength of the soil in different sites was measured by a direct shear apparatus (type B; shear box size, $62.5{\times}20mm$; ${\sigma}$, $1.434kg/cm^2$; speed, 1/100mm/min.). For the related element analyses, water content was moderated through a series of drainage experiments with 4 levels of drainage period, specific gravity was measured by KS F 308, analysis of particle size distribution, by KS F 2302 and soil samples were dried at $110{\pm}5^{\circ}C$ for more than 12 hours in dry oven. Soil hardness represents physical properties, such as particle size distribution, porosity, bulk density and water content of soil, and test of the hardness by soil hardness tester is the simplest approach and totally indicative method to grasp the mechanical properties of soil. It is important to understand the mechanical properties of soil as well as the chemical in order to realize the fundamental phenomena in the growth and the distribution of tree roots. The writer intended to study the correlation between the soil hardness and the distribution of tree roots of Pinus rigida Mill. planted in 1966 and Pinus rigida ${\times}$ taeda in 199 to 1960 in the denuded forest lands with and after several erosion control works. The soil texture of the sites investigated was SL originated from weathered granitic soil. The former is situated at Py$\ddot{o}$ngchangri, Ky$\ddot{o}$m-my$\ddot{o}$n, Kogs$\ddot{o}$ng-gun, Ch$\ddot{o}$llanam-do (3.63 ha; slope, $17^{\circ}{\sim}41^{\circ}$ soil depth, thin or medium; humidity, dry or optimum; height, 5.66/3.73 ~ 7.63 m; D.B.H., 9.7/8.00 ~ 12.00 cm) and the Latter at changun-long Kwangju-shi (3.50 ha; slope, $12^{\circ}{\sim}23^{\circ}$; soil depth, thin; humidity, dry; height, 10.47/7.3 ~ 12.79 m; D.B.H., 16.94/14.3 ~ 19.4 cm).The sampling areas were 24quadrats ($10m{\times}10m$) in the former area and 12 in the latter expanding from summit to foot. Each sampling trees for hardness test and investigation of root distribution were selected by purposive selection and soil profiles of these trees were made at the downward distance of 50 cm from the trees, at each quadrat. Soil layers of the profile were separated by the distance of 10 cm from the surface (layer I, II, ... ...). Soil hardness was measured with Yamanaka soil hardness tester and indicated as indicated soil hardness at the different soil layers. The distribution of tree root number per unit area in different soil depth was investigated, and the relationship between the soil hardness and the number of tree roots was discussed. The results obtained from the experiments are summarized as follows. 1. Analyses of simple relationship between shear strength and elements of shear strength, water content ($w_o$), void ratio ($e_o$), dry density (${\gamma}_d$) and specific gravity ($G_s$). 1) Negative correlation coefficients were recognized between shear strength and water content. and shear strength and void ratio. 2) Positive correlation coefficients were recognized between shear strength and dry density. 3) The correlation coefficients between shear strength and specific gravity were not significant. 2. Analyses of partial and multiple correlation coefficients between shear strength and the related elements: 1) From the analyses of the partial correlation coefficients among water content ($x_1$), void ratio ($x_2$), and dry density ($x_3$), the direct effect of the water content on shear strength was the highest, and effect on shear strength was in order of void ratio and dry density. Similar trend was recognized from the results of multiple correlation coefficient analyses. 2) Multiple linear regression equations derived from two independent variables, water content ($x_1$ and dry density ($x_2$) were found to be ineffective in estimating shear strength ($\hat{Y}$). However, the simple linear regression equations with an independent variable, water content (x) were highly efficient to estimate shear strength ($\hat{Y}$) with relatively high fitness. 3. A relationship between soil hardness and the distribution of root number: 1) The soil hardness increased proportionally to the soil depth. Negative correlation coefficients were recognized between indicated soil hardness and the number of tree roots in both plantations. 2) The majority of tree roots of Pinus rigida Mill and Pinus rigida ${\times}$ taeda planted in erosion-controlled lands distributed at 20 cm deep from the surface. 3) Simple linear regression equations were derived from indicated hardness (x) and the number of tree roots (Y) to estimate root numbers in both plantations.

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A Research in the Characteristic of Arthritis Patienth (관절염환자(關節炎患者)의 특성(特性)에 대한 조사(調査) 연구(硏究))

  • Kang Jeam-Dug;Nam Chul-Hyun;Kim Gi-Yeol
    • Journal of Society of Preventive Korean Medicine
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    • v.1 no.1
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    • pp.149-165
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    • 1997
  • In order that, investigating the feature of patients suffering arthritis, analysing its contents, and grasping a Primary factor affecting it, I might offerbasic datas which could help to plan and perform healthy affairs to thake precautions beforehand, I have investigated, analysed, and studied a total of 320 patients suffering arthritis, who have received physiotherapy in hospital located in Teaegu area for five months, from November 1 1995 to March 30 1996, of which summary and conclusion is this. 1. The general feature of patients in investigative objects In the distribution of the distinction of sex, men accounted for 26.9% and women, for 73.1%, and, in the fistribution of age, 60-year-old or more, most for 27.2% and from 20 to 29 years old, least for 14.0%. In the distinction of a vocation, housewives most accounted for 34.7% and students(jobless men), least for 19.3%. In the distinction of a matrimonial state, married persons most accounted for 76.7% and people living alone(divorce, separation by death, separation), least for 11.4%. In the distinction of an economic state, the middle classes most accounted for 73.5% and the upper classes, least for 2.9%. In the distinction of their academic careers, graduates of a primary school most accounted for 26.9% and graduates of university, for 14.1%, of which patients, having the ability to decode the national language, reached to 11.3%. In the distinction of the house form, people living in independent houses most accounted for 76.4% and residents in apartment(having an elevator), least for 9.4%. 2. In the distribution of the recurring state in the distinction of the feature, the recurring group was more than the group of patients falling that ill at first as 62.2% and in the distinction of the feature of the recurring group, the recurring group turned high in case of men being from 50s to 60s years old or more, people living alone (divorce, separation by death, separation), students (joblessmen), people working in farming, stockbeeding, forestry, fisheries, a simple labour, graduates of a primary school I having the ability to decode the national language, the upper classes, people part two years since they begined to suffer arthritis, people who had members having ever experienced arthritis among families. 3. In the distribution of arthritis on the distinction of bodily pars, a knee articulation most accounted for 50.2% and the articulation of fingers, for 8.8%, wile the simultaneous, several parts (multiple) accounted for 35.1%. In the distinction of the feature, arthritis of a knee turned high in case of men being from 20s to 30s years old, unmarried persons, people having academic careers of university, the middle classes, residents in apartment (having stairs). In the dictnction of a feature the case of several parts (multiple) turned high in case of women being from 50s to 60s years old or more, people living alone (divorce, separation by death, separation), people having the ability to decode th. national language, the graduates of a primary school, the upper classes, residents in apartment (having elevator). 4. In the distribution of arthritis on e distinction of a contracting term, two years or more most accounted for 51.6% and the case of contacting from one year to two years, for 15.3%. Analysing the distinction of the feature, the case of two years or more turned high in case of women being from 50s to 60s years old or more, people living alone (divorce separation by death, separation), the upper classes, people having the ability to decode the national language, residents in apartment (having elevator). 5. In the distribution of an treatment institution before patients came to help, their not curing most accounted for 39.1%, general, orthopedic, neurological surgery (physical therapy), for. 20.0%, and th. therapy of Chinese medicine (acupuncture, moxacautery, Chinese medicine), for 17.5%, and a pharmacy (medical therapy), for 13.4%. The case of patients not curing, in the distinction of a feature, turned high in case of men 20s years old, unmarried, the lower classes, people having academic careers of university, residents in apartment (having elevator). 6. In e distribution of the extent of satisfaction with treatment, common most accounted for 54.4% and some satisfaction, for 32.8%. The case of common, in the distinction of a feature, turned high, in case of men living alone from 50s to 60s years old (divorce, separation by death, separation), married persons, the upper classes, people having academic careers of university, residents in independent house, residents in apartment (having elevator), 7. In the distribution of the degree of knowledge of the cause of arthritis, patients knowing that the cause is to use very much a articulation in normal times most accounts for 60.1%, and patients knowing the state of short nutrition as a cause, for 2.5%. The case of patients knowing that the cause is to use very much in normal times, in the distinction of a feature, turned high in·case of ment being 20s and 60s years old or more, unmarried persons, e lower classes, people having the ability to decode. the national language, people having academic careers of university, residents in apartment (having stairs), 8. In the distribution of the state of physical exercise before arthritis contracted, patients exercising very much on the whole most accpimend for 40.3%, and patients not exercising, for 34.7%. The case of patients exercising very much on the whole, in the distinction of the feature, turned high in case of men being from 50s to 60s years old or more, people living alone(divorce, separation by death, separation), the lower classes, people having the ability to decode the national language, graduates of a primary school, residents in apartment (having elevator). 9. In the taste of patients suffering from arthritis, while the group of patients falling that ill at first and the recurring group didn't smoke cigarets, during alcohol and coffee on the whole, and the group of patients falling once again that ill drank a cup of distilled linquor and three cup of coffee or more on the whole per one day, and the group of patients falling that ill at first liked sort of vegetables and the recurring group liked very much sons of vegetables and fresh and meat in their loving food normal times. 10. Analysing the distribution on the dining table used by patients and the structure of a powder room, at first, in the structure of a powder room, the group of patients filling that ill have a toilet stool using as their sits, and a Bush toilet on the whole, and the recurring group, a toilet stool using as their sits and conventional type, and in the structure of a dinning table, the group of patients falling that ill at first and the recurring group turned high, each as 66.9% and 6.3%, who have a dining table carring here and there. 11. In the distribution of patients of arthritis in relation to stress, the case that they feeled severly symptoms of arthritis when thay got stress, turned high, each, as 78.6% in the recurring poop, and the case not knowing, as 61.5% in the first group. In the extent of stress normal times, the case that they got much stress on the whole turned high, each, as 72.4% in e recurring group, and the care that got less stress on the whole, as 60.0%. 12. In the distribution on the distinction of symptoms and impedimental extent, the recurring group turned high in each variable. Analysing the feature of the recurring group, in the distinction of symptoms, the case that they fooled much that the node of an articulation is stiff, turned high, as 71.6, and in the distinction of treatment before. patients came to helpk, the theraphy of Chinese medicine (physical theraphy), as 84.4%, the theraphy of Chinese medicine (acupuncture, moxacautery, Chinese medicine), as 73.2%, and in the distinction of the satisfing extent on treatment, the case of comman, as 72.3%, and in the cause of arthritis, the case not recruiting their health after a birth, as 68.5%, and the case not recovering wholely an articulation having got hurt, as 62.8%, and in the state of physical exercise before they begined suffering from arthritis, the case exercising very much on the whole, (as 74.2%), and in the extent of subjective impediment, the case of not being able to act almost, as 66.7%, the case of acting but feeling some hard, as 66.3%. 13. The correlation in variables in relation to arthritis Analysing realted variables, the recurring frequency showed correlation with such as the extent that patients got stress normal times, and the exercising state before suffering arthritis, and showed contra-correlation with academic careers, the wights, coffee. The cigaret, e loving food of taste, showed corralation with the weight, stature, alcohole as the loving food of taste. On the basis of this result medical members of heal, who are related to the regular education, public education or development of this program, should be concerned to prevent orthris.

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An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • 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.

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