• 제목/요약/키워드: the New Women

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Determination of metabolites of prostanozol in human urine by LC/ESI/MS and GC/TOF-MS (LC/ESI/MS와 GC/TOF-MS를 이용한 인체뇨시료에서의 Prostanozol 대사체 검출)

  • Yum, Tae-Woo;Paeng, Ki-Jung;Kim, Yun-Je
    • Analytical Science and Technology
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    • v.24 no.3
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    • pp.173-182
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    • 2011
  • This research examined prostanozol and its metabolites in urine of women who took the medicine (prostanozol). Prostanozol and its metabolites were successfully separated and detected by using LC/ESI/MS and GC/TOF-MS. Mass spectrum of LC/ESI/MS estimated molecular weight of Prostanozol and its metabolites and that of GC/TOF-MS verified them. For M1, carbon number 17 of Prostanozol substituted to a keto group and it is called 17-keto-Prostanozol. M2 turned out to be hydroxy-17-keto-Prostanozol. It came from substitution of one hydroxyl group of pyrazole nucleus and A-ring of M1. Substitution of one hydroxyl group of B-ring or C-ring became M3, hydroxy-17-keto-Prostanozol. M4 was found to be a hydroxy-17-keto-Prostsnozol transposed from one hydroxyl group to a D-ring. M5 has a hydroxyl group of carbon number 17. One hydroxyl group is substituted from B-ring or C-ring and it is assumed to be hydroxy-17-hydroxy-Prostanozol. M6 was turned out to be dihydroxy-17-keto-Prostanozol transposed from one hydroxyl group to pyrazole nucleus or A-ring and to B-ring or C-ring. Like M6, M7 has a keto group at carbon number 17 and was identified as dihydroxy-17-keto-Prostanozol. M7 has one hydroxyl group at pyrazole nucleus or A-ring and also at D-ring. At last M8 was found to be dihydroxy-17-hydroxy-Prostanozol. Pyrazole nucleus or A-ring has got one hydroxyl group and other rings were substituted to another hydroxyl group. From above, M5, M7 and M8 were verified as new metabolites that were not discovered yet. Prostanozol and all of the 8 metabolites formed glucuronic conjugates as a result of conjugation reaction test in human body. Some of 8 metabolites were excreted without forming conjugates. Particularly M6 and M7 were excreted as sulfate conjugates.

글로벌 아트페어(Global Art Fair) 비평적 읽기

  • Sim, Sang-Yong
    • The Journal of Art Theory & Practice
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    • no.6
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    • pp.51-76
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    • 2008
  • Nous obserbons dans le champs de l'art aujourd' hui, le changement radical provoquant $\'{e}$tant donn$\'{e}$ que le pouvoir du march$\'{e}$ de l'art s'augmente de plus en plus. C'est pour cela que le champ du discours de l'art n'est actuellement plus form$\'{e}$ par des notions esth$\`{e}$tiques artistiques, mais par celles qui sont r$\'{e}$serv$\'{e}$es au domaine de l'$\'{e}$conomie et du march$\'{e}$. Il n'est plus significatif de croire la valeur esth$\`{e}$tique de l'oeuvre d'art, puisque l'esth$\`{e}$tique elle-m$\^{e}$me ne fonctionne plus. Par contre, le syst$\`{e}$me de donner le prix $\`{a}$ l'oeuvre d'art fonctionne rigoureusement. En plus, cette situation s'aggrave $\'{e}$tant donn$\'{e}$ que la mondialisation du march$\'{e}$ de l'art s'installe avec rapidit$\'{e}$. Malgr$\'{e}$ la mondialisation de l'art, des gens qui habitent par exemple $\`{a}$ S$\'{e}$oul ne peuvent pas s' approcher facilement de ce qui se passe $\`{a}$ New York, le vrai centre de l'art contemporain. Dans cette situation, le champ de discours de l'art n'a pas d'autre solution de se r$\'{e}$tr$\'{e}$cir remaquablement et le sujet de discussion sur le grand art est remplac$\'{e}$ par celui du success de l'art. Cette recherche est arriv$\'{e}$e $\`{a}$ remarquer que le syst$\`{e}$me du foire internationale de l'art fonctionne comme une locomotive dans le march$\'{e}$ de l'art qui est le vrai dominateur de l'art contemporain. Aujourd'hui les grands clients du monde de l'art et les jeunes sp$\'{e}$ctateurs, les clients de l'avenir s'assemblent autour de quelques foires internationales r$\'{e}$put$\'{e}$s qui ont de l'autorit$\'{e}$. C'est ainsi que l'achat et la vante de l'oeuvres d'art est suffisamment mondialis$\'{e}$ et que le syst$\`{e}$me local du march$\'{e}$ est d$\'{e}$rang$\'{e}$ et s'$\'{e}$ffondr$\'{e}$gravement. Malgr$\'{e}$ la diff$\'{e}$rence significative, la majorit$\'{e}$ des galeries d'art lacaux s'oblige de suivre $\`{a}$ la suite du style du foire internationale de l'art. C'est la raison pour laquelle que cette recherche se fait une id$\'{e}$e nette que la prosp$\'{e}$rit$\'{e}$ actuelle du march$\'{e}$ de l'art n'est que la situation $\'{e}$conomique ou financi$\`{e}$re. A ce stade de la r$\'{e}$flexion, cette recherche arrivera $\`{a}$ poser une question primordiale ci-dessous: "Si l'art qu'on $\`{a}$ l'intention de proclamer ne serai plus possible de faire r$\'{e}$fl$\'{e}$chir sur la libert$\'{e}$ et la solidarit$\'{e}$ humain, la dignit$\'{e}$ de l'homme, cet art n'est plus autre chose que l'insignifiance. Au lieu de parcourir divers ph$\'{e}$nom$\`{e}$ne du march$\'{e}$ de l'art aujourd'hui, cette recherche fixera son attention sur la r$\'{e}$alit$\'{e}$ du foire internationales de l'art. Dans ce context, cette recherche sera compos$\'{e}$e par trois chapitres donc le premi$\`{e}$re essayera de r$\'{e}$pondre $\'{a}$ la question de son influence extraodinairement puissante. Le deuxi$\`{e}$me chapitre essayera d'analiser la r$\'{e}$alit$\'{e}$ et la source du pouvoir du foire internationale de l'art. Nous essayeront au troisi$\`{e}$me chapitre de configurer le point de vue critique qui permettra de bien comprendre notre sujet.

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An Analysis of Determinants of Health Knowledge, Attitude and Practice of Housewives in Korea (한국부인의 보건지식, 태도 및 실천에 영향을 미치는 제요인분석)

  • 남철현
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.3-50
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    • 1984
  • The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.

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A Study of Equipment Accuracy and Test Precision in Dual Energy X-ray Absorptiometry (골밀도검사의 올바른 질 관리에 따른 임상적용과 해석 -이중 에너지 방사선 흡수법을 중심으로-)

  • Dong, Kyung-Rae;Kim, Ho-Sung;Jung, Woon-Kwan
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.17-23
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    • 2008
  • Purpose : Because there is a difference depending on the environment as for an inspection equipment the important part of bone density scan and the precision/accuracy of a tester, the management of quality must be made systematically. The equipment failure caused by overload effect due to the aged equipment and the increase of a patient was made frequently. Thus, the replacement of equipment and additional purchases of new bonedensity equipment caused a compatibility problem in tracking patients. This study wants to know whether the clinical changes of patient's bonedensity can be accurately and precisely reflected when used it compatiblly like the existing equipment after equipment replacement and expansion. Materials and methods : Two equipments of GE Lunar Prodigy Advance(P1 and P2) and the Phantom HOLOGIC Spine Road(HSP) were used to measure equipment precision. Each device scans 20 times so that precision data was acquired from the phantom(Group 1). The precision of a tester was measured by shooting twice the same patient, every 15 members from each of the target equipment in 120 women(average age 48.78, 20-60 years old)(Group 2). In addition, the measurement of the precision of a tester and the cross-calibration data were made by scanning 20 times in each of the equipment using HSP, based on the data obtained from the management of quality using phantom(ASP) every morning (Group 3). The same patient was shot only once in one equipment alternately to make the measurement of the precision of a tester and the cross-calibration data in 120 women(average age 48.78, 20-60 years old)(Group 4). Results : It is steady equipment according to daily Q.C Data with $0.996\;g/cm^2$, change value(%CV) 0.08. The mean${\pm}$SD and a %CV price are ALP in Group 1(P1 : $1.064{\pm}0.002\;g/cm^2$, $%CV=0.190\;g/cm^2$, P2 : $1.061{\pm}0.003\;g/cm^2$, %CV=0.192). The mean${\pm}$SD and a %CV price are P1 : $1.187{\pm}0.002\;g/cm^2$, $%CV=0.164\;g/cm^2$, P2 : $1.198{\pm}0.002\;g/cm^2$, %CV=0.163 in Group 2. The average error${\pm}$2SD and %CV are P1 - (spine: $0.001{\pm}0.03\;g/cm^2$, %CV=0.94, Femur: $0.001{\pm}0.019\;g/cm^2$, %CV=0.96), P2 - (spine: $0.002{\pm}0.018\;g/cm^2$, %CV=0.55, Femur: $0.001{\pm}0.013\;g/cm^2$, %CV=0.48) in Group 3. The average error${\pm}2SD$, %CV, and r value was spine : $0.006{\pm}0.024\;g/cm^2$, %CV=0.86, r=0.995, Femur: $0{\pm}0.014\;g/cm^2$, %CV=0.54, r=0.998 in Group 4. Conclusion: Both LUNAR ASP CV% and HOLOGIC Spine Phantom are included in the normal range of error of ${\pm}2%$ defined in ISCD. BMD measurement keeps a relatively constant value, so showing excellent repeatability. The Phantom has homogeneous characteristics, but it has limitations to reflect the clinical part including variations in patient's body weight or body fat. As a result, it is believed that quality control using Phantom will be useful to check mis-calibration of the equipment used. A value measured a patient two times with one equipment, and that of double-crossed two equipment are all included within 2SD Value in the Bland - Altman Graph compared results of Group 3 with Group 4. The r value of 0.99 or higher in Linear regression analysis(Regression Analysis) indicated high precision and correlation. Therefore, it revealed that two compatible equipment did not affect in tracking the patients. Regular testing equipment and capabilities of a tester, then appropriate calibration will have to be achieved in order to calculate confidential BMD.

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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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Role, Change, Job Satisfaction and Obstacles in Carrying out the Role of Public Health Nurses in Health Center (보건소 보건간호사의 역할변화, 역할수행의 장애요인과 만족도)

  • Ahn, Kyeong-Sook;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.20 no.1
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    • pp.1-13
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    • 1995
  • Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

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A study of the Medical System in the Early Chosun-Dynasty (조선시대(朝鮮時代) 전기(前期)의 의료제도(醫療制度)에 대한 연구(硏究))

  • Han, Dae-Hee;Kang, Hyo-Shin
    • Journal of Korean Medical classics
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    • v.9
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    • pp.555-652
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    • 1996
  • Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

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Open Skies Policy : A Study on the Alliance Performance and International Competition of FFP (항공자유화정책상 상용고객우대제도의 제휴성과와 국제경쟁에 관한 연구)

  • Suh, Myung-Sun;Cho, Ju-Eun
    • The Korean Journal of Air & Space Law and Policy
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    • v.25 no.2
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    • pp.139-162
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    • 2010
  • In terms of the international air transport, the open skies policy implies freedom in the sky or opening the sky. In the normative respect, the open skies policy is a kind of open-door policy which gives various forms of traffic right to other countries, but on the other hand it is a policy of free competition in the international air transport. Since the Airline Deregulation Act of 1978, the United States has signed an open skies agreement with many countries, starting with the Netherlands, so that competitive large airlines can compete in the international air transport market where there exist a lot of business opportunities. South Korea now has an open skies agreement with more than 20 countries. The frequent flyer program (FFP) is part of a broad-based marketing alliance which has been used as an airfare strategy since the U.S. government's airline deregulation. The membership-based program is an incentive plan that provides mileage points to customers for using airline services and rewards customer loyalty in tangible forms based on their accumulated points. In its early stages, the frequent flyer program was focused on marketing efforts to attract customers, but now in the environment of intense competition among airlines, the program is used as an important strategic marketing tool for enhancing business performance. Therefore, airline companies agree that they need to identify customer needs in order to secure loyal customers more effectively. The outcomes from an airline's frequent flyer program can have a variety of effects on international competition. First, the airline can obtain a more dominant position in the air flight market by expanding its air route networks. Second, the availability of flight products for customers can be improved with an increase in flight frequency. Third, the airline can preferentially expand into new markets and thus gain advantages over its competitors. However, there are few empirical studies on the airline frequent flyer program. Accordingly, this study aims to explore the effects of the program on international competition, after reviewing the types of strategic alliance between airlines. Making strategic airline alliances is a worldwide trend resulting from the open skies policy. South Korea also needs to be making open skies agreements more realistic to promote the growth and competition of domestic airlines. The present study is about the performance of the airline frequent flyer program and international competition under the open skies policy. With a sample of five global alliance groups (Star, Oneworld, Wings, Qualiflyer and Skyteam), the study was attempted as an empirical study of the effects that the resource structures and levels of information technology held by airlines in each group have on the type of alliance, and one-way analysis of variance and regression analysis were used to test hypotheses. The findings of this study suggest that both large airline companies and small/medium-size airlines in an alliance group with global networks and organizations are able to achieve high performance and secure international competitiveness. Airline passengers earn mileage points by using non-flight services through an alliance network with hotels, car-rental services, duty-free shops, travel agents and more and show high interests in and preferences for related service benefits. Therefore, Korean airline companies should develop more aggressive marketing programs based on multilateral alliances with other services including hotels, as well as with other airlines.

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The Research on Online Game Hedonic Experience - Focusing on Moderate Effect of Perceived Complexity - (온라인 게임에서의 쾌락적 경험에 관한 연구 - 지각된 복잡성의 조절효과를 중심으로 -)

  • Lee, Jong-Ho;Jung, Yun-Hee
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.147-187
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    • 2008
  • Online game researchers focus on the flow and factors influencing flow. Flow is conceptualized as an optimal experience state and useful explaining game experience in online. Many game studies focused on the customer loyalty and flow in playing online game, In showing specific game experience, however, it doesn't examine multidimensional experience process. Flow is not construct which show absorbing process, but construct which show absorbing result. Hence, Flow is not adequate to examine multidimensional experience of games. Online game is included in hedonic consumption. Hedonic consumption is a relatively new field of study in consumer research and it explores the consumption experience as a experiential view(Hirschman and Holbrook 1982). Hedonic consumption explores the consumption experience not as an information processing event but from a phenomenological of experiential view, which is a primarily subjective state. It includes various playful leisure activities, sensory pleasures, daydreams, esthetic enjoyment, and emotional responses. In online game experience, therefore, it is right to access through a experiential view of hedonic consumption. The objective of this paper was to make up for lacks in our understanding of online game experience by developing a framework for better insight into the hedonic experience of online game. We developed this framework by integrating and extending existing research in marketing, online game and hedonic responses. We then discussed several expectations for this framework. We concluded by discussing the results of this study, providing general recommendation and directions for future research. In hedonic response research, Lacher's research(1994)and Jongho lee and Yunhee Jung' research (2005;2006) has served as a fundamental starting point of our research. A common element in this extended research is the repeated identification of the four hedonic responses: sensory response, imaginal response, emotional response, analytic response. The validity of these four constructs finds in research of music(Lacher 1994) and movie(Jongho lee and Yunhee Jung' research 2005;2006). But, previous research on hedonic response didn't show that constructs of hedonic response have cause-effect relation. Also, although hedonic response enable to different by stimulus properties. effects of stimulus properties is not showed. To fill this gap, while largely based on Lacher(1994)' research and Jongho Lee and Yunhee Jung(2005, 2006)' research, we made several important adaptation with the primary goal of bringing the model into online game and compensating lacks of previous research. We maintained the same construct proposed by Lacher et al.(1994), with four constructs of hedonic response:sensory response, imaginal response, emotional response, analytical response. In this study, the sensory response is typified by some physical movement(Yingling 1962), the imaginal response is typified by images, memories, or situations that game evokes(Myers 1914), and the emotional response represents the feelings one experiences when playing game, such as pleasure, arousal, dominance, finally, the analytical response is that game player engaged in cognition seeking while playing game(Myers 1912). However, this paper has several important differences. We attempted to suggest multi-dimensional experience process in online game and cause-effect relation among hedonic responses. Also, We investigated moderate effects of perceived complexity. Previous studies about hedonic responses didn't show influences of stimulus properties. According to Berlyne's theory(1960, 1974) of aesthetic response, perceived complexity is a important construct because it effects pleasure. Pleasure in response to an object will increase with increased complexity, to an optimal level. After that, with increased complexity, pleasure begins with a linearly increasing line for complexity. Therefore, We expected this perceived complexity will influence hedonic response in game experience. We discussed the rationale for these suggested changes, the assumptions of the resulting framework, and developed some expectations based on its application in Online game context. In the first stage of methodology, questions were developed to measure the constructs. We constructed a survey measuring our theoretical constructs based on a combination of sources, including Yingling(1962), Hargreaves(1962), Lacher (1994), Jongho Lee and Yunhee Jung(2005, 2006), Mehrabian and Russell(1974), Pucely et al(1987). Based on comments received in the pretest, we made several revisions to arrive at our final survey. We investigated the proposed framework through a convenience sample, where participation in a self-report survey was solicited from various respondents having different knowledges. All respondents participated to different degrees, in these habitually practiced activities and received no compensation for their participation. Questionnaires were distributed to graduates and we used 381 completed questionnaires to analysis. The sample consisted of more men(n=225) than women(n=156). In measure, the study used multi-item scales based previous study. We analyze the data using structural equation modeling(LISREL-VIII; Joreskog and Sorbom 1993). First, we used the entire sample(n=381) to refine the measures and test their convergent and discriminant validity. The evidence from both the factor analysis and the analysis of reliability provides support that the scales exhibit internal consistency and construct validity. Second, we test the hypothesized structural model. And, we divided the sample into two different complexity group and analyze the hypothesized structural model of each group. The analysis suggest that hedonic response plays different roles from hypothesized in our study. The results indicate that hedonic response-sensory response, imaginal response, emotional response, analytical response- are related positively to respondents' level of game satisfaction. And game satisfaction is related to higher levels of game loyalty. Additionally, we found that perceived complexity is important to online game experience. Our results suggest that importance of each hedonic response different by perceived game complexity. Understanding the role of perceived complexity in hedonic response enables to have a better understanding of underlying mechanisms at game experience. If game has high complexity, analytical response become important response. So game producers or marketers have to consider more cognitive stimulus. Controversy, if game has low complexity, sensorial response respectively become important. Finally, we discussed several limitations of our study and suggested directions for future research. we concluded with a discussion of managerial implications. Our study provides managers with a basis for game strategies.

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Steroid Effect on the Brain Protection During OPen Heart Surgery Using Hypothermic Circulatory Arrest in the Rabbit Cardiopulmonary bypass Model (저체온순환정지법을 이용한 개심술시 스테로이드의 뇌보호 효과 - 토끼를 이용한 심폐바이패스 실험모델에서 -)

  • Kim, Won-Gon;Lim, Cheong;Moon, Hyun-Jong;Chun, Eui-Kyung;Chi, Je-Geun;Won, Tae-Hee;Lee, Young-Tak;Chee, Hyun-Keun;Kim, Jun-Woo
    • Journal of Chest Surgery
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    • v.30 no.5
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    • pp.471-478
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    • 1997
  • Introduction: The use of rabbits as a cardiopulmonary bypass(CPB) animal model is extremely dif%cult mainly due to technical problems. On the other hand, deep hypothermic circulatory arrest(CA) is used to facilitate surgical repair in a variety of cardiac diseases. Although steroids are generally known to be effective in the treatment of cerebral edema, the protective effects of steroids on the brain during CA are not conclusively established. Objectives of this study are twofold: the establishment of CPB technique in rabbits and the evaluation of preventive effect of steroid on the development of brain edema during CA. Material '||'&'||' Methods: Fifteen New Zealan white rabbits(average body weight 3.5kg) were divided into three experimental groups; control CA group(n=5), CA with Trendelenberg position group(n=5), and CA with Trendelenberg position + steroid(methylprednisolone 30 mglkg) administration group(n=5). After anesthetic induction and tracheostomy, a median sternotomy was performed. An aortic cannula(3.3mm) and a venous ncannula(14 Fr) were inserted, respectively in the ascending aorta and the right atrium. The CPB circuit consisted of a roller pump and a bubble oxygenator. Priming volume of the circuit was approximately 450m1 with 120" 150ml of blood. CPB was initiated at a flow rate of 80~85ml/kg/min, Ten min after the start of CPB, CA was established with duration of 40min at $20^{\circ}C$ of rectal temperature. After CA, CPB was restarted with 20min period of rewarming. Ten min after weaning, the animal was sacrif;cod. One-to-2g portions of the following tissues were rapidly d:ssected and water contents were examined and compared among gr ups: brain, cervical spinal cord, kidney, duodenum, lung, heart, liver, spleen, pancreas. stomach. Statistical significances were analyzed by Kruskal-Wallis nonparametric test. Results: CPB with CA was successfully performed in all cases. Flow rate of 60-100 mlfkgfmin was able to be maintained throughout CPB. During CPB, no significant metabolic acidosis was detected and aortic pressure ranged between 35-55 mmHg. After weaning from CPB, all hearts resumed normal beating spontaneously. There were no statistically significant differences in the water contents of tissues including brain among the three experimental groups. Conclusion: These results indicate (1) CPB can be reliably administered in rabbits if proper technique is used, (2) the effect of steroid on the protection of brain edema related to Trendelenburg position during CA is not established within the scope of this experiment.

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