• Title/Summary/Keyword: treatment facilities

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Analysis study on substances subject to management using long-term water quality monitoring data in tributaries of the Nakdong River basin (낙동강유역 지류에서의 장기 수질모니터링 자료를 이용한 관리 대상물질 분석 연구)

  • Byungseok Kal;Jaebeom Park;Seongmin Kim;Sangmin Shin;Soonja Jang;Minjae Jeon;Donghyun Lee
    • Journal of Wetlands Research
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    • v.25 no.4
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    • pp.326-334
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    • 2023
  • The purpose of this study is to use long-term water quality monitoring data from tributaries of the Nakdong River system to identify problematic substances in tributaries by examining the rate of exceedance and increase in water quality targets. In the Nakdong River system, monitoring is conducted once a month for 38 tributaries that require intensive management, and this data was used to analyze trends in exceeding and increasing target water quality at each point. The analysis items are eight items that can be evaluated based on river water quality standards: DO, BOD, COD, TOC, SS, total phosphorus, fecal coliform, and total coliform. As a result of the analysis, the target water quality exceedance rate was more than 50%, and the items with an increasing trend were TOC, fecal coliform and total E. coli counts, and the items with an exceedance rate of less than 50% but an increasing trend were SS. TOC is believed to be caused by an increase in non-degradable substances, and the continued increase in Total Coliform will require management of Total ColiformTotal Coliform in effluent water from sewage treatment facilities in the future.

Introduction of a New Method for Total Organic Carbon and Total Nitrogen Stable Isotope Analysis of Dissolved Organic Matter in Aquatic Environments (수환경 내 용존성 유기물질의 총 유기탄소 및 총 질소 안정동위원소 신규 분석법 소개)

  • Si-yeong Park;Heeju Choi;Seoyeon Hong;Bo Ra Lim;Seoyeong Choi;Eun-Mi Kim;Yujeong Huh;Soohyung Lee;Min-Seob Kim
    • Korean Journal of Ecology and Environment
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    • v.56 no.4
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    • pp.339-347
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    • 2023
  • Dissolved organic matter (DOM) is a key component in the biogeochemical cycling in freshwater ecosystem. However, it has been rarely explored, particularly complex river watershed dominated by natural and anthropogenic sources, such as various effluent facility and livestock. The current research developed a new analytical method for TOC/TN (Total Organic Carbon/Total Nitrogen) stable isotope ratio, and distinguish DOM source using stable isotope value (δ13C-DOC) and spectroscopic indices (fluorescence index [FI] and biological index [BIX]). The TOC/TN-IR/MS analytical system was optimized and precision and accuracy were secured using two international standards (IAEA-600 Caffein, IAEA-CH-6 Sucrose). As a result of controlling the instrumental conditions to enable TOC stable isotope analysis even in low-concentration environmental samples (<1 mgC L-1), the minimum detection limit was improved. The 12 potential DOM source were collected from watershed, which includes top-soils, groundwater, plant group (fallen leaves, riparian plants, suspended algae) and effluent group (pig and cow livestock, agricultural land, urban, industry facility, swine facility and wastewater treatment facilities). As a result of comparing characteristics between 12 sources using spectroscopic indices and δ13C-DOC values, it were divided into four groups according to their characteristics as a respective DOM sources. The current study established the TOC/TN stable isotope analyses system for the first time in Korea, and found that spectroscopic indices and δ13C-DOC are very useful tool to trace the origin of organic matter in the aquatic environments through library database.

A study of the multicomponent therapeutic recreation function intervention strategy by analysis on the operating condition of the cognitive rehabilitation program in dementia care center

  • Moon-Sook Lee;Byung-Jun Cho;Jae-Sik Yang
    • Journal of the Korea Society of Computer and Information
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    • v.28 no.12
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    • pp.155-166
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    • 2023
  • This study was conducted with 50 elderly people each (5) participating in the cognitive rehabilitation treatment program at the Dementia Care Center in D City to derive the development direction and contents of a multidimensional therapeutic recreation program and a revitalization plan through analysis of the current status and actual conditions of the cognitive rehabilitation program at the Dementia Care Center. aperture) was selected, and 9 people were selected as the subject of expert group opinion collection. The collected data was SPSS ver. Using the 18.0 statistical program, descriptive statistics and the importance and priority of each component were analyzed by hierarchical structure analysis. First, unlike the needs of users, the cognitive rehabilitation support programs currently being provided are not sufficient and require considerable experience. It was found to be low, and the areas for improvement were the expansion of care and protection facilities and the development of various programs to meet the needs of users. Second, the importance and priority of each component of therapeutic recreation were categorized into 6 major categories: exercise therapy , middle category (16 items) behavior-centered approach to exercise therapy, small category (47 items) strength and brain gymnastics, and silver health gymnastics were the highest. This result shows that a multidimensional program plan that considers the priorities of each area must be made when developing a therapeutic recreation program.

A Study on Social Network Characteristics, Social Support, Functional Recovery, and Life Satisfaction of People with Mental Illness (정신질환자의 사회관계망 특성, 사회적 지지 그리고 삶의 만족도에 관한 연구)

  • Kim, Jin-Mi;Shin, Hyo-Jin
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.6
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    • pp.85-96
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    • 2023
  • In a reality where negative perceptions and social prejudices towards individuals with mental illnesses persist, the absence and lack of social support systems acquired through personal intimate social networks can be considered a significant hindrance to the quality of life for those with mental disorders. Therefore, this study examined the impact of the characteristics of social networks and social support on the life satisfaction of individuals with mental illnesses. A survey was conducted with 180 patients from seven mental health treatment facilities in the Daegu area. The data were analyzed using MANOVA, hierarchical multiple regression analysis, and Sobel test for mediation analysis with SPSS 25 software. The key findings of the study revealed that the intimacy aspect of social networks had a positive and significant effect on social support and life satisfaction. On the other hand, the size of the social network showed a negative influence on social support. Furthermore, social support partially mediated the relationship between the intimacy of social networks and life satisfaction, and it fully mediated the relationship between the size of social networks and life satisfaction. Based on these research outcomes, practical and policy-related recommendations are provided to enhance life satisfaction through increased social support for this population.

Relationship assessment of the residual antibiotics and the amount of N component by different production stages of liquid fertilizer from livestock manure (가축분뇨 유래 액비 생산단계별 항생제 잔류 농도와 질소 성분 함량과의 상관성 평가)

  • Song-Hee Ryu;Jin-Wook Kim;Young-Kyu Hong;Sung-Chul Kim;Jun-Hyeong Lee;Eun-A Jeong;Chang-Gyu Kim;Young-Man Yoon;Oh-Kyung Kwon
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.258-265
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    • 2023
  • After application of veterinary antibiotics, they may be partially metabolized before they are excreted by feces or urine either as unaltered form or as metabolites. Residual antibiotics enter the adjacent agricultural environments by spraying manure-based compost and liquid fertilizer on farmlands and lead to secondary pollution. The objective of this study was to compare the residual concentrations of 6 veterinary antibiotics by different production stages of liquid fertilizer from livestock manure recycling facilities. The relationship between concentration change of the residual antibiotics and the amount of liquid fertilizer component was also assessed. Pre-treatment showed the recovery of 63.4-106.7% at ppb level and the limit of quantification of 0.009-0.037 ㎍/L.As the result of analyzing the relationship between the residual concentrations of antibiotics and the amount of N component in liquid fertilizer by different production stages, the residual concentrations of antibiotics and N tended to decrease as the stabilization period elapsed during the liquid fertilization process. Average concentrations of sulfamethazine in raw materials, middle and final products of liquid fertilizer were 40.85, 26.17, 3.54 ㎍/L, respectively. Those of chlortetracycline decreased from 2.32 to 1.25 ㎍/L. The other 4 antibiotics also showed a decreasing trend by different production stages of liquid fertilizer. The amount of liquid fertilizer component N decreased from 0.21 to 0.096% by production stages of liquid fertilizer. It is considered that the correlation between residual antibiotic concentrations and N content can be applied as basic data for setting antibiotic reduction indicators.

Evaluation of applicability of xanthan gum as eco-friendly additive for EPB shield TBM soil conditioning (친환경 첨가제로서 잔탄검의 토압식 쉴드 TBM 쏘일 컨디셔닝 적용성 평가)

  • Suhyeong Lee;Hangseok Choi;Kibeom Kwon;Byeonghyun Hwang
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.26 no.3
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    • pp.209-222
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    • 2024
  • The Earth Pressure Balance (EPB) shield Tunnel Boring Machine (TBM) is widely used for underground tunnel construction for its advantages, such as eliminating the need for additional facilities compared to the slurry shield TBM, which requires Slurry Treatment Plant (STP). During EPB shield TBM excavation, a soil conditioning technique is employed to enhance the physical properties of the excavated soil by injecting additives, thus broadening the range of applicable ground conditions to EPB shield TBMs. This study explored the use of xanthan gum, a type of biopolymer, as an alternative to the commonly used polymer additive. Biopolymers, derived from biological sources, are fully biodegradable. In contrast to traditional polymers such as polyacrylic acid, which contain environmentally harmful components, xanthan gum is gaining attention as an eco-friendly material due to its minimal toxicity and environmental impact. Test conditions with similar workability were established through slump tests, and the rheological characteristics were assessed using a laboratory pressurized vane shear test apparatus. The experiments demonstrated that, despite exhibiting similar workability, the peak strength in the flow curve decreased with increasing the content of xanthan gum. Consequently, a correlation between the xanthan gum content and peak strength was established. Replacing the traditional polymers with xanthan gum could enable stable EPB shield TBM operation by reducing equipment load, in addition to offering environmental benefits.

Hydrogeological Characteristics of Groundwater in Small Watershed of the Nakdong River Basin (낙동강 하류 소유역의 지하수와 하천수의 수리지질학적 특성)

  • Sieun Kim;SeongYeon Jung;MoonSu Kim;Youn-Tae Kim;Yong-Hoon Cha;Chung-Mo Lee
    • Journal of the Korean earth science society
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    • v.45 no.1
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    • pp.72-84
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    • 2024
  • Recently, the vulnerability of water resources has been increasing owing to climate change, highlighting the importance of groundwater. In particular, the Nakdong River Basin, located in the southern part of Korea, experiences frequent water scarcity phenomena, such as droughts. This study analyzed the hydrogeological characteristics of the study area by examining groundwater and stream water in the Gwangrye Stream, downstream of the Nakdong River Basin, in August and October 2023. Therefore, we collected samples from 54 groundwater wells and five streams for water quality analysis. The results of the field tests indicated an increasing trend in electrical conductivity from upstream to downstream in the study area. Laboratory analyses confirmed that the concentration of Na increased from upstream to downstream more than that of Ca. In conclusion, both stream water and groundwater were influenced by anthropogenic contamination. These changes were closely related to land use in the study area. The upstream areas are primarily composed of forests, whereas the downstream areas are composed of industrial complexes, wastewater treatment facilities, and agricultural areas, which are likely to affect both stream water and groundwater.

Epidemiology of cleft lip and palate charity mission surgery at Bandung Cleft Lip and Palate Center, Indonesia: a 14-year institutional review

  • Ali Sundoro;Dany Hilmanto;Hardisiswo Soedjana;Ronny Lesmana;Selvy Harianti
    • Archives of Craniofacial Surgery
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    • v.25 no.2
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    • pp.62-70
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    • 2024
  • Background: The management of cleft lip and palate aims at improving the patient's aesthetic and functional outcomes. Delaying primary repair can disrupt the patient's functional status. Long-term follow-up is essential to evaluate the need for secondary repair or revision surgery. This article presents the epidemiology of cleft lip and palate, including comprehensive patient characteristics, the extent of delay, and secondary repair at our institutional center, the Bandung Cleft Lip and Palate Center, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia. Methods: This retrospective study aimed to determine the epidemiology and recurrence rates of cleft lip and palate at the Bandung Cleft Lip and Palate Center, Indonesia, from January 2007 to December 2021. The inclusion criteria were patients diagnosed with cleft lip and/or palate. Procedures such as labioplasty, palatoplasty, secondary lip and nasal repair, and alveolar bone grafting were performed, and data on recurrence were available. Results: In total, there were 3,618 patients with cleft lip and palate, with an age range of 12 months to 67 years. The mean age was 4.33 years, and the median age was 1.35 years. Males predominated over females in all cleft types (60.4%), and the cleft lip was on the left side in 1,677 patients (46.4%). Most cases were unilateral (2,531; 70.0%) and complete (2,349; 64.9%), and involved a diagnosis of cleft lip and palate (1,981; 54.8%). Conclusion: Delayed primary labioplasty can affect daily functioning. Primary repair for patients with cleft lip and palate may be postponed due to limited awareness, socioeconomic factors, inadequate facilities, and varying adherence to treatment guidelines. Despite variations in the timing of primary cleft lip repair (not adhering to the recommended protocol), only 10% of these patients undergo reoperation. Healthcare providers should prioritize the importance of the ideal timing for primary repair in order to optimize physiological function without compromising the aesthetic results.

A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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