• 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.

• Korean Journal of Agricultural Science
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• v.8 no.2
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• pp.203-211
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• 1981

Mechanization of rice transplanting operation is very important project not only to solve the labor shortage problem at the so-called labor demand peak seasons of the rice transplanting, but also to reduce the production cost of rice by reducing the labor requirements. For these reasons this study was carried out to find the basic data for encourage the project of mechanization of rice transplanting. 381 sample farms were surveyed with questionaries and interviewed with a considerable number of relative personels about the operation, selecting and ownership trend of the rice transplanter. Collected data was analized by computer of Chungnam National University computer center applied to frequencies, cross- tabulation, $x^2$-test. The analized results of this survey are summarized as follows; 1. About 76.09% of the farmers interviewed was individual ownership of rice transplanter but about 52.27% of the farmers who wanted to purchase it in 2 or 3 years supported the cooperative ownership and utilization. This fact suggested that cooperative system of village level should be thoroghly studied. 2. The 93.33% of respondents gave the answer that the yield of rice was not affected by the planting methods between machine and manual. 3. The farmers who had a rice transplanter owned 4- row type rice transplanter with mat type seedling but the 25% of the farmers wanted to purchase it in 2 or 3 years wanted to own a 4 row type rice transplanter with band type seedling. Therefore the introduction of the 4-row type rice transplanter with band type seedling to rural area should be considered again. 4. The percent of farmers who wanted the cooperative system of village level was 49.57-57.83% of the farmers who had it already and wanted to own it in near future. It was strengthened by this fact that seedling nursely work was technically supported by the governmental level.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.34 no.4
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• pp.57-65
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• 2016

Maeul-soop(Village forest) is a key element of Korean traditional village landscape historically and culturally. However, a number of Maeul-soops have been lost or declined due to various influences since the modern age. For this Maeul-soop that has a variety of conservation values including historical, cultural and ecological ones, attention and efforts for a systematic conservation and restoration of Maeul-soop are needed. The purpose of the present study is to provide information on ecological restoration and sustainable use and management of Maeul-soops based on component plant species, habitat and location characteristics of 499 Maeul-soops spread throughout Korea. Major six categories of threat factors to Maeul-soop ecosystem were identified and the influence of each factor was evaluated. For the evaluation of weight by threat factors for the influence on the vulnerability of Maeul-soop ecosystem, more three-dimensional analysis was conducted using Analytic Hierarchy Process (AHP) analysis method. In the results of evaluation using AHP analysis method, reduction of area, among six categories, was spotted as the biggest threat to existence of Maeul-soops. Next, changes in topography and soil environment were considered as a threat factor of qualitative changes in Maeul-soop ecosystem. Influence of vegetation structure and its qualitative changes on the loss or decline of Masul-soop was evaluated to be lower than that of changes in habitat. Based on weight of each factor, the figures were converted with 100 points being the highest score and the evaluation of vulnerability of Maeul-soop was conducted with the converted figures. In the result of evaluation of vulnerability of Maeul-soops, grade III showed the highest frequency and a normal distribution was formed from low grade to high grade. 38 Maeul-soops were evaluated as grade I which showed high naturality and 10 Maeul-soops were evaluated as grade V as their maintenance was threatened. Also in the results of evaluation of vulnerability of each Maeul-soop, restoration of Maeul-soop's own area was found as top priority to guarantee the sustainability of Maeul-soops. It was confirmed that there was a need to prepare a national level ecological response strategy for each vulnerability factor of Maeul-soop, which was important national ecological resources.

• Journal of agricultural medicine and community health
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• v.45 no.2
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• pp.89-99
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• 2020

Objective: This study aimed to report the relationship between walking activity and perceived physical activity barriers after classifying the age group(≤64, 65-74, ≥75). Methods: The subjects were conducted on 1500 residents of two areas, and the walking activity was defined as five or more times a week, 10 minutes or more at a time, and 30 minutes or more per day. Perceived physical activity barriers were lack of time, lack of social support, lack of energy, lack of willpower, and fear of falling. Results: In the group under 64 year, the lack of time (exp(B)=0.819, p=0.002) and the lack of willpower (exp(B)=0.656, p<0.001) were significantly associated. In the 65-74 year old group, the lack of willpower (exp(B)=0.714, p<0.001) and fear of falling (exp(B)=0.787, p=0.003) were a significant association. In the group aged 75 years and over, lack ofwill power (exp(B)=0.734, p<0.001) and fear of falling (exp(B)=0.807, p=0.003) were significantly associated. Conclusion: In order to solve the lack of willpower and lack of time, a walking activity should be performed together at a certain time in the village, and the elderly in the late ages should reduce the fear of falling by performing a fall prevention exercise in parallel.

• Parasites, Hosts and Diseases
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• v.58 no.3
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• pp.267-278
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• 2020

The heterogeneity and complexity of malaria involves political and natural environments, socioeconomic development, cross-border movement, and vector biology; factors that cannot be changed in a short time. This study aimed to assess the impact of economic growth and cross-border movement, toward elimination of malaria in Yunnan Province during its pre-elimination phase. Malaria data during 2011-2016 were extracted from 18 counties of Yunnan and from 7 villages, 11 displaced person camps of the Kachin Special Region II of Myanmar. Data of per-capita gross domestic product (GDP) were obtained from Yunnan Bureau of Statistics. Data were analyzed and mapped to determine spatiotemporal heterogeneity at county and village levels. There were a total 2,117 malaria cases with 85.2% imported cases; most imported cases came from Myanmar (78.5%). Along the demarcation line, malaria incidence rates in villages/camps in Myanmar were significantly higher than those of the neighboring villages in China. The spatial and temporal trends suggested that increasing per-capita GDP may have an indirect effect on the reduction of malaria cases when observed at macro level; however, malaria persists owing to complex, multi-faceted factors including poverty at individual level and cross-border movement of the workforce. In moving toward malaria elimination, despite economic growth, cooperative efforts with neighboring countries are critical to interrupt local transmission and prevent reintroduction of malaria via imported cases. Cross-border workers should be educated in preventive measures through effective behavior change communication, and investment is needed in active surveillance systems and novel diagnostic and treatment services during the elimination phase.

• Economic and Environmental Geology
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• v.31 no.1
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• pp.59-68
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• 1998

Gravity, magnetic and VLF surveys were carried out to investigate the dimension, nature and stability of the waste materials filled in the Seokdae landfill, Pusan. The Seokdae landfill, which is located in a former valley, was used as a dump for mainly domestic-type waste materials for 6 years from 1987. The landfill site is classfied into A, B, C and D areas according to the sequence of dumping period. The Bouguer gravity anomaly map shows maximum variation of 3.1 mgals on the landfill and its general appearance has close relation with the thickness of waste filled. The local variation of anomaly, however, reflect the degree of compactness of waste materials which may be affected by the nature of waste and dumping time. In the case of area A, where dumping process was terminated at the very last stage, most part show negative anomaly compared to other areas. We think that the composition of the waste materials in the area A is high in leftover food and paper trash and they are still in uncompacted condition. In area B, the general trend of variation of gravity anomaly is appeared to be high anomaly in northern part and decrease to the southern part. This is well matched with the prelandfill topography of the landfill site. The southern part of area B is located in the center of valley and its present surface is comparatively rugged, which may be due to the differential settlement of deep burried waste. The thickness of waste in area C is relatively thin, but the gravity anomaly appears to be low. Considering the present condition of surface, it can be inferred that low density wastes such as leftover food were mainly filled in this area. Area D, as in the case of area B, shows gravity anomaly that has close relation with the prelandfill topography. Magnetic data show the variation of total field intensity varies in the range of 46600~51000 nT, and reach maximum anomaly of 4400 nT. The overall pattern of magnetic anomaly well reflects the distribution of magnetic materials in the landfill. The result of VLF survey reveals several low resistivity zones, which may serve as underground passages for contaminant flow, in the area C located near the small Village.

• Journal of Korean Society of Rural Planning
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• v.21 no.2
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• pp.11-21
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• 2015

This study carried out evaluation of vulnerability in accessability and functionality using road network that was extracted from Intelligent Transportation System(ITS) and digital map. It was built in order to figure out accessability that locational data which include community center, public facilities, medical facilities and highway IC. The method for grasping functionality are Digital Elevation Model(DEM) and land slide hazard map provided by Korea Forest Service. The evaluation criteria for figure out accessability was set to related comparison of average time in urban area. Functionality value was calculated by the possibility of backing the vehicle possibility of snowfall and landslides. At last, this research computed weighting value through Analytic Hierarchy Process (AHP), calculated a vulnerable score. As the result, the accessability of rural village came out that would spend more time by 1.4 to 3.2 times in comparison with urban area. Even though, vulnerability of the road by a snowfall was estimated that more than 50% satisfies the first class, however, it show up that the road were still vulnerable due snowing because over the 14% of the road being evaluated the fifth class. The functionality has been satisfied most of the road, however, It was vulnerable around Lake Daechung and Piban-ryung, Yumti-jae, Suriti-jae where on the way Boeun. Also, the fifth class road are about 35 km away from the city hall on distance, take an hour to an hour and a half. The fourth class road are about 25 km away from the city hall on distance, take 25 min to an hour. The other class of the road take in 30 min from the city hall or aren't affected of weather and have been analyzed that a density of road is high. In A result that compare between distribution and a housing density came out different the southern and the eastern area, so this result could be suggested quantitative data for possibility of development.

• Journal of Korean Society of Rural Planning
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• v.15 no.2
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• pp.81-96
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• 2009

This study has found out the status of the environment ecology(topography structure. land-use, flora, plant community structure, wildbird) in 10 uninhabited islands(i.e. Kei island, Hadon island, Sangdon island, Daewa island, Hwanggang island, Naebi island, Oebi island, Prickly castor-oil tree island, Tongin island, Yuk island), Namhae-gun, Gyeongsangnam-do. Moreover, It has suggested ways of improving the environment ecology status by classifying the type of environment ecology about the degree of use and damage that based on the results of environment ecology survey. According to the results of topography structure survey, the survey site altitude was ranged within 1m$\sim$25m, otherwise, the radient was classified the rock area(.i.e. slope of less than $5^{\circ}$ the dead level) and the slope area where is steep slope. Moreover, there was showed evenly a variety of aspect. Land-use were divided the field(Kei island), dry native grasslands(Hadon island), naturalized grasslands(Sangdon island), Pinus thunbergii community(Dacwa island, Hwanggang island, Naebi island, Yuk island), the rock area(Oebi island, Prickly castor-oil tree island, Tongin island). As the results of flora survey, the number of plant species were 30$\sim$115 species and the naturalized species were found 2$\sim$12 species in each site. The results of plant community structure analysis, The dominant species were Pinus thunbergii and Pinus densiflora were in upper tree layer, furthermore, it were Pinus thunbergii, Eurya japonica, Prunus sargentii, Celtis sinensis, Morus bombycis, ect. in cannopy tree layer. In shrub layer, the dominant species were Rosa multiflora, Rubus crataegifolius, Parthenocissus tricuspidata, etc. The status of wildbird bird, had been found 42 species 938 individuals, especially, there were Bubo bubo kiautschensis(natural monument No. 324) and Haematopus ostralegus osculans(natural monument No. 326). According to these synthetic results, we are able to classify the 5 types of environment ecology such as the natural coast forest that composed of Pinus thunbergii and Pinus densiflora(Daewa island, Hwanggang island, Naebi island, Oebi island, Tongin island, Yuk island), the field in vegetation area(Kei island), vegetation succession area of fallow field type(Hadon island), vegetation damage area by the forest fire and disturbance elements(Prickly castor-oil tree island), dominant naturalized species grassland by grazing cattle(Sangdon island).

• Journal of Wetlands Research
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• v.9 no.1
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• pp.79-89
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• 2007

This paper provides a comprehensive overview of the present status of several environmental problems caused by emerging toxic substances such as persistent organic pollutants (POPs), endocrine disrupting chemicals (EDCs), and arsenic in various environmental media in Vietnam. Monitoring data reported during the 1990s demonstrated elevated contamination of DDTs in most of these compartments in Vietnam. Studies in frame of the Asia-Pacific Mussel Watch Program revealed that fish, mussels and resident birds from Vietnam contained higher concentrations of DDTs as compared to other countries in region, suggesting the role of Vietnamese environment as a significant emission source of DDT in the Southeast Asian region. The estimated dietary intakes of PCBs and DDTs for Vietnamese were relatively high among Asian developing countries, suggesting potential risk for humans posed by thesechemicals. Widespread contamination of some endocrine active compounds such as alkylphenols and phthalates was observed at various sites along the coasts of northern and middle Vietnam. The presence of significant source of bisphenol-A along Red River estuary was revealed with the concentrations comparable to those reported for developed nations. A case study on seasonal variation of alkylphenols and phthalates in surface water of river delta and estuary of north and middle Vietnam indicated the differences in distribution of these compounds between dry and rainy seasons. Higher concentrations of alkylphenols and phthalates were found in dry season in estuary; while the contrasting pattern was observed in the river delta, showing elevated residues in rainy season. This result suggests the different behavior of alkylphenols and phthalates in river delta and coastal environment. From ecotoxicological perspectives, concentrations of bis-phenol A and di(2-ethylhexyl)phthalates [DEHP] in surface water from some locations in Vietnam exceeded the guideline values for Ecotoxicological Effects and the Environmental Risk Limit, respectively, suggesting potential for toxic implications on aquatic wildlife. Widespread and elevated arsenic contamination was discovered inour recent surveys in groundwater in a large area of suburban areas of Hanoi city, the capital of Vietnam. The most recent investigation in 4 villages showed about more than 50 % of groundwater samples contained As concentrations exceeding 50 g/L (the WHO and Vietnamese standard). In particular, in Son Dong villages, 58 % of samples analyzed contained As concentrations higher than 200 g/L. Good correlations were found in As concentrations in water and hair and urine of peoples in corresponding families, suggesting the chronic exposure to As by people living in As-contaminated ground water areas. In Son Dong village, As levels in hair (mean: 1.7 mg/kg dry wt) and urine (g/g creatinine) exceeding the reference values recommended by WHO, suggesting potential for human risk posed by long term accumulation of As in human body. Future studies should be focused on the time trends of POPs and EDCs in biota in Vietnam in order to predict future trend of contamination and to reveal new clues for understanding possible toxic impacts on aquatic organisms. The issues of arsenic contamination in groundwater and their chronic toxic implications on human health should be systematically investigated in the future.

• Journal of dental hygiene science
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• v.6 no.4
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• pp.255-261
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• 2006

The purpose of This study was to survey the present state and prospect of geriatric denture prosthetic dentistry among community dental hygienists in Korea. Questionnaires about the present state and prospect of geriatric denture prosthetic dentistry were distributed to the community dental hygienists in Korea, July 2006. Collected questionnaires from 89 cases were analyzed. All collected data were analyzed using the SPSS program. The significance of differences among groups were assessed using chi-square test or Fisher's exact test. The results of this study were summarized as follows: The public relations of the geriatric denture prosthetic dentistry were enforced good, mainly by village offices. Appointed dental clinics made a production of full dentures connecting in Korean Dental Association. Above findings suggest that further study about the present state and prospect of geriatric denture prosthetic dentistry is necessary in improving the oral health related quality of life in elders.