• Journal of Preventive Medicine and Public Health
• /
• 제20권1호
• /
• pp.165-203
• /
• 1987

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

• Journal of Science of Art and Design
• /
• 제10권
• /
• pp.5-50
• /
• 2006

The terminology "human body" simply means a physical body but also more often, as an object in art works, carries symbolic concepts incorporating the whole history of human lives. Human body has been employed as an artistic object capturing physical body, delivering artist's idea expressing life indicators from different standpoints of times and places. This point of view about human body in art works has in fact rather short history since 1960's when modern thinking paradigm focusing upon rationality and reasoning has begun declining and on the contrary when the body used to be the servant of the mind and soul for a long time has begun attracting artist's attention as a real entity from the viewpoint of dichotomy. During the 1960's, frequent performances in Pop art and of Fluxus showed that the human body has been an important media for artistic communication after importance of body performances had been raised in Action painting in 1940's. The human body became a more determined media in body art works that had got into stride after Yves Kline's conceptual works applying body and its traces. These kinds of art works have continued and consolidated into the Feminism came into blossom in 1980's and into fragmentated and disembodied body art trend in 1990's. Through development of trends in body works, human body now might well be regarded as a clue provide from individual identity with implication over the world. This thesis is to analyse in semiotic way main works of Kiki Smith who is a representative artist devoting to Feminism and proposing extended significance of human body. In the analysis process of works done by two great artists with histrorical background of art trend in order to find and open an significance horizon of human body, semiotics and bodism are therefore perceived as pertinent and applied as basic tools. The first stage of analysis is to get the significances emerged in between expression part and contextual parts, which are separated structually from the most basic level. The study deals with body works furthermore in the way of structual cohesion of the expression and the context from the view of A J. Greimas' Structural Semantics and tried to build up a basic frame for the extended significances of human body. This thesis is, on the other hand, to attempt to contribute for extension of disembodied and fragmentated body discussed in the structural semantic frame earlier by Julia Kriesteva who delivers abjection concepts and phenomenology of Maurice Merleau-Ponty who enables to overview relationship between the body and the world from the viewpoint of Bodism, further into interpretation level. The other works are Kiki smith's that showed epics about death in mid-1980's, detailed humbleness of vulnerable human body exposed to dichotomy and fragmentation in 1990's and religion and mythology incorporating wouln healing in 2000's and henceforth. Through the analysis of Kiki Smith's representative work 'Pee body', it is verified and confirmed that fragmentated body showed beyond boundary gap of the human body and ultimately tends to imply human healing owing to divine maternity. Bodily symbols in Kiki Smith's are extended to the universal world to imply human life and death on the one hand and religion and mythology of human wound and divine healing one the other hand. This thesis through these process and results of analysis is in a broad context, to emphasize that human body as objectified text has a key indicator role to understand world as well as semiotic extension in art works in late 20th century so that we might confirm bodily symbol as a cultural context constitutes a section of contemporary visual arts.

• Journal of Intelligence and Information Systems
• /
• 제19권4호
• /
• pp.21-37
• /
• 2013

Recently, as the advent of the knowledge-based society, there are more people getting interested in the intellectual property. Especially, the ICT companies leading the high-tech industry are working hard to strive for systematic management of intellectual property. As we know, the patent information represents the intellectual capital of the company. Also now the quantitative analysis on the continuously accumulated patent information becomes possible. The analysis at various levels becomes also possible by utilizing the patent information, ranging from the patent level to the enterprise level, industrial level and country level. Through the patent information, we can identify the technology status and analyze the impact of the performance. We are also able to find out the flow of the knowledge through the network analysis. By that, we can not only identify the changes in technology, but also predict the direction of the future research. In the field using the network analysis there are two important analyses which utilize the patent citation information; citation indicator analysis utilizing the frequency of the citation and network analysis based on the citation relationships. Furthermore, this study analyzes whether there are any impacts between the size of the company and patent citation relationships. 74 S&P 500 registered companies that provide IT and communication services are selected for this study. In order to determine the relationship of patent citation between the companies, the patent citation in 2009 and 2010 is collected and sociomatrices which show the patent citation relationship between the companies are created. In addition, the companies' total assets are collected as an index of company size. The distance between companies is defined as the absolute value of the difference between the total assets. And simple differences are considered to be described as the hierarchy of the company. The QAP Correlation analysis and MR-QAP analysis is carried out by using the distance and hierarchy between companies, and also the sociomatrices that shows the patent citation in 2009 and 2010. Through the result of QAP Correlation analysis, the patent citation relationship between companies in the 2009's company's patent citation network and the 2010's company's patent citation network shows the highest correlation. In addition, positive correlation is shown in the patent citation relationships between companies and the distance between companies. This is because the patent citation relationship is increased when there is a difference of size between companies. Not only that, negative correlation is found through the analysis using the patent citation relationship between companies and the hierarchy between companies. Relatively it is indicated that there is a high evaluation about the patent of the higher tier companies influenced toward the lower tier companies. MR-QAP analysis is carried out as follow. The sociomatrix that is generated by using the year 2010 patent citation relationship is used as the dependent variable. Additionally the 2009's company's patent citation network and the distance and hierarchy networks between the companies are used as the independent variables. This study performed MR-QAP analysis to find the main factors influencing the patent citation relationship between the companies in 2010. The analysis results show that all independent variables have positively influenced the 2010's patent citation relationship between the companies. In particular, the 2009's patent citation relationship between the companies has the most significant impact on the 2010's, which means that there is consecutiveness regarding the patent citation relationships. Through the result of QAP correlation analysis and MR-QAP analysis, the patent citation relationship between companies is affected by the size of the companies. But the most significant impact is the patent citation relationships that had been done in the past. The reason why we need to maintain the patent citation relationship between companies is it might be important in the use of strategic aspect of the companies to look into relationships to share intellectual property between each other, also seen as an important auxiliary of the partner companies to cooperate with.