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Epidemiological Studies of Clonorchiasis. - I. Current Status and Natural Transition of the Endemicity of Clonorchis sinensis in Gimhae Gun and Delta, a High Endemic area in Korea (간흡충증(肝吸虫症)의 역학(疫學) - I. 고도유행지(高度流行地) 김해지방(金海地方)에 있어서의 간흡충감염(肝吸虫感染)의 현황(現況)과 자연추이(自然推移))

  • Kim, D.C.;Lee, O.Y.;Lee, J.S.;Ahn, J.S.;Chang, Y.M;Son, S.C.;Moon, I.S.
    • Journal of agricultural medicine and community health
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    • v.8 no.1
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    • pp.44-65
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    • 1983
  • As a part of the epidemiological studies of clonorchiasis, this study was conducted to evaluate the current endemicity and the natural transition of the Clonorchis infection in Gimhae Gun and delta area a high endemic area in Korea in recent years, prior to the introduction of praziquantel which will eventually influence the status of the prevalence. The data obtained in this study in 1983 were evaluated for natural transition of the infection in comparison with those obtained 16 years ago in 1967 by the author(Kim, 1974). The areas of investigation, villages and schools surveyed, methods and techniques used in this study were the same as in 1967, except for the contents of the questionnaire for raw freshwater fish consumption by the local inhabitants. 1) The prevalence rate of clonorchiasis in the general population of the villages was 48.1% on the average out of a total of 484 persons examined. The average of those of the riverside-delta area was 65.2% and 43.0% in the inland area. Among the schoolchildren, the prevalence rate was 8.2% on the average out of a total of 1,423 examined. By area, the prevalence rate was 10.8% in the riverside delta area and 2.8% in the inland area. By sex, difference in the prevalence was seen only in the inhabitants of the inland area showing 52.4% in the male and 33.5% in the female. 2) In the natural transition of the infection, the prevalence rate among the inhabitants has decreased from 68.8% in 1967 to 48.1% in 1983, and in the schoolchildren from 56.4% in 1967 to 8.2% in 1983. The reduction rate was higher in the riverside-delta area than in the inland area. 3) In the prevalence rate by age, 11.9% was first seen in the 5-9 age group and the rate gradually increased up to 75.0% in the 50-59 age group. By sex, the rate was higher in the male than in the female in the 20-29 age group and over. 4) In the natural transition of the prevalence rate by age, the reduction rate of the infection during the past 16 years was greater in the younger age groups up to the 40-49 age group and reached the same level in the age group 50-59. Reduction was seen again in the age group over 60s. By sex, the reduction rate was greater in the female than in the male in the 20-29 age group and over. By area, the reduction rate was greater in the riverside delta area than in the inland area, particularly in the young age groups. 5) In the intensity of the infection among the cases, the mean egg out-put per mg feces per infected cases(EPmg) in the inhabitants was 6.3. EPmg of those of the river-side-delta area was 15.4 and that of the in-land was 2.8. On the other hand, in the schoolchildren, EPmg was 3.2, and no difference was seen between the two areas, the river-side-delta area and the inland area. 6) In the transition of the intensity of the infection by area, EPmg among the inhabitants inexplically increased from 7.8 in 1967 to 15.4 in 1983. This was probably caused by uneven specimen collection in the process of sampling the population. EPmg of the inhabitants in the inland area and those of the schoolchildren of both riverside delta and inland areas showed a similar decrease in the past 16 years. 7) The intensity of the infection by age showed a relatively low level in the 20-29 age group and below, and EPmg 5.1-9.5 was seen in the 30-39 age group and over. Sex, Epmg was 5.8 in the male and 4.7 the female. By in 8) In the transition of the intensity of the infection, EPmg decreased from 6.2 in 1967 to 5.4 in 1983. By age, in contrast to the figures of 1967 in which EPmg gradually increased with some fluctuation from 1.1 in the 0-4 age group to peak 10.5 in the 50-59 age group, in 1983 lower intensity of the infection was seen in the age group from 10-14 to 20-29 with the EPmg range of 0.6-2.7. 9) In the distribution of the clonorchiasis cases by the range of EPmg value, 43.2% of the cases were in 0.1 0.9 and 34.6% in 1.0-4.9. As a whole by cumulative percent, 44.6% of them were under 0.9 as light infection and 86.1% of them under 9.9 up to moderate infection. By sex, no difference was seen in Epmg. 10) In the transition of the distribution by the range of Epmg, the cases were distributed up to the range 80.0-99.9 in 1967 and to 60.0-79.9 in 1983. By cumulative percent, in the range of 0.1-0.9 and less, light infection, 34.3% of them were distributed in 1967 and 44.6% in 1983 with about 10% increase. In the range of 5.0-9.9 and less, up to moderate infection, 83.2% in 1967 and 86.1% in 1983 of the cases were seen, respectively. 11) The practice of raw freshwater fish consumption among the inhabitants seems to have decreased in recent years. Those who admitted to raw freshwater fish consumption in the last two years among the infected inhabitants were 59.3%, although 86.8% of them professed to have experience with raw freshwater fish consumption. 31.7% of those who have had experience of the raw freshwater fish consumption denied any further consumption in recent years. From an interview of 543 school-children, 24.1% of them admitted to an experience of raw freshwater fish consumption. However, those who have practised in the past two years comprized 17.9%. Those who denied raw freshwater fish consumption in recent years among those who had such experience were 26.0% out of 131 interviewed. The rate of raw freshwater fish consumption in both inhabitants and schoolchildren were higher in the male than in the female. On the contrary, the rate of those who did not practise in recent years among those who had experience of raw freshwater fish consumption was higher in the female than in the male. 12) The major reason for the reduction of raw freshwater fish consumption among the local inhabitants was the risk of the fluke infection. However, it has become apparent that such change of taste has resulted from water pollution impact which has affected throughout the areas of the freshwater systems in this locality since last several years. 13) In animal survey, Clonorchis infection was seen in 14.8% of 88 dogs examined and 3.7% of 27 house rats examined. It was noted that populations of dogs and cats have increased in the villages surveyed. Although the prevalence rate was lower in the present survey than those of 1967, the significance of the animals as the reservoir host has not changed. 14) Prevalence rate of Clonorchis infection by cercariae in the first intermediate host, Parafossarulus manchouricus, was 0.6% out of 517 snails examined. The infection rate was lower in comparison with 2.3% out of 2,124 examined in 1967. Moreover, sharp decreases in number and distribution of the intermediate host snails in many watershed areas of the huge freshwater systems in this locality seemed to reduce transmission of Clonorchis in connection with the intermediate host stage of its life cycle. 15) Clonorchis infection in the second intermediate fish hosts was relatively low. The mean number of Clonorchis metacercaria per fish in Pseudorasbora parva was 517 in 1983, whereas it was 1943 in 1968 through 1969. Environmental water pollution has also caused the decreased fish population density in these areas, and this has also apparently affected to the practice of raw freshwater fish consumption among the local inhabitants. 16) In conclusion, endemicity of Clonorchis infection in Gimhae Gum and delta area of the Nagdong River has sharply decreased during the past 16 years. The major cause of the regressive transition of the infection was the water pollution of the land water systems of this locality. The pollution has upset the ecosystems comprizing of the intermediate hosts of Clonorchis in many areas, and also affected to a significant extent to the discontinuance of the local inhabitants for raw freshwater fish consumption.

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National Survey of Sarcoidosis in Korea (유육종증 전국실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.6
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    • pp.453-473
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    • 1992
  • Background: National survey was performed to estimate the incidence of sarcoidosis in Korea. The clinical data of confirmed cases were analysed for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1991 to December 1992. Data were retrospectively collected by correspondence with physicians in departments of internal medicine, dermatology, ophthalmology and neurology of the hospitals having more than 100 beds using returning postcards. In confirmed and suspicious cases of sardoidosis, case record chart for clinical and laboratory findings were obtained in detail. Results: 1) Postcards were sent to 523 departments in 213 hospitals. Internal medicine composed 41%, dermatology 20%, ophthalmology 20% and neurology 19%. 2) Postcards were returned from 241 departments (replying rates was 48%). 3) There were 113 confirmed cases from 50 departments and 10 cases. The cases were composed from internal medicine (81%), dermatology (13%), ophthalmology (3%) and neurology (3%). 78 confirmed cases were analysed, which were composed from department of internal medicine (92%), dermatology (5%), and neurology (3%). 4) The time span for analysed cases was 1980 to 1992. one case was analysed in 1980 and the number gradually increased to 18 cases in 1991. 5) The majority of patients (84.4%) were in the age group of 20 to 49 years. 6) The ratio of male to female was 1 : 1.5. 7) The most common chief complains were respiratory symptoms, dermatologic symptoms, generalized discomforts, visual changes, arthralgia, abdominal pains, and swallowing difficulties in order. 16% of the patients were asymptomatic. 8) Mean duration between symptom onset and diagnosis was 2 months. 9) The most common symptoms were respiratory, general, dermatologic, ophthalmologic, neurologic and cardiac origin in order. 10) Hemoglobin, hematocrits and platelet were in normal range. 58% of the patients had lymphopenia measuring less than 30% of white cell count. The ratio of CD4 to CD8 lymphocytes was $1.73{\pm}1.16$ with range of 0.43 to 4.62. ESR was elevated in 43% of the cases. 11) Blood chemistry was normal in most cases. Serum angiotensin converting enzyme (S-ACE) was $66.8{\pm}58.6\;U/L$ with the range of 8.79 to 265 U /L. Proteinuria of more than 150 mg was found in 42. 9% of the patients. 12) Serum IgG was elevated in 43.5%, IgA in 45.5%, IgM in 59.1% and IgE in 46.7%. The levels of complement C3 and C4 were in the normal range. Anti-nuclear antibody was detected in 11% of the cases. Kweim test was performed in 3 cases, and in all cases the result was positive. 13) FVC was decreased in 17.3%, FEV1 in 11.5%, FEV1/FVC in 10%, TLC in 15.2%, and DLco in 64.7%. 14) PaO2 was decreased below 90 mmHg in 48.6% and PaCO2 was increased above 45 mmHg in 5.7%. 15) The percentage of macrophages in BAL fluid was $51.4{\pm}19.2%$, lymphocytes $44.4{\pm}21.1%$, and the ratio of CD4 to CD8 lymphocytes was $3.41{\pm}2.07$. 16) There was no difference in laboratory findings between male and female. 17) Hilar enlargement on chest PA was present in 87.9% (bilaterally in 78.8% and unilaterally in 9.1%). 18) According to Siltzbach's classification, stage 0 was 5%, stage 158.3%, stage 228.3%, and stage 38.3%. 19) Hilart enlargement on chest CT was present in 92.6% (bilaterally 76.4% and unilaterally in 16.2%). 20) HRCT was done in 16 cases. The most common findings were nodules, interlobular thickening, focal patchy infiltrations in order. Two cases was normal finding. 21) Other radiologic examinations showed bone change in one case and splenomegaly in two cases. 22) Gallium scan was done in 12 cases. Radioactivity was increased in hilar and mediastinal lymph nodes in 8 cases and in parenchyme in 2 cases. 23) The pathologic diagnosis was commonly performed by transbrochial lung biopsy (TBLB, 47.3%), skin and mediastinal lymph nodes biopsy (34.5%), peripheral lymph nodes biopsy (23.6%), open lung biopsy (18.2%) and bronchial biopsy in order. 24) The most common findings in pathology were non·caseating granuloma (100%), multi-nucleated giant cell (47.3%), hyalinized acellular scar (34.5%), reticulin fibrin network (20%), inclusion body (10.9%), necrosis (9.1%), and lymphangitic distribution of granuloma (1.8%) in order. Conclusion: Clinical, laboratory, radiologic and pathologic findings were summarized. This collected data will assist in finding a test for detection and staging of sarcoidosis in Korea in near future.

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한국 청소년의 약물남용과 비행행위

  • 김성이
    • Korea journal of population studies
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    • v.11 no.2
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    • pp.54-66
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    • 1988
  • I. Introduction Since the 1970's drug abuse among young people has increasingly become a social problem in Korea. In the 1980's, drug abuse, especially glue sniffing, has become the cause of many unfortunated incidents resulting in harm to others as well as the abusers themselves. Taking into consideration of the seriousness of this problem, the Republic of Korea National Red Cross initiated a nation-wide research programme, to understand the present situation and to raise the level of public awareness. The goal of this research was to begin a nation - wide campaign against drug abuse. The research team was composed of the Advisary Committee members and the staff of the Youth Department of the Republic of Korea National Red Cross. The data were collected in February 1988 with the collaboration of the staff and volunteers in the local Chapters. The respondents were allocated nation-wide by the quota sampling method. The questionnaires were distributed to the respondents in three groups :2, 700 to junior and senior high school students, 605 to working youths, and 916 to delinquent youths. A total of 4, 221 questionnaires were collected. II. Characteristics of the Respondents The respondents in each group were selected evenly from rural and urban areas. The general characteristics of the respondents can be described as follow: in case of students, the proportions between male and female respondents, and between senior high school and junior high school students were almost evenly distributed. In case of working youths, the proportion of females (80.5%) was higher than those of the students and the delinquents groups. Delinquent youths were defined as those currently being under custody of the centers for juvenile delinquents. Of this number, 38.8% and 68.2% were junior and senior high school drop-outs respectively. The majority of them (92.6%) were male. As for the family background of the respondents, the proportion of those residing in poverty - stricken areas, and the proportion of those from broken families were higher in case of working youths and delinquent youths than those in case of students. III. Present Patterns of Drug Abuse The following summarizes the presents of drug abuse, as tabulated from the results of the survey. 1. Smoking The percentage of youths who smoke was 36% in the student group, 32% m the working youths group, and 94.4% in the delinquent youths group. 2. Alcohol 50.3% of students, 71.6% of working youths, and 93.3% of delinquent youths has experienced drinking alcohol beverages. 3. Tonic: non - alcoholic, caffeinated beverages popular in Korea and Japan The percentage of those who have used tonic at least once was over 90% in all of the three groups. 4. Sedative About 70% of each group has used sedative with the proportion of working youths use higher than those in other groups. 5. Stimulants Those who have used stimulants comprised around 15% in each group. 6. Tranquilizers Somewhat less than 5% of students and working youths, and 28% of delinquent youths, have used tranquilizers. 7. Hypnotics The users of hypnotics amounted to 0.4% of students, 2.6% of working youths and 7.1% of delinquent youths. 8. Marihuana Those who have used marihuana indicated 0.7% of students, 0.8% of working youths, and 13% of delinquent youths. 9. Glue-sniffing The percentage of glue-sniffing was 3.7%, 5% in the students group and in the youths group respectively, but the proportion was unusually high, at 40.7% in the delinquent youths group. From the results of the survey the present situation of drug abuse in Korea can be summarized as follows: 1. A high percentage of Korean youths have experienced smoking cigarettes and drinking alcoholic beverages. 2. Tonics (non - alcoholic, caffeinated beverages), antipyretic analgesics and stimulants quite regularly used. 3. Tranquilizers, hypnotics, marihuana and glue-sniffing are more widely used among delinquent youths than the other youths. From this fact, there exists a correlation between drug abuse and juvenile delinquency. IV. Time-series Analysis of the First Experience of Drug Abuse and Deviant Behaviour The respoundents were asked when they were first exposed to drugs and when they committed deviant acts. By calculating the average age of each experience, the following pattern was found (See Figure 1). Youths are first exposed to drugs by abuse of tonic(non - alcoholic, caffeinated beverages). At the age of 13, they amoke cigarettes, the use of antipyretic analgesics begins at 14 year old, while at the age of 15, they use tranquilizers, and at 16 hynotics. The period of drug abuse which starts from drinking caffeinated beverages and smoking cigarettes and ends in the use of hypnotics takes about three years. During this period, other delinquent behaviours begin to surface, that is, at the age of 13 when smoking cigarettes begins, the delinquent behaviour pattern starts with truancy. Next, they start taking money from others by using physical force. Prior to the age of 15, they are suspended from school, become hostile to adults, begin running away from home, and start using stimulants and alcohol. Soon they become involved even in glue-sniffing and in the use of marihuana. At the age of 15, they begin to see adult videos and carry weapons. Sexual promiscuity and usage of tranquilizers follows the viewing of adult videos. Consequently, by the time they reach the age of 16, they visit drinking establishments, and are picked up by police for committing delinquent acts. And finally, they come to use hypnotic - type drugs. From the above descriptions, drug abuse can be assumed to have a close correlation with delinquent behaviour. V. Social Factors Related to Drug Abuse As for the Korean youths, glue-sniffing is found to he related to aggressive delinquency, in such cases as run - aways, being picked up by the police, and taking money by force. Smoking cigarettes and drinking alcohol is found to be related to seeing adult videos and visiting drinking establishments. Hypnotics and marihuana were found to be representive of drugs which are related to degenerational delinquency, irrespective of social delinquency. The social factors connected with these drug abuse are as follows: 1. Individual factors Male students were more heavily involved in the usage of drug than females. Youths who do not attend church were more likely to be involved in drugs than those who attend. 2. Family factors The youths who were displeased with their mothers smoking and those who thought their parents did not love each other, or those whose parents had used drugs without prescription, were more likely to he drug users. 3. School factors Those youths who found school life boring, were unsuccessful in their studies, spend most of their time with friends, feel their teachers smoke too much, those who had a positive perception of their teachers smoking were likely to he drug users. To sum up, drug abusers depend on the influence of their parents, teachers and peers. IV. Reasons for Drug Abuse Korean students have mainly used drugs to release stress (42.8%), to stay awake (19.7%), and because of the easy accessibility of drugs( 16.6%). Other reasons are due to their ignorance of the side effects of the drugs (3.6%), natural curiosity (4.2%), and to increase strength(3.O%). From the above facts, the major reasons for drug abuse among Korean youths are to release stress and to stay awake in order to prepare exams. Furthermore, since drugs are readily available, we can conclude that drug abuse is caused by the school system(such as entrance exams) in Korea. VII. Conclusion Drug usage among Korean youths are relatively less common than those of western youths. In some cases, such as, glue-sniffing and use of stimulants, the pattern of drug abuse is found. Moreover, early drug abuse is evident, and it has a close connection with deviant behaviour, resulting in juvenile delinquency. Drug abuse cannot be attributed to any one social factor. Specifically, drug abuse depends on parents, peers, teachers and other members of the community, and also is influenced by social institutions such as the entrance exam system. Every person and organization concerned with youth must participate collectively in restraining drug abuse. Finally, it is suggested that social agencial working for youth welfare should make every effort to tackle this serious problem confronted by the Korean youths today.

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Contribution of Emotional Labor to Burnout and Work Engagement of School Foodservice Employees in Daegu and Gyeongbuk Province (대구·경북 일부지역 학교급식 조리종사자의 감정노동이 직무 소진 및 직무 열의에 미치는 영향)

  • Heo, Chang-Goo;Lee, Kyung-A
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.4
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    • pp.610-618
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    • 2015
  • The purpose of this study was to analyze differences in emotional labor strategies, burnout, and work engagement according to general characteristics of school foodservice employees as well as verify differential effects of two emotional labor strategies on burnout and work engagement. Our survey was administered to 400 school foodservice employees in Gyeongbuk from March 3 to April 25, 2014. A total of 358 completed questionnaires were returned, and 350 questionnaires were used for final analysis. For verification of mean differences, the mean scores for surface acting, deep acting, burnout, and work engagement were shown to be 2.38/5.00, 3.46, 2.67, and 3.41, respectively. The mean surface acting was significantly different according to cooking certification (P<0.001), turnover number (P<0.001), salary (P<0.001), and school level (P<0.01). The mean deep acting was significantly different according to educational background (P<0.001), cooking certification (P<0.001), employment status (P<0.001), salary (P<0.001), school level (P<0.01), and meal service time (P<0.05). The mean burnout was significantly different according to educational background (P<0.01), cooking certification (P<0.05), employment status (P<0.001), school level (P<0.001), and meal service time (P<0.001). The mean work engagement was significantly different according to cooking certification (P<0.001), employment satus (P<0.001), salary (P<0.001), school level (P<0.01), and meal service time (P<0.05). Verification of causal models found that surface acting and deep acting increased burnout and deep acting, respectively (research model). Additionally, surface acting did not influence work engagement, and deep acting did not influence burnout (alternative models). In other words, we identified that emotional labor strategies have differential influences on burnout and work engagement. Finally, implications and limitations of this study are discussed.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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Business Relationships and Structural Bonding: A Study of American Metal Industry (산업재 거래관계와 구조적 결합: 미국 금속산업의 분석 연구)

  • Han, Sang-Lin;Kim, Yun-Tae;Oh, Chang-Yeob;Chung, Jae-Moon
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.3
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    • pp.115-132
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    • 2008
  • Metal industry is one of the most representative heavy industries and the median sales volume of steel and nonferrous metal companies is over one billion dollars in the case America [Forbes 2006]. As seen in the recent business market situation, an increasing number of industrial manufacturers and suppliers are moving from adversarial to cooperative exchange attitudes that support the long-term relationships with their customers. This article presents the results of an empirical study of the antecedent factors of business relationships in metal industry of the United States. Commitment has been reviewed as a significant and critical variable in research on inter-organizational relationships (Hong et al. 2007, Kim et al. 2007). The future stability of any buyer-seller relationship depends upon the commitment made by the interactants to their relationship. Commitment, according to Dwyer et al. [1987], refers to "an implicit or explicit pledge of relational continuity between exchange partners" and they consider commitment to be the most advanced phase of buyer-seller exchange relationship. Bonds are made because the members need their partners in order to do something and this integration on a task basis can be either symbiotic or cooperative (Svensson 2008). To the extent that members seek the same or mutually supporting ends, there will be strong bonds among them. In other words, the principle that affects the strength of bonds is 'economy of decision making' [Turner 1970]. These bonds provide an important idea to study the causes of business long-term relationships in a sense that organizations can be mutually bonded by a common interest in the economic matters. Recently, the framework of structural bonding has been used to study the buyer-seller relationships in industrial marketing [Han and Sung 2008, Williams et al. 1998, Wilson 1995] in that this structural bonding is a crucial part of the theoretical justification for distinguishing discrete transactions from ongoing long-term relationships. The major antecedent factors of buyer commitment such as technology, CLalt, transaction-specific assets, and importance were identified and explored from the perspective of structural bonding. Research hypotheses were developed and tested by using survey data from the middle managers in the metal industry. H1: Level of technology of the relationship partner is positively related to the level of structural bonding between the buyer and the seller. H2: Comparison level of alternatives is negatively related to the level of structural bonding between the buyer and the seller. H3: Amount of the transaction-specific assets is positively related to the level of structural bonding between the buyer and the seller. H4: Importance of the relationship partner is positively related to the level of structural bonding between the buyer and the seller. H5: Level of structural bonding is positively related to the level of commitment to the relationship. To examine the major antecedent factors of industrial buyer's structural bonding and long-term relationship, questionnaire was prepared, mailed out to the sample of 400 purchasing managers of the US metal industry (SIC codes 33 and 34). After a follow-up request, 139 informants returnedthe questionnaires, resulting in a response rate of 35 percent. 134 responses were used in the final analysis after dropping 5 incomplete questionnaires. All measures were analyzed for reliability and validity following the guidelines offered by Churchill [1979] and Anderson and Gerbing [1988]., the results of fitting the model to the data indicated that the hypothesized model provides a good fit to the data. Goodness-of-fit index (GFI = 0.94) and other indices ( chi-square = 78.02 with p-value = 0.13, Adjusted GFI = 0.90, Normed Fit Index = 0.92) indicated that a major proportion of variances and covariances in the data was accounted for by the model as a whole, and all the parameter estimates showed statistical significance as evidenced by large t-values. All the factor loadings were significantly different from zero. On these grounds we judged the hypothesized model to be a reasonable representation of the data. The results from the present study suggest several implications for buyer-seller relationships. Theoretically, we attempted to conceptualize the antecedent factors of buyer-seller long-term relationships from the perspective of structural bondingin metal industry. The four underlying determinants (i.e. technology, CLalt, transaction-specific assets, and importance) of structural bonding are very critical variables of buyer-seller long-term business relationships. Our model of structural bonding makes an attempt to systematically examine the relationship between the antecedent factors of structural bonding and long-term commitment. Managerially, this research provides industrial purchasing managers with a good framework to assess the interaction processes with their partners and, ability to position their business relationships from the perspective of structural bonding. In other words, based on those underlying variables, industrial purchasing managers can determine the strength of the company's relationships with the key suppliers and its state of preparation to be a successful partner with those suppliers. Both the supplying and customer companies can also benefit by using the concept of 'structural bonding' and evaluating their relationships with key business partners from the structural point of view. In general, the results indicate that structural bonding gives a critical impact on the level of relationship commitment. Managerial implications and limitations of the study are also discussed.

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A Study of Reliability and Validity on the Korean Version of Social Adaptation Self Rating Scale(SASS) (한국어판 사회적응자기평가척도(SASS)의 신뢰도 및 타당도 연구)

  • Kim, Hyeong-Seob;Kim, Yong-Ku;Yoon, Choong-Han;Jeong, Han-Yong;Cheong, Young-Ki
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.212-227
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    • 2000
  • This study was designed to testify the reliability and validation on the Korean version of the Social Adaptation Self-rating Scale(SASS) which was developed from Bose et al. for the evaluation of social motivation and behavior of depressed patients in 1997. Interests for the social world, those of social functioning, of patients were involved in the addition of new measure of disturbance. And those were distinct from abnormalities of thought, mood and symptoms of patients with major depression. As the previous reports there were several evidences that treatments may be less likely to be effective if the system they act on is dysfunctional. Thus, a better social situation favoured better outcome. As a matter of fact, however, those reports were developed in the course of the evaluation of interpersonal therapy(IPT) and cognitive therapy. Accordingly the conversed question -whether pharmacological therapy with antidepressants can impact on social functioning in addition to addressing the core features of illness- has been addressed. To date, anyhow, it is accepted that enhancement of social functioning may be a therapeutic principle in its own right and illness rarely divorced from social context. In terms of those concepts the introduction of an assessment of social functioning into pharmacotherapeutic studies of depression has been welcomed and might be a potent instrument for evaluating the relative pharmacoeconomic benefits of different treatments. Despite of many scales which were applied for the evaluation of symptoms in the patients with depression, however, the scale for the evaluation of social functiong has not been introduced in Korea yet. Thus, this study was designed to introduce the concepts of social functioning in the patients with depression and to testify the reliability and validation on Korean version of SASS. This Korean version of SASS was submitted to a reliability and validation procedure based on the data from healthy general population survey in 291 individuals and 40 patients with major depression. Cronbach a was 0.790 in total subjects group and the correlation of test-retest was statistically significant(y=0.653, p<0.0l). Thus, the Korean version of SASS might be shown to be valid and reliable. The results of multivariate analyses allowed the identification of 3 principle factors(factor 1 = intersts in social activities, factor 2 = active interpersonal relationship, factor 3 = selfesteem) in normal group, however, it could be counted as only one factor in the depression group because nearly total items of SASS were involved in factor 1. In the view of these results, the Korean version of SASS may be useful additional tool for the evaluation of social functioning in depression.

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Current feeding practices and maternal nutritional knowledge on complementary feeding in Korea (이유기 보충식 현황과 어머니 인식 조사)

  • Yom, Hye Won;Seo, Jeong Wan;Park, Hyesook;Choi, Kwang Hae;Chang, Ju Young;Ryoo, Eell;Yang, Hye Ran;Kim, Jae Young;Seo, Ji Hyun;Kim, Yong Joo;Moon, Kyung Rye;Kang, Ki Soo;Park, Kie Young;Lee, Seong Soo;Shim, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1090-1102
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    • 2009
  • Purpose:To evaluate current feeding practices and maternal nutritional knowledge on complementary feeding. Methods:Mothers of babies aged 9-15 months who visited pediatric clinics of 14 general hospitals between September and December 2008 were asked to fill questionnaires. Data from 1,078 questionnaires were analyzed. Results:Complementary food was introduced at 4-7 months in 89% of babies. Home-made rice gruel was the first complementary food in 93% cases. Spoons were used for initial feeding in 97% cases. At 6-7 months, <50% of babies were fed meat (beef, 43%). Less than 12-month-old babies were fed salty foods such as salted laver (35%) or bean-paste soup (51%) and cow's milk (11%). The following were the maternal sources of information on complementary feeding: books/magazines (58%), friends (30%), internet web sites (29%), relatives (14%), and hospitals (4%). Compared to the 1993 survey, the incidence of complementary food introduction before 4 months (0.4% vs. 21%) and initial use of commercial food (7% vs. 39%) had decreased. Moreover, spoons were increasingly used for initial feeding (97% vs. 57%). The average maternal nutritional knowledge score was 7.5/10. Less percentage of mothers agreed with the following suggestions: bottle formula weaning before 15-18 months (68%), no commercial baby drinks as complementary food (67%), considering formula (or cow's milk) better than soy milk (65%), and feeding minced meat from 6-7 months (57%). Conclusion:Complementary feeding practices have considerably improved since the last decade. Pediatricians should advise timely introduction of appropriate complementary foods and monitor diverse information sources on complementary feeding.

Nutrition Survey in Koje Island (거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査))

  • Oh, Seoung-Ho;Chang, Soo-Kyung;Park, Michael Myung-Yun
    • Journal of Nutrition and Health
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    • v.10 no.4
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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A Study on Market Expansion Strategy via Two-Stage Customer Pre-segmentation Based on Customer Innovativeness and Value Orientation (고객혁신성과 가치지향성 기반의 2단계 사전 고객세분화를 통한 시장 확산 전략)

  • Heo, Tae-Young;Yoo, Young-Sang;Kim, Young-Myoung
    • Journal of Korea Technology Innovation Society
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    • v.10 no.1
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    • pp.73-97
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    • 2007
  • R&D into future technologies should be conducted in conjunction with technological innovation strategies that are linked to corporate survival within a framework of information and knowledge-based competitiveness. As such, future technology strategies should be ensured through open R&D organizations. The development of future technologies should not be conducted simply on the basis of future forecasts, but should take into account customer needs in advance and reflect them in the development of the future technologies or services. This research aims to select as segmentation variables the customers' attitude towards accepting future telecommunication technologies and their value orientation in their everyday life, as these factors wilt have the greatest effect on the demand for future telecommunication services and thus segment the future telecom service market. Likewise, such research seeks to segment the market from the stage of technology R&D activities and employ the results to formulate technology development strategies. Based on the customer attitude towards accepting new technologies, two groups were induced, and a hierarchical customer segmentation model was provided to conduct secondary segmentation of the two groups on the basis of their respective customer value orientation. A survey was conducted in June 2006 on 800 consumers aged 15 to 69, residing in Seoul and five other major South Korean cities, through one-on-one interviews. The samples were divided into two sub-groups according to their level of acceptance of new technology; a sub-group demonstrating a high level of technology acceptance (39.4%) and another sub-group with a comparatively lower level of technology acceptance (60.6%). These two sub-groups were further divided each into 5 smaller sub-groups (10 total smaller sub-groups) through two rounds of segmentation. The ten sub-groups were then analyzed in their detailed characteristics, including general demographic characteristics, usage patterns in existing telecom services such as mobile service, broadband internet and wireless internet and the status of ownership of a computing or information device and the desire or intention to purchase one. Through these steps, we were able to statistically prove that each of these 10 sub-groups responded to telecom services as independent markets. We found that each segmented group responds as an independent individual market. Through correspondence analysis, the target segmentation groups were positioned in such a way as to facilitate the entry of future telecommunication services into the market, as well as their diffusion and transferability.

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