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Comparison of the Clinical Outcomes of a Single Injection Adductor Canal Block with the Concomitant Use of Transdermal Buprenorphine and Continuous Adductor Canal Block after Total Knee Arthroplasty (슬관절 인공관절 전치환술 후 일회 주사 내전근관 차단술 및 경피성 Buprenorphine 병합 요법과 도관 삽입 지속적 내전근관 차단술의 임상결과 비교)

  • Huh, Jung-Wook;Park, Man-Jun;Ko, Young-Chul;Ha, Dong-Jun;Park, Joon-Hyung;Lee, Woo-Myung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.411-417
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    • 2019
  • Purpose: To compare the clinical outcomes of single injection adductor canal block (SACB), continuous adductor canal block (CACB), and the concomitant use of transdermal buprenorphine after total knee arthroplasty (TKA). Materials and Methods: A total of 125 patients who underwent TKA were divided into three groups and the clinical results were retrospecitively compared. Group I was comprised of patients with pain controlled by SACB (n=41). Group II consisted of patients with pain controlled by both SACB and transdermal buprenorphine (10 ㎍/h) (n=44). Group III contained patients with pain controlled by CACB (n=40). The visual analogue scale (VAS) was used as the pain control indicator and the patients were measured on a VAS for resting on the bed (VAS-Rest) at 12 hours, 24 hours, and 48 hours after surgery. The VAS while doing continuous passive motion (VAS-CPM) on the first and second postoperative day was also measured. In addition, the total amount of medications used (Butopahn, Tridol, and Ketorac) for the intravenous patient controlled analgesia (PCA) was counted for 48 hours after surgery. As the indicator of the functional recovery outcome, the incidence of nausea and vomiting was observed for 48 hours after surgery. The maximum knee joint flexion range and maximum walking distance on the first and second postoperative day, and the total length of stay at the hospital were compared. Results: The VAS-Rest was similar in the three groups at 12 hours after surgery, but at 24 hours and 48 hours after surgery, group II and III a lower VAS-CPM and total amount of medications used for PCA than group I (p<0.05). The three groups showed a low incidence of nausea and vomiting, maximum knee joint flexion range, and similar walking distance and total length of stay at the hospital. Conclusion: The combination of SACB and transdermal buprenorphine has great pain control effect initially. On the other hand, it is not associated with catheter complications and it is convenient to use and safety toward the renal function. Therefore, the concomitant use of SACB and transdermal buprenorphine can be an effective pain control method after TKA.

Exploring the Role of Preference Heterogeneity and Causal Attribution in Online Ratings Dynamics

  • Chu, Wujin;Roh, Minjung
    • Asia Marketing Journal
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    • v.15 no.4
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    • pp.61-101
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    • 2014
  • This study investigates when and how disagreements in online customer ratings prompt more favorable product evaluations. Among the three metrics of volume, valence, and variance that feature in the research on online customer ratings, volume and valence have exhibited consistently positive patterns in their effects on product sales or evaluations (e.g., Dellarocas, Zhang, and Awad 2007; Liu 2006). Ratings variance, or the degree of disagreement among reviewers, however, has shown rather mixed results, with some studies reporting positive effects on product sales (e.g., Clement, Proppe, and Rott 2007) while others finding negative effects on product evaluations (e.g., Zhu and Zhang 2010). This study aims to resolve these contradictory findings by introducing preference heterogeneity as a possible moderator and causal attribution as a mediator to account for the moderating effect. The main proposition of this study is that when preference heterogeneity is perceived as high, a disagreement in ratings is attributed more to reviewers' different preferences than to unreliable product quality, which in turn prompts better quality evaluations of a product. Because disagreements mostly result from differences in reviewers' tastes or the low reliability of a product's quality (Mizerski 1982; Sen and Lerman 2007), a greater level of attribution to reviewer tastes can mitigate the negative effect of disagreement on product evaluations. Specifically, if consumers infer that reviewers' heterogeneous preferences result in subjectively different experiences and thereby highly diverse ratings, they would not disregard the overall quality of a product. However, if consumers infer that reviewers' preferences are quite homogeneous and thus the low reliability of the product quality contributes to such disagreements, they would discount the overall product quality. Therefore, consumers would respond more favorably to disagreements in ratings when preference heterogeneity is perceived as high rather than low. This study furthermore extends this prediction to the various levels of average ratings. The heuristicsystematic processing model so far indicates that the engagement in effortful systematic processing occurs only when sufficient motivation is present (Hann et al. 2007; Maheswaran and Chaiken 1991; Martin and Davies 1998). One of the key factors affecting this motivation is the aspiration level of the decision maker. Only under conditions that meet or exceed his aspiration level does he tend to engage in systematic processing (Patzelt and Shepherd 2008; Stephanous and Sage 1987). Therefore, systematic causal attribution processing regarding ratings variance is likely more activated when the average rating is high enough to meet the aspiration level than when it is too low to meet it. Considering that the interaction between ratings variance and preference heterogeneity occurs through the mediation of causal attribution, this greater activation of causal attribution in high versus low average ratings would lead to more pronounced interaction between ratings variance and preference heterogeneity in high versus low average ratings. Overall, this study proposes that the interaction between ratings variance and preference heterogeneity is more pronounced when the average rating is high as compared to when it is low. Two laboratory studies lend support to these predictions. Study 1 reveals that participants exposed to a high-preference heterogeneity book title (i.e., a novel) attributed disagreement in ratings more to reviewers' tastes, and thereby more favorably evaluated books with such ratings, compared to those exposed to a low-preference heterogeneity title (i.e., an English listening practice book). Study 2 then extended these findings to the various levels of average ratings and found that this greater preference for disagreement options under high preference heterogeneity is more pronounced when the average rating is high compared to when it is low. This study makes an important theoretical contribution to the online customer ratings literature by showing that preference heterogeneity serves as a key moderator of the effect of ratings variance on product evaluations and that causal attribution acts as a mediator of this moderation effect. A more comprehensive picture of the interplay among ratings variance, preference heterogeneity, and average ratings is also provided by revealing that the interaction between ratings variance and preference heterogeneity varies as a function of the average rating. In addition, this work provides some significant managerial implications for marketers in terms of how they manage word of mouth. Because a lack of consensus creates some uncertainty and anxiety over the given information, consumers experience a psychological burden regarding their choice of a product when ratings show disagreement. The results of this study offer a way to address this problem. By explicitly clarifying that there are many more differences in tastes among reviewers than expected, marketers can allow consumers to speculate that differing tastes of reviewers rather than an uncertain or poor product quality contribute to such conflicts in ratings. Thus, when fierce disagreements are observed in the WOM arena, marketers are advised to communicate to consumers that diverse, rather than uniform, tastes govern reviews and evaluations of products.

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A Study on the Korean Shamanistic Myth "Samgong Bonpoori" from the Perspective of Analytical Psychology (무가 '삼공본풀이'에 대한 분석심리학적 고찰)

  • Myung-sook Hwang
    • Sim-seong Yeon-gu
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    • v.30 no.2
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    • pp.145-186
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    • 2015
  • This thesis discusses and analyzes Jeju island's shamanistic myth "Samgong Bonpoori" from the perspective of analytical psychology. Similar to the "I live on my fortune"-type folktales discovered in the Korean mainland, "Samgong Bonpoori" is such a widespread myth that similar folktales are found not only in East Asian regions, including Korea, Japan, and China, but also in Ireland. The essence of the story is as follows; One day, a father asked his three daughters whose fortune they lived on. The first two daughters claimed that they owe their lives to their parents. However, the youngest daughter, Gameunjang-agi, replied, against his expectation, that "I live on my own fortune," and showed her fortune and virtue were physically embodied in the line drawn from her genitals to navel. Her answer enrages his father so fiercely that she was expelled and forced to embark on a journey with no one but a black cow carrying food to accompany her. In retaliation for telling lies against her, Gameunjang-agi transformed her two sisters into a centipede and a mushroom, while her parents were turned into beggars afflicted with blindness. Afterward, Gameunjang-agi wandered around the country and eventually found love with a Chinese yam digger. Not long after, they got married, and as a couple, they stumbled upon roots of gold in fields, which brought them an incredible amount of wealth. After this miracle has happened, Gameunjang-agi began to wonder about the status of her parents and decided to organize a party for all the beggars and the blinds in the country. She eventually found her parents and got a chance to reconcile with her sisters. The story ends with her parents regaining their eyesight and Gameunjang-agi reestablishing herself as the "Goddess of Providence." "Samgong Bonpoori" is a myth about a God. A God is ontologically a supremely perfect being; however, in this thesis, it will be discussed as a part of a folktale. Gameunjang-agi can be seen as the anima archetype of the father, which reveals the process of a paternal consciousness being transformed over time. At first, her parents deny Gameunjang-agi. However, after years of suffering from blindness, they regain their eyesight and finally recognize their daughter. This signifies that Gameunjang-agi is a being that has come into the world for a certain "purpose." Gameunjang-agi embodies the creative function of "femininity" that can renew the existing collective consciousness embedded in the patriarchal system. Such recognition of femininity matters to men to a great degree as well as to women. Without knowing their true nature (femininity), the two sisters submit themselves to their parents and conventional values. Not until they suffer from being transformed and captured into small and insignificant beings, a centipede and a mushroom, which symbolize their shadow, they fail to develop their self-awareness. Meanwhile, by reconciling with her parents and sisters--playing a significant role in reuniting the family--Gameunjang-agi turns out to be a figure that can reveal what it truly means to have self-awareness and achieve Self-realization. In conclusion, this story illustrates that recognition of femininity matters to men to a great degree as well as to women, and women's Self-realization plays a critical role in revitalizing the collective consciousness embedded in the patriarchal system.

The Effect of the Gap between College Students' Perception of the Importance of Coffee Shops and Their Satisfaction after Patronizing Coffee Shops on Their Purchasing Behavior (대전원교학생대가배점중요성적감지화타문광고가배점지후적만의도지간적차거대타문구매행위적영향(大专院校学生对咖啡店重要性的感知和他们光顾咖啡店之后的满意度之间的差距对他们购买行为的影响))

  • Lee, Won-Ok
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.4
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    • pp.1-10
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    • 2009
  • The purpose of this study was to categorize the gap between coffee shop 'importance' (as perceived by customers before patronizing the coffee shop) and 'satisfaction' (perception of customers after patronizing the coffee shop) as positive or negative and to analyze the effect of these gaps on purchasing behavior. To do this, I used the gap between importance and satisfaction regarding the choice of a coffee shop as the explanatory variable and performed an empirical analysis of the direction and size of the effect of the gap on purchasing behavior (overall satisfaction, willingness-to-revisit) by applying the Ordered Probit Model (OPM). A previous study that used IPA to evaluate the effects of gaps estimated the direction and size of a quadrant but failed to analyze the effect of gaps on customers. In this study, I evaluated the effects of positive and negative gaps on customer satisfaction and willingness-to-revisit. Using OPM, I quantified the effect of positive and negative gaps on overall customer satisfaction and willingness-to-revisit. Per-head expenditure, frequency of visits, and coffee-purchasing place had the most positive effects on overall customer satisfaction. Frequency of visits, followed by per-head expenditure and then coffee-purchasing place, had the most positive impact on willingness-to-visit. Thus per-head expenditure and frequency of visits had the greatest positive effects on overall satisfaction and willingness-to-revisit. This finding implies that the higher the actual satisfaction (gap) of customers who spend KRW5,000 or more once or more per week at coffee shops is, the higher their overall satisfaction and willingness-to-revisit are. Despite the fact that economical efficiency had a significant effect on overall satisfaction and willingness-to-revisit, college and university students still use coffee shops and are willing to spend KRW5,000 because they do not only purchase coffee as a product itself, but use the coffee shop for other activities, such as working, meeting friends, or relaxing. College and university students also access the Internet in coffee shops via personal laptops, watch movies, and study; thus, coffee shops should provide their customers with the appropriate facilities and services. The fact that a positive gap for coffee shop brand had a positive effect on willingness-to-revisit implies that the higher the level of customer satisfaction, the greater the willingness-to-revisit. A negative gap for this factor, on the other hand, implies that the lower the level of customer satisfaction, the lower the willingness-to-revisit. Thus, the brand factor has a comparatively greater effect on satisfaction than the other factors evaluated in this study. Given that the domestic coffee culture is becoming more upscale and college/university students are sensitive to this trend, students are attentive to brands. In most upscale coffee shops in Korea, the outer wall is built out of glass that can be opened, the interiors are exotic with an open kitchen. These upscale coffee shops function as landmarks and match the taste of college/university students. Coffee shops in Korea have become a cultural brand. To make customers feel that coffee shops are upscale, good quality establishments and measures to provide better services in terms of brand factor should be instituted. The intensified competition among coffee shop brands in Korea as a result of the booming industry indicates that provision of additional services is needed to differentiate competitors. These customers can also use a scanner free of charge. Another strategy that can be used to boost brands could be to provide and operate a seminar room for seminars and group study. If coffee shops adopt these types of strategies, college/university students would be more likely to consider the expenses they incur worthwhile and, subsequently, they would be more likely to be satisfied with the brands of these coffee shops, with an associated increase in their willingness-to-revisit. Gender and study year had the most negative effects on overall satisfaction and willingness-to-revisit. Female students were more likely to be satisfied and be willing to return than male students, and third and fourth-year students were more likely to be satisfied and willing-to-return than first or second-year students. Students who drink coffee, read books, and use laptops alone at coffee shops are easily noticeable. High-grade students tend to visit coffee shops alone in order to use their time efficiently for self-development and to find jobs. The economical efficiency factor had the greatest effect on overall satisfaction and willingness-to-revisit in terms of a positive gap. The higher the actual satisfaction (gap) of students with the price of the coffee, the greater their overall satisfaction and willingness-to-revisit. Economical efficiency with a negative gap had a negative effect on willingness-to-revisit, which implies that a less negative gap will result in a greater willingness-to-revisit. Amid worsening market conditions, coffee shops located around colleges/universities are using strategies, such as a point or membership card, strategic alliances with credit-card companies, development of a set menu or seasonal menu, and free coffee-shot services to increase their competitive edge. Product power also had a negative effect in terms of a negative gap, which indicates that a higher negative gap will result in a lower willingness-to-revisit. Because there are many more customers that enjoy coffee in this decade, as compared to previous decades, the new generation of customers, namely college/university students, want various menu items in addition to coffee, and coffee shops should, therefore, add side menu items, such as waffles, rice cakes, cakes, sandwiches, and salads. For example, Starbucks Korea is making efforts to enhance product power by selling rice cakes flavored in strawberry, wormwood, and pumpkin, and providing coffee or cream free of charge. In summary, coffee shops should focus on increasing their economical efficiency, brand, and product power to enhance the satisfaction of college/university students. Because shops adjacent to colleges or universities enjoy a locational advantage, providing differentiated services in terms of economical efficiency, brand, and product power, is likely to increase customer satisfaction and return visits. Coffee shop brands should, therefore, be innovative and embrace change to meet their customers' desires. Because this study only targeted college/university students in Seoul, comparative studies targeting diverse regions and age groups are required to generalize the findings and recommendations of this study.

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Serum 25-Hydroxy Vitamin $D_3$ Analysis of Korean People (한국인 일반인의 혈청 25-Hydroxy Vitamin $D_3$의 분석)

  • Kim, Bo-Kyung;Jung, Hyun-Mi;Kim, Yun-Kyung;Kim, So-Young;Kim, Jee-Hyun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.133-137
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    • 2010
  • Purpose: The main function of vitamin D is the mineralization of the brain by increase of calcium and phosphorus, in case it is insufficient in children, lime deposition on cartilage cannot occur so it leads to rachitis, and in adults, it leads to osteomalacia or osteoporosis. It is also strongly believed in the academic world that vitamin D can restrict the growth of cancer cells and prevent heart diseases, which is also somewhat proven in epidemiological researches. While the right density of vitamin D is still being studied, 20-32 ng/mL is believed to be the most ideal density. Therefore, I wanted analyze how much density of 25-Hydroxyvitamin D3 that Koreans possess. Materials and Methods: From February 20th, 2008 to April 21st, 2009, the collection of 2800 serums, from medical examination treated subjects by Neodin Medical Institute, have been tested. The targets were tested by 25-Hydroxyvitamin D (125I Kit: Diasorin, USA), and were analyzed by dividing into many different categories (gender, age, season, region). Results: The average density of male were 20 ng/mL, female 17.08 ng/mL. Per age groups, the density of males were as follows: 10~20-18 ng/mL, 21~30-17 ng/mL, 31~40-19 ng/mL, 41~50-21 ng/mL, 51~60-22 ng/mL, 61~70-22 ng/mL, 71~80-22 ng/mL and 81~90-19.9 ng/mL. Average density of females per age groups, were as follows: 10~20-16 ng/mL, 20~30-15.26 ng/mL, 30~40-16 ng/mL, 40~50-17 ng/mL, 50~60-19 ng/mL, 60~70-19 ng/mL, 70~80-19 ng/mL, and 80~90-17 ng/mL. Per seasons, From December to May, the subjects showed the density of 15.97 ng/mL, while from June to November, it showed 21.60 ng/mL. On density of males from January to April regionally, Seoul+Gyeonggi-Do-15.52 ng/mL, Gangwon-Do-15.33 ng/mL, Choongchung-Do-18.03 ng/mL, Jeonla-Do-18.68 ng/mL, Gyungsang-Do-18.76 ng/mL and Cheju Do-21.23 ng/mL. Conclusions: The vitamin D of Koreans is has been insufficient compared to the suggested amount. Ultraviolet rays, which is the main source of vitamin D is critical, therefore it is suggested that more outdoor activities can definitely help.

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The Experimental Study for Myocardial Preservation Effect of Ischemic Preconditioning (허혈성 전조건화 유발이 심근보호에 미치는 영향에 관한 실험적 연구)

  • 이종국;박일환;이상헌
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.119-130
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    • 2004
  • Decrease in cardiac function after open heart surgery is due to an ischemia induced myocardial damage during surgery, and ischemic preconditioning, a condition in which the myocardial damage does not accumulate after repeated episodes of ischemia but protects itself from damage after prolonged ischemia due to myocytes tolerating the ischemia, is known to diminish myocardial damage, which also helps the recovery of myocardium after reperfusion, and decreases incidences of arrythmia. Our study is performed to display the ischemic preconditioning and show the myocardial protective effect by applying cardioplegic solution to the heart removed from rat. Material and Method: Sprague-Dawley male rats were used, They were fixed on a modified isolated working heart model after cannulation. The reperfusion process was according to non-working and working heart methods and the working method was executed for 20 minutes in which the heart rate, aortic pressure, aortic flow and coronary flow were measured and recorded. The control group is the group which the extracted heart was fixed on the isolated working heart model, recovered by reperfusion 60 minutes after infusion and preserved in the cardioplegic solution 20 minutes after the working heart perfusion and aortic cross clamp, The thesis groups were divided into group I, which ischemic hearts that were hypoxia induced were perfused by cardioplegic solution and preserved for 60 minutes; group II, the cardioplegic solution was infused 45 seconds (II-1), 1 minutes (II-2), 3 minutes (II-3), after the ischemia induction, 20 minutes after working heart perfusion and aortic cross clamp; and group III, hearts were executed on working heart perfusion for 20 minutes and aortic cross clamp was performed for 45 seconds (III-1), 1minute (III-2), 3 minutes (III-3), reperfused for 2 minutes to recover the heart, and then aortic cross clamping was repeated for reperfusion, all the groups were compared based on hemodynamic performance after reperfusion of the heart after preservation for 60 minutes. Result: The recovery time until spontaneous heart beat was longer in groups I, II-3, III-2 and III-3 to control group (p<0.01). Group III-1 (p<0.05) had better results in terms of recovery in number of heart rates compared to control group, and recovered better compared to II-1 (p<0.05). The recovery of aortic blood pressure favored group III-1 (p<0.05) and had better outcomes compared with II-1 (p<0.01). Group III-1 also showed best results in terms of cardiac output (p<0.05) and group III-2 was better compared to II-2 (p<0.05). Group I (p<0.01) and II-3 (p<0.05) showed more cardiac edema than control group. Conclusion: When the effects of other organs are dismissed, protecting the heart by infusion of cardioplegic solution after enforcing ischemia for a short period of time before the onset of abnormal heart beats for preconditioning has a better recovery effect in the cardioplegic group with preconditioning compared to the cardioplegic solution itself. we believe that further study is needed to find a more effective method of preconditioning.

Oxidative Inactivation of Peroxiredoxin Isoforms by H2O2 in Pulmonary Epithelial, Macrophage, and other Cell Lines with their Subsequent Regeneration (폐포상피세포, 대식세포를 비롯한 각종 세포주에서 H2O2에 의한 Peroxiredoxin 동위효소들의 산화에 따른 불활성화와 재생)

  • Oh, Yoon Jung;Kim, Young Sun;Choi, Young In;Shin, Seung Soo;Park, Joo Hun;Choi, Young Hwa;Park, Kwang Joo;Park, Rae Woong;Hwang, Sung Chul
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.31-42
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    • 2005
  • Background : Peroxiredoxins (Prxs) are a relatively newly recognized, novel family of peroxidases that reduce $H_2O_2$ and alkylhydroperoxide into water and alcohol, respectively. There are 6 known isoforms of Prxs present in human cells. Normally, Prxs exist in a head-to-tail homodimeric state in a reduced form. However, in the presence of excess $H_2O_2$, it can be oxidized on its catalytically active cysteine site into inactive oxidized forms. This study surveyed the types of the Prx isoforms present in the pulmonary epithelial, macrophage, endothelial, and other cell lines and observed their response to oxidative stress. Methods : This study examined the effect of exogenous, excess $H_2O_2$ on the Prxs of established cell lines originating from the pulmonary epithelium, macrophages, and other cell lines, which are known to be exposed to high oxygen partial pressures or are believed to be subject to frequent oxidative stress, using non-reducing SDS polyacrylamide electrophoresis (PAGE) and 2 dimensional electrophoresis. Result : The addition of excess $H_2O_2$ to the culture media of the various cell-lines caused the immediate inactivation of Prxs, as evidenced by their inability to form dimers by a disulfide cross linkage. This was detected as a subsequent shift to its monomeric forms on the non-reducing SDS PAGE. These findings were further confirmed by 2 dimensional electrophoresis and immunoblot analysis by a shift toward a more acidic isoelectric point (pI). However, the subsequent reappearance of the dimeric Prxs with a comparable, corresponding decrease in the monomeric bands was noted on the non-reducing SDS PAGE as early as 30 minutes after the $H_2O_2$ treatment suggesting regeneration after oxidation. The regenerated dimers can again be converted to the inactivated form by a repeated $H_2O_2$ treatment, indicating that the protein is still catalytically active. The recovery of Prxs to the original dimeric state was not inhibited by a pre-treatment with cycloheximide, nor by a pretreatment with inhibitors of protein synthesis, which suggests that the reappearance of dimers occurs via a regeneration process rather than via the de novo synthesis of the active protein. Conclusion : The cells, in general, appeared to be equipped with an established system for regenerating inactivated Prxs, and this system may function as a molecular "on-off switch" in various oxidative signal transduction processes. The same mechanisms might applicable other proteins associated with signal transduction where the active catalytic site cysteines exist.

An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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A Study on medical Qigong mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) (${\ll}$삼일신고(三一神誥)${\gg}$에 나타난 의료기공(醫療氣功)에 관(關)한 연구(硏究))

  • Ban, Chang-Yul
    • Journal of Korean Medical Ki-Gong Academy
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    • v.7 no.2
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    • pp.40-94
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    • 2004
  • Recently, meditation, Zen meditation and Qigong became popular in western. For that reason, Value of Korea traditional methods for health promotion have been evaluated but theoretical evidence about that is insufficient. ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). So, I reviewed history of Korea Qigong according to period, in order to produce theoretical evidence of Korea medical Qigong and investigated ${\ulcorner}$Han${\lrcorner}$ thought (${\ulcorner}$${\lrcorner}$ 思想) as theoretical evidence of Korea Qigong. I have obtained following results by comparing meaning of god, a view of human body and practice method of the ${\ll}$Samilshingo${\gg}$ (三一神誥) with ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). Sinsundo(神仙道) of native to race became active during the period of the Three Kingdoms but more disappeared due to under the influence of Taoism. So only has been remained in existence since the period of the unity silla. There could accept positively the foreign ideas belonging to Confucianism, Buddhism and Taoism have been brought since the period of the Three Kingdoms because ${\ll}$Samilshingo${\gg}$ (三一神誥), one of three the scriptures as the origin of ${\ulcorner}$Han${\lrcorner}$ thought(${\ulcorner}$${\lrcorner}$ 思想) included the original form of three religion belonging to Confucianism, Buddhism, Taoism. Three common results as theoretical evidence of Qigong were found out by comparing ${\ll}$Samilshingo${\gg}$ (三一神誥) with ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經). First, in meaning of god, there is not only different from the gods of heaven and the gods of human but also keep understanding with each other and there was common feature of logical structure that function of god was divided into three. Second, In a view of human body, there were in common with ${\ll}$Samilshingo${\gg}$ (三一神誥) as theory of only as energy(氣一元論), theory of bisection as truth false(眞妄二分論), theory of trisection as spirit(性) destiny(命) nature(精) and mind(心) energy(氣) body(身)(性 命 精, 心 氣 身의 三分論) and ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經) as theory of only as energy(氣一元論), theory of bisection as shape and god(形神二分論), theory of trisection as nature(精) energy(氣) god(神) or shape(形) energy(氣) god(神)(精 氣 神, 形 氣 神의 三分論) according to formal part. Also, spirit(性) destiny(命) nature(精) as truths of three(三眞) were understand as nature(精) energy(氣) god(神) as treasure of three(三寶) by part of reason and mind(心) energy(氣) body(身) as false of three(三妄) were understand as nature(精) energy(氣) god(神) as treasure of three(三寶) by part of function. Third, In practice method, pause of thinking(止感) modulation of breath(調息). prohibition of sensibility(禁觸) mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) as practice method each were understand regulation of an etiological cause as an internal cause, an external cause and not internal and external cause in oriental medicine. Namely, pause of thinking(止感) was understand as regulation method of emotion, mind and nature. modulation of breath(調息) was not only as modulation of energy from the inner parts of the body but also that from the internal and external parts of the body, prohibition of sensibility(禁觸) was understand as regulation method of ear, eye, mouth, and nose and posture, life style. These results suggest that ${\ll}$Samilshingo${\gg}$ (三一神誥) is worth meaning of Korea medical Qigong because meaning of god, a view of human body, practice method of mentioned in ${\ll}$Samilshingo${\gg}$ (三一神誥) is common with that of ${\ll}$The Yellow Emperor's Inner Classic${\gg}$ (黃帝內經) as theoretical evidence of Qigong.

Example of Legislation on the Space Relations of Every Countries in the World and Main Contents of the Space Exploration Promotion Act and Future Task in Korea (세계 각국의 우주관계 입법례와 우리나라 우주 개발진흥법의 주요내용 및 앞으로의 과제)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.20 no.1
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    • pp.9-43
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    • 2005
  • The Korean government established her first "National Space Program" in 1996, and revised it in 2000 and 2005. As embedded in the National Space Program, Korea aims to become one of the world's top countries in space technology by 2010. All of 13 satellites are planned to be put into orbit as schematized, which include 7 multi-purpose satellites, 4 science satellites and 2 geostationary orbit satellites. The Space Center in Korea is to be built at Woinara-Do, Bongrae-Myon, Koheung-Goon, Junlanam Province on the southern coast of the Korean peninsular. The first phase of the construction of the space center will be finished by 2007 for launch of KSLV-l. This will make Korea be the 13th advanced country in space development having a launching site in the world. The "Space Center" will serve as the infrastructure for the development of space technology and related technology, and plan to launch a low earth orbit satellite in 2007. A second science satellite made in Korea will be launched from the space center by 2007. From 2010, the center will be operated on a commercial basis operating launch facilities for low-to mid-altitude orbit satellites. Since the 'Aircraft Industry Promotion Act' was replaced by the 'Aerospace Industry Development Promotion Acf of 1987, this Act had been amended seven times from 1991 year to 2004. Most of developed countries has been enacted the space law including the public or private items such as an (1)DSA, (2)Russia, (3)the United Kingdom, (4)Germany, (5)France, (6)Canada, (7)Japan, (8)Sweden, (9)Australia, (10)Brazil, (11)Norway, (12)South Africa, (13)Argentina, (14)Chile, (15)Ukrainian etc. As the new Space Exploration Promotion Act was passed by the resolution of the Korean Congress on May 3, 2005, so the Korean government has made the public proclamation the abovementioned Act on May 31, this year. This Act takes effect on December 1, 2005 after elapsing six months from the date of promulgation. The main contents of Space Exploration Promotion Act of 2005 is as the following (1)establishing a basic plan for promoting space exploration, (2)establishment and function of national space committee, (3)procedure and management of domestic and international registration of space objects, (4)licensing of launch by space launch vehicles, (5)lability for damages caused by space accidents and liability insurance, (6) organizing and composition of the space accident investigation committee, (7)Support of non-governmental space exploration project, (8)Requesting Support and Cooperation of Space Exploration, (9)Rescue of Astronauts and Restitution of Space Objects, etc.. In oder to carry out successfully the medium and long basic plan for promoting space exploration and to develope space industry in Korea, I think that it is necessary for us to enlarge and to reorganize the function and manpower of the Space Technology Development Division of the Ministry of Science & Technology and the Korea Aerospace Research Institute. Korea has been carrying out its space program step by step according to the National Space Program. Korea also will continually strengthen the exchange and cooperation with all the countries in the world under the principle of equality, friendship relations and mutual benefits. Together with all other peoples around the globe, Korea will make due contribution towards the peaceful utilization of space resources and promotion of human progress and prosperity.

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