To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.
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.
The present study was conducted to analyze the degree of changes in knowledge and attitude toward health, arid health promoting activities after providing health education intervention for a year to elementary school children, to examine the factors effecting knowledge, attitude and health promoting practices for obesity and diet, and to analyze whether changes are present in health level according to changes in knowledge on health and health promoting activities. After conducting a pre-survey rio 354 subjects of 3rd and 4th grade students and their mothers in the city area of Kyungju, in April, 1999, 301. responses with the responding rate of 85% were obtained. Final analysis was done with 231 pairs of a student and his/her mother who could be followed up after a year among 301 pairs of the respondents, excluding those students who transferred, those who were excused from school early, those who did not take abdominal fat measurements, and those students and mothers respondents whose survey was incomplete. Based on the changes before and after the intervention, the scores on knowledge about obesity and diet showed a significant difference in normal weight group, and the scores on the attitude toward obesity and diet increased significantly in obesity group but decreased significantly in normal weight group(p<0.01). The scores of practicing health promoting activities were significantly increased in both groups, and although the waist-hip ratio (WHR) did not change in obesity group, the rate increased significantly in normal weight group(p<0.01). As for changes on the knowledge of obesity and diet before and after the intervention while dividing the scores into 3 levels based on the scores of the pre-survey and compared to changes in the scores one year after, in the case of the changes in the scores in the 1st third, the score on the knowledge about obesity and diet changed from 1.3 in the pre survey to 3.7 after the intervention, showing significant increase(p<0.01) The scores of practicing health promoting activities for obesity and diet were significantly increase in all three levels(p<0.01), and the degree of changes in the scores was 7.0 points in the 1st third, 4.4 points for the and third and 1.8 points for the 3rd third, showing a significant difference among the three levels(p<0.01). It was shown that the increase in BMI in those students whose mothers have the education level higher than university was significantly higher than the increase in BMI in those students whose mothers have the education level under high school, and those students whose mothers are in their 30's showed higher changes in practicing health promoting activities for obesity and diet. When the scores of mothers' knowledge and attitude toward obesity and diet were compared by dividing the scores into tertile, the score of students' knowledge changed significantly according to the scores of mothers' attitude toward obesity and diet. In multiple regression analysis on changes in the scores of knowledge about obesity and diet, the student variables of the degree of awareness on the seriousness of obesity, and the scores of previous knowledge on diet and obesity were selected the significant variables, and among the mother variables, the degree of guiding the child on diet and the education level were the significant variables. In multiple regression analysis to analyze the factors effecting changes in the attitude toward obesity and diet, the student variables of the BMI, scores of previous knowledge on obesity and diet, and scores on the previous attitude toward obesity and diet were shown to be significant. In multiple regression analysis on the factors effecting changes in health promoting activities for obesity and diet, the student variables of the BMI, scores on the previous attitude toward obesity and diet, and changes in the scores of obesity and diet were selected the significant variables.
Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset:
As having the movement of developing private brand (PB) goods, domestic big retailers are facing up with new problems. Thus, it is required studies of PB products, and how consumers recognize PB products as a consideration commodity set. Also, it is worthy in order that it gives us the important meaning on the marketing strategy with focusing on evaluating the differences between customers buying PB grocery goods with respect to demographic characteristics and purchasing behaviors. PB has some advantages for customers and retailers. However, according to AC Nielson's report (2005), Asian and emerging market has 1/5 sales relatively to Western countries. But we can assume that the emerging market has the most potential growth through this result. As a result from several other studies, it becomes necessary to not only increase the rate of selling composition of PB product temporarily, but also analyze the characteristics of customers using big retailers and segmenting customer groups to make PB product as a consideration commodity set for them. In addition, it is needed to have a variety of acts of marketing. From studies related to PB, there is a prejudice - cheap products have low quality - but, evaluation by customers who have used those products shows neutral stand, and there is a study representing that it is the most important to accumulate the belief between the retailers selling PB products and consumers using those for the accurate evaluation and intention on purchasing. Also, by the result from analyzing the characteristics of customers buying PB products, we could assume that higher income and higher education level, more preference on PB products. Especially, according to TNS's research, the primary targets of PB product are 30's who seeks value for money and planned spending habits, and 40's who have teenager children, and are interested in encouraging themselves. This paper used Probit model to analyze the characteristics of consumers. This model helps us to analyze with the variables representing the demographic characteristics of consumers (gender, age, educational level, occupation, income level, living area), and variables related to purchasing behavior (visiting frequency on big retailers, the average amount that they pay for goods in there, and check-up which brand made those goods). The method we used in this study is by man to man interview and survey on-line with the rate of 89% and 11% in Seoul and Gyunggi Province, respectively, for about one month from the beginning of February, 2008. As a result of this, under the assumption that people buy PB products more as long as they go shopping more, it was not meaningful for target groups which we pointed out as frequently visiting customers to be. Although, we have expected women buy more PB products than men do, gender doesn't mean anything for the result. And, it has inferred that married people buy more PB goods than singles do. It was also meaningless with variables related to occupation. Because housewives are often exposed to any kind of supermarket than workers are, we could not get any relatives. Moreover, we couldn't proof that younger generation prefer big retailers more than older people who 50~60's. Education levels doesn't affect on the purchase of PB product as well. Related to living area, the result is statistically not similar as we expected whether living in Seoul or not. It shows there is no relationship with the preference on retail brands and PB products, and it is similar with the study researched by TNS(2008) that customers tend to buy PB product impulsively no matter which brand it is and where they are even though their shopping place is the big market where customers are often using. Variables on which we had meaningful results are income level and living place. That is, customers who have 3,000,000~6,000,000 WON every month on average are more willing to buy PB products than other customers whose income is over 6,000,000 WON, and residents not living in Seoul prefer PB goods than those who are living in Seoul. To explain more about what we got, if there is only one condition about customer's visiting frequency on big retails, we could come up with this result that more exposed to PB products, more purchasing frequency. Consequently, it brings the important insight that large retailers have to prepare something to make customers visit them often to increase selling rate of PB products. To demonstrate the result of analyzing more, what is more efficient variables are demographically including marital status, income level, and residential area to buy items that affect the PB products and could include the frequency of visiting large markets by the purchase habits. Specifically, then, married couples rather than singles, middle-income customers than high-income customers, and local residents not living in Seoul than customers in Seoul are more likely to purchase PB goods. In addition, as long as a customer visits two times more, then the purchasing rate of PB products is to increase over 5.3%. Therefore, it seems that retailers are better to make a shopping place as fun and comfortable places. With overwhelming the idea that PB products are just cheap, one-time purchase goods, it is needed to increase the loyalty on those goods like NB products, try to make PB products as a consideration products set, and occur to sustainable sales. Especially, as suggested by this paper, it seems like it strongly needs to identify the characteristics of customers who prefer PB, to segment those customers, and to select the main target, and to do positioning with well-planned marketing strategies. Then, it is able to give us a meaningful point on marketing strategy by developing the field of PB study, identifying the difference of life style and shopping habits of customers.
This paper examines the circulation and dissemination of painting during and after the nineteenth century through a case study on the One Hundred Fans paintings produced as decorative folding screens at the time. One Hundred Fans paintings refer to depictions of layers of fans in various shapes on which pictures of diverse themes are drawn. Fans and paintings on fans were depicted on paintings before the nineteenth century. However, it was in the nineteenth century that they began to be applied as subject matter for decorative paintings. Reflecting the trend of enjoying extravagant hobbies, fans and paintings on fans were mainly produced as folding screens. The folding screen of One Hundred Fans from the collection of the Museum am Rothenbaum Kulturen und Künste der Welt (hereafter Rothenbaum Museum) in Germany was first introduced to Korean in the exhibition The City in Art, Art in the City held at the National Museum of Korea in 2016. Each panel in this six-panel folding screen features more than five different fans painted with diverse topics. This folding screen is of particular significance since the National Museum of Korea holds the original drawings. In the nineteenth century, calligraphy and painting that had formerly been enjoyed by Joseon royal family members and the nobility in private spaces began to spread among common people and was distributed through markets. In accordance with the trend of adorning households, colorful decorative paintings were preferred, leading to the popularization of the production of One Hundred Fans folding screens with pictures in different shapes and themes. A majority of the Korean collection in the Rothenbaum Museum belonged to Heinrich Constantin Eduard Meyer(1841~1926), a German businessman who served as the Joseon consul general in Germany. From the late 1890s until 1905, Meyer traveled back and forth between Joseon and Germany and collected a wide range of Korean artifacts. After returning to Germany, he sequentially donated his collections, including One Hundred Fans, to the Rothenbaum Museum. Folding screens like One Hundred Fans with their fresh and decorative beauty may have attracted the attention of foreigners living in Joseon. The One Hundred Fans at the Rothenbaum Museum is an intriguing work in that during its treatment, a piece of paper with the inscription of the place name "Donghyeon" was found pasted upside down on the back of the second panel. Donghyeon was situated in between Euljiro 1-ga and Euljiro 2-ga in present-day Seoul. During the Joseon Dynasty, a domestic handicraft industry boomed in the area based on licensed shops and government offices, including the Dohwaseo (Royal Bureau of Painting), Hyeminseo (Royal Bureau of Public Dispensary), and Jangagwon (Royal Bureau of Music). In fact, in the early 1900s, shops selling calligraphy and painting existed in Donghyeon. Thus, it is very likely that the shops where Meyer purchased his collection of calligraphy and painting were located in Donghyeon. The six-panel folding screen One Hundred Fans in the collection of the Rothenbaum Museum is thought to have acquired its present form during a process of restoring Korean artifacts works in the 1980s. The original drawings of One Hundred Fans currently housed in the National Museum of Korea was acquired by the National Folk Museum of Korea between 1945 and 1950. Among the seven drawings of the painting, six indicate the order of their panels in the margins, which relates that the painting was originally an eight-panel folding screen. Each drawing shows more than five different fans. The details of these fans, including small decorations and patterns on the ribs, are realistically depicted. The names of the colors to be applied, including 'red ocher', 'red', 'ink', and 'blue', are written on most of the fans, while some are left empty or 'oil' is indicated on them. Ten fans have sketches of flowers, plants, and insects or historical figures. A comparison between these drawings and the folding screen of One Hundred Fans at the Rothenbaum Museum has revealed that their size and proportion are identical. This shows that the Rothenbaum Museum painting follows the directions set forth in the original drawings. The fans on the folding screen of One Hundred Fans at the Rothenbaum Museum are painted with images on diverse themes, including landscapes, narrative figures, birds and flowers, birds and animals, plants and insects, and fish and crabs. In particular, flowers and butterflies and fish and crabs were popular themes favored by nineteenth century Joseon painters. It is noteworthy that the folding screen One Hundred Fans at the Rothenbaum Museum includes several scenes recalling the typical painting style of Kim Hong-do, unlike other folding screens of One Hundred Fans or Various Paintings and Calligraphy. As a case in point, the theme of "Elegant Gathering in the Western Garden" is depicted in the Rothenbaum folding screen even though it is not commonly included in folding screens of One Hundred Fans or One Hundred Paintings due to spatial limitations. The scene of "Elegant Gathering in the Western Garden" in the Rothenbaum folding screen bears a resemblance to Kim Hong-do's folding screen of Elegant Gathering in the Western Garden at the National Museum of Korea in terms of its composition and style. Moreover, a few scenes on the Rothenbaum folding screen are similar to examples in the Painting Album of Byeongjin Year produced by Kim Hong-do in 1796. The painter who drew the fan paintings on the Rothenbaum folding screen is presumed to have been influenced by Kim Hong-do since the fan paintings of a landscape similar to Sainsam Rock, an Elegant Gathering in the Western Garden, and a Pair of Pheasants are all reminiscent of Kim's style. These paintings in the style of Kim Hong-do are reproduced on the fans left empty in the original drawings. The figure who produced both the original drawings and fan paintings appears to have been a professional painter influenced by Kim Hong-do. He might have appreciated Kim's Painting Album of Byeongjin Year or created duplicates of Painting Album of Byeongjin Year for circulation in the art market. We have so far identified about ten folding screens remaining with the One Hundred Fans. The composition of these folding screens are similar each other except for a slight difference in the number and proportion of the fans or reversed left and right sides of the fans. Such uniform composition can be also found in the paintings of scholar's accoutrements in the nineteenth century. This suggests that the increasing demand for calligraphy and painting in the nineteenth century led to the application of manuals for the mass production of decorative paintings. As the demand for colorful decorative folding screens with intricate designs increased from the nineteenth century, original drawings began to be used as models for producing various paintings. These were fully utilized when making large-scale folding screens with images such as Guo Ziyi's Enjoyment-of-Life Banquet, Banquet of the Queen Mother of the West, One Hundred Children, and the Sun, Cranes and Heavenly Peaches, all of which entailed complicated patterns. In fact, several designs repeatedly emerge in the extant folding screens, suggesting the use of original drawings as models. A tendency toward using original drawings as models for producing folding screens in large quantities in accordance with market demand is reflected in the production of the folding screens of One Hundred Fans filled with fans in different shapes and fan paintings on diverse themes. In the case of the folding screens of One Hundred Paintings, bordering frames are drawn first and then various paintings are executed inside the frames. In folding screens of One Hundred Fans, however, fans in diverse forms were drawn first. Accordingly, it must have been difficult to produce them in bulk. Existing examples are relatively fewer than other folding screens. As discussed above, the folding screen of One Hundred Fans at the Rothenbaum Museum and its original drawings at the National Museum of Korea aptly demonstrate the late Joseon painting trend of embracing and employing new painting styles. Further in-depth research into the Rothenbaum painting is required in that it is a rare example exhibiting the influence of Kim Hong-do compared to other paintings on the theme of One Hundred Fans whose composition and painting style are more similar to those found in the work of Bak Gi-jun.