• Title/Summary/Keyword: Lead

Search Result 18,649, Processing Time 0.043 seconds

Effects of Nitrogen Application Levels on Grain Yield and Yield-related Traits of Rice Genetic Resources (질소비료 시비 수준이 벼의 수량 및 수량구성요소에 미치는 영향)

  • Tae-Heon Kim;Suk-Man Kim
    • KOREAN JOURNAL OF CROP SCIENCE
    • /
    • v.68 no.4
    • /
    • pp.276-284
    • /
    • 2023
  • Nitrogen is a major and essential macronutrient for plant growth and development. However, excessive nitrogen application can lead to ecological pollution or greenhouse gas emissions, consequently resulting in climate change. In this study, we used 153 genetic resources of rice to evaluate the effects of the levels of nitrogen application on grain yield and yield-related traits. Significant differences were noted in the yield and yield-related traits of genetic resources between two nitrogen application levels, namely, 4.5 kg/10a (NN: normal nitrogen condition) and 9.0 kg/10a (LN: low-nitrogen condition). Among the tested traits, days to heading (DTH), clum length (CL), grain yield per plant (GYP), number of panicles per plant (NPP), and number of spikelets per panicle (NSP) decreased by 1.8 to 17.9% when the nitrogen application levels decreased from NN to LN. The 1,000-grain weight (TWG) and percentage of ripened grain (PRG) increased by 2.6 to 11.2% under these conditions. Based on nitrogen application levels, two-way analysis of variance (ANOVA) demonstrated significant differences in GYP, NPP, and PRG but not in NSP and TGW. NPP exhibited negative correlations with NSP (-0.44) and TGW (-0.44), and TGW displayed a negative correlation with PRG (-0.34), whereas, GYP exhibited a positive correlation with PRG (0.37) and NSP (0.38). A similar pattern was recorded under the LN condition. NPP, TGW, and PRG were clustered as PA (principle axis) 1 under the LN condition by factor analysis. NSP and GYP were clustered as PA (principle axis) 2. These results demonstrated NPP and NSP as the primary factors contributing to the decrease in grain yield under LN conditions. In conclusion, we selected eight genetic resources that exhibited higher GYP under both NN and LN conditions with higher NPP or NSP. These genetic resources can be considered valuable breeding materials for the adaptation of plants to nitrogen deficiency.

The "Pan-National Scientification Movement" in Elementary Schools ('국민학교'로 들어온 '전(全) 국민의 과학화운동')

  • Kang, Eugene
    • Journal of Korean Elementary Science Education
    • /
    • v.43 no.2
    • /
    • pp.301-321
    • /
    • 2024
  • This study aims to elucidate the historical origins of the long-term demand for the integration of "science subject classes" and "science-related events" within the context of science education for teachers. During the 1970s, science education in elementary schools faced a dual challenge marked by the tension between implementing the third curriculum, which emphasized fundamental science, and the "Pan-National Scientification Movement," which focused on technology education. The Ministry of Education was compelled to integrate the sudden demands of the Yushin regime into the ongoing third curriculum. As these demands emerged from dual policy directives, activities related to elementary science education were subsequently categorized into formal science subject classes and extracurricular science-related events. Although the movement did not directly alter the curriculum, it instigated modifications in personnel structure, activity spaces, and evaluation systems within schools. The introduction of the Pan-National Scientification Movement in elementary schools resulted in changes including the establishment of a new "science lead teacher system," the creation of a dedicated "science corner," and the implementation of a "science badge system." Although the movement was abruptly introduced, it ostensibly contributed to the advancement of the inquiry-oriented approach promoted by the third curriculum. Paradoxically, this advancement was facilitated by the integration of the consequences of the movement into schools' autonomous, extracurricular activities spearheaded by frontline education offices and schools. Although the movement represented a government-driven policy at a particular juncture in time, the manner in which science education practitioners responded to urgent governmental mandates, while preserving the integrity of the long-established third curriculum framework, involved dividing education activities into subject-specific classes and extracurricular science activities. Examining how science education practitioners in the 1970s proactively addressed these challenges offers valuable insights for the science education community in adapting to the current rapidly evolving educational landscape.

Psychological Aspects of "Myeong-Dang" (Bright Yard, Auspicious Site) According to Pungsu (땅에 투사된 자기의 상징 - 명당의 분석심리학적 측면 -)

  • Cheol Joong Kang
    • Sim-seong Yeon-gu
    • /
    • v.26 no.1
    • /
    • pp.67-88
    • /
    • 2011
  • Pungsu is an ancient logic that systemizes geography based on the Yin-Yang and The Five Elements Principle. It is defined as the unique and highly systemized ancient Eastern art of selecting auspicious sites and arranging harmonious structures such as graves, houses, and cities on them by evaluating the surrounding landscape and cosmological directions. Pungsu helps allegedly one improve life by receiving vital energy(Shengqi, 生氣)-energy flow that flows under the ground. It is traditional belief that the living lead their lives on the ground, indirectly receiving the energy coming out of the ground, whereas the dead are buried under the ground, allowing them to directly absorb energy from the ground, which makes Shengqi the dead receive bigger and more obvious than that the living receive. This energy absorbed by the dead from the ground was believed to be passed on to their descendants. This phenomenon is called "Induction of vital energy between Ancestors and Descendants". People searched for the sites which were believed to contain rich and positive vital energy flow. They also tried to bury their ancestors under such sites hoping to receive the Shengqi coming from underground which they believed would help them thrive and prosper. The efforts to locate the sites which have the most vital energy, auspicious sites or "Bright Yard(明堂)", are easily observed in Asia including China and Korea. The ultimate goal of searching for auspicious sites lies in human(whether alive or dead) receiving vital energy from the nature to enjoy happy lives. In choosing a place to live or to bury their dead ancestors, people tried to understand the energy flow of the site considering the factors related with mountain, water, and direction. If we take a closer look into the methods of finding auspicious sites, we can see that people have tried to see the outer conditions of lands, mountains and waters within the perfect harmony if possible. Auspicious site or Bright Yard is the site with those elements in perfect order and harmony, that is, it is the place which derives the most vital energy from the best order and harmony of nature. As this shows, an auspicious site symbolizes totality-the Self, and it seems to be projected to the land. It is believed to be an attempt that the reason why we try to find auspicious sites to internalize the totality that we projected to the outer world. Therefore, this auspicious site is what our foremost values, symbol of the Self, such as harmony, equilibrium, perfection, and uniqueness are reflected to the land. Through the process of finding such a site, we try to gain totality of psyche.

Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
    • /
    • v.34 no.1
    • /
    • pp.78-86
    • /
    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

The Association of Dual Job on Dental Hygienists' Job Satisfaction (치과위생사의 직무만족도와 동시일자리(부업)의 관련성)

  • Mi-Sook Yoon;Go-eun Kim;Han-A Cho
    • Journal of Korean Dental Hygiene Science
    • /
    • v.6 no.2
    • /
    • pp.51-64
    • /
    • 2023
  • Background: This study was conducted to determine the association with dual jobbing on dental hygienists' job satisfaction and to identify the factors that lead to dual jobs. Methods: This study was an online survey of 110 currently employed dental hygienists conducted during the month of May 2022. To determine job satisfaction, we used the 20-item Korea-Minnesota Satisfaction Questionnaire (K-MSQ). Survey questions related to dual job were adapted and supplemented from the dual job survey instrument for dental hygienists to identify intention to dual job and future intention to dual job. Descriptive statistics, independent t-test, ANOVA and Scheffe's post hoc analysis, and multiple logistic regression were performed. Results: The dual job rate and future dual job rate of the participants in this study were about 27% and 47%, respectively. The means for Intrinsic job satisfaction, Extrinsic job satisfaction, and job satisfaction were 3.44, 3.15, and 3.36, respectively. It was statistically significant that extrinsic job satisfaction increased with increasing position, and intrinsic job satisfaction, extrinsic job satisfaction, and job satisfaction increased with increasing salary. Those currently working dual jobs cited "self-actualization" as a reason for doing so, and those who intended to work dual jobs in the future cited "not being paid enough in their primary job" as a reason. We found that a one-unit increase in intrinsic job satisfaction and job satisfaction increases the odds of future intention to dual job by about 1.07 and 1.05 times, respectively (p<0.05). Conclusion: This study confirmed the influence of dental hygienists' job satisfaction on intention to dual job and future intention to dual job, and self-actualization was found to be the main factor. Therefore, the consideration of dual jobs in the future will affect the improvement of dental hygienists as professionals and the reduction of turnover through better working conditions.

Estimation of Rice Cultivation Impacts on Water Environment with Environmental Characteristics and Agricultural Practices by Nitrogen Balances (질소수지에 의한 환경특성과 영농방법별 벼농사의 수질영향 평가)

  • Roh, Kee-An;Kim, Min-Kyeong;Ko, Byong-Gu;Kim, Gun-Yeob;Shim, Kyo-Moon;Lee, Deog-Bae
    • Korean Journal of Soil Science and Fertilizer
    • /
    • v.42 no.6
    • /
    • pp.439-446
    • /
    • 2009
  • Nitrogen balance in the regional scale which was calculated the difference between nitrogen input and output was estimated to assess the impact of rice cultivation on water environment. Nitrogen balances in Gyeonggi province, where nitrogen concentration in irrigation water was high and in Chungnam province, where nitrogen absorbtion by rice was high, were -5.4 and -8.3 kg $-8.3kg\;ha^{-1}\;yr^{-1}$, respectively. Nitrogen balances of paddy field in Gangwon province, where nitrogen output was small and irrigation water was clean, and in Gyeongnam province, where organic matter content of soil was high and rice yield was low, were 4.9 and $14.0kg\;ha^{-1}\;yr^{-1}$, respectively. Average nitrogen balance and total nitrogen absorption of paddy field in Korea were estimated to $-0.3kg\;ha^{-1}\;yr^{-1}$ and $-3,315Mg\;yr^{-1}$, respectively. When the nitrogen concentration in irrigation water was increased by $1mg \;L^{-1}$, nitrogen balance of rice paddy changed by $-2.91kg\;ha^{-1}\;yr^{-1}$. Also, when nitrogen fertilizer applied was decreased from 110 to $90kg\;ha^{-1}$ and the same harvest was maintained, the nitrogen absorption by rice paddy from irrigation water was estimated to increase by 10,600 Mg per year in Korea. However, in cases, the harvest was reduced to either 90% or 85%, nitrogen balances were changed from -11.7 to -2.3 and $2.4kg\;ha^{-1}$, respectively. These results suggest that the reduction of nitrogen fertilizer use may not always lead to a negative nitrogen balance and sustainable agriculture can achieve by not cutting down the use of fertilizer only but by reduction of fertilizer application concurrently by maintenance of harvest and by utilization of environmental characteristics such as nutrient contents in irrigation water and soils.

Possibility of Establishing an International Court of Air and Space Law (국제항공우주재판소의 설립 가능성)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.24 no.2
    • /
    • pp.139-161
    • /
    • 2009
  • The idea of establishing an International Court of Air and Space Law (hereinafter referred to ICASL) is only my academic and practical opinion as first proposal in the global community. The establishment of the International Court of Air and Space Law can promote the speed and promote fairness of the trial in air and space law cases. The creation of an ICASL would lead to strengthening of the international cooperation deemed essential by the global community towards joint settlement in the transnational air and space cases, claims and would act as a catalyst for the efforts and solution on aircraft, satellite and space shuttle's accidents and cases and all manpower, information, trial and lawsuit to be centrally managed in an independent fashion to the benefit of global community. The aircraft, satellite and spacecraft's accidents attributes to the particular and different features between the road, railway and maritime's accidents. These aircraft, satellite and spacecraft's accidents have incurred many disputes between the victims and the air and space carriers in deciding on the limited or unlimited liability for compensation and the appraisal of damages caused by the aircraft's accidents, terror attack, satellite, space shuttle's accidents and space debris. This International Court of Air and Space Law could hear any claim growing out of both international air and space crash accidents and transnational accidents in which plaintiffs and defendants are from different nations. This alternative would eliminate the lack of uniformity of decisions under the air and space conventions, protocols and agreements. In addition, national courts would no longer have to apply their own choice of law analysis in choosing the applicable liability limits or un-limit for cases that do not fall under the air and space system. Thus, creation of an International Court of Air and Space Law would eliminate any disparity of damage awards among similarly situated passengers and shippers in nonmembers of air and space conventions, protocols, agreements and cases. Furthermore, I would like to explain the main items of the abovementioned Draft for the Convention or Statute of the International Court of Air and Space Law framed in comparison with the Statute of the International Court of Justice, the Statue of the International Tribunal for the Law of the Sea and the Statute of the International Criminal Court. First of all, in order to create the International Court of Air and Space Law, it is necessary for us to legislate a Draft for the Convention on the Establishment of the International Court of Air and Space Law. This Draft for the Convention must include the elected method of judges, term, duty and competence of judge, chambers, jurisdiction, hearing and judgment of the ICASL. The members of the Court shall be elected by the General Assembly and Council of the ICAO and by the General Assembly and Legal Committee of the UNCOPUOS from a list of persons nominated by the national groups in the six continent (the North American, South American, African, Oceania and Asian Continent) and two international organization such as ICAO and UNCOPUOS. The members of the Court shall be elected for nine years and may be re-elected as one time. However, I would like to propose a creation an International Court of Air and Space Law in extending jurisdiction to the International Court of Justice at the Hague to in order to decide the air and space convention‘s cases. My personal opinion is that if an International Court on Air and Space Law will be created in future, it will be settled quickly and reasonably the difficulty and complicated disputes, cases or lawsuit between the wrongdoer and victims and the injured person caused by aircraft, satellite, spacecraft's accidents or hijacker and terrorists etc. on account of deciding the standard of judgment by judges of that’s court. It is indeed a great necessary and desirable for us to make a new Draft for the Convention on a creation of the International Court of Air and Space Law to handle international air and space crash litigation. I shall propose to make a new brief Draft for the Convention on the Creation of an International Court of Air and Space Law in the near future.

  • PDF

Effect of Acutely Increased Glucose Uptake on Insulin Sensitivity in Rats (단기간의 당섭취 증가가 인슐린 감수성에 미치는 영향)

  • Kim, Yong-Woon;Ma, In-Youl;Lee, Suck-Kang
    • Journal of Yeungnam Medical Science
    • /
    • v.14 no.1
    • /
    • pp.53-66
    • /
    • 1997
  • Insulin resistance is a prominent feature of diabetic state and has heterogeneous nature. However, the pathogenetic sequence of events leading to the emergence of the defect in insulin action remains controversial. It is well-known that prolonged hyperglycemia and hyperinsulinemia are one of the causes of development of insulin resistance, but both hyperglycemia and hyperinsulinemia stimulate glucose uptake in peripheral tissue. Therefore, it is hypothesized that insulin resistance may be generated by a kind of protective mechanism preventing cellular hypertrophy. In this study, to evaluate whether the acutely increased glucose uptake inhibits further glucose transport stimulated by insulin, insulin sensitivity was measured after preloaded glucose infusion for 2 hours at various conditions in rats. And also, to evaluate the mechanism of decreased insulin sensitivity, insulin receptor binding affinity and glucose transporter 4 (GLUT4) protein of plasma membrane of gastrocnemius muscle were assayed after hyperinsulinemic euglycemic clamp studies. Experimental animals were divided into five groups according to conditions of preloaded glucose infusion: group I, basal insulin ($14{\pm}1.9{\mu}U/ml$) and basal glucose ($75{\pm}0.7mg/dl$), by normal saline infusion; group II, normal insulin ($33{\pm}3.8{\mu}U/ml$) and hyperglycemia ($207{\pm}6.3mg/dl$), by somatostatin and glucose infusion; group III, hyperinsulinemia ($134{\pm}34.8{\mu}U/ml$) and hyperglycemia ($204{\pm}4.6mg/dl$), by glucose infusion; group IV, supramaximal insulin ($5006{\pm}396.1{\mu}U/ml$) and euglycemia ($l00{\pm}2.2mg/dl$), by insulin and glucose infusion; group V, supramaximal insulin ($4813{\pm}687.9{\mu}U/ml$) and hyperglycemia ($233{\pm}3.1mg/dl$), by insulin and glucose infusion. Insulin sensitivity was assessed with hyperinsulinemic euglycemic clamp technique. The amounts of preloaded glucose infusion(gm/kg) were $1.88{\pm}0.151$ in group II, $2.69{\pm}0.239$ in group III, $3.54{\pm}0.198$ in group IV, and $4.32{\pm}0.621$ in group V. Disappearance rates of glucose (Rd, mg/kg/min) at steady state of hyperinsulinemic euglycemic clamp studies were $16.9{\pm}3.88$ in group I, $13.5{\pm}1.05$ in group II, $11.2{\pm}1.17$ in group III, $13.2{\pm}2.05$ in group IV, and $10.4{\pm}1.01$ in group V. A negative correlation was observed between amount of preloaded glucose and Rd (r=-0.701, p<0.001) when all studies were combined. Insulin receptor binding affinity and content of GLUT4 were not significantly different in all experimental groups. These results suggest that increased glucose uptake may inhibit further glucose transport and lead to decreased insulin sensitivity.

  • PDF

A Study on the Effect of the Introduction Characteristics of Cloud Computing Services on the Performance Expectancy and the Intention to Use: From the Perspective of the Innovation Diffusion Theory (클라우드 컴퓨팅 서비스의 도입특성이 조직의 성과기대 및 사용의도에 미치는 영향에 관한 연구: 혁신확산 이론 관점)

  • Lim, Jae Su;Oh, Jay In
    • Asia pacific journal of information systems
    • /
    • v.22 no.3
    • /
    • pp.99-124
    • /
    • 2012
  • Our society has long been talking about necessity for innovation. Since companies in particular need to carry out business innovation in their overall processes, they have attempted to apply many innovation factors on sites and become to pay more attention to their innovation. In order to achieve this goal, companies has applied various information technologies (IT) on sites as a means of innovation, and consequently IT have been greatly developed. It is natural for the field of IT to have faced another revolution which is called cloud computing, which is expected to result in innovative changes in software application via the Internet, data storing, the use of devices, and their operations. As a vehicle of innovation, cloud computing is expected to lead the changes and advancement of our society and the business world. Although many scholars have researched on a variety of topics regarding the innovation via IT, few studies have dealt with the issue of could computing as IT. Thus, the purpose of this paper is to set the variables of innovation attributes based on the previous articles as the characteristic variables and clarify how these variables affect "Performance Expectancy" of companies and the intention of using cloud computing. The result from the analysis of data collected in this study is as follows. The study utilized a research model developed on the innovation diffusion theory to identify influences on the adaptation and spreading IT for cloud computing services. Second, this study summarized the characteristics of cloud computing services as a new concept that introduces innovation at its early stage of adaptation for companies. Third, a theoretical model is provided that relates to the future innovation by suggesting variables for innovation characteristics to adopt cloud computing services. Finally, this study identified the factors affecting expectation and the intention to use the cloud computing service for the companies that consider adopting the cloud computing service. As the parameter and dependent variable respectively, the study deploys the independent variables that are aligned with the characteristics of the cloud computing services based on the innovation diffusion model, and utilizes the expectation for performance and Intention to Use based on the UTAUT theory. Independent variables for the research model include Relative Advantage, Complexity, Compatibility, Cost Saving, Trialability, and Observability. In addition, 'Acceptance for Adaptation' is applied as an adjustment variable to verify the influences on the expected performances from the cloud computing service. The validity of the research model was secured by performing factor analysis and reliability analysis. After confirmatory factor analysis is conducted using AMOS 7.0, the 20 hypotheses are verified through the analysis of the structural equation model, accepting 12 hypotheses among 20. For example, Relative Advantage turned out to have the positive effect both on Individual Performance and on Strategic Performance from the verification of hypothesis, while it showed meaningful correlation to affect Intention to Use directly. This indicates that many articles on the diffusion related Relative Advantage as the most important factor to predict the rate to accept innovation. From the viewpoint of the influence on Performance Expectancy among Compatibility and Cost Saving, Compatibility has the positive effect on both Individual Performance and on Strategic Performance, while it showed meaningful correlation with Intention to Use. However, the topic of the cloud computing service has become a strategic issue for adoption in companies, Cost Saving turns out to affect Individual Performance without a significant influence on Intention to Use. This indicates that companies expect practical performances such as time and cost saving and financial improvements through the adoption of the cloud computing service in the environment of the budget squeezing from the global economic crisis from 2008. Likewise, this positively affects the strategic performance in companies. In terms of effects, Trialability is proved to give no effects on Performance Expectancy. This indicates that the participants of the survey are willing to afford the risk from the high uncertainty caused by innovation, because they positively pursue information about new ideas as innovators and early adopter. In addition, they believe it is unnecessary to test the cloud computing service before the adoption, because there are various types of the cloud computing service. However, Observability positively affected both Individual Performance and Strategic Performance. It also showed meaningful correlation with Intention to Use. From the analysis of the direct effects on Intention to Use by innovative characteristics for the cloud computing service except the parameters, the innovative characteristics for the cloud computing service showed the positive influence on Relative Advantage, Compatibility and Observability while Complexity, Cost saving and the likelihood for the attempt did not affect Intention to Use. While the practical verification that was believed to be the most important factor on Performance Expectancy by characteristics for cloud computing service, Relative Advantage, Compatibility and Observability showed significant correlation with the various causes and effect analysis. Cost Saving showed a significant relation with Strategic Performance in companies, which indicates that the cost to build and operate IT is the burden of the management. Thus, the cloud computing service reflected the expectation as an alternative to reduce the investment and operational cost for IT infrastructure due to the recent economic crisis. The cloud computing service is not pervasive in the business world, but it is rapidly spreading all over the world, because of its inherited merits and benefits. Moreover, results of this research regarding the diffusion innovation are more or less different from those of the existing articles. This seems to be caused by the fact that the cloud computing service has a strong innovative factor that results in a new paradigm shift while most IT that are based on the theory of innovation diffusion are limited to companies and organizations. In addition, the participants in this study are believed to play an important role as innovators and early adapters to introduce the cloud computing service and to have competency to afford higher uncertainty for innovation. In conclusion, the introduction of the cloud computing service is a critical issue in the business world.

  • PDF

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
    • /
    • v.1 no.1
    • /
    • pp.5-9
    • /
    • 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.

  • PDF