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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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A Study on the Consideration of the Locations of Gyeongju Oksan Gugok and Landscape Interpretation - Focusing on the Arbor of Lee, Jung-Eom's "Oksan Gugok" - (경주 옥산구곡(玉山九曲)의 위치비정과 경관해석 연구 - 이정엄의 「옥산구곡가」를 중심으로 -)

  • Peng, Hong-Xu;Kang, Tai-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.36 no.3
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    • pp.26-36
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    • 2018
  • This study aims to examine the characteristics of landscape through the analysis of location and the landscape of Gugok while also conducting the empirical study through the literature review, field study, and digital analysis of the Okgung Gugok. Oksan Gugok is a set of songs set in Ogsan Creek(玉山川)or Jagyese Creek(紫溪川, 紫玉山), which flows in front of the Oksan Memorial Hall(李彦迪), which is dedicated to the Lee Eong-jeok (李彦迪). We first ascertained the location and configuration of Oksan Gogok. Second, we confirmed the accurate location of Oksan Gogok by utilizing the digital topographic map of Oksan Gogok which was submitted by Google Earth Pro and Geographic Information Center as well as the length of the longitude of the gravel measured by the Trimble Juno SB GPS. Through the study of the literature and the field investigation, The results of the study are as follows. First, Yi Eonjeok was not a direct composer of Oksan Gugok, nor did he produce "Oksan Gugokha(Music)". Lee Ia-sung(李野淳), the ninth Youngest Son of Tweo-Kye, Hwang Lee, visited the "Oksan Gugokha" in the spring of 1823(Sunjo 23), which was the 270th years after the reign of Yi Eonjeok. At this time, receiving the proposal of Ian Sung, Lee Jung-eom(李鼎儼), Lee Jung-gi(李鼎基), and Lee Jung-byeong(李鼎秉), the descendants of Ian Sung set up a song and created Oksan Gugok Music. And the Essay of Oksan Travel Companions writted by Lee Jung-gi turns out being a crucial data to describe the situation when setting up the Ok-San Gugok. Second, In the majority of cases, Gogok Forest is a forest managed by a Confucian Scholar, not run by ordinary people. The creation of "Oksan Bugok Music" can be regarded as an expression of pride that the descendants of Yi Eonjeok and Lee Hwang, and next generation of several Confucian scholars had inherited traditional Neo-Confucian. Third, Lee Jung-eom's "Oksan Donghaengki" contains a detailed description of the "Oksan Gugokha" process and the process of creating a song. Fourth, We examined the location of one to nine Oksan songs again. In particular, eight songs and nine songs were located at irregular intervals, and eight songs were identified as $36^{\circ}01^{\prime}08.60^{{\prime}{\prime}}N$, $129^{\circ}09^{\prime}31.20^{{\prime}{\prime}}E$. Referring to the ancient kingdom of Taojam, the nine-stringed Sainam was unbiased as a lower rock where the two valleys of the East West congregate. The location was estimated at $36^{\circ}01^{\prime}19.79^{{\prime}{\prime}}N$, $129^{\circ}09^{\prime}30.26^{{\prime}{\prime}}E$. Fifth, The landscape elements and landscapes presented in Lee Jung-eom's "Oksan Gugokha" were divided into form, semantic and climatic elements. As a result, Lee Jung-eom's Cho Young-gwan was able to see the ideal of mountain water and the feeling of being idle in nature as well as the sense of freedom. Sixth, After examining the appearance of the elements and the frequency of the appearance of the landscape, 'water' and 'mountain' were the absolute factors that emphasized the original curved environment at the mouth of Lee Jung-eom. Therefore, there was gugokga can gauge the fresh ideas(神仙思想)and retreat ever(隱居思想). This inherent harmony between the landscape as well as through the mulah any ideas that one with nature and meditation, Confucian tube.

A Thermal Time-Driven Dormancy Index as a Complementary Criterion for Grape Vine Freeze Risk Evaluation (포도 동해위험 판정기준으로서 온도시간 기반의 휴면심도 이용)

  • Kwon, Eun-Young;Jung, Jea-Eun;Chung, U-Ran;Lee, Seung-Jong;Song, Gi-Cheol;Choi, Dong-Geun;Yun, Jin-I.
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.8 no.1
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    • pp.1-9
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    • 2006
  • Regardless of the recent observed warmer winters in Korea, more freeze injuries and associated economic losses are reported in fruit industry than ever before. Existing freeze-frost forecasting systems employ only daily minimum temperature for judging the potential damage on dormant flowering buds but cannot accommodate potential biological responses such as short-term acclimation of plants to severe weather episodes as well as annual variation in climate. We introduce 'dormancy depth', in addition to daily minimum temperature, as a complementary criterion for judging the potential damage of freezing temperatures on dormant flowering buds of grape vines. Dormancy depth can be estimated by a phonology model driven by daily maximum and minimum temperature and is expected to make a reasonable proxy for physiological tolerance of buds to low temperature. Dormancy depth at a selected site was estimated for a climatological normal year by this model, and we found a close similarity in time course change pattern between the estimated dormancy depth and the known cold tolerance of fruit trees. Inter-annual and spatial variation in dormancy depth were identified by this method, showing the feasibility of using dormancy depth as a proxy indicator for tolerance to low temperature during the winter season. The model was applied to 10 vineyards which were recently damaged by a cold spell, and a temperature-dormancy depth-freeze injury relationship was formulated into an exponential-saturation model which can be used for judging freeze risk under a given set of temperature and dormancy depth. Based on this model and the expected lowest temperature with a 10-year recurrence interval, a freeze risk probability map was produced for Hwaseong County, Korea. The results seemed to explain why the vineyards in the warmer part of Hwaseong County have been hit by more freeBe damage than those in the cooler part of the county. A dormancy depth-minimum temperature dual engine freeze warning system was designed for vineyards in major production counties in Korea by combining the site-specific dormancy depth and minimum temperature forecasts with the freeze risk model. In this system, daily accumulation of thermal time since last fall leads to the dormancy state (depth) for today. The regional minimum temperature forecast for tomorrow by the Korea Meteorological Administration is converted to the site specific forecast at a 30m resolution. These data are input to the freeze risk model and the percent damage probability is calculated for each grid cell and mapped for the entire county. Similar approaches may be used to develop freeze warning systems for other deciduous fruit trees.

A Study on the Characteristics of Stream Flow Path and Water System Distribution in Gugok Garden, Korea (한국 구곡원림(九曲園林)의 하천 유로 및 수계별 분포 특성)

  • Rho, Jae-Hyun;Choi, Young-Hyun
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.39 no.4
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    • pp.50-65
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    • 2021
  • In this study, the water flow system by measuring the flow-way type and distance of flow path that composes the Gugok through literature survey, field survey, and map work on Gugok gardens in Korea whose existence has been confirmed, while investigating and analyzing watersheds, river orders, and river grades. It was intended to reveal the watershed distribution and stream morphological characteristics of the Gugok gardens and to use them as basic data for future enjoyment and conservation of the Gugok gardens. The conclusion of the study is as follows. First, Of the 93 Gugok gardens that have been confirmed to exist, it was found that 11 places(11.8%) were found to have a descending(top-down) type of Gugok that develops while descending along a stream. Second, As a result of analysis of the length of the flow path for each valley, Okryudonggugok(玉流洞九曲, Namsan-gugok) in Gimcheon, Gyeongsangbuk-do was found to have the shortest length of 0.44km among the surveyed valleys, while the flow distance of Muheulgugok(武屹九曲) located in Seongju-gun and Gimcheon-si, Gyeongsangbuk-do was 31.1km, showing the longest flowing distance. The average flow path length of the Gugok Garden in Korea was 6.24km, and the standard deviation was 4.63km, indicating that the deviation between the 'curved type'e and the 'valley type' was severe. In addition, 14(15.1%) Gugok gardens were found to be partially submerged due to dam construction. Third, As a result of analyzing the waters area where Gugok garden is located, the number of Nakdong river basins was much higher at 52 sites(55.9%), followed by the Hangang river basin at 27 sites(28.7%), the Geum river basin at 9 sites(9.7%), and the Yeongsan river and Seomjin river basins at 5(5.4%). Fourth, All Gugok gardens located in the Han river region were classified as the Han river system, and the Gugok garden located on the Nakdong river was classified as the main Nakdong river system, except for 7 places including 5 places in the Nakdong Gangnam Sea water system and 2 places in the Nakdong Gangdong sea water system. As a result of synthesizing the river order of the flow path where Gugok garden is located, Gugok, which uses the main stream as the base of Gugok, is 3 places in the Hangang water system, 5 places in the Nakdong river system, 2 places in the Geumgang water system, and 1 place in the Yeongsangam/Seomjin river system. A total of 11 locations(11.5%) were found, including 36 locations(38.2%) in the first branch, 29 locations(31.2%) in the second branch, and 16 locations(17.0%) in the third branch. And Gugok garden, located on the 4th tributary, was found to be Taehwa Five-gok(太華五曲) set in Yonghwacheon Stream in Cheorwon in the Han river system, and Hoenggyegok(橫溪九曲) in Yeongcheon Hoenggye Stream in the Nakdong river system. Fifth, As a result of the river grade analysis of the rivers located in the Gugok garden Forest, the grades of the rivers located in the Gugok garden were 13 national rivers(14.0%), 7 local first-class rivers(7.5%), and 74 local second-class rivers(78.5%) was shown.

Comparative Analysis of Community Health Practitioner's Activities and Primary Health Post Management Before and After Officialization of Community Health practitioner (보건진료원의 정규직화 전과 후의 보건진료원 활동 및 보건진료소 관리운영체계의 비교 분석)

  • Yun, Suk-Ok;Jung, Moon-Sook
    • Journal of agricultural medicine and community health
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    • v.19 no.2
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    • pp.141-158
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    • 1994
  • 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.

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Spatial Distribution of Aging District in Taejeon Metropolitan City (대전광역시 노령화 지구의 공간적 분포 패턴)

  • Jeong, Hwan-Yeong;Ko, Sang-Im
    • Journal of the Korean association of regional geographers
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    • v.6 no.2
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    • pp.1-19
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    • 2000
  • This study is to investigate and analyze regional patterns of aging in Taejeon Metropolitan city-the overpopulated area of Choong-Cheong Province-by cohort analysis method. According to the population structure transition caused by rapid social and economic changes, Korea has made a rapid progress in population aging since 1970. This trend is so rapid that we should prepare for and cope with aging society. It is not only slow to cope with it in our society, but also there are few studies on population aging of the geographical field in Korea. The data of this study are the reports of Population and Housing Censuses in 1975 and 1985 and General Population and Housing Censuses with 10% sample survey in 1995 taken by National Statistical Office. The research method is to sample as the aging district the area with high aged population rate where the populations over 60 reside among total population during the years of 1975, 1985, 1995 and to sample the special districts of decreasing population where the population decreases very much and the special districts of increasing population in which the population increases greatly, presuming that the reason why aged population rate increases is that non-elderly population high in mobility moves out. It is then verified and ascertained whether it is true or not with cohort analysis method by age. Finally regional patterns in the city are found through the classification and modeling by type based on the aging district, the special districts of decreasing population, and the special districts of increasing population. The characteristics of the regional patterns show that there is social population transition and that non-elderly population moves out. The aging district with the high aged population rate is divided into high-level keeping-up type, relative falling type below the average of Taejeon city in aging progress, and relative rising type above the average of the city. This district can be found at both the central area of the city and the suburbs because Taejeon city has the characteristic of over-bounded city. But it cannot be found at the new built-up area with the in-migration of large population. The special districts of decreasing population where the population continues to decrease can be said to be the population doughnuts found at the CBD and its neighboring inner area. On the other hand, the special districts of increasing population where the population continues to increase are located at the new built-up area of the northern part in Taejeon city. The special districts of decreasing population are overlapping with the aging district and higher in aged population rate by the out-migration of non-elderly population. The special districts of increasing population are not overlapping with the aging district and lower in aged population rate by the in-migration of non-elderly population. To clarify the distribution map of the aging district, the special districts of decreasing and increasing population and the aging district are divided into four groups such as the special districts of decreasing population group-the same one as the aging district, the special districts of decreasing population group, the special districts of increasing population group, and the other district. With the cohort analysis method by age used to investigate the definite increase and decrease of aging population through population transition of each group, it is found that the progress of population aging is closely related to the social population fluctuation, especially that aged population rate is higher with the out-migration of non-elderly population. This is to explain each model of CBD, inner area, and the suburbs after modeling the aging district, the special districts of decreasing population, and the special districts of increasing population in Taejeon city. On the assumption that the city area is a concentric circle, it is possible to divide it into three areas such as CBD(A), the inner area(B), and the suburbs(C). The special districts of increasing and decreasing population in the city are divided into three districts-the special districts of decreasing population(a), the special districts of increasing population(b), and the others(c). The aging district of this city is divided into the aging district($\alpha$) and the others($\beta$). And then modeling these districts, it is probable to find regional patterns in the city. $Aa{\alpha}$ and $Ac{\beta}$ patterns are found in the CBD, in which $Aa{\alpha}$ is the special district of decreasing population and is higher in aged population rate because of aged population low in mobility staying behind and out-migration of non-elderly population. $Ba{\alpha}$, $Ba{\beta}$, $Bb{\beta}$, and $Bc{\beta}$ patterns are found in the inner area, in which neighboring area $Ba{\alpha}$ pattern is located. $Bb{\beta}$ pattern is located at the new developing area of newly built apartment complex. $Cb{\beta}$, $Cc{\alpha}$, and $Cc{\beta}$ patterns are found in the suburbs, among which $Cc{\alpha}$ pattern is highest in population aging. It is likely that the $Cc{\beta}$ under housing land readjustment on a large scale will be the $Cb{\beta}$ pattern. As analyzed above, marriage and out-migration of new family, non-elderly population, with house purchase are main factors in accelerating population aging in the central area of the city. Population aging is responsible for the great increase of aged population with longer life expectancy by the low death rate, the out-migration of non-elderly population, and the age group of new aged population in the suburbs. It is necessary to investigate and analyze the regional patterns of population aging at the time when population problems caused by aging as well as longer life expectancy are now on the increase. I hope that this will help the future study on population aging of the geographical field in Korea. As in the future population aging will be a major problem in our society, local autonomy should make a plan for the problem to the extent that population aging progresses by regional groups and inevitably prepare for it.

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