• 제목/요약/키워드: Member Function

검색결과 470건 처리시간 0.033초

삼차원게임이론의 관점에서 바라 본 유럽연합의 FTA 협상 전략 및 정치: 한-EU FTA와 EU-일본 EPA의 비교를 중심으로 (FTA Negotiation Strategy and Politics in the Viewpoint of the Three-Dimensional Game Theory: Korea-EU FTA and EU-Japan EPA in Comparison)

  • 김현정
    • 국제지역연구
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    • 제22권2호
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    • pp.81-110
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    • 2018
  • 본 논문에서는 삼차원게임이론의 논리 구조를 통해 지역경제통합체, 즉 유럽연합의 통상 협상 전략 및 협상력을 분석하였다. 삼차원게임이론에서는 협상자가 각 면 게임의 경계에 서서 게임을 동시에 운용해 나아가면서, 각 방향으로부터 제약을 받거나 때때로 제약을 기회로 활용하는 등 삼중 측면의 협상 전략이 상존함을 강조하였다. 삼차원게임이론에 대한 연구는 지역연합이 협상의 주체로서 등장하여 국제레벨, 지역레벨 및 회원국레벨의 의견을 조율하고, 이해관계를 조정하는 과정을 체계화하기 위한 목적을 가진다. 본 연구에서는 최근 체결된 EU-일본 EPA(Economic Partnership Agreement) 협상과정을 사례로 한-EU FTA 사례와 비교 분석하여, 지역경제협력체의 FTA 추진 시 적용할 수 있는 삼차원게임이론의 논리를 정리하였다. 또한 본고에서는 지역경제통합체의 통상협상 대상국은 협상에 임할 때 어떠한 전략에 대응할 수 있을 것인가에 관해 분석하였다. EU 지역차원의 통상정책 영역은 기술적 특성으로 정치화되기 어려운 영역에 관한 연합의 배타적 권한화가 이미 완성되었으며, 연합 차원의 정책과정이 정치쟁점으로 드러나지 않아왔던 점 그리고 여론 전달 과정이 더블 스텝 접근 방식인 점 등이 복합되어 그 특성을 형성해 왔다. 결론적으로 EU의 통상영역 정책 과정은 다양한 중앙조직에 의한 권한 배분으로 복잡하고 정교한 과정을 구성한다. 이러한 공동정책 결정과정과 통상 영역의 구조적 특성으로 말미암아 오히려 협상의 메커니즘 역설적으로 단순화되었고, 공동체 차원의 협상력은 높아졌다. 결과적으로 유럽위원회는 국제레벨 단계의 양자간 통상협상에서 매우 강력한 협상 행위자로 기능하게 된다.

삼중고 탈피 후 대역전의 성공을 이끈 걸 그룹'카라'의 차별화 전략 (The Korean Girl Group Kara's Differentiation Strategy Which Overcome the Trilemma and Led to the Great Reversal Success)

  • 김정섭
    • 한국엔터테인먼트산업학회논문지
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    • 제15권2호
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    • pp.169-178
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    • 2021
  • 걸 그룹 '카라'는 데뷔 성적 부진, 팀 해체 위기, 소속사 경영 위기란 삼중고에 시달렸지만, 모두 극복하고 회생해 한국 대중음악사에 위업을 남겼다. 그러나 그 성공전략은 이들의 앨범·공연 프로젝트에 참여한 내부자들에 의해 전혀 공개된 적이 없다. 따라서 본 연구는 사실상 활동 종료 상태인 '카라'의 성과 요인을 분석해 학술적 시사점을 제공하고 고인이 된 경영자 이호연 대표와 '카라'의 핵심 구성원 구하라의 업적을 기리고자 실시하였다. 이에 따라 자료 분석을 선행한 뒤 2020년 11~12월 프로젝트에 참여한 매니저, 작곡자, 스타일리스트, 멤버 구하라(그녀만 생전인 2019년 별도 인터뷰)를 대상으로 심층 인터뷰를 실시했다. 분석 모델은 포터(Porter)의 경쟁 우위 전략과 음악 산업의 가치사슬 모델을 결합해 '상품 혁신 차별화'(프로듀싱, 음원·앨범 제작, 공연활동)와 '마케팅 차별화'(표적시장 설정, 이미지 특화, 홍보·소통)의 범주로 나눠 설정하였다. 연구 결과, 상품 차별화에서 무모한 스타 가수 모방하기 대신 힐링을 유발하는 '밝은 에너지의 발산'을 목표로 구성원들이 지닌 고유의 개성과 진솔함의 가치를 재발견해 창작한 밝은 노래 및 댄스들과 완전히 조화시키고, 마케팅 차별화에서는 일본의 10~20대를 표적시장으로 정해 팬·미디어와 친화성을 높여 역전에 성공한 것으로 분석되었다. 본 연구는 포터의 차별화가 아이돌 그룹의 육성, 흥행, 그리고 부활 실현에서도 유의미한 전략으로 기능할 수 있음을 시사한다. 일본 배우 게키단 히토리의 호명은 '카라'의 일본 흥행을 이끈 강력한 점화효과를 유발했기에 초기 또는 명사 팬덤의 활동이 차별화 실현의 유효한 촉매제가 될 수 있음을 재확인시켜준다.

CUE 도메인 포함 단백질인 CUEDC2는 KIF5A의 C-말단과 결합을 통하여 Kinesin-1와 결합 (CUEDC2, CUE Domain Containing Protein 2, Associates with Kinesin-1 by Binding to the C-Terminus of KIF5A)

  • 김명훈;표세영;정영주;박성우;서미경;이원희;엄상화;김무성;이정구;석대현
    • 생명과학회지
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    • 제33권11호
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    • pp.868-875
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    • 2023
  • Kinesin-1은 kinesin superfamily (KIF) 단백질 중에서 처음으로 확인된 모터 단백질로 세포내 미세소관 의존하여 세포내 cargo를 수송한다. Kinesin-1은 두 개의 중쇄(KHC, 또는 KIF5)와 두 개의 경쇄(KLC)로 구성된다. KIF5A의 C-말단의 93개 아미노산은 KIF5B와 KIF5C의C-말단 꼬리 영역과는 상동성이 없다. 본 연구에서 우리는 KIF5A의 C-말단 영역과 특이적으로 결합하는 단백질을 분리하기 위해 효모 2-하이브리드 스크리닝을 하였다. 본 연구에서 우리는 KIF5A와 결합하는 단백질로 유비퀴틴화 경로 및 단백질 수송에 관여하는 어댑터 단백질로 기능하는 CUE 도메인을 가진 CUEDC2를 확인하였다. CUEDC2는 KIF5A의 C-말단 영역과 결합하지만, KIF5B, KIF3A 및KLC1과는 결합하지 않았다. KIF5A는 CUEDC2의 C-말단 영역과 특이적으로 결합하였지만, CUEDC2의 다른 isoform인 CUEDC1과는 결합하지 않았다. 또한, KIF5A와 CUEDC2의 결합은 글루타티온 S-트랜스퍼라제(GST) 풀다운으로 단백질간 결합을 확인하였다. HEK-293T 세포에서 myc-KIF5A와 FLAG-CUEDC2을 공동 발현되었을 때, CUEDC2는 kinesin-1과 공동 면역 침전되었고, myc-KIF5A와 EGFP-CUEDC2는 세포내의 같은 위치에서 발현하였다. 이러한 결과들은 kinesin-1에 의한 세포내 화물 수송에서 CUEDC2는 KIF5A에 결합하여 kinesin-1과 화물을 연결하는 어댑터 단백질 역할을 시사한다.

퇴원환자의 가정간호 이용의사와 관련 요인 (A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire)

  • 이지현;이영은;이명화;손수경
    • 재활간호학회지
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    • 제2권2호
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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경제력집중(經濟力集中) : 기본시각(基本視角)과 정책방향(政策方向) (The Concentration of Economic Power in Korea)

  • 이규억
    • KDI Journal of Economic Policy
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    • 제12권1호
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    • pp.31-68
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    • 1990
  • 경제력집중(經濟力集中)은 경제적(經濟的) 자원(資源)과 수단(手段)의 상당부분이 소수의 경독주체(經瀆主體)에 집중되어 이들이 자원배분(資源配分)의 흐름에 큰 영향을 미칠 수 있는 상태를 말한다. 그러므로 경제력집중(經濟力集中)은 본질상 자유시장기구(自由市場機構)의 생리와는 부합하지 않지만 자본주의(資本主義)의 역사로 볼 때 그것이 바로 자유경쟁(自由競爭)의 소산이라는 측면도 있다는 점이 문제가 된다. 구미(歐美)와 일본(日本) 등에 있어서 자본주의체제(資本主義體制)의 진화궤적(進化軌跡)은 이 문제가 어떻게 전개되는가에 따라 결정되어 왔다. 우리나라에서의 경제역집중(經濟力集中)은 다수의 독(獨) 과점적(寡占的) 대기업(大企業)들이 소유관계(所有關係)로 결합되어 있는 기업집단(企業集團) 즉 소위 재벌(財閥)의 문제로 집약될 수 있다. 우리나라의 기업집단(企業集團)의 성장은 시장기구(市場機構)의 작동결과에 기인한 면도 있지만 고도경제성장기(高度經濟成長期)의 정부정책(政府政策)에 의하여 촉진된 것도 부인할 수 없다. 기업집단(企業集團)에 의한 경제력집중(經濟力集中)은 과거 우리나라의 정치(政治) 경제(經濟) 사회(社會)가 거쳐온 진화과정(進化過程)을 집약적으로 나타내는 것 이다. 그러므로 우리나라에서 민주주의(民主主義)와 자본주의(資本主義)의 이념(理念)과 질서(秩序)에 대한 국민적(國民的) 합의(合意)를 모색하려는 현시점에서 경제력집중(經濟力集中)을 객관적으로 인식하여 효율(效率)과 형평(衡平)을 조화하는 적절한 대응방향을 모색 하는 것은 매우 긴요한 과제이다.

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가설품패시인(假设品牌是人), 혹통과고사포장장품패의인화(或通过故事包装将品牌拟人化) (If This Brand Were a Person, or Anthropomorphism of Brands Through Packaging Stories)

  • Kniazeva, Maria;Belk, Russell W.
    • 마케팅과학연구
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    • 제20권3호
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    • pp.231-238
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    • 2010
  • 本研究的焦点是品牌的拟人化. 品牌拟人化被定义为将品牌看作是人类. 具体来说, 本研究的目标是理解如何将品牌拟人化的方法. 通过分析消费者对食品包装上的故事的阅读, 我们试图展示行销者和消费者如何将一系列品牌拟人化并创造意义. 我们的研究问题是一个品牌对不同的消费者具有多个或单一意义, 联想, 个性的可能性. 我们首先强调了本研究在理论和实践方面的重要性, 解释了为什么我们关注作为品牌意义传递工具的包装. 然后我们阐述了我们量性研究方法, 讨论了结果. 最后总结了管理方面的启示和对未来研究的建议. 本研究先让消费者直接阅读品牌意义传递的工具然后让这些消费者口头自由表达他们所感受到的意义. 具体来说, 为了获得有关感知意义的数据, 我们要求参与者去阅读选择的品牌食品包装上的非营养的故事. 包装在消费者研究方面还没有得到足够的关注(Hine, 1995). 直到现在, 研究还是仅关注包装的实用功能并形成了探索营养信息的影响的研究主体. (例如Lourei ro, McCluskey and Mittelhammer, 2002; Mazis and Raymond, 1997; Nayga, Lipinski and Savur, 1998; Wansik, 2003). 一个例外是最近的研究, 将注意力转向非营养信息的包装说明, 并视其为文化产品和将品牌神话的工具(Kniazeva and Belk, 2007). 下一步就是探索这些神话活动如何影响品牌个性感知以及这些感知如何与消费者相关. 这些都是本研究所要强调的. 我们用深度访谈来帮助消除量性研究的局限性. 我们的便利样本的构成具有人口统计和消费心态学的多样化以达到获得消费者对包装故事的不同的感知. 我们的参与者是美国的中产居民, 并没有表现出Thompson(2004)所描述的 "文化创造者" 的极端生活方式. 九名参与者被采访关于他们食品消费偏好和行为的问题. 他们被要求看看12个展示的食品产品包装并阅读包装上的文字信息. 之后, 我们继续进行关注消费者对阅读材料的解释的问题. (Scott and Batra, 2003). 平均来看, 每个参与者感知4-5个包装. 我们的深度访谈是一对一的并长达半个小时. 采访内容被录音下来并转录, 最后有140页的文字. 产品赖在位于美国西海岸的当地食品杂货店, 这些产品代表了食品产品类别的基本范围, 包括零食, 罐装食品, 麦片, 婴儿食品和茶. 我们使用Strauss和Corbin (1998)提出的发展扎根理论的步骤来分析数据. 结果表明, 我们的研究不支持先前的研究所假设的一个品牌/一个个性的概念. 因此我们展示了在消费者看来多个品牌个性可以在同一品牌身上很好的共存, 尽管行销者试图创造更多单一的品牌个性. 我们延伸了Fournier's (1998) 的假设, 某人的人生计划可以形成与品牌关系的强度和本质. 我们发现这些人生计划也影响感知的品牌拟人化和意义. Fournier提出了把消费者人生主题(Mick和Buhl, 1992)和拟人化产品的相关作用联系在一起的概念框架. 我们发现消费者人生计划形成了把品牌拟人化和品牌与消费者现有的关注相关联的方式. 我们通过参与者发现了两种品牌拟人化的方法. 第一种, 品牌个性通过感知的人口统计, 消费心态学和社会个性所创造. 第二, 第二, 在我们的研究还涉及到品牌的消费者所存在的问题与消费者的个性被混合, 以连接到他们(品牌为朋友, 家庭成员, 隔壁邻居)或远离自己的品牌个性和疏远他们(品牌作为二手车推销员, "一群高管".) 通过关注食品产品包装, 我们阐明了非常具体的, 被广泛使用, 但很少深入研究的营销传播工具: 品牌故事. 近期的研究已经视包装为神话制造者. 对行销者来说要创作出和产品及消费它们的消费者相连的文字故事的挑战越来越大, 并建议 "为创造需求的消费者神话的构成材料的多样化是后现代消费者可论证的需求"(Kniazeva和Belk, 2007). 作为叙述故事的的工具, 食品包装可以食品包装可以用理性和感性的方式, 为消费者提供无论是 "讲座" 或 "戏剧"(Randazzo, 2006), 神话(Kniazeva and Belk, 2007; Holt, 2004; Thompson, 2004), 或意义(McCracken, 2005) 作为他们拟人化产品的构成材料. 孕育工艺品牌个性掌握在作家/营销人员手中, 在读者/消费者心目中. 这些消费者会赋予品牌有意义的脸谱.

일본 '고증파(考證派)' 의학에 관한 연구 (A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan)

  • 박현국;김기욱
    • 대한한의학원전학회지
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    • 제20권4호
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    • pp.211-250
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    • 2007
  • 1. The 'Kao Zheng Pai(考證派) comes from the 'Zhe Zhong Pai' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金娥), Yoshida Koton(吉田篁墩) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li '(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 1739${\sim}$1798) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai, Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 1749${\sim}$1787) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論) and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯) 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai 's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋司"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue", "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Rits(森立之 1807${\sim}$ 1885) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken and later became a pupil of Shou Gu Yi Zhai, a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("神農本草經"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"(神農本草經) and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"("枳園隨筆") that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"("說文解字") to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據). Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬 1804${\sim}$1876) learned scriptures and ancient texts from confucian scholar Asaka Gonsai, and learned medicine from his father Huai Yaun(槐園). He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi" and "Lao Yi Zhi Yan" but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 912-955) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 1755-1810) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi" and "Jin Qui Yao Lue Ji Yi" are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng" is a collection of essays on research. Also there are the "Su Wen Shi"("素問識"), "Ling Shu Shi"("靈樞識"), and the "Guan lu Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 1789-1827), and his works include works of research such as "Nan Jing Shu Jeng"("難經疏證"), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"("疾雅"), "Ming Yi Gong An"("名醫公案"), and "Yi Ji Kao"("醫籍考"). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 1789-1827), Yuan Jian(元堅 1795-1857) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(樂匙). He left about 15 texts, including "Su Wen Shao Shi"("素間紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"(傷寒廣要), and "Zhen Fu Yao Jue"("該腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(失數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', 'the founding of Ji Shou Guan and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai ' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

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일본 '고증파(考證派)' 의학에 관한 연구 (A Study on The 'Kao Zheng Pai'(考證派) of The Traditional Medicine of Japan)

  • 박현국;김기욱
    • 동국한의학연구소논문집
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    • 제10권
    • /
    • pp.1-40
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    • 2008
  • 1.The 'Kao Zheng Pai'(考證派) comes from the 'Zhe Zhong Pai(折衷派)' and is a school that is influenced by the confucianism of the Qing dynasty. In Japan Inoue Kinga(井上金峨), Yoshida Koton(古田篁墩 $1745{\sim}1798$) became central members, and the rise of the methodology of historical research(考證學) influenced the members of the 'Zhe Zhong Pai', and the trend of historical research changed from confucianism to medicine, making a school of medicine based on the study of texts and proving that the classics were right. 2. Based on the function of 'Nei Qu Li'(內驅力) the 'Kao Zheng Pai', in the spirit of 'use confucianism as the base', researched letters, meanings and historical origins. Because they were influenced by the methodology of historical research(考證學) of the Qing era, they valued the evidential research of classic texts, and there was even one branch that did only historical research, the 'Rue Xue Kao Zheng Pai'(儒學考證派). Also, the 'Yi Xue Kao Zheng Pai'(醫學考證派) appeared by the influence of Yoshida Kouton and Kariya Ekisai(狩谷掖齋). 3. In the 'Kao Zheng Pai(考證派)'s theories and views the 'Yi Xue Kao Zheng Pai' did not look at medical scriptures like the "Huang Di Nei Jing"("黃帝內經") and did not do research on 'medical' related areas like acupuncture, the meridian and medicinal herbs. Since they were doctors that used medicine, they naturally were based on 'formulas'(方劑) and since their thoughts were based on the historical ideologies, they valued the "Shang Han Ja Bing Lun" which was revered as the 'ancestor of all formulas'(衆方之祖). 4. The lives of the important doctors of the 'Kao Zheng Pai' Meguro Dotaku(目黑道琢) Yamada Seichin(山田正珍), Yamada Kyoko(山田業廣), Mori Ritsi(森立之) Kitamura Naohara(喜多村直寬) are as follows. 1) Meguro Dotaku(目黑道琢 $1739{\sim}1798$) was born of lowly descent but, using his intelligence and knowledge, became a professor as a Shi Jing Yi(市井醫) and as a professor for 34 years at Ji Shou Guan(躋壽館) mastered the "Huang Di Nei Jing" after giving over 300 lectures. Since his pupil, Isawara Ken(伊澤蘭軒) taught the Lan Men Wu Zhe(蘭門五哲) and Shibue Chusai(澀江抽齋), Mori Ritsi(森立之), Okanishi Gentei(岡西玄亭), Kiyokawa Gendoh(淸川玄道) and Yamada Kyoko(山田業廣), Meguro Dotaku is considered the founder of the 'Yi Xue Kao Zheng Pai'. 2) The family of Yamada Seichin(山田正珍 $1749{\sim}1787$) had been medical officials in the Makufu(幕府) and the many books that his ancestors had left were the base of his art. Seichin learned from Shan Ben Bei Shan(山本北山), a 'Zhe Zhong Pai' scholar, and put his efforts into learning, teaching and researching the "Shang Han Lun"("傷寒論"). Living in a time between 'Gu Fang Pai'(古方派) member Nakanishi Goretada(中西惟忠) and 'Kao Zheng Pai' member Taki Motohiro(多紀元簡), he wrote 11 books, 2 of which express his thoughts and research clearly, the "Shang Han Lun Ji Cheng"("傷寒論集成") and "Shang Han Kao"("傷寒考"). His comparison of the 'six meridians'(3 yin, 3 yang) between the "Shang Han Lun" and the "Su Wen Re Lun"("素問 熱論") and his acknowledgement of the need and rationality of the concept of Yin-Yang and Deficient-Replete distinguishes him from the other 'Gu Fang Pai'. Also, his dissertation of the need for the concept doesn't use the theories of latter schools but uses the theory of the "Shang Han Lun" itself. He even researched the historical parts, such as terms like 'Shen Nong Chang Bai Cao'(神農嘗百草) and 'Cheng Qi Tang'(承氣湯). 3) The ancestor of Yamada Kyoko(山田業廣) was a court physician, and learned confucianism from Kao Zheng Pai's Ashikawa Genan(朝川善庵) and medicine from Isawa Ranken(伊澤蘭軒) and Taki Motokata(多紀元堅), and the secret to smallpox from Ikeda Keisui(池田京水). He later became a lecturer at the Edo Yi Xue Guan(醫學館) and was invited as the director to the Ji Zhong(濟衆) hospital. He also became the first owner of the Wen Zhi She(溫知社), whose main purpose was the revival of kampo, and launched the monthly magazine Wen Zi Yi Tan(溫知醫談). He also diagnosed and prescribed for the prince Ming Gong(明宮). His works include the "Jing Fang Bian"("經方辨"), "Shang Han Lun Si Ci"("傷寒論釋詞"), "Huang Zhao Zhu Jia Zhi Yan Ji Yao"("皇朝諸家治驗集要") and "Shang Han Ja Bing Lun Lei Juan"("傷寒雜病論類纂"). of these, the "Jing Fang Bian"("經方辨") states that the Shi Gao(石膏) used in the "Shang Han Lun" had three meanings-Fa Biao(發表), Qing Re(淸熱), Zi Yin(滋陰)-which were from 'symptoms', and first deducted the effects and then told of the reason. Another book, the "Jiu Zhe Tang Du Shu Ji"("九折堂讀書記") researched and translated the difficult parts of the "Shang Han Lun", "Jin Qui Yao Lue"("金匱要略"), "Qian Jin Fang"("千金方"), and "Wai Tai Mi Yao"("外臺秘要"). He usually analyzed the 'symptoms' of diseases but the composition, measurement, processing and application of medicine were all in the spectrum of 'analystic research' and 'researching analysis'. 4) The ancestors of Mori Ritsi(森立之 $1807{\sim}1885$) were warriors but he became a doctor by the will of his mother, and he learned from Shibue Chosai(澁江抽齋) and Isawaran Ken(伊澤蘭軒) and later became a pupil of Shou Gu Yi Zhai(狩谷掖齋), a historical research scholar. He then became a lecturer of medical herbs at the Yi Xue Guan, and later participated in the proofreading of "Yi Xin Fang"("醫心方") and with Chosai compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志"). He visited the Chinese scholar Yang Shou Jing(楊守敬) in 1881 and exchanged books and ideas. Of his works, there are the collections(輯複本) of "Shen Nong Ben Cao Jing"("神農本草經") and "You Xiang Yi Hwa"("遊相醫話") and the records, notes, poems, and diaries such as "Zhi Yuan Man Lu"("枳園漫錄") and "Zhi Yuan Sui Bi"(枳園隨筆) that were not published. His thoughts were that in restoring the "Shen Nong Ben Cao Jing", "the herb to the doctor is like the "Shuo Wen Jie Zi"(說文解字) to the scholar", and he tried to restore the ancient herbal text using knowledge of medicine and investigation(考據), Also with Chosai he compiled the "Jing Ji Fang Gu Zhi"("經籍訪古志") using knowledge of ancient text. Ritzi left works on pure investigation, paid much attention to social problems, and through 12 years of poverty treated all people and animals in all branches of medicine, so he is called a 'half confucianist half doctor'(半儒半醫). 5) Kitamurana Ohira(喜多村直寬, $1804{\sim}1876$) learned scriptures and ancient texts from confucian scholar Asaka Gonsai(安積艮齋), and learned medicine from his father Huai Yaun(槐園), He became a teacher in the Yi Xue Guan in his middle ages, and to repay his country, he printed 266 volumes of "Yi Fang Lei Ju"("醫方類聚") and 1000 volumes of "Tai Ping Yu Lan"("太平禦覽") and devoted it to his country to be spread. His works are about 40 volumes including "Jin Qui Yao Lue Shu Yi"("金匱要略疏義") and "Lao Yi Zhi Yan"(老醫巵言) but most of them are researches on the "Shang Han Za Bing Lun". In his "Shang Han Lun Shu Yi"("傷寒論疏義") he shows the concept of the six meridians through the Yin-Yang, Superficial or internal, cold or hot, deficient or replete state of diseases, but did not match the names with the six meridians of the meridian theory, and this has something in common with the research based on the confucianism of Song(宋儒). In clinical treatment he was positive toward old and new methods and also the experience of civilians, but was negative toward western medicine. 6) The ancestor of the Taki family Tanbano Yasuyori(丹波康賴 $912{\sim}955$) became a Yi Bo Shi(醫博士) by his medical skills and compiled the "Yi Xin Fang"("醫心方"). His first son Tanbano Shigeaki(丹波重明) inherited the Shi Yao Yuan(施藥院) and the third son Tanbano Masatada(丹波雅忠) inherited the Dian You Tou(典藥頭). Masatada's descendents succeeded him for 25 generations until the family name was changed to Jin Bao(金保) and five generations later it was changed again to Duo Ji(多紀). The research scholar Taki Motohiro was in the third generation after the last name was changed to Taki, and his family kept an important part in the line of medical officers in Japan. Taki Motohiro(多紀元簡 $1755{\sim}1810$) was a teacher in the Yi Xue Guan where his father was residing, and became the physician for the general Jia Qi(家齊). He had a short temper and was not good at getting on in the world, and went against the will of the king and was banished from Ao Yi Shi(奧醫師). His most famous works, the "Shang Han Lun Ji Yi"("傷寒論輯義") and "Jin Qui Yao Lue Ji Yi"("金匱要略輯義") are the work of 20 years of collecting the theories of many schools and discussing, and is one of the most famous books on the "Shang Han Lun" in Japan. "Yi Sheng"("醫勝") is a collection of essays on research. Also there are the "Su Wen Shi"(素問識), "Ling Shu Shi"("靈樞識"), and the "Guan Ju Fang Yao Bu"("觀聚方要補"). Taki Motohiro(多紀元簡)'s position was succeeded by his third son Yuan Yin(元胤 $1789{\sim}1827$), and his works include works of research such as "Nan Jing Shu Jeng"(難經疏證), "Ti Ya"("體雅"), "Yao Ya"("藥雅"), "Ji Ya"(疾雅), "Ming Yi Gong An"(名醫公案), and "Yi Ji Kao"(醫籍考). The "Yi Ji Kao" is 80 volumes in length and lists about 3000 books on medicine in China before the Qing Dao Guang(道光), and under each title are the origin, number of volumes, state of existence, and, if possible, the preface, Ba Yu(跋語) and biography of the author. The younger sibling of Yuan Yin(元胤 $1789{\sim}1827$), Yuan Jian(元堅 $1795{\sim}1857$) expounded ancient writings at the Yi Xue Guan only after he reached middle age, was chosen for the Ao Yi Shi(奧醫師) and later became a Fa Yan(法眼), Fa Yin(法印) and Yu Chi(禦匙). He left about 15 texts, including "Su Wen Shao Shi"("素問紹識"), "Yi Xin Fang"("醫心方"), published in school, "Za Bing Guang Yao"("雜病廣要"), "Shang Han Guang Yao"("傷寒廣要"), and "Zhen Fu Yao Jue"("診腹要訣"). On the Taki family's founding and working of the Yi Xue Guan Yasuka Doumei(矢數道明) said they were "the people who took the initiative in Edo era kampo medicine" and evaluated their deeds in the fields of 'research of ancient text', the founding of Ji Shou Guan(躋壽館) and medical education', 'publication business', 'writing of medical text'. 5. The doctors of the 'Kao Zheng Pai' based their operations on the Edo Yi Xue Guan, and made groups with people with similar ideas to them, making a relationship 'net'. For example the three families of Duo Ji(多紀), Tang Chuan(湯川) and Xi Duo Cun(喜多村) married and adopted with and from each other and made prefaces and epitaphs for each other. Thus, the Taki family, the state science of the Makufu, the tendency of thinking, one's own interests and glory, one's own knowledge, the need of the society all played a role in the development of kampo medicine in the 18th and 19th century.

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기업정보 기반 지능형 밸류체인 네트워크 시스템에 관한 연구 (A Study on Intelligent Value Chain Network System based on Firms' Information)

  • 성태응;김강회;문영수;이호신
    • 지능정보연구
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    • 제24권3호
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    • pp.67-88
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    • 2018
  • 최근까지도 중소기업의 지속성장 및 경쟁력 확보에 대한 중요함을 인식함에 따라, 정부 차원에서의 유형 자원(R&D 인력, 자금 등)에 대한 지원이 주로 투입되어 왔다. 그러나 사업지원의 적절성이나 효과성, 효율성 면에서 서로 상충되는 정책부분이 존재하여 과소 지원이나 중복 지원 등 지원체계의 비효율성 문제가 제기되어온 것도 사실이다. 정부나 기업 관점에서는 중소기업의 한정된 자원으로 인해, 외부와의 협력을 통한 기술개발 및 역량강화가 기업의 경쟁우위를 창출하는 근간이라 보고 있으며, 이를 위한 가치창출 활동을 강조하고 있다. 기업 레벨에서의 지식생태계 구축을 통해 일련의 가치사슬로부터 기업거래 관계를 분석하고 결과를 가시화할 수 있는 밸류체인 네트워크 분석이 필요한 것도 이 때문이다. 특허/제품/기업명 검색을 통해 관련 제품의 정보나 특허 보유 기업의 기술(제품) 현황 정보를 제공하는 기술기회발굴시스템(Technology Opportunity Discovery system), 기업(재무)정보와 신용정보을 열람하게 해주는 CRETOP이나 KISLINE 등은 존재하고 있으나 밸류체인 네트워크 분석기반으로 유사(경쟁)기업의 리스트나 향후 거래 가능한 잠재 거래처 정보를 제공해주는 시스템은 부재한 실정이다. 따라서, 본 고에서는 KISTI에서 개발 운영중인 기업 비즈니스 전략수립 지원 파트너인 '밸류체인 네트워크 시스템(Value Chain Network System : VCNS)'을 중심으로, 탑재된 네트워크 기반 분석모듈의 유형, 이를 지원하는 참조정보 및 데이터베이스(D/B)의 구성 로직과 시스템 활용방안을 고찰하며, 산업구조를 이해하고 기업의 신제품 개발을 위한 핵심정보가 되고 있는 지능형 밸류체인 분석 시스템의 네트워크 가시화 기능을 살펴보기로 한다. 한 기업이 다른 기업 대비 경쟁우위를 확보하기 위해서는 보유 특허 또는 현재 생산하고 있는 제품에 대한 경쟁자 식별이 필요하며, 세부 업종별 유사(경쟁)기업을 탐색하는 일은 대상기업의 사업화 경쟁력 확보에 핵심이 된다. 또한 기업간 비즈니스 활동인 거래정보는 유사 분야로 진출할 경우 잠재 거래처 정보를 제공하는 중요한 역할을 수행한다. 이러한 기업간 판매정보를 기반으로 구축된 네트워크 맵을 활용하여 기업 또는 업종 수준의 경쟁자를 식별하는 일은 밸류체인 분석의 핵심모듈로 탑재될 수 있다. 밸류체인 네트워크 시스템(VCNS)은 단순 수집된 종래의 기업정보에 밸류체인(value chain) 및 산업구조 분석개념을 접목하여 개별 기업의 시장경쟁 상황은 물론 특정 산업의 가치사슬 관계를 파악할 수 있다. 특히 업종구조 파악, 경쟁사 동향 파악, 경쟁사 분석, 판매처 및 구매처 발굴, 품목별 산업동향, 유망 품목 발굴, 신규 진입기업 발굴, VC별 핵심기업 및 품목 도출, 해당 기업별 보유 특허 파악 등 기업 레벨에서의 유용한 정보분석 툴로 활용 가능하다. 또한, 거래처 정보 및 재무데이터로부터 분석된 결과의 객관성 및 신뢰성을 기반으로, 현재 국내에서 이용 중인 15,000여개 회원기업과 연구개발서비스업 종사자, 출연(연) 및 공공기관 등에서 사업평가 정보지원, R&D 의사결정 지원 및 중 단기 수요예측 전망 등 다양한 목적(용도)에 밸류체인 네트워크 시스템을 활용할 수 있을 것으로 기대된다. 기업의 사업경쟁력 강화를 위해 정부기관 및 민간 연구개발서비스 기업을 중심으로 기술(특허) 및 시장정보가 제공되어 왔으며, 이는 특허분석(등급, 계량분석 위주) 또는 시장분석(시장보고서 기반 시장규모 및 수요예측 위주)의 형태로 지원되어 왔다. 그러나 기업이 사업화진출 단계에서 겪게 되는 애로요인의 하나인 정보부족을 해결하는데 한계가 있었으며, 특히 경쟁기업 및 거래가능 기업 후보군에 대한 탐색정보는 입수하기 어려웠다. 본 연구를 통해 제안된 네트워크맵 및 보유 데이터 기반의 실시간 밸류체인 가시화 서비스모듈이 중견 중소기업이 당면한 신규시장 진출시 경쟁기업 대비 예상점유율, (예상)매출액 수준, 어느 기업을 컨택하여 유통망(원자재/부품에 대한 공급처, 완제품/모듈에 대한 수요처)을 확보할 지에 대한 핵심정보를 제공할 수 있을 것으로 기대된다. 향후 연구에서는 대체기업(또는 대체품목) 경쟁지표의 개발과 연구주체의 참여를 통한 경쟁요인별 지표의 고도화 연구, VCNS의 성능향상을 위한 데이터마이닝 기술 및 알고리즘을 추가 반영하도록 수행하고자 한다.

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

  • 방숙;한성현;이정자;안문영;이인숙;김은실;김종호
    • Journal of Preventive Medicine and Public Health
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    • 제20권1호
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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