• Title/Summary/Keyword: Prevention activity

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Application of the Extract of Zanthoxylum piperitum DC to Manufacturing Eco-friendly Nosocomial Infection Control Protective Materials (초피의 항균 활성을 이용한 원내 감염 제어 친환경 방호 소재 개발)

  • Shin Young Park;Ki Yun Kim;Do Youn Jun;Sung Chul Kim;Hyo-Il Jung;Young Ho Kim
    • Journal of Life Science
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    • v.33 no.10
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    • pp.820-827
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    • 2023
  • Since COVID-19 began at the end of 2019, the wearing time of protective clothing used to prevent pathogenic bacteria and virus infection has increased, and the development of safe protective materials that are human-friendly and have antibacterial and antiviral functions has been required. In this study, we investigated the possibility of developing natural antibacterial protection materials using ethanol extract of the medicinal plant Zanthoxylum Piperitum DC. The antibacterial activity assay of the 80% ethanol extract of Z. piperitum DC leaves against various nosocomial infectious bacteria, using the disk diffusion method, showed that Staphylococcus aureus ATCC 25923, Klebsiella pneumoniae ATCC 13883, Salmonella typhimurium, and Aeromonas hydrophila are sensitive to the inhibitory action of the extract. The IC50 values of the ethanol extract against S. aureus, K. pneumoniae, P. vulgaris and A. hydrophila were about 0.59 mg/ml, 0.50 mg/ml, 1.06 mg/ml, and 0.06 mg/ml, respectively. To determine whether the ethanol extract of Z. piperitum DC leaves can be applied to the development of antibacterial protective fabric, the ethanol extract was tested using a protective fabric from the KM Health Care Corp. using the JIS L1902-Absorption method. As a result, the bacteriostatic and bactericidal activity values of S. aureus ATCC 25923 and K. pneumoniae ATCC 13883 appeared to be more than 2.0 when treated with the ethanol extract at a concentration of 1% (w/v). Together, these results suggest that Z. piperitum DC leaves can be applied to develop natural antibacterial functional protective fabrics.

Study on the Long-term Forecasting of Brown Planthopper Outbreaks (벼멸구 발생의 장기예찰을 위한 기초적 연구)

  • Paik Woon Hah;Paik Hyun Joon
    • Korean journal of applied entomology
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    • v.16 no.3 s.32
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    • pp.171-179
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    • 1977
  • Since the outbreak of the brown planthopper (Nilaparvata lugens) in 1915 caused tremendous losses in rice production, one of the more effective method of prevention of such a disaster could be the establishment of longterm forecasting system, In 1916 the author indicated there was a correlation between sunspot activities and brown planthopper and the white back planthopper outbreaks. However, the examples seem to be too small size to state a definite correlation. The purpose of the present study IS to revi~w the history of the brown planthopper outbreaks, and to establish a more effective forcasting system. The present forcasting methods are based on light trap catches of adults which already migrate into this country from mainland China. The regular cycle of 11.2 years of sunspot activity began in 1710, and was continued to present. To gather more records of brown planthopper, the author checked 'Joseon Wangjo Silrok' and analized the so-called 'Hwang' 'Hwang-chung' and 'Chung' which have multiple meanings, together with 'Samguk Sagi' 'Goryo Sa' and 'Munheon Bigo.' The results obtained by the about from review of these old literature citations revealed that ten species of insect and unknown species were involved: i. e., pine moth (Dendrolimus spectabilis), army worm (Mythimna separata), brown planthopper (Nilarvata lugens), white-back planthopper (Sogatella furcifera), migratory locust (Locutsa migratoria), rice stem borer (Chilo suppressalis,), mole cricket (Gryllotalpa africana), rice-plant weevil (Echinocnemus squameus), cut worm (Euxoa segetum), and mulberry pyralid Margaronia pyloalis) The suspected incidence of planthopper in old records expressed by 'Hwang' or 'Chung' revealed a total or 25 out of 37 in 'Samguk sagi,' 21 out of 49 in 'Goryo sa,' 9 of 73 in 'Wanjo-silrog,' and none of 8 in 'Munheon bigo' were planthoppers. Therefore, a total of 36 out of 167 records of insect incidence in the old literature can be possibly attributed to planthoppers. The brown planthopper and white-back planthopper migrate together to Korea every year from mainland China, However, the number of each species are differ by year. In 1975 outbreak the brown planthopper was dominant; and the white-back planthopper prevailed in 1946 and 1977 outbreaks, During the course of this study, the author was able to add a new record of outbreak of planthop per. In 1916 the white-back planthopper outbreak caused serious losses in Chungcheong-namdo and Jeonla-namdo, with losses estimated as high as 160 and 190 thousand seok (23.2 and 27.5 thousand M/T), in Naju and Secheon county, respectively. Since 1912, major outbreaks of brown planthopper or white-back planthopper have been recored 5 times. These occurrences coincide and well matched the period of minimum number of sunspots, With these authenticated records of planthoppers, the author believes there is a close correlation between brown planthopper and white-back planthopper outbreaks in Korea and sunspot activities. Therefore, in years of low number of sunspots, we should watch for and expect outbreaks of these. insects. At this time, it will be necessary to provide all possible prevention measures.

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Environmental Interpretation on soil mass movement spot and disaster dangerous site for precautionary measures -in Peong Chang Area- (산사태발생지(山沙汰發生地)와 피해위험지(被害危險地)의 환경학적(環境學的) 해석(解析)과 예방대책(豫防對策) -평창지구(平昌地區)를 중심(中心)으로-)

  • Ma, Sang Kyu
    • Journal of Korean Society of Forest Science
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    • v.45 no.1
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    • pp.11-25
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    • 1979
  • There was much mass movement at many different mountain side of Peong Chang area in Kwangwon province by the influence of heavy rainfall through August/4 5, 1979. This study have done with the fact observed through the field survey and the information of the former researchers. The results are as follows; 1. Heavy rainfall area with more than 200mm per day and more than 60mm per hour as maximum rainfall during past 6 years, are distributed in the western side of the connecting line through Hoeng Seong, Weonju, Yeongdong, Muju, Namweon and Suncheon, and of the southern sea side of KeongsangNam-do. The heavy rain fan reason in the above area seems to be influenced by the mouktam range and moving direction of depression. 2. Peak point of heavy rainfall distribution always happen during the night time and seems to cause directly mass movement and serious damage. 3. Soil mass movement in Peongchang break out from the course sandy loam soil of granite group and the clay soil of lime stone and shale. Earth have moved along the surface of both bedrock or also the hardpan in case of the lime stone area. 4. Infiltration seems to be rapid on the both bedrock soil, the former is by the soil texture and the latter is by the crumb structure, high humus content and dense root system in surface soil. 5. Topographic pattern of mass movement spot is mostly the concave slope at the valley head or at the upper part of middle slope which run-off can easily come together from the surrounding slope. Soil profile of mass movement spot has wet soil in the lime stone area and loose or deep soil in the granite area. 6. Dominant slope degree of the soil mass movement site has steep slope, mostly, more than 25 degree and slope position that start mass movement is mostly in the range of the middle slope line to ridge line. 7. Vegetation status of soil mass movement area are mostly fire field agriculture area, it's abandoned grass land, young plantation made on the fire field poor forest of the erosion control site and non forest land composed mainly grass and shrubs. Very rare earth sliding can be found in the big tree stands but mostly from the thin soil site on the un-weatherd bed rock. 8. Dangerous condition of soil mass movement and land sliding seems to be estimated by the several environmental factors, namely, vegetation cover, slope degree, slope shape and position, bed rock and soil profile characteristics etc. 9. House break down are mostly happen on the following site, namely, colluvial cone and fan, talus, foot area of concave slope and small terrace or colluvial soil between valley and at the small river side Dangerous house from mass movement could be interpreted by the aerial photo with reference of the surrounding site condition of house and village in the mountain area 10. As a counter plan for the prevention of mass movement damage the technics of it's risk diagnosis and the field survey should be done, and the mass movement control of prevention should be started with the goverment support as soon as possible. The precautionary measures of house and village protection from mass movement damage should be made and executed and considered the protecting forest making around the house and village. 11. Dangerous or safety of house and village from mass movement and flood damage will be indentified and informed to the village people of mountain area through the forest extension work. 12. Clear cutting activity on the steep granite site, fire field making on the steep slope, house or village construction on the dangerous site and fuel collection in the eroded forest or the steep forest land should be surely prohibited When making the management plan the mass movement, soil erosion and flood problem will be concidered and also included the prevention method of disaster.

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Development and application of prediction model of hyperlipidemia using SVM and meta-learning algorithm (SVM과 meta-learning algorithm을 이용한 고지혈증 유병 예측모형 개발과 활용)

  • Lee, Seulki;Shin, Taeksoo
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.111-124
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    • 2018
  • This study aims to develop a classification model for predicting the occurrence of hyperlipidemia, one of the chronic diseases. Prior studies applying data mining techniques for predicting disease can be classified into a model design study for predicting cardiovascular disease and a study comparing disease prediction research results. In the case of foreign literatures, studies predicting cardiovascular disease were predominant in predicting disease using data mining techniques. Although domestic studies were not much different from those of foreign countries, studies focusing on hypertension and diabetes were mainly conducted. Since hypertension and diabetes as well as chronic diseases, hyperlipidemia, are also of high importance, this study selected hyperlipidemia as the disease to be analyzed. We also developed a model for predicting hyperlipidemia using SVM and meta learning algorithms, which are already known to have excellent predictive power. In order to achieve the purpose of this study, we used data set from Korea Health Panel 2012. The Korean Health Panel produces basic data on the level of health expenditure, health level and health behavior, and has conducted an annual survey since 2008. In this study, 1,088 patients with hyperlipidemia were randomly selected from the hospitalized, outpatient, emergency, and chronic disease data of the Korean Health Panel in 2012, and 1,088 nonpatients were also randomly extracted. A total of 2,176 people were selected for the study. Three methods were used to select input variables for predicting hyperlipidemia. First, stepwise method was performed using logistic regression. Among the 17 variables, the categorical variables(except for length of smoking) are expressed as dummy variables, which are assumed to be separate variables on the basis of the reference group, and these variables were analyzed. Six variables (age, BMI, education level, marital status, smoking status, gender) excluding income level and smoking period were selected based on significance level 0.1. Second, C4.5 as a decision tree algorithm is used. The significant input variables were age, smoking status, and education level. Finally, C4.5 as a decision tree algorithm is used. In SVM, the input variables selected by genetic algorithms consisted of 6 variables such as age, marital status, education level, economic activity, smoking period, and physical activity status, and the input variables selected by genetic algorithms in artificial neural network consist of 3 variables such as age, marital status, and education level. Based on the selected parameters, we compared SVM, meta learning algorithm and other prediction models for hyperlipidemia patients, and compared the classification performances using TP rate and precision. The main results of the analysis are as follows. First, the accuracy of the SVM was 88.4% and the accuracy of the artificial neural network was 86.7%. Second, the accuracy of classification models using the selected input variables through stepwise method was slightly higher than that of classification models using the whole variables. Third, the precision of artificial neural network was higher than that of SVM when only three variables as input variables were selected by decision trees. As a result of classification models based on the input variables selected through the genetic algorithm, classification accuracy of SVM was 88.5% and that of artificial neural network was 87.9%. Finally, this study indicated that stacking as the meta learning algorithm proposed in this study, has the best performance when it uses the predicted outputs of SVM and MLP as input variables of SVM, which is a meta classifier. The purpose of this study was to predict hyperlipidemia, one of the representative chronic diseases. To do this, we used SVM and meta-learning algorithms, which is known to have high accuracy. As a result, the accuracy of classification of hyperlipidemia in the stacking as a meta learner was higher than other meta-learning algorithms. However, the predictive performance of the meta-learning algorithm proposed in this study is the same as that of SVM with the best performance (88.6%) among the single models. The limitations of this study are as follows. First, various variable selection methods were tried, but most variables used in the study were categorical dummy variables. In the case with a large number of categorical variables, the results may be different if continuous variables are used because the model can be better suited to categorical variables such as decision trees than general models such as neural networks. Despite these limitations, this study has significance in predicting hyperlipidemia with hybrid models such as met learning algorithms which have not been studied previously. It can be said that the result of improving the model accuracy by applying various variable selection techniques is meaningful. In addition, it is expected that our proposed model will be effective for the prevention and management of hyperlipidemia.

Study on Safety Management Activity of Blood Test Room of Nuclear Medicine Department (핵의학과 혈액검사실의 안전 관리 활동에 대한 고찰)

  • Sim, Seong-Jae;Shin, Young-Kyun;Moon, Hyeong-Ho;Yoo, Seon-Hee;Jo, Shi-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.104-110
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    • 2011
  • Purpose: The object evaluation method about medical institutes of these days increases credibility of consumers about medical services by conducting a certification system about medical institutes. In addition, as nuclear medicine test rooms and diagnosis test medicine room adopt many kinds of international certification systems, the matters regarding safety management of test rooms are being regarded as important. Since the blood test rooms of nuclear medicine are exposed to many harmful factors such as infection from clinical specimen and radioactive isotope reagent, there is a need to pay lots of attention to the safety management of staff and patients. Therefore, this study discusses safety management activities of staff and patients, which are conducted in the blood test rooms of the nuclear medicine department in Asan Medical Center. Materials and Methods: In the blood test rooms of the nuclear medicine department in Asan Medical Center, the matters regarding comprehensive safety management by the person in charge of safety management are offered and all staff members of the test rooms apply them into work. Safety management education is regularly conducted according to established regulations, and infection is prevented through implementation of wearing personal protectors and hand sanitation during test work. In addition, technical safety guides and accident guides for interruption of electric power are provided against emergencies. Through infection management guides, infection prevention and preparation methods for infection are learned and radioactive isotope management, safety management about reagent use and safety guides about harmful chemical substances are being applied to work. Results: The blood test rooms of the nuclear medicine department apply safety management regulations to work. Under the situation where hand sanitation should be conducted, hands are washed to prevent infection between staff and patients, and for preventing infection from clinical specimen, personal protectors are worn. The reagent, which is classified as harmful substance, is separately stored to be easily recognized, radioactive wastes and general medical wastes are also safely managed. Through these lots of safety management activities, safety management awareness of staff members is enhanced, and patients are protected from many dangers. Conclusion: Staff members of the blood test rooms of the nuclear medicine department should be fully aware of safety management regulations and apply them to work. When better safety management suggestions are made, they need to be examined and applied for increasing quality of safety management for staff and patients.

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Suicide Ideation and the Related Factors among Korean Adults by Gender (한국 성인의 성별 자살생각 관련 요인 분석)

  • Park, Eunok
    • Journal of agricultural medicine and community health
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    • v.39 no.3
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    • pp.161-175
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    • 2014
  • Objectives: This study investigates the prevalence of suicide ideation and its the related factors by gender among Korean adults. Methods: National cross-sectional data from the database of the first and second year of $5^{th}$ Korean National Health and Nutritional Examination Survey (KNHANES V-1, V-2) were used for this study. 13,165 adults (${\geq}20$ years) were included in this analysis. Results: The prevalence of suicide ideation was 9.8% for men, 18.9% for women. Renal failure, depression, melancholy, stress, perceived health status, and smoking were significant risk factors among both men and women for suicide ideation. Divorced, separated or widowed of marital status and severe physical activity were related factors of suicide ideation for men. Low educational attainment, and alcohol dependency were associated factors of suicide ideation for women. Conclusions: There was gender difference of prevalence and risk factors of suicide ideation. These gender differences should be considered for planning and implementing suicide prevention program.

Research on Environmentally-Sound Erosion Control Works(II) -The Management and Guidelines of Riparian Zone in Japan- (환경(環境)과 조화한 사방사업(砂防事業)(II) -일본(日本)에 있어서 수변지역(水邊地域)의 관리(管理)와 지침(指針)-)

  • Chun, Kun-Woo;Kim, Kyoung-Nam;Seomun, Won;Yeom, Kyu-Jin;Ezaki, Tsugio
    • Journal of Forest and Environmental Science
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    • v.14 no.1
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    • pp.112-127
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    • 1998
  • A meeting for Japan Society of Erosion Control Engineering took place, from May 20-21 in Sapporo, Japan, with the presentations of 21 special topics and 185 general papers. Special topics consists of 6 copies on volcanic disaster prevention, 6 copies on the activity report of Earthquake Erosion Control Engineering Society, 5 copies on the management and guidelines of riparian zone and 4 copies on debris disaster occurred in 1997. General papers consists of 10 copies on slope stability, 10 copies on slope failure, 9 copies on earthquake, 41 copies on environmental erosion control, 25 copies on debris flow, 11 copies on warning and refuge, 10 copies on erosion control plan, 11 copies on erosion control project, 10 copies on erosion control facility, 12 copies on volcanic erosion control, 4 copies on revegetation technology, 4 copies on forest hydrology, 4 copies on avalanche, 4 copies on landslide, 18 copies on debris flow and 2 other copies presented by international student. Among the special topics, 5 papers with the titles of the function and structure of riparian zone, the interactive relation of flood and riparian zone, the management method of channel and river forest for controlling debris flow, the forest restoration efforts by native population, the law and social issue for building river riparian zone were presented in the subsection of "The Management and Guidelines of Riparian Zone". Thus, this article summarize and introduce the presented contents which are very important and can be referred to keep environmentally sound-river in the erosion control field.

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A study on the incremental oral health care of C pediatric clinic using a Dentocult-SM test (C소아치과의원의 개량형 Dentocult-SM검사를 이용한 계속관리에 관한 조사 연구)

  • Woo, Hee-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.8 no.2
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    • pp.39-51
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    • 2008
  • The research was conducted to 100 child patients selected by random sampling, which got a Dentocult-SM test in the first visit and then was being continuously managed, out of child patients of a pediatric clinic located in Gyeonggi-do. The period of there search is one year from June 2007 to May 2008, Using Dentocult-SM test, we analyzed the correlation between the distribution of dental plaque, a streptococcus mutans in saliva and condition of dental caries cavity in the teeth of child patients, then we measured the distribution of a streptococcusmutans. According to SM score, we applied incremental oral heath care for child patients to clinical and obtained the following results, 1. In terms of the age of child patients in research, the number of 3 years old patients was 29(lst ranked), the number of 2 years old patients was 28(2nd ranked). 2. The result of SM score showed that female child patients(52.0%) was higher than male ones in negative, male child patients(52.0%) was higher than female ones in mild, female child patients(68.2%) was higher than male ones in moderate, male child patients(57.1%) was higher than female ones in severe. 3. At the first visit, the SM score showed statistically remarkable difference between dt and dmft. We can also confirm the average of severe is the highest. 4. At the second visit, the SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 5. At the third visit, The SM score showed statistically remarkable difference among dt, ft, and dmft index We can also confirm the average of severe is the highest. 6. The comparison of dmft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative and mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in moderate and severe. 7. The comparison of dt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for negative, mild, and moderate, In addition to that, we can con firm that the incremental oral heath care makes statistically remarkable differences in severe. 8. The comparison of mt index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild and moderate, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences m severe. 9. The comparison of ft index differences to SM score showed statistically no remarkable difference in incremental oral heath care for mild, In addition to that, we can confirm that the incremental oral heath care makes statistically remarkable differences in negative, moderate, and severe. 10. According to the comparison of dmft index to the age, the 4 years old patients showed the highest number(5.50 in the first visit and 6,08 in the second one). In the third visit, the 6 years old patients showed the highest number(7.00). By the above results, we can find that the incremental oral heath care by SM score makes the results of oral care better. Therefore, the improvement or maintenance in oral health of child patients needs continuing personal oral health management and regular systematic management focused on prevention by the specialist.

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Comparison of Association Rule Learning and Subgroup Discovery for Mining Traffic Accident Data (교통사고 데이터의 마이닝을 위한 연관규칙 학습기법과 서브그룹 발견기법의 비교)

  • Kim, Jeongmin;Ryu, Kwang Ryel
    • Journal of Intelligence and Information Systems
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    • v.21 no.4
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    • pp.1-16
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    • 2015
  • Traffic accident is one of the major cause of death worldwide for the last several decades. According to the statistics of world health organization, approximately 1.24 million deaths occurred on the world's roads in 2010. In order to reduce future traffic accident, multipronged approaches have been adopted including traffic regulations, injury-reducing technologies, driving training program and so on. Records on traffic accidents are generated and maintained for this purpose. To make these records meaningful and effective, it is necessary to analyze relationship between traffic accident and related factors including vehicle design, road design, weather, driver behavior etc. Insight derived from these analysis can be used for accident prevention approaches. Traffic accident data mining is an activity to find useful knowledges about such relationship that is not well-known and user may interested in it. Many studies about mining accident data have been reported over the past two decades. Most of studies mainly focused on predict risk of accident using accident related factors. Supervised learning methods like decision tree, logistic regression, k-nearest neighbor, neural network are used for these prediction. However, derived prediction model from these algorithms are too complex to understand for human itself because the main purpose of these algorithms are prediction, not explanation of the data. Some of studies use unsupervised clustering algorithm to dividing the data into several groups, but derived group itself is still not easy to understand for human, so it is necessary to do some additional analytic works. Rule based learning methods are adequate when we want to derive comprehensive form of knowledge about the target domain. It derives a set of if-then rules that represent relationship between the target feature with other features. Rules are fairly easy for human to understand its meaning therefore it can help provide insight and comprehensible results for human. Association rule learning methods and subgroup discovery methods are representing rule based learning methods for descriptive task. These two algorithms have been used in a wide range of area from transaction analysis, accident data analysis, detection of statistically significant patient risk groups, discovering key person in social communities and so on. We use both the association rule learning method and the subgroup discovery method to discover useful patterns from a traffic accident dataset consisting of many features including profile of driver, location of accident, types of accident, information of vehicle, violation of regulation and so on. The association rule learning method, which is one of the unsupervised learning methods, searches for frequent item sets from the data and translates them into rules. In contrast, the subgroup discovery method is a kind of supervised learning method that discovers rules of user specified concepts satisfying certain degree of generality and unusualness. Depending on what aspect of the data we are focusing our attention to, we may combine different multiple relevant features of interest to make a synthetic target feature, and give it to the rule learning algorithms. After a set of rules is derived, some postprocessing steps are taken to make the ruleset more compact and easier to understand by removing some uninteresting or redundant rules. We conducted a set of experiments of mining our traffic accident data in both unsupervised mode and supervised mode for comparison of these rule based learning algorithms. Experiments with the traffic accident data reveals that the association rule learning, in its pure unsupervised mode, can discover some hidden relationship among the features. Under supervised learning setting with combinatorial target feature, however, the subgroup discovery method finds good rules much more easily than the association rule learning method that requires a lot of efforts to tune the parameters.

A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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