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Isolation rate of 4 type virus of acute gastroenteritis in full-term neonates during neonatal period (신생아기 급성 장염의 4종 바이러스 양성률)

  • Moon, Soo Kyoung;Lee, Jae In;Yoon, Hye Sun;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.855-861
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    • 2007
  • Purpose : The most common causes of acute viral gastroenteritis in newborn period are rotavirus, astrovirus, norovirus and enteric adenovirus. This study was designed to investigate the clinical characteristics, clinical symptoms, isolation rate and distribution of these viruses in full-term neonates during neonatal period. We also studied the influence on the viral isolation rate by postnatal care place and feeding type. Methods : We evaluated 112 healthy full-term neonates who were admitted to Eulji hospital, presenting with symptoms of acute viral gastroenteritis from September 2004 to August 2005. Epidemiologic, clinical and laboratory data were reviewed. Enzyme-linked immunosorbent assay (ELISA) for rotavirus, astrovirus and norovirus and RT-PCR for enteric adenovirus were performed in study subjects.Results : The mean age at the admission was $11.4{\pm}5.4days$, mean weight loss was $5.9{\pm}5.1%$, mean hospitalization duration was $6.3{\pm}3.4days$. Moderate and severe weight loss were expressed in 51.7% and metabolic acidosis was in 13.4%. The percent of living in postnatal care facility (PCF) was 74.1 % and the percent of mixed feeding was 64.3%. Isolation rate of virus was 33%. The most prevalent virus was rotavirus (59.5%), followed by astrovirus (29.7%) and norovirus (10.8%). There was no differences in virus isolation rate by postnatal care place and by feeding type. The rotavirus was main virus in both home group and PCF group. But astrovirus was more detected in PCF and norovirus was more detected in home (P<0.05). According to monthly distribution of virus, acute viral gastroenteritis in newborn period was concentrated in September to December. Conclusion : The isolation rate of 4 type viruses was 33% and rotavirus was the leading cause of acute gastroenteritis during neonatal period. There was no differences in clinical characteristics on each viral groups.

A Study on the Meaning & Classification of Conventional Markets (전통시장 개념 및 분류체계 재정립에 관한 연구)

  • Kim, Young-Ki;Kim, Seung-Hee;Lim, Jin
    • Journal of Distribution Science
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    • v.9 no.2
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    • pp.83-95
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    • 2011
  • Conventional markets in Korea have played a pivotal role in the vitalization of local communities and economies along with the distribution of products. Although many people believe the markets to be disorderly, they are lively and provide local people with things to enjoy, watch and buy. However, superstores have undergone a mushrooming proliferation since Korea opened its gates to multinational superstores in 1996. This phenomenon has caused a crisis for Korea's conventional markets. They have lost their competitiveness because of this environmental change, inefficient management, and their outmoded facilities. Government efforts to revitalize the markets have centered on redevelopment of the facilities, a perspective that has caused not only the fall of the old business districts but also the decline of the distribution function. Under these conditions, the traditional market has re-entered into competition. The Korean government enacted a special law to revitalize the conventional markets and has been implementing many policies to support them since 2003. In 2009, the government amended the law and adopted the Business Improvement District System. The government also changed the official term from 'old markets' to 'Conventional markets'. Despite this legal amendment, though, we still need to re-establish the concept of the Conventional market. Historically, markets grew up spontaneously to dispose of surplus products. Some manmade markets were established through urban planning or as public facilities. Their businesses transactions have always been based on mutual trust between consumers and trades people, the traditional way of commercial dealing. Conventional markets can be defined, then, as creatures of societal necessity where transactions for services and products are based on mutual trust. Problematically, unlisted markets are left out of government support. Although unlisted markets have performed almost the same functions as listed markets, they exist only as a statistic as far as the special law is concerned. In some areas, there are more unlisted markets than unlisted ones. Therefore, it is necessary to establish systematic management methods for the unlisted markets. Some unlisted markets received support in the form of facility improvement from local governments' budgets in the early stage of the special law's enforcement. The current government also assists with safety issues involving unlisted markets; however, the current special law provides no legal framework for unlisted markets. Moreover, consumers cannot tell the difference between unlisted markets and listed ones. Finding a solution to this problemrequires new standards and a wider scope of support by which the efficiency of the market improvement support system might be enhanced.

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Evaluation and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Resources (음식물 자원화시설의 설치·운영에 대한 일반현황의 평가 및 개선 방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.63-75
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    • 2004
  • This research sought to determine the status of the installation and operation of domestic public resource-making facilities of resource-making facilities and come up with corresponding improvement measures. Currently compost is most numerous set-up out of facilties already established ever since, then the rest of them are feeds, anaerobic degradation, sewage combination, and combination of compost and feeds in order. As such, food waste is processed more into compost than into feeds, presumably because relevant facilities, which were originally designed for processing into feeds, were converted into composting facilities due to little demand for the processed feeds. The finding says that many related firms had yet to register their businesses in accordance with feeds and fertilizers management laws, and that food waste resources-making facilities used various basic facilities but few of them treated food waste in linkage with leaching water, bad odors, and energy. Some of current facilities were found to be 7 years old and thus outdated. Due to lack of skilled operational manpower, many facilities had less than 300 days of normal operation yearly, and some needed minor and serious repairs periodically. In overall facilities, 87% of the planned food waste was rolled in, thus requiring measures to treat the whole planned volume. For costs of resource-making facilities, some with a capacity of below 50 tons topped 100 million won, and facilities with a capacity of over 50 tons required less installation costs. Overall, installation costs ranged from 10 million to 20 million, and to 200 million won per ton, and this suggests a need to establish the installation cost calculation criteria, as well as to reshape the facility criteria. With operating costs varying greatly according to the size and treatment methods of facilities, the finding indicates a need to rationalize the operating costs, and to plan appropriate-size installation and operation of facilities to ensure economic operation.

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Analysis and Improvement Measures on the Status of the Installation and Operation of Facilities for Recycling Food Waste into Compost (음식물쓰레기 퇴비화시설의 설치 및 운영 현황분석 및 개선방안)

  • Ryu, Ji-Young;Kong, Kyu-Sik;Shin, Dae-Yewn;Phae, Chae-Gun
    • Journal of the Korea Organic Resources Recycling Association
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    • v.12 no.3
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    • pp.95-111
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    • 2004
  • This research sought to determine the status of the installation and operation of composting facilities of domestic public resource-making facilities and come up with corresponding improvement measures. The composting facilities were the most extensively installed of related facilities with over a 0.5 ton treated volume per day. The monthly and yearly carry-in volume of food waste were found to stand at 1,101.7 tons per day and 930.9 tons per day, thus falling short of the average planned volume of 1,270.9 tons. Many composting facilities, which were installed in areas for which factory registration were not approved, did not get approvals. Composting facilities underwent operation stoppage mainly due to faulty fermentation and crushing equipment. Mainly metals contained in food waste caused faults to the crushing equipment, thus requiring a facility designing against faults and corrosion. The initial water content was found to stand at 50-60%, thus complying with the requirement. However, since the composting food waste had an appropriate mixture of sawdust, food waste, and returned compost, it should meet the initial conditions. For fermentation facilities, the duration time for fermentation was 15 days, and post-fermentation tanks required 21 days of duration time, thus establishing the minimum criteria. However, some facilities did not meet the requirements, taking more time in decomposition, thus suggesting a need to determine the duration time according to facilities. In composting food waste, microorganism-based thermal oxidizer-operated fermentation tanks should be used to ensure an economic operation. On the contrary, 14 out of 25 survey targets heated fermentation tanks in any form. These thermal facilities contain the growth of bacteria, lowering chemical reaction in composting; thus composting facilities should be basically designed to use microorganism-based thermal oxidizers in drying water. An average daily volume of food waste and supplementary materials that was injected in producing compost was 22.8 tons. This volume produced 7.3 tons of compost per day, decreasing 68%. Properties of produced compost were analyzed by its color, absence or presence of remaining decomposition heat, and smell, to assess the quality. As a result, the composting process was not properly installed nor operated in about 50% of composting facilities. Compost should be produced to be soil-friendly.

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Current Status and the Future Prospect of Rehabilitation Nursing in Korea (한국 재활간호 현황과 전망)

  • Kang, Hyun-Sook;Suh, Yeon-Ok;Lee, Hae-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.2
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    • pp.240-247
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    • 2001
  • The history of rehabilitation of disabilities in Korea began with the foreigners and missionaries who were interested in it after Korean War. In 1981, Disabled Persons Welfare Act was enacted and the 88 Paralympics brought the nations attention to the welfare and rehabilitation of persons with disabilities. Since then, the facilities and the services for the disabled persons have expanded rapidly and the rehabilitation treatment and nursing intervention are drawing more attention. Against this background, the survey on the current status of disabilities, welfare service, facilities, and rehabilitation nursing was conducted. The results of this survey are as follows. 1. According to the 2000 census of disabilities, the number of persons with disabilities in Korea is estimated at 1,449,500, or 3.09% of the entire Korean population, 0.74% up from 2.35% in 1995. 2. Disability Types in 2000 The 2000 census showed that the persons with disabilities numbered 1,449,496 out of the total population and 1,024,371 persons are registered for disability, making up 70.7% of the estimated disabled population. Among them, physically disabled persons accounted for the largest 41.7% (605,127) and mentally retarded persons stood at the smallest 9% (13,481). 3. Percentage of Disability Presence The survey showed that more than 90% of disability were acquired. However, 44.8% of mental disability and 61.4% of hearing/speaking disability were not acquired after birth. This means that these disabilities happened by congenital cause or birth accident. 4. Yearly Figure of Registered Disabled Persons In 1989, 218,601 persons registered for disability and, in 2000, the number increased by 4.7 times to 1,024,371. These figures are different from the actual number of disabled persons. According to the 1995 census, 1,053,486 were disabled persons but only 378,323registered for disability. And, in the 2000 census, 1,024,371 out of the 1,449,496 of disabled persons registered for disability. 5. Welfare Service for Persons with Disability 62.6% of the total disabled people are registered and physically disabled persons accounted for the highest percentage of 96.7%. 26.5% of non-registered disabled people said that they didnt know the registration procedure. The rest of them replied that they didnt think they were disabled or that registration didnt seem to give any benefits. 6. Welfare Policies for Disabled Persons The welfare benefits given to the disabled are as follows: Issuance of disabled sign for car drivers, Permission to use LPG fuel, Communication fee reduction, Tax exemption related to cars, Reduction of public facility fees, Household allowance, Tax reduction or exemption, Medical allowance and education subsidy for children, and Housing. 7. Current Condition of Welfare Facilities by Disability Type The welfare institutions for disabilities numbered 188 in total and they can accommodate 16,823 persons. Categories of these institutions are physical disability(37), visual disability(10), hearing/speaking disability(14), mental retardation(59), and sanatoriums(68). 8. Human Resource of Rehabilitation of Disabilities Advanced education programs include rehabilitation nursing in its curriculum and this was selected as the program of Korean Academic Society of Nursing in 1990. In November 1997, Korean Academic Society of Rehabilitation Nursing was launched and many academic meeting and seminars were held. This organization is also making efforts to develop the education program for qualified rehabilitation nursing professionals and to develop the standards of rehabilitation nursing practice. In the professionals of the rehabilitation, there are rehabilitation specialist, physical therapist, speech therapist, occupational therapist. It is needed to come up with the measures to supply stable human resources following the demand of disabled persons and to recognize the private certificates for rehabilitation professionals as official ones after reviewing the education and training programs of private institutions. 9. Rehabilitation Nursing 1) Rehabilitation nursing was taught as an independent subject in 11 undergraduate programs and 9 graduate programs. 2) Research on rehabilitation nursing in Korea were 24 experimental research and 11 non-experimental research. The intervention of experimental research were mostly education and exercise rehabilitation programs. 3) In the three rehabilitation hospitals, nursing is divided into two categories, direct nursing and education & counseling. Direct nursing includes tracheostomy or nasogastric tube care, urination and defication, skin care, pain control, complication prevention and care, prevention of injury from a fall, etc.

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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

Morbidity Patterns and Health Care Behavior of Residents in Urban Low Income Area (도시영세지역(都市零細地域) 주민(住民)의 상병(傷病)및 의료이용(醫療利用) 양상(樣相) -대구직할시를 중심으로-)

  • Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.25-39
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    • 1985
  • This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

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Visual Characteristics of the Busan Port Landscape Viewed from Young-do Island (영도에서 조망하는 부산항 경관의 시각적 특성)

  • Park, Moon-Sook;Kang, Young-Jo;Cho, Seung-Rae;Kang, Hyon-Woo;Cha, Myeong-Sook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.4
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    • pp.35-44
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    • 2010
  • This study will define the features of the viewpoint that best enables the view of Busan Port from Young-Do. Special focus will be on spatial distribution, the type Busan Port sights that can be experienced from Young-Do, the compositional characteristic of a port landscape and visual characteristic. The results are based on 27 selected viewpoints and are as follows. Firstly, the patterns of the spatial distribution of viewpoints are classified as park, public facility and wayside types. It was found that most viewpoints are located along a wayside. Secondly, the types of Busan Port sights that can be experienced from Young-Do are divided into three kinds: surrounding stand-line type, facing the port and the type of penetrating city. The major type was of penetrating city among the three patterns. The reason for this is that the point of view for Busan Port was changed into a prospect over the sea since city and road sections have been expanding due to the urbanization of Young-Do. Thirdly, the compositional characteristics of the port landscape are divided into three styles: panoramic, corridor, and rooftop. The most frequent type is the rooftop style among the three characteristics. This fact indicates that the picture of Busan Port seen from Young-Do loses continuity of view and that housetops inhibit the sense of distance. Lastly, the visual characteristics of the viewpoint were analyzed. The angles of the declination of the viewpoints are concentrated on the horizontally closed parts. Thirteen points lie between $-3^{\circ}$ and $-1^{\circ}$, and twelve points between $-6^{\circ}$ and $-4^{\circ}$. The visual axes of the depression are two points because sight is interrupted by buildings which are built when the city expands. Two viewpoints for experiencing the optimum landscape of depression should be prepared to ensure continuous preservation of the viewpoints. The sight creates a wide prospect, reaching from 0.2km to 6.4km. It is expected that the results of this study can be used for the landscape plans of port cities including the management and preservation of viewpoints.

Birth and Infant Death Reporting System via Computer Network (출생 및 영아사망 신고체계 및 전산정보체계 개발)

  • Park, Jung-Han;Lee, Young-Sook;Rhee, Jung-Ae;Cho, Hyun;Chung, Young-Hae;Park, Soon-Woo;Jun, Hae-Ri
    • Health Policy and Management
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    • v.8 no.2
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    • pp.125-148
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    • 1998
  • Accurate vital statistics are essential for a national health planning and evaluation. Among various vital statistics, birth and death rates, and infant and matemal mortality rates together with the causes of death are the very basic ones for above purposes as well as for the maternal and child health management. These statistics are based on the birth and death reports. It is required by law to report every birth and death within one month after its occurrence. However, in case of a neonatal death occurring prior to the birth report, most of the birth and death are not reported. Thus accurate infant and maternal mortality rates are not available yet in Korea. The main objective of this study is to develop a birth and infant death reporting system via computer network. We designed a new birth report form based on the current form and data from the analysis of medical record forms of 14 hospitals. A new form is basically addition of essential medical information to the current birth report form. Since a revision of the rules and regulations related wtih the birth report is necessary to use a new form, we kept the current from intact to make it acceptable to the government office for a field trial. We also developed computer programs for data input for birth and death reports at a medical faciltiy, data processing for production of maternal and child health indices at a health center, and management of maternal and child health services including immunization and postantal care at health center. The birth certificate and birth report can be printed out at a medical facility. The computer packages were programmed by Borland Delphi 3.0 and can be run under Windows 95 system. We proposed a new birth and death reporting system via computer network after a field trial for data input, transmission, and processing. The medical and demographic data o birth and death at medical facilities will be sent to health centers directly via computer network. The health center will retain the medical data for analysis and forward only the data for birth and death reports required by current regulations to the Dong, Up, or Myun Office. Once the birth or death is reported via computer network to the Dong Office, then the Dong Office will notify the baby's mother of the birth report and request to submit the baby's name by mail. When the baby's name its submitted. the Dong Office will forward the birth reports to the Common Court and Statistics Agency in the same way as the current system, Upon the completion of birth registration of the Common Court, the court will issue the birth certificate to mother which will be used in lieu of the family record. The advantages of proposed birth and death reporting system via computer network ar as follows ; I) The accuracy, timing, and completeness of reporting will be improved and more accurate maternal and child health indices can be obtained, ii) The maternal and child health services of health center will be obtained, iii) Epidemiologic data for pregnancy and birth can be obtained, iv) Manpower for birth and death reporting will be saved.

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Landscape Design for Daechon Soul Island Resort Complex (대천 소울 아일랜드 리조트 조경설계)

  • Kwon, Jin-Wook
    • Journal of the Korean Institute of Landscape Architecture
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    • v.38 no.1
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    • pp.74-83
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    • 2010
  • This study is a development plan of a resort in a regional center that aims to generate tourism consumptions that have ripple effects on the regional economy by developing abandoned mine complexes in Daechon. Thanks to economic growth, the public awareness of tourism has changed. Hence, want for tourism influences development and advancement of recreational spaces, combining with various cultural contents. Development associated with environmental issues caused by modernization has become a major issue. At this point, to rediscover and specialize industrial complexes of bygone days as tourism resources signifies regeneration of regional resources. This study aims to find a solution for appropriate tourism development as part of the measures to revitalize the regional economy in underdeveloped areas and to improve the polluted environment. The result of the study is summarized as follows: First, in regional development alongside the development of a resort complex, it is important to construct environmental similarities. Minimizing differences in landscape structures is especially necessary because it will cause tourism resources in a regional center to be naturally linked to regional activities. These will then be recognized as attractions in the neighborhood. Therefore, it is desirable to reflect a spatial structure for environmental convergence, and, at the same time, to fulfill operation purposes by space through differentiation of movement lines. Second, in utilization of existing environmental resources, it is desirable to express localities and to develop differentiated elements. Facilities should not be homogenized, attaching importance to trends. Therefore, in establishing a development plan, it is important to have an attitude to accept existing roles and functions in a transformative manner. Third, recreational facilities in resort spaces generally have the problems of being uniformly planned as part of a development project and being limited to landscape facilities. Introduction of specialized facilities that can be reconciled with the regional environment and that can be open influences the landscape structure of the entire region and brings ripple effects as key facilities for activation of tourism.