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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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EFFECTS OF FLUORIDE MOUTHRINSE ON CELL ACTIVITY OF GINGIVAL FIBROBLASTS OF CHILDREN (불소양치용액이 소아 치은 섬유아세포의 세포활성에 미치는 영향에 관한 연구)

  • Lee, Dong-Hyun;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.1
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    • pp.204-219
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    • 1997
  • The use of fluoride is one of the most effective methods for caries prevention. Fluoridation of public water supply has been recognized, for many years, as an effective way to reduce dental caries. The fluoride supplement has been recommended when the natural fluoride was unavailable or below the optimal range. However the mechanism of caries prevention by fluoride has not yet been clarified and it is well known that an overdose of fluoride results inacute and chronic toxicity, especially dental fluorosis. Fluoride mouthrinsing solution is widely used in dentistry due to its effectiveness in carrying anticariogenic action. Understanding the effects of fluoride mouthrinsing solution on human gingival fibroblasts will provide the safety rationale for its use during the caries preventive therapy. The purpose of this study was to evaluate the cytotoxic effect of fluoride mouthrinsing solution on the human gingival fibroblast in vitro. The human gingival fibroblasts were cultured from healthy gingiva on the extracted deciduous teeth of children. Cells were inoculated into a 24-well plate with $1{\times}10^4cells/well$ of medium at $37^{\circ}C$, 100% humidity, 5% $CO_2$ incubator for 24 hours. And the cells were counted by using the hemocytometer at each designed study. Human gingival fibroblasts were cultured in growth medium after one minute application range of 0.02%-0.2% NaF solution and 0.1% $SnF_2$ solution. The cells used in this study were between fifth to eighth passage number. The cell morphology was examined by inverted microscope and cell proliferation was measured by incorporating $[^3H]$-thymidine into DNA. DNA synthesis by human gingival fibroblasts was assessed by $[^3H]$-thymidine uptake assays while the cell activity was measured by MTT assay. Each concentrated fluoride mouthrinsing solution was estimated for its biocompatability with fibroblasts by the tissue culture technique. The results of this study were as follows : 1. It was observed that at 0.05%, 0.2% NaF mouthrinsing solution the cytoplasmic processes became globular. When 0.1% $SnF_2$ mouthrinsing solution was applied, the cytoplasmic process and cell morphology were disappeared. 2. DNA synthetic activity was reduced regardless of the concentration of the fluoride mouthrinsing solution. However, the result is statistically insignificant except 0.1% $SnF_2$ mouthrinsing solution(p<0.05). 3. Our results indicate that 0.02%, 0.05% concentrations of NaF mouthrinsing solution caused minimal cytotoxicity. But 0.2% NaF and 0.1% $SnF_2$ concentration were a significant difference between the cell activity in the experimental group and control group (p<0.05). 4. After appling 0.05% & 0.02% NaF fluoride mouthrinsing solution, cell activity was restored to the control groups level according to incubating time. The results suggest that direct exposure to fluoride solution inhibits gingival fibroblast activity. Therefore, for the most effective use of fluoride use, lowering the concentration of fluoride mouthrinsing is advisable because it maintains biocompatability and free ion in the oral fluid.

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Analysis of Users Characteristics and Behaviors in Recreation Forest (II) - With a Special Reference to Users' Satisfaction - (자연휴양림(自然休養林) 이용자(利用者)의 특성(特性) 및 이용행태(利用行態) 분석(分析) (II) - 이용자(利用者)의 만족도(滿足度)를 중심(中心)으로 -)

  • Lee, Chang-Heon
    • Journal of Korean Society of Forest Science
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    • v.86 no.3
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    • pp.352-364
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    • 1997
  • This study examined and analyzed users' behavior to recreation forest facilities and their satisfaction to recreation forest in order to offer some basal data which would be helpful to create new recreation forest, to supply users' needs in exsiting recreation forest, and to make excellent maintenance of recreation forest. The results are as follows ; Restroom, campground and forest aromatic bath ground were the most popular facilities with the users of recreation forest. And restroom, snack stand and water cooler were the most required facilities by the users. Before using recreation forest, users' expectation to enjoy aesthetics of nature, to be released from their fatigue and to rest, was the highest one. And users were satisfied most as they expected most from recreation forest. The major variables played for users' satisfaction about facility allocation and its harmony to the forest, were how clean the facilities are, how well they are repaired and maintained, how much noise users make around them, how easy to use them, and how beautiful the surroundings are. Users' satisfaction variables about vegetation condition of recreation forest, were diversity of vegetation, the shade of trees, the reservation of the forest, and the accordance of vegetation with the surroundings. Users' satisfaction variables about facility condition in recreation forest, were how easy to access to the recreation facilities and restroom, how clean they are, how well the trash cans are allocated, how easy to access to the field kitchen. And how good the forest is protected and nurtured, how well the forest managers conduct users' behavior, how effectively recreation forest is guided and informed to the public, were their major satisfaction variables about the management of Recreation Forest.

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The study of developing the freezing seal isolation method for the pre insulated heat transfer pipe (이중보온 열수송관에 대한 동결차수공법개발에 관한 연구)

  • You, Byounghee;Ahn, Changkoo;Kim, Woocheol;Shin, Ikho
    • Journal of Energy Engineering
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    • v.26 no.3
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    • pp.105-112
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    • 2017
  • A lot of piping systems have been used from nuclear power systems to water supply systems. The maintenance of the piping systems is needed to ensure proper operation of the piping systems. Failure of the large pipe systems especially such as KDHC(Korea District Heating Corporation) can be a matter directly related to the enterprise productivity and profitability. It can also lead to very important issues in promoting public safety and convenience. Therefore a method of quick and safety repairs have been emerged as the most important problem. In this study, freezing seal isolation method using liquid nitrogen cryogenic refrigerant was developed for the maintenance of a pre insulated heat transport pipe of KDHC with a diameter of 300 mm. In this study, by employing computational analysis techniques we performed the flow and heat transfer analysis for the targeted pre insulated heat transfer pipe and freezing seal jacket(ice-Plug) and have selected for optimal system. The detailed design model based on the results of the computational analysis finally was produced. A laboratory-scale test apparatus were designed and the freezing seal isolation self-test carried out. Also the performance assessment tests in the test bed of KDHC were carried out for on-site application.

Proposal of the Development Direction on the Special Act on Underground Safety Management for Preparation of the Proactive Underground Safety Management System (선제적 지하안전관리체계 마련을 위한 지하안전관리에 관한 특별법의 발전방향 제시)

  • Han, Yushik
    • Journal of the Korean Geotechnical Society
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    • v.34 no.7
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    • pp.17-27
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    • 2018
  • Sinkholes have occurred in various places around the world and concerns about public safety have been raised in recent years. Particularly, a ground subsidence may occur due to a variety of conditions when developing underground spaces. Ground subsidence refers to the sinking of the Earth's surface caused by the loss of the soil constituting ground due to a certain artificial cause in the ground. Ground subsidence is induced by artificial causes such as the leakage of water supply/sewage pipes and groundwater disturbance, and it is different from a sinkhole, where the sinking of the Earth's surface is induced by the cavity formed due to the melting of limestone in the ground with limestone bedrock. In recent underground development in the urban areas of Korea, damages to surrounding buildings have frequently led to many difficulties with civil complaints and compensation issues, and the collapse of some buildings has resulted in the loss of lives and property. Accordingly, the central government has legislated the Special Act on Underground Safety Management, which will take effect from January 1, 2018. This law specifies an underground safety management system for securing underground safety, under which underground safety impact assessment is performed for projects involving underground excavation work that exceeds a certain size, and safety inspection is regularly performed for underground facilities and the surrounding ground. In this study, the contents of the special act on underground safety management are reviewed, and the direction of development of underground safety policy for preparing preemptive underground safety management preparation and response system is suggested.

The Origin and Geochemical Behavior of Fluoride in Bedrock Groundwater: A Case Study in Samseung Area (Boeun, Chungbuk) (화강암 지역 암반 지하수 내 불소 이온의 기원 및 거동: 충북 보은 삼승면 일대의 현장 조사와 실내 실험 연구)

  • Chae, Gi-Tak;Koh, Dong-Chan;Choi, Byoung-Young
    • The Journal of Engineering Geology
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    • v.18 no.4
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    • pp.555-566
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    • 2008
  • Hydrogeochemical study in Samseung area (Boeun, Chungbuk) and waterrock interaction experiment using rock samples from the area were performed to elucidate the fluoride source in groundwater and explaining geochemical behavior of fluoride ion. Fluoride concentration of public water supply mostly using groundwater in Boeun area was significantly higher in South Korea. The maximum fluoride concentration of the study area was 3.9 mg/L, and 23% of samples exceeded the Korean Drinking Water Standard of fluoride (1.5 mg/L). The average concentration of fluoride was 1.0 mg/L and median was 0.5 mg/L. Because of high skewness (1.3), median value is more appropriate to represent fluoride level of this area. The relationships between fluoride ion and geochemical parameters ($Na^+$, $HCO_3$, pH, etc.) indicated that the degree of waterrock interaction was not significant. However, high fluoride samples were observed in $NaHCO_3$ type on Piper's diagram. The negative relationship between fluoride and $NO_3$ ion which might originate from surface contaminants was obvious. These results indicate that fluoride ion in groundwater is geogenic origin. The source of fluoride was proved by waterrock interaction batch test. Fluoride concentration increased up to 1.2 mg/L after 96 hours of reaction between water and biotite granite. However, the relationship between well depth and fluoride ion, and groundwater age and fluoride ion was not clear. This indicates that fluoride ion is not correlated with degree of waterrock interaction in this area but local heterogeneity of fluoriderich minerals in granite terrain. High fluoride concentration in Boeun area seems to be correlated with distribution of permeable structures in hard rocks such as lineaments and faults of this area. This entails that the deep bedrock groundwater discharges through the permeable structures and mixed with shallow groundwater.

A Study on the Role of the Commune's Cooperation in the French New Town Development and Management System (프랑스 신도시개발 및 관리에서 꼬뮌협력체에 관한 연구)

  • Choi, Sang-Hee;Kim, Doo-Hwan;Yoon, In-Sook;Seo, Jin-Won;Kim, Ryoon-Hee
    • Land and Housing Review
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    • v.3 no.4
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    • pp.369-378
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    • 2012
  • In France, there are many forms of organizations based on the intercommunal solidarity for city development and management. The purpose of the collaboration among Communes is to achieve high quality and well-equipped service-delivery system through co-operation of public services needed grand finances : water supply and sewage system and waste disposal system etc. The cooperation among French Communes and its effects, even though these were owing to the existing French local administration system, continued throughout regional co-management and social co-development process. This study suggested some characteristics and implications of the collaborative-style French new-town development and management organizations focused on the EPA, SAN and CA. First, the role of developmental corporation like EPA and its collaborative structure of decision-making are meaningful, because in these ways many related Communes could share a goal of new town development. Second, the way of new town corporation (SAN) is important in the sense of enabling the Communes to collaborate with each others while maintaining autonomy, so those are not simply state-directed objects, which was very difficult in the former French local administration system. Finally, transforming to CA (Communautes d'agglomeration:city community), EPA as an intercommunal corporation is possible to extend its purpose to the domain of regional planning including new town and periphery areas and change its position to a subject which can practice Commune's sustainable development according to stages of city's development and maturity. The most important implication of this study on urban development in Korea is that administrative consultative council or association among local governments and related authorities need to be established and effectively operate because multi-stakeholders could share a goal of urban development and management through that.

A Study on Improvement Plans for Local Safety Assessment in Korea (국내 지역안전도 평가의 개선방안 연구)

  • Kim, Yong-Moon
    • Journal of Korean Society of Disaster and Security
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    • v.14 no.4
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    • pp.69-80
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    • 2021
  • This study tried to suggest improvement measures by discovering problems or matters requiring improvement among the annual regional safety evaluation systems. Briefly introducing the structure and contents of the study, which is the introduction, describes the regional safety evaluation method newly applied by the Ministry of Public Administration and Security in 2020. Utilization plans were also introduced according to the local safety level that was finally evaluated by the local government. In this paper, various views of previous researchers related to regional safety are summarized and described. In addition, problems were drawn in the composition of the index of local safety, the method of calculating the index, and the application of the current index. Next, the problems of specific regional safety evaluation indicators were analyzed and solutions were presented. First, "Number of semi-basement households" is replaced with "Number of households receiving basic livelihood" of 「Social Vulnerability Index」 in the field of disaster risk factors is replaced with "the number of households receiving basic livelihood". In addition, the "Vinyl House Area" is evaluated by replacing "the number of households living in a Vinyl House, the number of container households, and the number of households in Jjok-bang villages" with data. Second, in the management and evaluation of habitual drought disaster areas, local governments with a water supply rate of 95% or higher in Counties, Cities, and Districts are treated as "missing". This is because drought disasters rarely occur in the metropolitan area and local governments that have undergone urbanization. Third, the activities of safety sheriffs, safety monitor volunteers, and disaster safety silver monitoring groups along with the local autonomous prevention foundation are added to the evaluation of the evaluation index of 「Regional Autonomous Prevention Foundation Activation」 in the field of response to disaster prevention measures. However, since the name of the local autonomous disaster prevention organization may be different for each local government, if it is an autonomous disaster prevention organization organized and active for disaster prevention, it would be appropriate to evaluate the results by summing up all of its activities. Fourth, among the Scorecard evaluation items, which is a safe city evaluation tool used by the United Nations Office for Disaster Risk Reduction(UNDRR), the item "preservation of natural buffers to strengthen the protection functions provided by natural ecosystems" is borrowed, which is closely related to natural disasters. The Scorecard evaluation is an assessment index that focuses on improving the disaster resilience of local governments while carrying out the campaign "Creating cities resilient to climate crises and disasters" emphasized by UNDRR. Finally, the names of "regional safety level" and "local safety index" are similar, so the term of local safety level is changed to "natural disaster safety level" or "natural calamity safety level". This is because only the general public can distinguish the local safety level from the local safety index.

Comparison of Nutrient Balance in a Reclaimed Tidal Upland between Chemical and Compost Fertilization for the Winter Green Barley Cultivation (간척농경지에서 비종에 따른 동계 청보리 재배 포장의 영양물질 수지 비교)

  • Song, In-Hong;Lee, Kyong-Do;Kim, Ji-Hye;Kang, Moon-Seong;Jang, Jeong-Ryeol
    • Korean Journal of Environmental Agriculture
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    • v.31 no.2
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    • pp.137-145
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    • 2012
  • BACKGROUND: Along with the surplus rice production, introduction of upland crop cultivations into newly reclaimed tidal areas has gained public attentions in terms of farming diversification and farmers income increase. However, its impacts on the surroundings have not been well studied yet, especially associated with nutrient balance from reclaimed upland cultivation. The objective of this study was to investigate water and nutrient balance during winter barley cultivation as affected different fertilization methods. METHODS AND RESULTS: TN and TP balance for three different plots treated by livestock compost, chemical fertilizer, and no application were monitored during winter green barley cultivation (2010-2011) at the NICS Kyehwa experimental field in Jeonbuk, Korea. Nutrient content in soil and pore water near soil surface appeared to increase, while sub-soil layer remained similar with no fertilization plot. Livestock compost application appeared to increase organic matter content in surface soil compared to chemical fertilization. Crop yield was the greatest with livestock compost application (10.6 t/ha) followed by chemical fertilization (6.9 t/ha) and no application (1.8 t/ha). The nitrogen uptake rate was also greater with livestock compost (52.4%) than chemical fertilizer (48.1%). Phosphorus uptake rate was much smaller (about 7.0%) compared to nitrogen. Nutrient loss by surface and subsurface runoff seemed to be minimal primarily due to small rainfall amount during the winter season. Most of the remaining nutrients, particularly phosphate seemed to be stored in soil layer. Phosphate accumulation appeared to be more phenomenal in the plot applied by livestock compost with higher phosphorus content. CONCLUSION: This study demonstrated that livestock compost application to tidal upland may increase barley crop production and also improve soil fertility by supplying organic content. However, excessive phosphorus supply with livestock compost seems likely to cause a phosphate accumulation problem, unless the nitrogen-based fertilization practice is adjusted.

A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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