A Study on the Development Direction of Medical Image Information System Using Big Data and AI (빅데이터와 AI를 활용한 의료영상 정보 시스템 발전 방향에 대한 연구)
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- KIPS Transactions on Computer and Communication Systems
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- v.11 no.9
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- pp.317-322
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- 2022
The rapid development of information technology is also bringing about many changes in the medical environment. In particular, it is leading the rapid change of medical image information systems using big data and artificial intelligence (AI). The prescription delivery system (OCS), which consists of an electronic medical record (EMR) and a medical image storage and transmission system (PACS), has rapidly changed the medical environment from analog to digital. When combined with multiple solutions, PACS represents a new direction for advancement in security, interoperability, efficiency and automation. Among them, the combination with artificial intelligence (AI) using big data that can improve the quality of images is actively progressing. In particular, AI PACS, a system that can assist in reading medical images using deep learning technology, was developed in cooperation with universities and industries and is being used in hospitals. As such, in line with the rapid changes in the medical image information system in the medical environment, structural changes in the medical market and changes in medical policies to cope with them are also necessary. On the other hand, medical image information is based on a digital medical image transmission device (DICOM) format method, and is divided into a tomographic volume image, a volume image, and a cross-sectional image, a two-dimensional image, according to a generation method. In addition, recently, many medical institutions are rushing to introduce the next-generation integrated medical information system by promoting smart hospital services. The next-generation integrated medical information system is built as a solution that integrates EMR, electronic consent, big data, AI, precision medicine, and interworking with external institutions. It aims to realize research. Korea's medical image information system is at a world-class level thanks to advanced IT technology and government policies. In particular, the PACS solution is the only field exporting medical information technology to the world. In this study, along with the analysis of the medical image information system using big data, the current trend was grasped based on the historical background of the introduction of the medical image information system in Korea, and the future development direction was predicted. In the future, based on DICOM big data accumulated over 20 years, we plan to conduct research that can increase the image read rate by using AI and deep learning algorithms.
This study is concerned on Why The Certified Security certification is needed and How to control the security quality to get better service to the clients. Theses days are required The Certified Certificate in all the industry. And in this point of view, the certified certificate is a kind of confirmation by an authority to the person who has how much special knowledge and practice in a certain field. Moreover, in the functionalism society the certified certificate system would be very positive effect to the related industry and society as official measurement by an authority. The security is freedom from fear and anxiety. Which means the security can not be operated in isolation from citizen's safe-living expectation, and which is also dealing with valuable human being's life. For getting the better purpose the security industry employees should have more organized special training and education. As my understanding the certified certificate exam system is the confirmation by an authority, the certified certificate is only neutral evidence to get the confidence and credit from the clients. In this point of view the core point is How to control The Certified Certificate by a credied authority.
Khori(高麗) refers to the Chaabog(reindeer) that live on lichens(蘚) on Mt. Soyon(鮮) in which pastures are the cold and dry plateau of North Eurasia. Thus, the origin region of the Khori or Koguryo that are the ancestors of the reindeer-herding pastoral nomads(馴鹿 遊牧民) can be said to be the Steppe-Taiga-Tundra pastoral areas of North Eurasia and North America. When the pastoral nomads moved on to the great mountain(大山) zone of the Jangbaek(長白) to the Baekdu(白頭) Mountains, they could have been in contact with pastoral farmers or agricultural farmers living there and they became the farmers remaining on agricultural farms. They were the Koryo people, the ancestors of Korea. Staying in one place, they gradually forgot the origin of their reindeer-herding pastoral nomadic history in the Northwest area of Mt. Soyon, the small mountain(小山) zone of the Steppe-Taiga-Tundra pastoral areas. In other words, they lost their identity as reindeer-herding pastoral nomads when they entered the agricultural area after leaving the pastoral area. However, since their basic genes had already formed when they lived on the cold and dry plateau of North Eurasia, it is possible to study their pastoral nomadic history focusing on 'the minority living in the broad area(廣域少數)', by utilizing highly advanced biotechnological science and focusing on genes and information technology innovation, and removing various past hindrances in research. Therefore, it is not so difficult to restore the reindeerherding pastoral nomadic history of the Koguryo(高句麗) people and secure their pastoral nomadic identity, of which the first steps have already been taken into their historical stages. The Eurasian continent and the Korean peninsula, especially the cold and dry plateau of North Eurasia and the Korean peninsula have been closely related to each other ecologically and historically. They can never be a separate space at all. The Eurasian continent lies horizontally east to west and thus, the continent forms an isothermal zone. Also, since the time of producing their own foods, it was relatively easy for people with their technology to move to other places owing to the pastoral nomadic characteristic of mobility. Unlike the Chungyen(中原) region, western Asia and the regions covering the Siberia-Manchu-Korean peninsula where food production revolution was first made were connected to the Mongolian lichens route(蘚苔之路: Ni, ukinii jam) and steppe roads. Although the ecological conditions of nature have changed a bit throughout a long history, it was natural for the many tribes in North Asia living on the largest Steppe-Taiga-Tundra area in the world to have believed 'the legends related to animals in relation to their founders and ancestors(獸祖傳說)'. Assuming that Siberian tigers and the tigers living on Mt. Baekdu were connected ecologically and genetically because of the ecological characteristics of the animals, and their migration from plateau to plateau, we would suspect that the Chosun(朝鮮) tribe living on Mt. Baekdu were ethnically and culturally more closely connected to the farther removed Ural-Altai tribes that lived on the cold and dry plateau region than to the Han(i14;) tribe who lived in Chungyen(中原) that was close to Mt. Baekdu. More evidence is the structure of the Korean language which has the form of 'Subject + Object + Verb', which is assumed to have originated from the speedy lifestyle of the reindeer-herding pastoral nomads. The structure is quite different from that of the Han(漢) language, which is based on agricultural life. Also, it is natural for reindeer riding reindeerherding pastoral nomads or horse-riding sheep-herding pastoral nomads(騎馬, 羊遊牧民) to have held military and political power over the region and eventually to have established an ancient pastoral nomadic empire in the process of their conquest of agricultural regions. The stages for founding global empires in the history of mankind maybe largely divided into two, in terms of ecological conditions and occupations. They are the steppes and the oceans. Of course, the steppe-based empires were established based on the skills to deal with horses and the ability to shoot arrows while riding horses, along with the use of iron ware in the 8th century BC. The steppe-based empires became the foundation for an oceanic empire, which could have been established by the use of warships and warship guns since the 15th Century. Based on those facts, we know that Chosun, Puyo(夫餘), and Koguryo are the products of a developmental process of pastoral nomadic empires on the steppes. Maybe we can easily find the pastoral nomadic identity of the Koguryo more than we expected when we trace the origins and history of the Korean tribe living in the pastures located in the northwest area of Mt. Jangbaek by focusing on pastoral nomadic mobility and organization just as we have investigated the historic origins of Anglo-Saxons in America by focusing on the times before the 15th Century. In the process, we should keep in mind that English culture originated from the Industrial Revolution and was directly delivered to the American continent, although America was far from England and was not an intermediate point on long sojourns either. Further, American culture came back to England in a more advanced form later. The most important thing currently to be resolved is to cause Koreans to look back on their own history in a freer way of thinking and with diverse, profound, and sharp insight, taking away the old and existing conventional recognition that is entangled with complicated interests with Korean people and other countries. The meanings of Chosun, Khori, and Solongos have been interpreted arbitrarily without any historic evidence by the scholars who followed conventional tradition of fixed-minded aristocrats in an agricultural society. If the Siberian cultural properties of the stone age, the earthenware age, the bronze age, and the iron age are analyzed in such a way, archaeological discovery will never be able to contribute to the restoration of the Koguryo's pastoral nomadic identity. One should transcend the errors that tend to interpret the cultural properties discovered in the pastoral nomadic regions as not being differentiated from those of agricultural regions and just interpret them altogether from the agricultural point of view. A more careful intention is required in the interpretation of cultural properties of ancient Korean empires that seem to have been formed due to mutual interactions of pastoral nomadic and agricultural cultures. Also, it is required that the conventional recognition chain of 'reverse-genes' be severed, which has placed more weight on agricultural properties than pastoral nomadic ones, since their settlement on agricultural farms was made after the establishment of their ancient pastoral nomadic empires. There is no reason at all to place priority on stoneware, earthenware, bronze ware, and iron ware than on wooden ware(木器) and other ware which were made of animal skins(皮器), bones and horns(骨角器), in analyzing the history in the regions of reindeer or sheep pastures. Reading ancient Korean history from the perspective of pastoral nomadic history, one feels strongly the instinctive emotions to return to the natural 'mother place'. The reindeer-herding pastoral nomadic identity of the Koguryo people that has been accumulated in volumes in their genes and hidden deep inside and have interacted organically could be reborn with Burqanism(Burqan refers to 不咸 in Chinese), which was their religion by birth and symbolized as the red willow(紅柳=不咸). The mother place of the Koguryo's people is the endless vast green pastures of North Eurasia and North America, where we anticipated the development of Korean livestock farming following the inherent properties in the genes of the reindeer-herding pastoral nomads with Korean ancestors. We anticipate that the place would be the core resource that could contribute to the development of life of living creatures following the inherent properties of their genes and biotechnological factors. In other words, biotechnology used for a search for clues on the well-being of humans could be the fruit brought by Burqanism of the Koguryo people and the fruit of the globalization of Korean livestock farming. It is the Chosun farmer in China come from the vast nomadic reindeer pastures of North Eurasia that resolved the food problem of a billion Chinese people with lowland paddy rice seeds (水稻) by transforming Heilongjiang Province(黑龍江省) into an oceanic lowland paddy rice field(水田). Even Mao Tse-tung(毛擇東) could not resolve the food problem by his revolution campaigns for tens of years. Today is the very time that requires the development of special livestock farming following the inherent properties of the ancient Korean reindeer-herding pastoral nomads that respected the dignity of life on the cold and dry plateau of North Eurasia and the America continent. I suggest that research should be started from the pastures of the Dariganga Steppe in East Mongolia that was the homeland of Hanwoo(韓牛) and the central horse-herding steppe place(牧馬場) of Chingis Khan's Mongolia. The Dariganga Steppe is awash with an affluent natural environment for pastoral nomadic living however, the quality of life of the pastoral nomads there is still low. I suggest we Koreans, the descendents of the Koguryo, should take our first steps for our livestock farming business project and develop the Northern nomadic pastures, here at the pastures of the Dariganga Steppe, which is the Mongolian core place of state-of-the-art technology for military weapons.
Korea's business is composed of a few large-sized enterprises (which can be abbreviated as LSE) and a majority of small-sized enterprises (SSE). Although there has been a growing recognition of the need for the development of medium-sized enterprises (MSE) which can serve as a link between SSE and LSE, as yet there has not yet been a consensus on the definition, characteristics and the function of the MSE in Korea. Nowadays, the world is being globalized, and Japan and China are in competition to ne a great economic power. While East Asia is experiencing rapid changes, promoting MSE which can secure flexibility and efficiency through covering up the limitation of LSE and SSE is needed in order to respond the global market which is being specialized. The features of MSE in Japan can be listed as follows. First, the MSE in Japan is developing the company through getting into niche markets which are hard for major companies to enter rather than developing markets in order to compete against major companies directly. While MSEs are endeavoring to build the business firmly in the domestic market, they can possess special and competitive technical skills through trials and errors; so that they can get a chance develop their business through independent business system rather than putting their effort to compete against major companies. Second, from the MSEs with competitive edge in the market, there are many contributions to the national exportation. Those MSEs produce in domestic and maintain the quality of high price products which need cutting-edge technology, while they relocate the low and middle priced goods to the country where manufacturing costs are low, so that they can maintain the price competitiveness. Third, the industrial structure in Japan is formed from dual structure between major companies and small sized companies. In other words, in Japan's industrial structure which are composed of subcontract structure, this dual structure has taken a major role of small sized companies' growth and manufacturing businesses' international competitive power. Forth, MSE in Japan adopt a strategy of putting their value on qualitative scale growth rather than quantitative scale growth. In this paper, the case of Japanese MSE is analyzed. Along with its long history of Industrialization, Japan has a corporate environment where the SSEs can develop as a MSE and later a LSE through a full-support system. Among its SSEs, there are a number of world class corporations equipped with a large domestic market, win-win cooperation with the LSEs and an independent technology development. It can also be observed that these SSEs develop into MSEs with sustainable growth potentials. This study will focus on the condition under which the MSEs of Japan have been developed, and how they have survived the competition between SSEs and LSEs. Through this study, this paper attempts to offer solutions to Korea's polarization between the SSE and LSE, while providing the basis for SSEs revitalization. In general, if both extremities phenomenon deepen between LSE and SSE, there are possible fears of occurring disutility in national economy by the monopolization of LSE. For that reason, enterprise group, which can make SSE or MSE compete LSE in some area and ease the monopoly and oligopoly problem, is needed. This awareness has been shared for ages long. Nevertheless, there is no legal definition for MSE in Japan, and there is no definition about the enterprise size or unified view of MSE between scholars, but it is defined differently by each of academical person or research institution and study meeting. For that reason, this paper will organize the definition of MSE in Japan, and then will propose the characteristics of the background which has made MSE secure competitiveness and sustainable growth in global market. This study focus on that because through this process, the positive change to the awareness of MSE can be proposed in Korea and to seek the policy direction for building institutional framework which can make SSE become MES. Through this way, the fundamentals for SSE to become MSE can be managed and some appropriate suggestions which will be able to make MSE enter the global market in the future can also be proposed. Due to these facts, this study is very important and well timed task. In a sense of this way, this study will examine the definition and role of MSE in Japan. after this examination, this study will deal with the status, special feature, and promotion policy for MSE. Through this analysis of MSE in Japan, the foundation which be able to set the desirable role model for MSE in Korea can be proposed. Also, the political implication which is needed to push ahead to contribute to creating employment and economic growth through sustainable growth of MSEs in economic system of Korea can be offered through this study. It has been found that Japan's MSE functions as an indispensable link among various industrial structures by holding a significant position in employment rate, production and value added. Although the MSEs took up less than 1% of the entire number of businesses with 2700 manufacturing firms and 7000 non-manufacturing firms, its employment ratios are about 15%, while taking about 25% of the manufacturing industry's exports. In industries such as machinery and electronics which is considered Japan's major industry, the MSEs showed a higher than average ratio of manufacturing exports and employment rate. It can be analyzed that behind Japan's advantageous industries, close and deeply knit MSEs exist. Although there are no clearly stated policies geared towards the MSEs by the Japanese government, various political measures exist such as the R&D Project and the inducement of cooperation between enterprises which gives room for MSEs to participate in the SSE policies. In relation to these findings, the following practical measures can be considered in order to revitalize Korea's MSEs: First, there is a need for a legal definition of MSE and the incentives to provide legal support for its growth. Second, if a law to support the MSEs is established, it could provide a powerful inducement for the SSE to grow as a MSE, rather than stay as a SSE. Third, there is a need for a strategy of MSEs to establish a stable base in the domestic market and then advance to the global market with the accumulated trial and error and competitiveness. Fourth, the SSE themselves need the spirit of entrepreneurship in order to make the leap to a MSE. Because if nothing is to be changed about the system on the firms that grew, and the parts of the past custom was left to be managed alone, confusion and absence of management can take place. No matter how much tax favors the government will give and no matter how much incentive there could be through the policies, there are limits for industries to higher the ability to propagate. And because of that it is a period where industries need their own innovative skills to reform their firms.
The total forest land area in Korea accounts for some 67 percent of the nation's land total. Its productivity, however, is very low. Consequently, forest production accounts for only about 2 percent of the gross national product and a minor proportion of no more than about 5 percent versus primary industry. In this case, however, only the direct income from forestry is taken into account, making no reference to the forestry output induced by other industrial sectors. The value added Or the induced forestry output in manufacturing the primary wood products into higher quality products, makes a larger contribution to the economy than direct contribution. So, this author has tried to analyze the structure of forestry and compute the repercussion effect and the induced output of primary forest products when utilized by other industries for their raw materials, Hsing the input-output table and attached tables for 1963 and 1966 issued by the Bank of Korea. 1. Analysis of forestry structure A. Changes in total output Durng the nine-year period, 1961-1969, the real gross national product in Korea increased 2.1 times, while that of primary industries went up about 1. 4 times. Forestry which was valued at 9,380 million won in 1961, was picked up about 2. 1 times to 20, 120 million won in 1969. The rate of the forestry income in the GNP, accordingly, was no more than 1.5 percent both in 1961 and 1962, whereas its rate in primary industries increased 3.5 to 5.4 percent. Such increase in forestry income is attributable to increased forest production and rise in timber prices. The rate of forestry income, nonetheless, was on the decrease on a gradual basis. B. Changes in input coefficient The input coefficient which indicates the inputs of the forest products into other sectors were up in general in 1966 over 1963. It is noted that the input coefficient indicating the amount of forest products supplied to such industries closely related with forestry as lumber and plywood, and wood products and furniture, showed a downward trend for the period 1963-1966. On the other hand, the forest input into other sectors was generally on the increase. Meanwhile, the input coefficient representing the yolume of the forest products supplied to the forestry sector itself showed an upward tendency, which meant more and more decrease in input from other sectors. Generally speaking, in direct proportion to the higher input coefficient in any industrial sector, the reinput coefficient which denotes the use of its products by the same sector becomes higher and higher. C. Changes in ratio of intermediate input The intermediate input ratio showing the dependency on raw materials went up to 15.43 percent m 1966 from 11. 37 percent in 1963. The dependency of forestry on raw materials was no more than 15.43 percent, accounting for a high 83.57 percent of value added. If the intermediate input ratio increases in any given sector, the input coefficient which represents the fe-use of its products by the same sector becomes large. D. Changes in the ratio of intermediate demand The ratio of the intermediate demand represents the characteristics of the intermediary production in each industry, the intermediate demand ratio in forestry which accunted for 69.7 percent in 1963 went up to 75.2 percent in 1966. In other words, forestry is a remarkable industry in that there is characteristics of the intermediary production. E. Changes in import coefficient The import coefficient which denotes the relation between the production activities and imports, recorded at 4.4 percent in 1963, decreased to 2.4 percent in 1966. The ratio of import to total output is not so high. F. Changes in market composition of imported goods One of the major imported goods in the forestry sector is lumber. The import value increased by 60 percent to 667 million won in 1966 from 407 million won in 1963. The sales of imported forest products to two major outlets-lumber and plywood, and wood products and furniture-increased to 343 million won and 31 million won in 1966 from 240million won and 30 million won in 1963 respectively. On the other hand, imported goods valued at 66 million won were sold to the paper products sector in 1963; however, no supply to this sector was recorded in 1963. Besides these major markets, primary industries such as the fishery, coal and agriculture sectors purchase materials from forestry. 2. Analysis of repercussion effect on production The repercussion effect of final demand in any given sector upon the expansion of the production of other sectors was analyzed, using the inverse matrix coefficient tables attached to the the I.O. Table. A. Changes in intra-sector transaction value of inverse matrix coefficient. The intra-sector transaction value of an inverse matrix coefficient represents the extent of an induced increase in the production of self-support products of the same sector, when it is generated directly and indirectly by one unit of final demand in any given sector. The intra-sector transaction value of the forestry sector rose from 1.04 in 1963 to 1, 11 in 1966. It may well be said, therefore, that forestry induces much more self-supporting products in the production of one unit of final demand for forest products. B. Changes in column total of inverse matrix coefficient It should be noted that the column total indicates the degree of effect of the output of the corresponding and related sectors generated by one unit of final demand in each sector. No changes in the column total of the forestry sector were recorded between the 1963 and 1966 figures, both being the same 1. 19. C. Changes in difference between column total and intra-sector transaction amount. The difference between the column total and intra-sector transaction amount by sector reveals the extent of effect of output of related industrial sector induced indirectly by one unit of final demand in corresponding sector. This change in forestry dropped remarkable to 0.08 in 1966 from 0.15 in 1963. Accordingly, the effect of inducement of indirect output of other forestry-related sectors has decreased; this is a really natural phenomenon, as compared with an increasing input coefficient generated by the re-use of forest products by the forestry sector. 3. Induced output of forestry A. Forest products, wood in particular, are supplied to other industries as their raw materials, increasng their value added. In this connection the primary dependency rate on forestry for 1963 and 1966 was compared, i. e., an increase or decrease in each sector, from 7.71 percent in 1963 to 11.91 percent in 1966 in agriculture, 10.32 to 6.11 in fishery, 16.24 to 19.90 in mining, 0.76 to 0.70 in the manufacturing sector and 2.79 to 4.77 percent in the construction sector. Generally speaking, on the average the dependency on forestry during the period 1963-1966 increased from 5.92 percent to 8.03 percent. Accordingly, it may easily be known that the primary forestry output induced by primary and secondary industries increased from 16, 109 million won in 1963 to 48, 842 million won in 1966. B. The forest products are supplied to other industries as their raw materials. The products are processed further into higher quality products. thus indirectly increasing the value of the forest products. The ratio of the increased value added or the secondary dependency on forestry for 1963 and 1966 showed an increase or decrease, from 5.98 percent to 7.87 percent in agriculture, 9.06 to 5.74 in fishery, 13.56 to 15.81 in mining, 0.68 to 0.61 in the manufacturing sector and 2.71 to 4.54 in the construction sector. The average ratio in this connection increased from 4.69 percent to 5.60 percent. In the meantime, the secondary forestry output induced by primary and secondary industries rose from 12,779 million Wall in 1963 to 34,084 million won in 1966. C. The dependency of tertiary industries on forestry showed very minor ratios of 0.46 percent and 0.04 percent in 1963 and 1966 respectively. The forestry output induced by tertiary industry also decreased from 685 million won to 123 million won during the same period. D. Generally speaking, the ratio of dependency on forestry increased from 17.68 percent in 1963 to 24.28 percent in 1966 in primary industries, from 4.69 percent to 5.70 percent in secondary industries, while, as mentioned above, the ratio in the case of tertiary industry decreased from 0.46 to 0.04 percent during the period 1963-66. The mining industry reveals the heaviest rate of dependency on forestry with 29.80 percent in 1963 and 35.71 percent in 1966. As it result, the direct forestry income, valued at 8,172 million won in 1963, shot up to 22,724 million won in 1966. Its composition ratio lo the national income rose from 1.9 percent in 1963 to 2.3 per cent in 1966. If the induced outcome is taken into account, the total forestry production which was estimated at 37,744 million won in 1963 picked up to 105,773 million won in 1966, about 4.5 times its direct income. It is further noted that the ratio of the gross forestry product to the gross national product. rose significantly from 8.8 percent in 1963 to 10.7 percent in 1966. E. In computing the above mentioned ratio not taken into consideration were such intangible, indirect effects as the drought and flood prevention, check of soil run-off, watershed and land conservation, improvement of the people's recreational and emotional living, and maintenance and increase in the national health and sanitation. F. In conclusion, I would like to emphasize that the forestry sector exercices an important effect upon the national economy and that the effect of induced forestry output is greater than its direct income.
The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.
Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.
As an official journal of the Asian-Australasian Association of Animal Production Societies (AAAP), the Asian-Australasian Journal of Animal Sciences (AJAS) was born in February 1987 and the first issue (Volume 1, Number 1) was published in March 1988 under the Editorship of Professor In K. Han (Korea). By the end of 2001, a total of 84 issues in 14 volumes and 1,761 papers in 11,462 pages had been published. In addition to these 14 volumes, a special issue entitled "Recent Advances in Animal Nutrition" (April, 2000) and 3 supplements entitled "Proceedings of the 9th AAAP Animal Science Congress" (July, 2000) were also published. Publication frequency has steadily increased from 4 issues in 1988, to 6 issues in 1997 and to 12 issues in 2000. The total number of pages per volume and the number of original or review papers published also increased. Some significant milestones in the history of the AJAS include that (1) it became a Science Citation Index (SCI) journal in 1997, (2) the impact factor of the journal improved from 0.257 in 1999 to 0.446 in 2000, (3) it became a monthly journal (12 issues per volume) in 2000, (4) it adopted an English editing system in 1999, and (5) it has been covered in "Current Contents/Agriculture, Biology and Environmental Science since 2000. The AJAS is subscribed by 842 individuals or institutions. Annual subscription fees of US$ 50 (Category B) or US$ 70 (Category A) for individuals and US$ 70 (Category B) or US$ 120 (Category A) for institutions are much less than the actual production costs of US$ 130. A list of the 1,761 papers published in AJAS, listed according to subject area, may be found in the AJAS homepage (http://www.ajas.snu.ac.kr) and a very well prepared "Editorial Policy with Guide for Authors" is available in the Appendix of this paper. With regard to the submission status of manuscripts from AAAP member countries, India (235), Korea (235) and Japan (198) have submitted the most manuscripts. On the other hand, Mongolia, Nepal, and Papua New Guinea have never submitted any articles. The average time required from submission of a manuscript to printing in the AJAS has been reduced from 11 months in 1997-2000 to 7.8 months in 2001. The average rejection rate of manuscripts was 35.3%, a percentage slightly higher than most leading animal science journals. The total number of scientific papers published in the AJAS by AAAP member countries during a 14-year period (1988-2001) was 1,333 papers (75.7%) and that by non- AAAP member countries was 428 papers (24.3%). Japanese animal scientists have published the largest number of papers (397), followed by Korea (275), India (160), Bangladesh (111), Pakistan (85), Australia (71), Malaysia (59), China (53), Thailand (53), and Indonesia (34). It is regrettable that the Philippines (15), Vietnam (10), New Zealand (8), Nepal (2), Mongolia (0) and Papua New Guinea (0) have not actively participated in publishing papers in the AJAS. It is also interesting to note that the top 5 countries (Bangladesh, India, Japan, Korea and Pakistan) have published 1,028 papers in total indicating 77% of the total papers being published by AAAP animal scientists from Vol. 1 to 14 of the AJAS. The largest number of papers were published in the ruminant nutrition section (591 papers-44.3%), followed by the non-ruminant nutrition section (251 papers-18.8%), the animal reproduction section (153 papers-11.5%) and the animal breeding section (115 papers-8.6%). The largest portion of AJAS manuscripts was reviewed by Korean editors (44.3%), followed by Japanese editors (18.1%), Australian editors (6.0%) and Chinese editors (5.6%). Editors from the rest of the AAAP member countries have reviewed slightly less than 5% of the total AJAS manuscripts. It was regrettably noticed that editorial members representing Nepal (66.7%), Mongolia (50.0%), India (35.7%), Pakistan (25.0%), Papua New Guinea (25.0%), Malaysia (22.8%) and New Zealand (21.5%) have failed to return many of the manuscripts requested to be reviewed by the Editor-in-Chief. Financial records show that Korea has contributed the largest portion of production costs (68.5%), followed by Japan (17.3%), China (8.3%), and Australia (3.5%). It was found that 6 AAAP member countries have contributed less than 1% of the total production costs (Bangladesh, India, Indonesia, Malaysia, Papua New Guinea and Thailand), and another 6 AAAP member countries (Mongolia, Nepal and Pakistan, Philippine and Vietnam) have never provided any financial contribution in the form of subscriptions, page charges or reprints. It should be pointed out that most AAAP member countries have published more papers than their financial input with the exception of Korea and China. For example, Japan has published 29.8% of the total papers published in AJAS by AAAP member countries. However, Japan has contributed only 17.3% of total income. Similar trends could also be found in the case of Australia, Bangladesh, India, Indonesia, Malaysia and Thailand. A total of 12 Asian young animal scientists (under 40 years of age) have been awarded the AJAS-Purina Outstanding Research Award which was initiated in 1990 with a donation of US$ 2,000-3,000 by Mr. K. Y. Kim, President of Agribrands Purina Korea Inc. In order to improve the impact factor (citation frequency) and the financial structure of the AJAS, (1) submission of more manuscripts of good quality should be encouraged, (2) subscription rate of all AAAP member countries, especially Category B member countries should be dramatically increased, (3) a page charge policy and reprint ordering system should be applied to all AAAP member countries, and (4) all AAAP countries, especially Category A member countries should share more of the financial burden (advertisement revenue or support from public or private sector).
Festivals are an indispensable feature of cultural tourism(Formica & Uysal, 1998). Cultural tourism festivals are increasingly being used as instruments promoting tourism and boosting the regional economy. So much research related to festivals is undertaken from a variety of perspectives. Plans to revisit a particular festival have been viewed as an important research topic both in academia and the tourism industry. Therefore festivals have frequently been leveled as cultural events. Cultural tourism festivals have become a crucial component in constituting the attractiveness of tourism destinations(Prentice, 2001). As a result, a considerable number of tourist studies have been carried out in diverse cultural tourism festivals(Backman et al., 1995; Crompton & Mckay, 1997; Park, 1998; Clawson & Knetch, 1996). Much of previous literature empirically shows the close linkage between tourist satisfaction and behavioral intention in festivals. The main objective of this study is to investigate the effects of evaluation attributes of cultural tourism festivals on satisfaction and behavioral intention. accomplish the research objective, to find out evaluation items of cultural tourism festivals through the literature study an empirical study. Using a varimax rotation with Kaiser normalization, the research obtained four factors in the 18 evaluation attributes of cultural tourism festivals. Some empirical studies have examined the relationship between behavioral intention and actual behavior. To understand between tourist satisfaction and behavioral intention, this study suggests five hypotheses and hypothesized model. In this study, the analysis is based on primary data collected from visitors who participated in '2006 Gwangju Kimchi Festival'. In total, 700 self-administered questionnaires were distributed and 561 usable questionnaires were obtained. Respondents were presented with the 18 satisfactions item on a scale from 1(strongly disagree) to 7(strongly agree). Dimensionality and stability of the scale were evaluated by a factor analysis with varimax rotation. Four factors emerged with eigenvalues greater than 1, which explained 66.40% of the total variance and Cronbach' alpha raging from 0.876 to 0.774. And four factors named: advertisement and guides, programs, food and souvenirs, and convenient facilities. To test and estimate the hypothesized model, a two-step approach with an initial measurement model and a subsequent structural model for Structural Equation Modeling was used. The AMOS 4.0 analysis package was used to conduct the analysis. In estimating the model, the maximum likelihood procedure was used.In this study Chi-square test is used, which is the most common model goodness-of-fit test. In addition, considering the literature about the Structural Equation Modeling, this study used, besides Chi-square test, more model fit indexes to determine the tangibility of the suggested model: goodness-of-fit index(GFI) and root mean square error of approximation(RMSEA) as absolute fit indexes; normed-fit index(NFI) and non-normed-fit index(NNFI) as incremental fit indexes. The results of T-test and ANOVAs revealed significant differences(0.05 level), therefore H1(Tourist Satisfaction level should be different from Demographic traits) are supported. According to the multiple Regressions analysis and AMOS, H2(Tourist Satisfaction positively influences on revisit intention), H3(Tourist Satisfaction positively influences on word of mouth), H4(Evaluation Attributes of cultural tourism festivals influences on Tourist Satisfaction), and H5(Tourist Satisfaction positively influences on Behavioral Intention) are also supported. As the conclusion of this study are as following: First, there were differences in satisfaction levels in accordance with the demographic information of visitors. Not all visitors had the same degree of satisfaction with their cultural tourism festival experience. Therefore it is necessary to understand the satisfaction of tourists if the experiences that are provided are to meet their expectations. So, in making festival plans, the organizer should consider the demographic variables in explaining and segmenting visitors to cultural tourism festival. Second, satisfaction with attributes of evaluation cultural tourism festivals had a significant direct impact on visitors' intention to revisit such festivals and the word of mouth publicity they shared. The results indicated that visitor satisfaction is a significant antecedent of their intention to revisit such festivals. Festival organizers should strive to forge long-term relationships with the visitors. In addition, it is also necessary to understand how the intention to revisit a festival changes over time and identify the critical satisfaction factors. Third, it is confirmed that behavioral intention was enhanced by satisfaction. The strong link between satisfaction and behavioral intentions of visitors areensured by high quality advertisement and guides, programs, food and souvenirs, and convenient facilities. Thus, examining revisit intention from a time viewpoint may be of a great significance for both practical and theoretical reasons. Additionally, festival organizers should give special attention to visitor satisfaction, as satisfied visitors are more likely to return sooner. The findings of this research have several practical implications for the festivals managers. The promotion of cultural festivals should be based on the understanding of tourist satisfaction for the long- term success of tourism. And this study can help managers carry out this task in a more informed and strategic manner by examining the effects of demographic traits on the level of tourist satisfaction and the behavioral intention. In other words, differentiated marketing strategies should be stressed and executed by relevant parties. The limitations of this study are as follows; the results of this study cannot be generalized to other cultural tourism festivals because we have not explored the many different kinds of festivals. A future study should be a comparative analysis of other festivals of different visitor segments. Also, further efforts should be directed toward developing more comprehensive temporal models that can explain behavioral intentions of tourists.
Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(