• (The)Study of the Eastern Classic
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• no.69
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• pp.115-146
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• 2017

This paper is about the research on ontology design for a digital archive of seonsaengan(先生案) of the Joseon Period. Seonsaengan is the register of staff officials at each government office, along with their personal information and records of their transfer from one office to another, in addition to their DOBs, family clan, etc. A total of 176 types of registers are known to be kept at libraries and museums in the country. This paper intends to engage in the ontology design of 47 cases of such registers preserved at the Jangseogak Archives of the Academy of Korean Studies (AKS) with a focus on their content and structure including the names of the relevant government offices and posts assumed by the officials, etc. The work for the ontology design was done with a focus on the officials, the offices they belong to, and records about their transfers kept in the registers. The ontology design categorized relevant resources into classes according to the attributes common to the individuals. Each individual has defined a semantic postposition word that can explicitly express the relationship with other individuals. As for the classes, they were divided into eight categories, i.e. registers, figures, offices, official posts, state examination, records, and concepts. For design of relationships and attributes, terms and phrases such as Dublin Core, Europeana Data Mode, CIDOC-CRM, data model for database of those who passed the exam in the past, which are already designed and used, were referred to. Where terms and phrases designed in existing data models are used, the work used Namespace of the relevant data model. The writer defined the relationships where necessary. The designed ontology shows an exemplary implementation of the Myeongneung seonsaengan(明陵先生案). The work gave consideration to expected effects of information entered when a single registered is expanded to plural registers, along with ways to use it. The ontology design is not one made based on the review of all of the 176 registers. The model needs to be improved each time relevant information is obtained. The aim of such efforts is the systematic arrangement of information contained in the registers. It should be remembered that information arranged in this manner may be rearranged with the aid of databases or archives existing currently or to be built in the future. It is expected that the pieces of information entered through the ontology design will be used as data showing how government offices were operated and what their personnel system was like, along with politics, economy, society, and culture of the Joseon Period, in linkage with databases already established.

• 한국노년학
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• v.41 no.2
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• pp.197-215
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• 2021

This study aims to evaluate Person Centered Care practice and characteristics of care services in Korean long-term care facilities using Dementia Care Mapping as a tool. DCM, systematic observational evaluation tool for measuring dementia patients' QOL, was transformed into self-report rating scale. The process of transforming DCM into a scale of 34 items involves operationalization of DCM concepts and it's adaptation into Korean long-term care practices. Review by research team of Bradford university was added to maintain DCM concept and meaning in this scale. The scale with Cronbach alpha of .88 was surveyed on 343 care workers. Survey result shows PCC value practiced by them is 3.77(of 5 likert scale) and values on each categories of PCC reveal the characteristics of care in Korean facilities; attachment(4.02), comfort(3.95), inclusion(3.89), identity(3.67) and occupation(3.41). Dementia care in Korean facilities focuses on recipients'safety, comfort but lacks individualistic care and the meaningful and fulfilling occupation for patients. Looking at the organizational and individual factors influencing DCM values, the small facilities showed higher PCC values and there are no significant difference in PCC values between public and private facilities. Managers and care workers with career of 1~2 years showed higher PCC values compared to other career ranks and lengthes. This study suggests care practice should be centered on personhood of patients in long-term care facilities, for which introduction of unit care and education of PCC for service providers including support personnel are needed. DCM and Korean DCM scale developed in this study are suggested for the PCC-based assessment on care quality.

• Journal of the Korean Society for Library and Information Science
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• v.56 no.4
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• pp.491-514
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• 2022

Public reforms based on New Public Management have made the public sector specialized, and accordingly the role of public administration has expanded as well as the demand on professional jobs has increased. On the other hand, with the rapid development of information and communication technology, the data produced by public sector organizations has also significantly increased. This environmental changes made data management and a data management job in the public sector critical. However, there have been very few studies of conceptualizations and systematic investigations on data management jobs. Moreover, specific definitions, types or qualifications of/for a data management job or a person who do this job are rarely reflected in relevant laws and regulations. Based on the systematic literature review, this study conceptualized professionalism, identified its multiple dimensions, and draw a conceptual research framework. Focusing on the professional control on personnel management which is one of the dimensions of professionalism, relevant laws, work guidelines and job descriptions included in job openings were analyzed with regard to a data management job in the public sector. The findings are as follows. First, an assigned role and responsibility associated with a data management job have vague boundaries. Second, work guidelines and manuals only focus on the post quality control stage rather than equally addressing all the eight stages of the data lifecycle. Third, neither a data management job in the public sector nor a person who take care of this job is not appropriately defined. Therefore, a role and responsibility of/for the job and a person in charge should be reflected in the relevant laws and guidelines in a tailored way. More importantly, job analyses and evaluations should be thoroughly conducted to enhance professionalism on data management jobs in the long term.

• The Journal of KAIRB
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• v.2 no.1
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• pp.23-31
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• 2020

Purpose: To obtain opinions from Korean Institutional Review Board (IRB) members' self-evaluation on ability to conduct fairness review of clinical trial protocol with presence of conflict of interest and from investigators and IRB members on financial conflict of interest through surveying. Methods: IRB members and researchers in 9 different hospitals were asked to answer survey questions via email. Results: Responders were 115 personnel (IRB Chair/vice 18, medical member 30, non-medical member 28, and researcher 39) from 9 centers. Compared to IRB medical members, IRB chair/vice respondents scored higher with statistically significance on 10 point scale (8.44±1.381 vs. 7.30±1.685, p=0.005) when asked to self-evaluate fairness reviewing a protocol proposed by an investigator from the same department and a protocol from the company that supports the scientific committee of responders. When reviewing a protocol proposed by a hospital director, non-medical members scored statistically significantly higher than medical-members (7.47±1.76 vs. 8.07±2.70, p=0.034). When asked about the limitation of labor fee for principal investigator on phase 3 Human clinical trials of the Investigational new drug, while the responses range was wide, 60% answered that labor cost of principal investigator should be less than 30% of total budget for clinical trials with a budget of 100 million won. 51.3% answered that there is no need to disclose the labor cost of the principal investigator in the consent form. Since every investigator can be influenced unconsciously by conflict of interest, the answer that 'responder agrees that there is need for management' was the most chosen answer (IRB member 61.8%, investigator 64.1%, multiple answers allowed). Conclusion: Considering scores on questions of fairness by IRB members were between 7.23-8.56 on scale of 0 to 10 point when IRB members were asked about reviewing a clinical trial protocol, it cannot be said with absolute certainty that there is no issue regarding fairness in the review process. Therefore, there should be more ways to safeguard fairness for these issues. There is a need that the disclosure amount of honorarium from sponsor should be lower than 100 million Korean won. Considering the results of the survey in which respondents expressed their thoughts, it is likely that more education on the concept of conflict of interest is needed.

• Journal of Korea Society of Industrial Information Systems
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• v.28 no.6
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• pp.53-62
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• 2023

This paper has suggested the necessity of introducing training contents using XR(Extended reality) technology as a way to lower the high rate of nursing accidents among unskilled technical personnel in domestic shipbuilding industry, focusing on cable pulling using winch. The occurrence rate of nursing accidents in the domestic shipbuilding industry was almost double(197.4%) (2017~2020) when compared with other manufacturing industries. In particular, it is worth noting that more than 31.8% of nursing accidents in the shipbuilding industry occurred among workers whose job experience is no more than 6 months. Most of new workers are seen to have hard time due to several factors such as lack of work information, inexperience, and unfamiliarity with the working environments. This indicates that it is essential to incorporate more effective training method that could help new workers become familiar with technical skills as well as working environments in a short period of time. Currently, education/training at the domestic shipyard is biased toward technical skills such as welding, painting, machine installation, and electrical installation. Contrary, even more important training required to get new workers used to the working environment has remained at a superficial level such as explaining ship building processes using 2D drawings. This may be the reason why it is inevitable to repeat similar training at OJT (On-the-Job Training) even at the leading domestic companies. Domestic shipbuilding industries have been attracting a lot of new workers thanks to recent economic recovery, which is very likely to increase the occurrence of disasters. In this paper, the introduction of training using XR technology was proposed, and as a specific example, the process of pulling cables using winches on ships was implemented as XR-based training content by using Unity. Using the developed content, it demonstrated that new workers can experience the actual work process in advance through simulation in a virtual space, thereby becoming more effective training content that can help new workers become familiar with the work environment.

• Journal of Global Scholars of Marketing Science
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• v.20 no.3
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• pp.239-248
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• 2010

This paper describes a collaborative project between academia and industry which focused on improving the marketing and product development strategies for two private label apparel brands of a large regional department store chain in the southeastern United States. The goal of the project was to revitalize product lines of the two brands by incorporating student ideas for new solutions, thereby giving the students practical experience with a real-life industry situation. There were a number of key players involved in the project. A privately-owned department store chain based in the southeastern United States which was seeking an academic partner had recognized a need to update two existing private label brands. They targeted middle-aged consumers looking for casual, moderately priced merchandise. The company was seeking to change direction with both packaging and presentation, and possibly product design. The branding and product development divisions of the company contacted professors in an academic department of a large southeastern state university. Two of the professors agreed that the task would be a good fit for their classes - one was a junior-level Intermediate Brand Management class; the other was a senior-level Fashion Product Development class. The professors felt that by working collaboratively on the project, students would be exposed to a real world scenario, within the security of an academic learning environment. Collaboration within an interdisciplinary team has the advantage of providing experiences and resources beyond the capabilities of a single student and adds "brainpower" to problem-solving processes (Lowman 2000). This goal of improving the capabilities of students directed the instructors in each class to form interdisciplinary teams between the Branding and Product Development classes. In addition, many universities are employing industry partnerships in research and teaching, where collaboration within temporal (semester) and physical (classroom/lab) constraints help to increase students' knowledge and experience of a real-world situation. At the University of Tennessee, the Center of Industrial Services and UT-Knoxville's College of Engineering worked with a company to develop design improvements in its U.S. operations. In this study, Because should be lower case b with a private label retail brand, Wickett, Gaskill and Damhorst's (1999) revised Retail Apparel Product Development Model was used by the product development and brand management teams. This framework was chosen because it addresses apparel product development from the concept to the retail stage. Two classes were involved in this project: a junior level Brand Management class and a senior level Fashion Product Development class. Seven teams were formed which included four students from Brand Management and two students from Product Development. The classes were taught the same semester, but not at the same time. At the beginning of the semester, each class was introduced to the industry partner and given the problem. Half the teams were assigned to the men's brand and half to the women's brand. The teams were responsible for devising approaches to the problem, formulating a timeline for their work, staying in touch with industry representatives and making sure that each member of the team contributed in a positive way. The objective for the teams was to plan, develop, and present a product line using merchandising processes (following the Wickett, Gaskill and Damhorst model) and develop new branding strategies for the proposed lines. The teams performed trend, color, fabrication and target market research; developed sketches for a line; edited the sketches and presented their line plans; wrote specifications; fitted prototypes on fit models, and developed final production samples for presentation to industry. The branding students developed a SWOT analysis, a Brand Measurement report, a mind-map for the brands and a fully integrated Marketing Report which was presented alongside the ideas for the new lines. In future if the opportunity arises to work in this collaborative way with an existing company who wishes to look both at branding and product development strategies, classes will be scheduled at the same time so that students have more time to meet and discuss timelines and assigned tasks. As it was, student groups had to meet outside of each class time and this proved to be a challenging though not uncommon part of teamwork (Pfaff and Huddleston, 2003). Although the logistics of this exercise were time-consuming to set up and administer, professors felt that the benefits to students were multiple. The most important benefit, according to student feedback from both classes, was the opportunity to work with industry professionals, follow their process, and see the results of their work evaluated by the people who made the decisions at the company level. Faculty members were grateful to have a "real-world" case to work with in the classroom to provide focus. Creative ideas and strategies were traded as plans were made, extending and strengthening the departmental links be tween the branding and product development areas. By working not only with students coming from a different knowledge base, but also having to keep in contact with the industry partner and follow the framework and timeline of industry practice, student teams were challenged to produce excellent and innovative work under new circumstances. Working on the product development and branding for "real-life" brands that are struggling gave students an opportunity to see how closely their coursework ties in with the real-world and how creativity, collaboration and flexibility are necessary components of both the design and business aspects of company operations. Industry personnel were impressed by (a) the level and depth of knowledge and execution in the student projects, and (b) the creativity of new ideas for the brands.

• Journal of Intelligence and Information Systems
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• v.26 no.3
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• pp.71-90
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• 2020

Recently, the global insurance industry is rapidly developing digital transformation through the use of artificial intelligence technologies such as machine learning, natural language processing, and deep learning. As a result, more and more foreign insurers have achieved the success of artificial intelligence technology-based InsurTech and platform business, and Ping An Insurance Group Ltd., China's largest private company, is leading China's global fourth industrial revolution with remarkable achievements in InsurTech and Digital Platform as a result of its constant innovation, using 'finance and technology' and 'finance and ecosystem' as keywords for companies. In response, this study analyzed the InsurTech and platform business activities of Ping An Insurance Group Ltd. through the ser-M analysis model to provide strategic implications for revitalizing AI technology-based businesses of domestic insurers. The ser-M analysis model has been studied so that the vision and leadership of the CEO, the historical environment of the enterprise, the utilization of various resources, and the unique mechanism relationships can be interpreted in an integrated manner as a frame that can be interpreted in terms of the subject, environment, resource and mechanism. As a result of the case analysis, Ping An Insurance Group Ltd. has achieved cost reduction and customer service development by digitally innovating its entire business area such as sales, underwriting, claims, and loan service by utilizing core artificial intelligence technologies such as facial, voice, and facial expression recognition. In addition, "online data in China" and "the vast offline data and insights accumulated by the company" were combined with new technologies such as artificial intelligence and big data analysis to build a digital platform that integrates financial services and digital service businesses. Ping An Insurance Group Ltd. challenged constant innovation, and as of 2019, sales reached $155 billion, ranking seventh among all companies in the Global 2000 rankings selected by Forbes Magazine. Analyzing the background of the success of Ping An Insurance Group Ltd. from the perspective of ser-M, founder Mammingz quickly captured the development of digital technology, market competition and changes in population structure in the era of the fourth industrial revolution, and established a new vision and displayed an agile leadership of digital technology-focused. Based on the strong leadership led by the founder in response to environmental changes, the company has successfully led InsurTech and Platform Business through innovation of internal resources such as investment in artificial intelligence technology, securing excellent professionals, and strengthening big data capabilities, combining external absorption capabilities, and strategic alliances among various industries. Through this success story analysis of Ping An Insurance Group Ltd., the following implications can be given to domestic insurance companies that are preparing for digital transformation. First, CEOs of domestic companies also need to recognize the paradigm shift in industry due to the change in digital technology and quickly arm themselves with digital technology-oriented leadership to spearhead the digital transformation of enterprises. Second, the Korean government should urgently overhaul related laws and systems to further promote the use of data between different industries and provide drastic support such as deregulation, tax benefits and platform provision to help the domestic insurance industry secure global competitiveness. Third, Korean companies also need to make bolder investments in the development of artificial intelligence technology so that systematic securing of internal and external data, training of technical personnel, and patent applications can be expanded, and digital platforms should be quickly established so that diverse customer experiences can be integrated through learned artificial intelligence technology. Finally, since there may be limitations to generalization through a single case of an overseas insurance company, I hope that in the future, more extensive research will be conducted on various management strategies related to artificial intelligence technology by analyzing cases of multiple industries or multiple companies or conducting empirical research.

• Journal of Environmental Health Sciences
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• v.17 no.2
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• pp.54-66
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• 1991

As a result of measuring illumination and making up a question at home visit directly by investigator who trained over twenty days period from October 4 to 24, 1990, in order to render help which illumination problem against house, society against eyes or framing of health instruction potgram by seizing natural lighting actual conditions of house and actual conditions of wearing spectacles and by investigating interrelationship, I can summarize as follows. 1) In property of investigation subject, woman 66.9%, In an age, the twenties was largest of 27.4%, the forties was 20.2%, the fifties was 18.6%, the thirties was 17.4%. In academic career, those of upper secondary school grauates was largest of 28.6%, those who possess university career was 25.9%, those who middle school career was 20.9%, decoding of Korean alphabet was 2%. 2) By a residence area, a big city was 43.3%, farming and fishing villages were 20.3%, the rest was a small town and the administrative office of town, township. In positon of house, the middle area was 43.6%, resident of suburb area was 38.0%. In form of house, a Korean-style house was 40.8%, a western-style house was 34.8%, an apartment house was 11.0%. In the a standard of living, the middle classes 77.2%, the lower classes were 15.3%. In residential house unit of area, from 21 to 30 unit of area was largest of 31.5%, from 10 to 20 unit of area was 19.9%, from 31 to 40 was 18.7%. 3) The wearing spectacles rate of study user was 44.1%. By the area, those who wearing spectacles was more than a half of 50.8% in the resident of big city area. As passing from the farm area to the city, that is being resident of big city was high wearing spectacles rate. In position of house, as being residence in central street showed high wearing spectacles rate. (central street was 51.5%, the middle area was 44.5% and the suburb area was 40.1%.) It seemed similarity difference a variable by position of house from wearing spectacles in standard of 1%. By form of house, wearing spectacles rate those who resident in apartment house was 49.5%, that rate those who resident in a western-style house was high of 49.0%, that rate those who resident in a Korean-style house was the lowest 39.0%. By social position of resident in room, in students case who study showed very high, as university students were very high of 62.3% idn wearing spectacles rate, middle and high school students 'were 50.0%, members of society were 47.6%, workers 20.3%. It seemed similarity difference from academic career in standard of 1%. By an age, the thirties was high of 54.1% in wearing spectacles rate, the twenties was 43.2%, the teenage was the lowest of 11.8%. 4) In illumination of study, over 200Lux was high of 40.1%. but below 99Lux which inappropriate illumination to see the books was 32.4%. Average by area, below 99Lux was 22.7% and over 400Lux was 50.0% in case of wooden floor. As examine by area, below 99Lux was high of 27.0% a case of wooden floor in the big city area, it was not good in illumination passing from the farm area(15.0%) to the city(19.0%). Average illlumination by area of the main living room below 99Lux was high of 37.5%, less than 200Lux was 58.5% of whole. In general, illumination of the main livingroom was inappropriate. By area, the big city was 32.5% below 99Lux, the middle and small city area were 33.8%, town and township area were 45.0%, farming and fishing area were 42.8%. By area, in the big city, illumination of study was 52.5% over 200Lux and 28.9% below 99Lux. In case of the middle and small city, study user of below 99Lux was 38.8% and over 200Lux was 46.9%. In case of the seat of town township, below 99Lux was 34.1% and over 200Lux was 39.7%. In case of farming and fishing area, illumination of study was 33.4% below 99Lux and 48.4% over 200Lux. It tends to high rate of inappropriate illumination. 5) By position of house, in case of wooden floor, less than 100Lux was 24.5% in central street. It was bad illumination than others position of house. In case of the main livingroom, less than 100Lux was 40.4% in the suburb area. It was bad iliumnation than others position of house. In case of study, less than 100Lux was 35.4% in the middle area, it was worse in illumination. In case of the main living room, is seemed similarity difference in standard of 1%. 6) By form of house, in case of wooden floor, illumination of less than 100Lux was 23.8% in a western-style house, it was bad illumination than others form of house. In case of the main livingroom, illumination of less than 100Lux was 47.4% in a Korean-style house, it was remarkably bad illumination than others form of house. In case of study, a Korean-style house was 38.8%, it was very bad illumination than others form of house. In case of the main livingroom and study, it seemed similatrity difference each as P < 0.01 and P < 0.05 in standard of 1%. 7) The wearing spectacles rate of those who use room of illumination over 400Lux was 40.7%, and that of those who use room of illumination less than 100Lux was 28.1%. It seemed similarity differecce in standard of 1%. 8) In period of wearing spectacles, 21.3% of total investigator-highest-was from before five years, 8.6% was from before three years. Among those who use of illumintion less than 99Lux, 34.0% began to wear spectacles from before two years 31.7% was from before five years, 30.3% was from before four years. It seemed similarity difference from period of wearing spectacles by illumination in standard of 1 %. 9) Among cause which sight grow worse, the first was that it was each 33.2% and 27.4% in response rate because watch TV nearly to wearing spectacles person and non-wearing person. The second was that a lot of seeing books was 25.3% in wearing spectacles person and response rate for dark illumination was 7.4% in nonwearing spectacles person. It seemed similarity difference in standard of 1%. (P < 0.01). 10) In experience which take medicine good for eyes, it was 50.1% in wearing spectacles person and 8.5% in non-wearing spectacles person. It seemed similarity difference in standard of 1%(P < 0.01). As we have seen above, inappropriate illumination can be a cause of wearing spectacles. Nevertheless, actually, is realities to indifferent against illumination of house. So it must learn knowledge about health obstacle of illumination through society instruction and school eduction against students as well as general residents. In case that natural lighting is inappropriate structural of house, we must be able to maintain appropriate illumination through artificial illumination. And so eyes which is core of human life have to be protected, related the authorities, related group, and all health medical personnel will organically cooperate with and make efforts.

• Journal of Intelligence and Information Systems
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• v.27 no.1
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• pp.1-21
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• 2021

As the global business environment changes, uncertainties in technology development and market needs increase, and competition among companies intensifies, interests and demands for R&D activities of individual companies are increasing. In order to cope with these environmental changes, R&D companies are strengthening R&D investment as one of the means to enhance the qualitative competitiveness of R&D while paying more attention to facility investment. As a result, facilities or R&D investment elements are inevitably a burden for R&D companies to bear future uncertainties. It is true that the management strategy of increasing investment in R&D as a means of enhancing R&D capability is highly uncertain in terms of corporate performance. In this study, the structural factors that influence the R&D capabilities of companies are explored in terms of technology management capabilities, R&D capabilities, and corporate classification attributes by utilizing data mining techniques, and the characteristics these individual factors present according to the level of R&D capabilities are analyzed. This study also showed cluster analysis and experimental results based on evidence data for all domestic R&D companies, and is expected to provide important implications for corporate management strategies to enhance R&D capabilities of individual companies. For each of the three viewpoints, detailed evaluation indexes were composed of 7, 2, and 4, respectively, to quantitatively measure individual levels in the corresponding area. In the case of technology management capability and R&D capability, the sub-item evaluation indexes that are being used by current domestic technology evaluation agencies were referenced, and the final detailed evaluation index was newly constructed in consideration of whether data could be obtained quantitatively. In the case of corporate classification attributes, the most basic corporate classification profile information is considered. In particular, in order to grasp the homogeneity of the R&D competency level, a comprehensive score for each company was given using detailed evaluation indicators of technology management capability and R&D capability, and the competency level was classified into five grades and compared with the cluster analysis results. In order to give the meaning according to the comparative evaluation between the analyzed cluster and the competency level grade, the clusters with high and low trends in R&D competency level were searched for each cluster. Afterwards, characteristics according to detailed evaluation indicators were analyzed in the cluster. Through this method of conducting research, two groups with high R&D competency and one with low level of R&D competency were analyzed, and the remaining two clusters were similar with almost high incidence. As a result, in this study, individual characteristics according to detailed evaluation indexes were analyzed for two clusters with high competency level and one cluster with low competency level. The implications of the results of this study are that the faster the replacement cycle of professional managers who can effectively respond to changes in technology and market demand, the more likely they will contribute to enhancing R&D capabilities. In the case of a private company, it is necessary to increase the intensity of input of R&D capabilities by enhancing the sense of belonging of R&D personnel to the company through conversion to a corporate company, and to provide the accuracy of responsibility and authority through the organization of the team unit. Since the number of technical commercialization achievements and technology certifications are occurring both in the case of contributing to capacity improvement and in case of not, it was confirmed that there is a limit in reviewing it as an important factor for enhancing R&D capacity from the perspective of management. Lastly, the experience of utility model filing was identified as a factor that has an important influence on R&D capability, and it was confirmed the need to provide motivation to encourage utility model filings in order to enhance R&D capability. As such, the results of this study are expected to provide important implications for corporate management strategies to enhance individual companies' R&D capabilities.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

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