• Title/Summary/Keyword: The Rural Residents

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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A Review of Current Status and Placeness on the Yusang-Goksu Ruins in Hwanggak-dong, Geumma, Iksan (익산 금마 황각동 유상곡수 유적 일대의 현황과 장소성에 대한 일고찰)

  • Rho, Jae-Hyun;Han, Min-Soon;Seo, Youn-Mi;Park, Yool-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.3
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    • pp.20-35
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    • 2022
  • This study was conducted on the locational results of the 'Yusanggoksu(流觴曲水)' petroglyphs located in Hwanggak-dong(黃閣洞), Shinsong-ri, Geumma-myeon, Iksan-si through literature study, analysis of old maps and aerial photos, field observations, drone photography, elevation surveys, and interviews with residents. It was attempted for the purpose of illuminating and preserving the relics of the domestic Yusanggoksu garden by clarifying the spatiality of this place by tracing the spatiality and examining the possibility of enjoying the Yusanggoksu water system in this place. The conclusion of this study is as follows. The area around Hwanggak-dong, where the Yusanggoksu remains, has been selected as the most beautiful scenic spot in Iksan in various documents. The origin of 'Hwanggak' is considered to be closely related to the nickname of Uijeongbu(議政府). In other words, he paid attention to the relationship with Yanggok, So Se-yang(蘇世讓), who served as Chan-seong Jwa(左贊成). In particular, he paid attention to the relationship with his birthplace, Taeheojeong, a separate book, and Toehyudang, a retreat hall), tombs, and posthumous Confucian academies were distributed in the vicinity. Haseo-dae(荷鋤臺), a wide rock on which a hoe is hung on a rock after field work, seems to express a leisurely rural life and a simple and hermit life, based on the examples of Chinese and Korean poetry. The dark blood on the upper part of the Seobwi Rock with the inscription 'Yusanggoksu', which is the core of this site, is identified as a chailgong(遮日孔) to support the water system, and Ilgan-pavilion and Mojeong(茅亭) nearby are to support the yusanggoksu. It seems to have performed a spatial function for The inscription 'Hwanggak-dong' engraved on the front of Deungzanbawi is the gateway to Hwanggakdongcheon(黃閣洞天) and identified the idealized world existing in the village. Judging from the documentary records of the Iksan-gun 『Chongswaelog(叢瑣錄)』, the rock letters 'Hwanggak-dong' and 'Haseodae' were engraved on March 29, 1901, the 5th year of Gwangmu, the 5th year of the Korean Empire, by Iksan-gun Governor Oh Haeng-mook(吳宖默) and his acquaintance Seokseong Kim In-gil(金寅吉) Confirmed. Also, considering the tense of Lee Bong-gu's 「Hwanggakdongun(黃閣洞韻)」 and So Jin-deok, a descendant of Yanggok, 「Hwanggakdongsihoe(黃閣洞詩會)」, it is presumed that it was related to Goksuyeon(曲水宴) in Hwanggak-dong. It can be inferred that the current affairs meetings were held at least until the early days of Japanese colonial rule. Meanwhile, the maximum width of the current curved waterway was calculated as 11.3m and the transverse slope was 15.0%. If so, it is estimated that the width and extension distance of the curved waterway would have been much longer. Judging from the use of mochun(暮春), drinking and poetry, the tense 'Hwanggakdongsihoe' related to the Yusanggoksu relics in Hwanggak-dong, and the existence of a pavilion presumed to be Yusangjeong(流觴亭) called Ilgan-pavilion in the nearby Yusanggoksu site It is confirmed that it was a space where Yusanggoksuyeon(流觴曲水宴) spread at least until the end of the Joseon Dynasty. Unfortunately, it remains a limitation of the study that it cannot be confirmed due to lack of data on the rock characters of 'Yusanggoksu' and those who enjoyed it before the end of the Joseon Dynasty. This is an area that needs to be elucidated through continuous efforts to find data on this issue in the future.

Recognition and Attitude to Implement at ion of Service Area Assigned System of Public Health Programs among the Health Officer (공공보건사업의 지역담당제 실시에 관한 보건기관 근무 공무원의 인식과 태도)

  • Kim, Mi-Soon;Lee, Moo-Sik;Kim, Nam-Song
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.15-41
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    • 2001
  • Since medical clients and the community they live in are expected to be center of future public health and medical care system, new service programs must be developed with patients focused on in line with widening public access of information and social participation. Patients- focused service shall mean the area- oriented provision of public health service. In this study, health officers working at public health centers, public health sub- centers and medical offices in Jeonbuk- do area were taken for population in order to investigate their attitudes toward and knowledge about the service area assigning system under the public health programs. Findings from the survey to 260 health officers, divided by general category, are as follows : Government officers at public health organizations appeared to have high grade of understanding to the service area assigning system and also great appreciation for the necessity of it. Regarding the timing for the system to be introduced, they support the gradual implementation and, as for the type of service to be provided, they preferred home nursing and treatment of chronic diseases. Highly positive responses were centered on the health classes under the health promotion projects, and as far as health projects for the old are concerned, services for home nursing, for the disabled and for home- alone people are favored most. On the other hand, budgeting, manpower and reorganization are rated as prerequisite to establishment of the service area assigning system. From the viewpoint of system side, the improvement of working conditions is rendered as most urgent, while the information system for establishing the service area assigning system is conceived far from satisfactory. Proper assignment of specialists was noted as mostly important to establish the delivery system for medical service through the service area assigning system by team. As merits of the service area assigning system, it is pointed out that, through the system, health clients can better be managed and the nursing quality will be improved thank to the enhanced specialization. It is also perceived that the district health service is not well prepared to respond to the increased and diversified needs of community people and, furthermore, service programs of health centers have not been fully developed. The most serious problem standing in the way to expansion of health projects is, it is noted, uniformity (formality) of the project. Based on the results of the survey which suggest time has ripen to introduce the service area assigning system, following strategies are proposed to anchor down the system as soon as possible: First, we should introduce the system gradually, starting from the area selected, and in consideration of area specialities, refraining from the hitherto stereotyped way of providing health service. Second, we should seek to properly assign the specialists and improve the working conditions of the assigned officers by securing sufficient budget, since it is a most urgent step to lay foundation for the service area assigning system. Third, best service program should be developed to meet the satisfaction of community people by responding to their needs and solidifying the management of medical clients. Fourth, wide scope of study should further be conducted in order to help this system take roots in the central living of community residents since pilot project on the experimental base attended by specialists only can not win popularity among the masses.

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A Study on the Characteristics and Management Plan of Old Big Trees in the Sacred Natural Sites of Handan City, China (중국 한단시 자연성지 내 노거수의 특성과 관리방안)

  • Xi, Su-Ting;Shin, Hyun-Sil
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.41 no.2
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    • pp.35-45
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    • 2023
  • First, The spatial distribution characteristics of old big trees were analyzed using ArcGIS figures by combining basic information such as species and ages of old big trees in Handan City, which were compiled by the local bureau of landscaping. The types of species, distribution by ages of trees, ownership status, growth status, and diversity status were comprehensively analyzed. Statistically, Styphnolobium, Acacia, Gleditsia, and Albizia of Fabaceae accounted for the majority, of which Sophora japonica accounted for the highest proportion. Sophora japonica is widely and intensively distributed to each prefecture and district in Handan city. According to the age and distribution, the old big trees over 1000 years old were mainly Sophora japonica, Zelkova serrata, Juniperus chinensis, Morus australis Koidz., Dalbergia hupeana Hance, Ceratonia siliqua L., and Pistacia chinensis, and Platycladus orientalis. Second, as found in each type of old big tree status, various types of old big tree status were investigated, the protection management system, protection management process, and protection management benefits were studied, and the protection of old big tree was closely related to the growth environment. Currently, the main driving force behind the protection of old big trees is the worship of old big trees. By depositing its sacredness to the old big tree and sublimating the natural character that nature gave to the old big tree into a guiding consciousness of social activities, nature's "beauty" and personality's "goodness" are well combined. The protection state of the old big tree is closely related to the degree of interaction with the surrounding environment and the participation of various cultures and subjects. In the process of continuously interacting with the surrounding environment during the long-term growth of old big trees, it seems that a natural sanctuary was formed around old big trees in the process of voluntarily establishing a "natural-cultural-scape" system involving bottom-up and top-down cross-regions, multicultural and multi-subjects. Third, China focused on protecting and recovering old big trees, but the protection management system is poor due to a lack of comprehensive consideration of historical and cultural values, plant diversity significance, and social values of old big trees in the management process. Three indicators of space's regional characteristics, property and protection characteristics, and value characteristics can be found in the evaluation of the natural characteristics of old giant trees, which are highly valuable in terms of traditional consciousness management, resource protection practice, faith system construction, and realization of life community values. A systematic management system should be supported as to whether they can be protected and developed for a long time. Fourth, as the perception of protected areas is not yet mature in China, "natural sanctuary" should be treated as an important research content in the process of establishing a nature reserve system. The form of natural sanctuary management, which focuses on bottom-up community participation, is a strong supplement to the current type of top-down nature reserve management in China. Based on this, the protection of old giant trees should be included in the form of a nature reserve called a natural monument in the nature reserve system. In addition, residents of the area around the nature reserve should be one of the main agents of biodiversity conservation.

Association of Health-related Behaviors with Socio-demographic Characteristics (건강증진과 관련된 행태에 영향을 미치는 인구사회학적 특성)

  • Roh, Won-Hwan;Kim, Seok-Beom Gib;Kang, Pock-Soo
    • Journal of agricultural medicine and community health
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    • v.23 no.2
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    • pp.157-174
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    • 1998
  • A survey was conducted to study the influence of socia-demographic factors on health-related behaviors. from June 1 to July 31, 1996. The study population was 1,903 adults in Kyongju City. A questionnaire method was used to collect data. Health-related behaviors included 24 items for men and 26 items for women. The followings are summaries of findings : The compliance of health promotion activities was higher when the age was older in men, when married, when having no religion and when the education level was higher than the other groups. And it was significantly higher when the income was lower in men and higher in women, in the residents living in apartment, in white collar workers, in the chronic ill people and when the body weight was lower than the other groups. Notable differences were found in the composition of health behavior factors for socio-demographic characteristics. Men used more tobacco, coffee and tea, salt and alcohol than women. However, the practice rates of regular exercise and physical examination were higher in men than women. On the other hand, the practice rates of fruit/vegetable intake, milk drinking and regular tooth brushing were higher in women than men. When the age was old, the amount of fruit/vegetable intake, the frequency of physician visit and health check-up, and regularity of meal were increased. When the income was high, the use rate of seat-belts, the amount of coffee, milk, fruit/vegetable and red meat intake were increased. The frequency of regular exercise. tooth brushing, health check-up, pap test and breast self examination were higher in the rich than the poor. When the education level was high, the frequency of regular exercise and tooth brushing, and the use rate of seat belts were increased, and the amount of alcohol consumption and salt intake were decreased. These findings suggest that socio-demographic factors are significantly associated with the patterns of health behaviors. In conclusion public health programs and individual counseling efforts should be multifaceted and behavior-specific to encourage to practice healthy life-style.

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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Anthropometric Measurements and Biochemical Nutritional Status of the Older Residents (50 years and over) in Andong Area (2) (안동주변 농촌지역 50세 이상 주민의 신체계측치 및 생화학적 영양상태에 관한 연구 (2))

  • Lee, Hye-Sang;Kwun, In-Sook;Kwon, Chong-Suk
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.12
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    • pp.1599-1608
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    • 2008
  • This study aimed to assess the health status based on the anthropometric and biochemical measurements of middle-aged and elderly people living in Andong area. The subjects were 1,384 people (532 males, 852 females) aged 50 years and over (average 62.7 years). The mean anthropometric values for males and females were heights of 163.7 and 151.5 cm; weights 63.6 and 57.3 kg; body mass index (BMI) 23.6 and $24.9kg/m^2$; body fat 21.8 and 31.8%, respectively. Height and weight were lower, however, waist circumference (in female) and BMI were higher than those of the 2001 National Health and Nutrition Survey (NHNS). Obesity incidences of male and female subjects were 28.7% and 47.3% by BMI; 25.8% and 50.8% by % body fat; and 15.6% and 80.9% by waist circumference, respectively. Also, abdominal adiposity was very severe in female subjects of 50s. The mean biochemical measurements of male and female were as follows: systolic and diastolic blood pressure 136.9, 83.8 mmHg and 133.6, 82.5 mmHg; hemoglobin (Hb) 14.3 and 13.0 g/dL; hematocrit (Ht) 44.7 and 39.8%; blood albumin 4.15 and 4.04 g/dL; total-cholesterol 170.0 and 183.1 mg/dL; HDL-cholesterol 43.6 and 42.7 mg/dL; fasting blood glucose 96.7 and 93.0 mg/dL, respectively. Also, the prevalence of biochemically abnormal subjects according to each cut-off point of biochemical measurements were analyzed. The results for male and female were; hypertension 58.0% and 47.2%; iron deficient anemia 19.3% and 20.6% by Hb, 7.2% and 11.9% by Ht; hypoalbuminemia 9.8% and 11.7%; diabetes 12.0% and 10.2%; hypercholesterolemia 19.5% and 30.5%, respectively. From those results we found that hypoalbuminemia, hypertension and hypercholesterolemia were prevalent, and obesity in females of 50s, iron-deficient anemia and diabetes in males of 70 years and over were significant health problems in this area. Therefore, it seems to be necessary to examine their health status periodically and provide the appropriate health and nutrition education program, which includes low sodium intake, balanced diet, exercise and weight control, to prevent the occurrence of chronic diseases.