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A Study on the Risk Factors for Maternal and Child Health Care Program with Emphasis on Developing the Risk Score System (모자건강관리를 위한 위험요인별 감별평점분류기준 개발에 관한 연구)

  • 이광옥
    • Journal of Korean Academy of Nursing
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    • v.13 no.1
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    • pp.7-21
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    • 1983
  • For the flexible and rational distribution of limited existing health resources based on measurements of individual risk, the socalled Risk Approach is being proposed by the World Health Organization as a managerial tool in maternal and child health care program. This approach, in principle, puts us under the necessity of developing a technique by which we will be able to measure the degree of risk or to discriminate the future outcomes of pregnancy on the basis of prior information obtainable at prenatal care delivery settings. Numerous recent studies have focussed on the identification of relevant risk factors as the Prior infer mation and on defining the adverse outcomes of pregnancy to be dicriminated, and also have tried on how to develope scoring system of risk factors for the quantitative assessment of the factors as the determinant of pregnancy outcomes. Once the scoring system is established the technique of classifying the patients into with normal and with adverse outcomes will be easily de veloped. The scoring system should be developed to meet the following four basic requirements. 1) Easy to construct 2) Easy to use 3) To be theoretically sound 4) To be valid In searching for a feasible methodology which will meet these requirements, the author has attempted to apply the“Likelihood Method”, one of the well known principles in statistical analysis, to develop such scoring system according to the process as follows. Step 1. Classify the patients into four groups: Group $A_1$: With adverse outcomes on fetal (neonatal) side only. Group $A_2$: With adverse outcomes on maternal side only. Group $A_3$: With adverse outcome on both maternal and fetal (neonatal) sides. Group B: With normal outcomes. Step 2. Construct the marginal tabulation on the distribution of risk factors for each group. Step 3. For the calculation of risk score, take logarithmic transformation of relative proport-ions of the distribution and round them off to integers. Step 4. Test the validity of the score chart. h total of 2, 282 maternity records registered during the period of January 1, 1982-December 31, 1982 at Ewha Womans University Hospital were used for this study and the“Questionnaire for Maternity Record for Prenatal and Intrapartum High Risk Screening”developed by the Korean Institute for Population and Health was used to rearrange the information on the records into an easy analytic form. The findings of the study are summarized as follows. 1) The risk score chart constructed on the basis of“Likelihood Method”ispresented in Table 4 in the main text. 2) From the analysis of the risk score chart it was observed that a total of 24 risk factors could be identified as having significant predicting power for the discrimination of pregnancy outcomes into four groups as defined above. They are: (1) age (2) marital status (3) age at first pregnancy (4) medical insurance (5) number of pregnancies (6) history of Cesarean sections (7). number of living child (8) history of premature infants (9) history of over weighted new born (10) history of congenital anomalies (11) history of multiple pregnancies (12) history of abnormal presentation (13) history of obstetric abnormalities (14) past illness (15) hemoglobin level (16) blood pressure (17) heart status (18) general appearance (19) edema status (20) result of abdominal examination (21) cervix status (22) pelvis status (23) chief complaints (24) Reasons for examination 3) The validity of the score chart turned out to be as follows: a) Sensitivity: Group $A_1$: 0.75 Group $A_2$: 0.78 Group $A_3$: 0.92 All combined : 0.85 b) Specificity : 0.68 4) The diagnosabilities of the“score chart”for a set of hypothetical prevalence of adverse outcomes were calculated as follows (the sensitivity“for all combined”was used). Hypothetidal Prevalence : 5% 10% 20% 30% 40% 50% 60% Diagnosability : 12% 23% 40% 53% 64% 75% 80%.

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Origin and Storage of Large Woody Debris in a Third-order Mountain Stream Network, Gangwon-do, Korea (강원도 산지계류 내 유목의 기원과 현존량)

  • Kim, Suk Woo;Chun, Kun Woo;Seo, Jung Il;Lim, Young Hyup;Nam, Sooyoun;Jang, Su Jin;Kim, Yong Suk;Lee, Jae Uk
    • Korean Journal of Environment and Ecology
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    • v.34 no.3
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    • pp.249-258
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    • 2020
  • This study aims to provide reference material for effective forest management techniques at the catchment scale, based on the field investigation of large woody debris (LWD) in 11 streams within a third-order forest catchment in Gangwon Province, Korea. To achieve this aim, we analyzed the morphological features of LWD pieces, and the storage and distribution status of LWD by stream order throughout the entire investigation. As a result, a total of 1,207 individual pieces of LWD were categorized into three types as follows: (ⅰ) 1,142 pieces (95%) as only trunk and 65 pieces (5%) as a trunk with root wad, (ⅱ) 1,015 pieces (84%) as non-thinned and 192 pieces (16%) as the thinned, and (ⅲ) 1,050 pieces (87%) as conifer and 157 pieces (13%) as broadleaf. Additionally, in-stream LWD loads (㎥/ha) decreased with increasing stream order, yielding 105.4, 71.3, and 35.6 for first-, second-, and third-order streams, respectively. On the other hand, the ratio of LWD jams to the total LWD volume increased with increasing stream order, yielding 11%, 43%, and 49% for first-, second-, and third-order streams, respectively. Finally, a comparison of the in-stream LWD load with previous studies in several countries around the world indicated that in-stream LWD load was positively correlated with forest stand age even though the climate, topography, forest soil type, forest composition, stand growth rate, disturbance regime, and forest management practices were different. These results could contribute to understanding the significance of LWD as a by-product of forest ecosystems and an indicator of riparian forest disturbance. Based on this, we conclude that advanced forest management techniques, including treatment of thinning slash and stand density control of riparian forest by site location (hillslope and riparian zone, or stream order), should be established in the future, taking the forest ecosystem and the aquatic environment from headwater streams to low land rivers into consideration.

Association between antioxidant vitamin intake and obesity among Korean women: using the Korea National Health and Nutrition Examination Survey 2007 ~ 2016 (우리나라 성인 여성의 항산화비타민 섭취량과 비만의 연관성 : 2007 ~ 2016년 국민 건강영양조사 자료를 이용하여)

  • Ham, Dongwoo;Kim, Seong-Ah;Jun, Shinyoung;Kang, Min-Sook;Joung, Hyojee
    • Journal of Nutrition and Health
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    • v.51 no.5
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    • pp.400-413
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    • 2018
  • Purpose: This study examined the association between the antioxidant vitamin intake and obesity in Korean women. Methods: Adult women aged ${\geq}19years$ who completed a health examination and nutrition survey from the Korea National Health and Nutrition Examination Survey between 2007 ~ 2016 were selected for the study (n = 30,425). A BMI ${\geq}25kg/m^2$ and waist circumference ${\geq}85cm$ were defined as obesity and abdominal obesity, respectively. The individual antioxidant vitamin intake was estimated by linking the antioxidant vitamin composition database of commonly consumed foods and the subjects' 24-hour recall food consumption data. Carotenoids, retinol, vitamin A (retinol activity equivalent), vitamin C, tocopherols, and vitamin E (${\alpha}$-tocopherol equivalent) were included in the analysis. Each vitamin intake was converted to the nutrient density per 1,000 kcal. Odds ratio (ORs) and 95% confidence interval (CI) for obesity according to each tertile of the nutrient density was obtained from multiple logistic regression adjusted for age, household income, education level, smoking, alcohol consumption, and physical activity. Results: The mean intake of ${\alpha}$-carotene, retinol, vitamin E, ${\alpha}$-tocopherol, and ${\gamma}$-tocopherol per 1,000 kcal was significantly lower in the obese group than in the normal group. A higher intake of lycopene was inversely associated with obesity (highest vs. lowest; OR = 0.89, 95% CI: 0.83-0.96) and abdominal obesity (highest vs. lowest; OR = 0.88, 95% CI: 0.81-0.95). Higher intakes of ${\alpha}$-carotene, total carotenoids, vitamin A, and ${\gamma}$-tocopherol also had a negative relationship with abdominal obesity. The antioxidant vitamin intakes from eggs, milk and dairy products, seasoning, and grains were significantly lower in the obese group than in the normal group. Conclusion: This study showed that the dietary intake of antioxidant vitamins was inversely associated with obesity and abdominal obesity among Korean women. Further study will be needed to examine the causal relationship between the antioxidant vitamin and obesity.

Reconsideration of Acer pictum complex in Korea (한국산(韓國産) 고로쇠분류군(分類群)에 대한 재고(再考))

  • Chang, Chin-Sung
    • Korean Journal of Plant Taxonomy
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    • v.31 no.3
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    • pp.283-309
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    • 2001
  • Acer pictum complex (A. pictum Thunb. ex Murray with varieties, A. okamotoanum Nakai, A. truncatum Bunge) in eastern Asia causes frequent difficulty in identification. One hundred twenty five specimens from A. pictum complex of China, Korea and Japan and A. cappadocicum var. sinicum of China were compared to investigate patterns of intra- and interspecific variation and to evaluate a recognition of several species as well as many varieties using 22 characters for morphometric analysis. The first three PCA accounted for 59% of the total variance. No strong discontinuities existed among taxa with respect to fruit and leaf characters. Much overlap among all taxa occurred the central region of the scatter diagram. Many characters appeared to show some clinal variation with changes from east of China to Japan through Korea. This was true not only when all species as considered as a single taxon, but when characters of individual taxa were compared with geography. As one considers a path from the western part of the ranges to areas to the east, the leaves become larger in most respects and become increasingly many lobed (five to seven or nine). In general, there was a tendency toward larger nutlet with smaller wing in the area toward northeast of China (=A. truncatum), while in the east of ranges (Island Ullung-do), plants were larger with respect to characters of fruit and leaves (=A. okamotoanum). The morphological differentiation between A. okamotoanum and Japanese and Korean individuals of A. pictum was not considered sufficient to warrant recognition of either specific or varietal status and should be treated as con specific under A. pictum var. mono. Since the lectotype of Acer pictum had minute hairs uniformly on the under surface of leaves(A. pictum var. pictum), the glabrous type of A. pictum was called A. pictum var. mono as Ohahsi suggested. The univaraite analysis (the mean and maximum/minium of nutlet size and wing/nutlet length ratio) indicated geographical differentiation of northeastern populations, A. truncatum, was distinctive, but Korean individuals of A. truncatum showed an affinity between Chinese individuals of A. truncatum and Korean individuals of A. Pictum var. mono. The current results, together with qualitative character, trunk features, justify subspecific status for this taxon. The previous varieties of A. mono in Korea were indistinguishable from typical form of A. Pictum var. mono on the basis of the wing angle and nutlet size, rejecting continued recognition of these taxa as distinctive varieties. Therefore, it is recommended that only one polymorphic species of A. pictum be recognized in addition to three varieties.

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Development of computer program for the Growth Function in plant Growth Analysis: Effect of Seed Weight and Resources on Growth of Wild Radish (Raphanus raphanistrum) (植物의 成長과 成長解析에 對한 Computer Program 開發에 關한 硏究 - 種子의 무게, 資源이 植物의 成長에 미치는 影響)

  • Choe, Hyun Sup
    • The Korean Journal of Ecology
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    • v.13 no.3
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    • pp.225-236
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    • 1990
  • We studied that seeds of wild radish with different size of weight can be obtained for the purpose of differentiation and growth of these seeds by total growth periods. This study is practised a view of plant eco-physiological side and dry-matter production. Through whole growth periods, we knowthat seed weight of L plots was higher than that of M and S plots. In the 33th day after day after germination, growth values of L, M and S plots were 13.93, 7.77, and 4.61 g/plant, respectively. Growth of shoot (cotyledon and leaf) area and shoot weight were shown the similar trends with individual plant dry-amtter weight. In the 33th day after germination, shoot area of L, M and S plots were 21.55, 11.81 and 8.75 $cm^3$/plant and shoot dry weight of L, M and S plots were 10.83, 6.03, 3.50 g/plant, respectively. In the early stage of growth (the 10-14th day after germination), the values of RGR of seed weight of L, M, S plots were 0.2887, 0.2807 and 0.2365 g/g/day, in the late stage of growth, those values of RGR of L, M, S plote were 0.2721, 0.1716, 0.1727 g/g/day, respectively. In the early stage of growth (the 14th day after germination), the values of NAR or L, M and S plots were 0.1513, 0.1373, and 0.1094 g/$cm^2$/day, respectively. It is thought that seed weights were influenced seriously effect in the early stage of growth. The NAR value, in the late stage of growth (the-28-33th day after germination), of L, M and S plots were not large different as 0.1086, 0.1097 and 0.112 g/$cm^2$/day, respectively. The LAR values of M and S (2.0396, 2.1520 $m^2$/g) plots, in the early stage of growth, were higher than L (1.9037 $m^2$/g) plots. In the late stage of growth, the value of LAR of L plots were nearly same as M plots, but the value of S plots were higher than that of L and M plots (0.0458 $m^2$/g). And, in the early stage of growth, the values of SLA of L, M and S plots were 2.2123, 2.2107 and 2.8448 $m^2$/g, respectively. We measured the photosynthetic rates and the respiratory rates as the physiological characteristics of wild radish. In the early stage of growth, the photosynthetic rates of L, M and S plots were 12.4, 14.4, 9.8 $\mu$mol /$m^2$/sec and 9.4, 11.4, 9.8 $\mu$mol/$m^2$ /sec in the late stage of growth, respectively. In this result, it could be informed that photosynthetic rates in the late stage of growth were lower than the early stage. In the middle stage of growth, the respiratory rates were 0.793, $\mu$mol/$m^2$/min in shoot, and 3.28 $\mu$mol/$m^2$/min in root without relation to seed weight. The growth analysis of plants was used by Hunt & Parson s computer program (1974, 1981) and its results used this program were good. Therefore, in this sense, it could be expected that the computer program used and developed largely in researches of plant growth.

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Multilateral Approach to forming Air Logistics Hub on North East Asia Region (동북아 항공물류허브을 구축하기 위한 다자적 접근방안)

  • Hong, Seock-Jin
    • The Korean Journal of Air & Space Law and Policy
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    • v.19 no.2
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    • pp.97-136
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    • 2004
  • The Northeast Asian air cargo market has expanded tremendously as a result of the opening up of the Chinese market. The importance of the Asia-Pacific region in the global air transport has also increased. The exchange of human and material resources, services, and information in Northeast Asia, which is expected to increase in the near future, requires that the airlines operating within this region adopt a more liberalized approach. This paper introduced alternatives which can be applied to the Northeast Asian airlines industry so as to bring about the integration of regional air transport: First, this paper found a need for individual Northeast Asian nations to alter their policies towards the airlines industry. Second, each country should further liberalize their respective domestic air transport. Third, there is a need for freer air service agreements to be signed between the nations of Northeast Asia. Fourth, the strategic alliances between the airlines operating in Northeast Asia should be further strengthened. Fifth, this liberalization process should be carried out in an incremental manner, beginning with more competitive airports and routes, or with less-in-demand routes. Sixth, there is a need for a shuttle system to be put into place between the main airports in China, Korea, and Japan. Seventh, these three nations jointly develop aviation safety and security systems that are in accordance with international standards. Eighth, the liberalization process of the aviation industry should be undertaken in conjunction with other related fields. Ninth, organizations linking together civil aviation organization in the Asia-Pacific area should be formed, as should each government linking together. By doing so, these countries will be able to establish regular venues through which to exchange opinions on the integration and liberalization of the air cargo market so as to induce the gradual liberalization of the actual market. The liberalization of the air transport in Northeast Asia will prove to be a daunting task in the short term. However, if the Chinese airlines continue to exhibit continuous growth and Japanese airlines are able to complete their move towards a low-cost structure, this process could be completed earlier than expected. Over the last twenty five years the air transport has undergone tremendous changes. The most important factor behind these changes has been the increased liberalization of the market. As a result, rates have decreased while demand has increased. This has resulted in turning the air transport industry, which was long perceived as an industry in decline, into a high-growth industry. The only method of increasing regional exchanges in the air transport is to pursue further liberalization. The country which implements this liberalization process at the earliest date may very well emerge as a leading force within the air transport industry.

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Structural Analysis of the Community Welfare Problems -In Busanjingu, Busan, Korea- (지역사회복지의 문제점에 관한 구조화분석 -부산진구를 대상으로-)

  • Park, Jung-Mi;Park, Sung-Hyun;Yu, Dong-Chul
    • Korean Journal of Social Welfare
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    • v.64 no.1
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    • pp.199-223
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    • 2012
  • The purpose of this study is to clarify the mechanism and essence of problems by understanding the whole structure of the complicated problems that exist in the social welfare field with DEMATEL method, one of structural models. This paper consists of (1) What kind of social welfare problems exist in the community that is related to welfare? (2) What kind of thoughts do people who work in social welfare field have related to these problems? (3) Are there any differences in structure of thoughts among social welfare civil servants who take charge of planning and dividing budgets for community welfare, social workers who provide services personally and civic activists who criticize and keep watch on behalf of civilians? In order to achieve the purpose of this study, data were collected in Busan Busanjingu and the survey was conducted from the year of 2005 when community welfare plan was first established up to now. The major structural problems of the community welfare of the Pusan Jin-gu, Korea, are: 1) welfare budget allocation procedure is not logical, 2) the outskirts of the Pusan Jin-gu are isolated as poor areas, 3) geographic imbalance is severe among communities, and 4) the social welfare response system to support future population structure needs to be more developed. All of these problems are the fundamental origin to the social resource disparity within communities. The major problems of the community social welfare in Pusan Jin-gu, Korea were recognized by different perspective in terms of professional career such as social welfare civil servants, social workers, and civic activists. Majority of the social welfare civil servants thought "severe geographic imbalance"; majority of the social workers believed "lack of the social welfare response system to support the structure of the population in the future" and "disparity in social resources within the communities"; and majority of the civic activists said "limitation for understanding various social welfare needs because of short term need assessments" as main issues of the community social welfare. It seems that this paper is able to be used as a framework to establish community welfare plans and individual programs in Busan Busanjingu.

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Ecological Health Assessments on Turbidwater in the Downstream After a Construction of Yongdam Dam (용담댐 건설후 하류부 하천 생태계의 탁수영향 평가)

  • Kim, Ja-Hyun;Seo, Jin-Won;Na, Young-Eun;An, Kwang-Guk
    • Korean Journal of Ecology and Environment
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    • v.40 no.1
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    • pp.130-142
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    • 2007
  • This study was to examine impacts of turbid water on fish community in the downstream of Yongdam Dam during the period from June to October 2006. For the research, we selected six sampling sites in the field: two sites were controls with no influences of turbid water from the dam and other remaining four sites were the stations for an assessment of potential turbid effects. We evaluated integrative health conditions throughout applications of various models such as necropsy-based fish health assessment model (FHA), Index of Biological Integrity (IBI) using fish assemblages, and Qualitative Habitat Evaluation Index (QHEI). Laboratory tests on fish exposure under 400 NTU were performed to find out impact of turbid water using scanning electron microscope (SEM). Results showed that fine solid particles were clogging in the gill in the treatments, while particles were not found in the control. This results indicate that when inorganic turbidity increases abruptedly, fish may have a mechanical abrasion or respiratory blocking. The stream health condition, based on the IBI values, ranged between 38 and 48 (average: 42), indicating a "excellent" or "good" condition after the criteria of US EPA (1993). In the mean time, physical habitat condition, based on the QHEI, ranged 97 to 187 (average 154), indicating a "suboptimal condition". These biological outcomes were compared with chemical dataset: IBI values were more correlated (r=0.526, p<0.05, n=18) with QHEI rather than chemical water quality, based on turbidity (r=0.260, p>0.05, n=18). Analysis of the FHA showed that the individual health indicated "excellent condition", while QHEI showed no habitat disturbances (especially bottom substrate and embeddeness), food-web, and spawning place. Consequently, we concluded that the ecological health in downstream of Yongdam Dam was not impacted by the turbid water.

The Associated Factors of Health Examinations Behaviors among Some Elderly Persons in Urban and Rural Areas (일부 도시·농촌지역 고령자의 건강검진 수진행동에 관련된 요인)

  • Kim, Yong-Ik;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.1-14
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    • 2004
  • Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

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Factors Affecting the Implementation Success of Data Warehousing Systems (데이터 웨어하우징의 구현성공과 시스템성공 결정요인)

  • Kim, Byeong-Gon;Park, Sun-Chang;Kim, Jong-Ok
    • Proceedings of the Korea Society of Information Technology Applications Conference
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    • 2007.05a
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    • pp.234-245
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    • 2007
  • The empirical studies on the implementation of data warehousing systems (DWS) are lacking while there exist a number of studies on the implementation of IS. This study intends to examine the factors affecting the implementation success of DWS. The study adopts the empirical analysis of the sample of 112 responses from DWS practitioners. The study results suggest several implications for researchers and practitioners. First, when the support from top management becomes great, the implementation success of DWS in organizational aspects is more likely. When the support from top management exists, users are more likely to be encouraged to use DWS, and organizational resistance to use DWS is well coped with increasing the possibility of implementation success of DWS. The support of resource increases the implementation success of DWS in project aspects while it is not significantly related to the implementation success of DWS in organizational aspects. The support of funds, human resources, and other efforts enhances the possibility of successful implementation of project; the project does not exceed the time and resource budgets and meet the functional requirements. The effect of resource support, however, is not significantly related to the organizational success. The user involvement in systems implementation affects the implementation success of DWS in organizational and project aspects. The success of DWS implementation is significantly related to the users' commitment to the project and the proactive involvement in the implementation tasks. users' task. The observation of the behaviors of competitors which possibly increases data quality does not affect the implementation success of DWS. This indicates that the quality of data such as data consistency and accuracy is not ensured through the understanding of the behaviors of competitors, and this does not affect the data integration and the successful implementation of DWS projects. The prototyping for the DWS implementation positively affects the implementation success of DWS. This indicates that the extent of understanding requirements and the communication among project members increases the implementation success of DWS. Developing the prototypes for DWS ensures the acquirement of accurate or integrated data, the flexible processing of data, and the adaptation into new organizational conditions. The extent of consulting activities in DWS projects increases the implementation success of DWS in project aspects. The continuous support for consulting activities and technology transfer enhances the adherence to the project schedule preventing the exceeding use of project budget and ensuring the implementation of intended system functions; this ultimately leads to the successful implementation of DWS projects. The research hypothesis that the capability of project teams affects the implementation success of DWS is rejected. The technical ability of team members and human relationship skills themselves do not affect the successful implementation of DWS projects. The quality of the system which provided data to DWS affects the implementation success of DWS in technical aspects. The standardization of data definition and the commitment to the technical standard increase the possibility of overcoming the technical problems of DWS. Further, the development technology of DWS affects the implementation success of DWS. The hardware, software, implementation methodology, and implementation tools contribute to effective integration and classification of data in various forms. In addition, the implementation success of DWS in organizational and project aspects increases the data quality and system quality of DWS while the implementation success of DWS in technical aspects does not affect the data quality and system quality of DWS. The data and systems quality increases the effective processing of individual tasks, and reduces the decision making times and efforts enhancing the perceived benefits of DWS.

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