• The Korean Journal of Archival Studies
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• no.69
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• pp.95-128
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• 2021

As interest in private records began to develop in the research of archivists, discussions began about the value of private records and how to collect and manage private records from the standpoint of archivists. After that, the conceptual discussion on community archives, from the point of view of the community, collecting and preserving their own records, and the democratization of records and the sovereignty of records are discussed. As a result of this trend, maeul making projects were started in each region, and citizen archivists appeared who do archives activities. and research on the role and system of public institutions to support them and community archives. Recently, as research on regional record activities has begun, the current status of education and activities in each region is being announced. in addition archives education programs are being actively conducted nationwide to train citizen archivists. The purpose of this thesis is to find out their identity of their, in order to cultivate sustainable citizen archivists and to suggest the direction the citizen archivists training program should pursue. First, we consider that the educational goal of citizen archivists training program is to train citizen archivists who practice the knowledge learned through education, and examine the identity of 'citizen archivist', the goal of training education. In this study, local archivists are regarded as local members who engage in archiving activities based on their locality, and they are judged to be the main actors and core beings in building community archives. Also the activities of citizen archivists are viewed as active and subjective beings that realize 'Archival autonomy' by implementing 'Archival autonomy'. In addition, it analyzes the cases of researchable citizen archivist training programs in Korea that were conducted to foster local archivists and examines the current situation. Finally, the direction of citizen archivists training program for cultivating citizen archivists is presented. In this paper, I think that the citizen archivists training program should be designed as a curriculum to parctice the education goal, not as public program.

• Journal of Intelligence and Information Systems
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• v.28 no.4
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• pp.251-273
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• 2022

Recently, research on applying text analysis to deep learning has steadily continued. In particular, researches have been actively conducted to understand the meaning of words and perform tasks such as summarization and sentiment classification through a pre-trained language model that learns large datasets. However, existing pre-trained language models show limitations in that they do not understand specific domains well. Therefore, in recent years, the flow of research has shifted toward creating a language model specialized for a particular domain. Domain-specific pre-trained language models allow the model to understand the knowledge of a particular domain better and reveal performance improvements on various tasks in the field. However, domain-specific further pre-training is expensive to acquire corpus data of the target domain. Furthermore, many cases have reported that performance improvement after further pre-training is insignificant in some domains. As such, it is difficult to decide to develop a domain-specific pre-trained language model, while it is not clear whether the performance will be improved dramatically. In this paper, we present a way to proactively check the expected performance improvement by further pre-training in a domain before actually performing further pre-training. Specifically, after selecting three domains, we measured the increase in classification accuracy through further pre-training in each domain. We also developed and presented new indicators to estimate the specificity of the domain based on the normalized frequency of the keywords used in each domain. Finally, we conducted classification using a pre-trained language model and a domain-specific pre-trained language model of three domains. As a result, we confirmed that the higher the domain specificity index, the higher the performance improvement through further pre-training.

• Journal of The Korean Association For Science Education
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• v.43 no.1
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• pp.49-57
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• 2023

The purpose of this study is to analyze the school biology curriculum of the Royal Society of Biology (RSB) for school biology education in the United Kingdom (UK), and to examine the implications for Korean school biology education. The RSB school biology curriculum consists of three dimensions (the practices of biology, the concepts of biology, and the application of biology) and seven big questions. The contents of RSB school biology curriculum are structured according to age, 5-11, 11-16, and 16-19. The practices of biology of the UK RSB school biology curriculum emphasize biology activities should be linked to other communities and communicated and shared through evidence-based discussions. The concepts of biology dimension of the UK RSB school biology curriculum systematized the contents to be detailed considering school-level and ages with 5-7, 7-11, 11-14, 14-16, and 16-19 years old. The UK RSB biology curriculum is composed of human health, biological structure and function, biological growth and reproduction, and biological coexistence, showing a significant difference from Korean national curriculum when comparing the content elements with the core concepts of biology. In terms of the application of biology of the RSB school biology curriculum, three themes were commonly applied to all students, regardless of school level or age, such as development of application methods to promote health and environmental welfare, evaluation of the impact and application of biology knowledge. However, the content elements of the three themes were systematized according to the ages of 5-11, 11-16, and 16-19 years old. It is necessary to reorganize the contents of biology curriculum in Korea by referring to the content system of the UK RSB biology curriculum and to research ways to strengthen connectivity according to age or school level as well as dimensions and big questions.

• Journal of The Korean Association For Science Education
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• v.43 no.6
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• pp.549-562
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• 2023

The current society is in the VUCA era, where various risks produced by humans are spread along with the development of science and technology. There is a need to increase the level of risk literacy of citizens to strengthen their daily preparedness to respond to these risks. For this on, it is necessary to reconsider the role of science education so that risks can be perceived and responded to scientifically and objectively. Accordingly, in order to investigate the role of science education in a risk society, this study reviewed the history of risk perception and response related to science and analyzed its characteristics. In this process, perception and response to risks arising from blood pressure were analyzed in three contexts (historical context, curriculum context, textbook context). For historical context, journals registered in SCIE were selected as research subjects among journals where research related to the history of knowledge of the heart and cardiovascular system was conducted. Papers with the keywords 'hypertension' and 'history' were selected from the journals, and changes in perception and responses related to blood pressure were compared and analyzed by period. The curriculum context is analyzed from the 1st national curriculum to the 2022 revised curriculum, and content elements and achievement standard related to blood pressure were compared and analyzed. It was confirmed that risks arising from blood pressure were not included from the 1st to the 6th national curriculum, and that risks arising from blood pressure were included from the 7th national curriculum (excluding the 2009 revised curriculum). For the textbook context, the 7th national curriculum BiologyⅠ, the 2015 revised curriculum Life ScienceⅠ, and Health were selected, and through text mining, keywords that representing curriculums and textbooks were selected, and the presentation of risk perception and response was analyzed based on the keywords. And by analyzing the figures and tables presented in the textbook, the characteristics of risk perception and risk response were derived. This study is meaningful in that it was able to confirm the role of risk perception and response in science education.

• Journal of Preventive Medicine and Public Health
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• v.31 no.1 s.60
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• pp.139-156
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• 1998

Diving related disease including decompression sickness is an important occupational health problem and diving fishermen remain a fairly hazardous occupation in Korea. To prevent diving related disease, we investigate diving patterns, incidence of diving related diseases, and contributing factors of 433 diving fishermen of three coast interviewing and mailing questionnaire in 1996. Mean age of divers was 39.7 years, ranged from 24 to 58 years, 92.8% of these were male, and 58.4% of divers were high school graduates. Mean duration of work as a diver was 12.9 years, ranged from 2 to 40 years. It was found that 70.4% of divers were using hookah system, 22.2% of helmet, and only 2.5% SCUBA. About half of them have learned diving skills from other divers. The peak season of diving was from April to June and mean working days were 20.3 days per month during the peak season. On the average, the divers dived 5-6 times, ranged from 1 to 10 times a day with 51.1 minutes of diving time, ranged from 20 to 120 minutes, at 30 m or 40 m in depth, and 35.5 minute of interval on surface. Most divers ascended slowly making decompression stop, yet the decompression profile used was not based on any scientific knowledge except for their own experiences. It appeared that each diving system had slightly different diving patterns. There were 282(65.0%) divers that suffered from DCS in 1995 and 31.2% of divers were given recompression therapy at a medical facility since they worked as diving fishermen. Skin and musculoskeletal complaints were common symptoms of DCS and 39% of divers experienced a voiding difficulty. In univariate analysis, females have an increased frequency of DCS(93% vs 66% for males). Old age, long duration of work, helmet diving, diving time, diving depth, repetitive diving, and blow up were all contributing factors to DCS. It was found that most diving patterns exceed no decompression limit and did not use the standard decompression table. This suggests that most of divers are at high risk of developing diving related disease with prolonged dives and lengthy repetitive diving in deep depth. Considering the diving patterns and economic aspect of professional diving, the incidence of DCS among diving fishermen in Korea will not decrease in the near future. These findings suggest that periodical health surveillance for divers, and education of health and safety are important for reducing the risk of diving related disease in the population of diving fishermen.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.4
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• pp.14-23
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• 2014

The purpose of this study is to contribute in building credibility of the methodology of the appearance of the traditional colors and the interpretation of the meaning of those appearances by analyzing the spatial construction and configuration and the traditional colors that appear in spatial elements about the scenery component that appear in Seyeonjeong. We conducted a literature research about the traditional colors, the background of the creation of Seyeonjeong, and etc. For the contents for the empirical analysis, we took the scenery and space elements in the poems, such as Eobusasisa and O-u-ga, and the contents of poems related to ojeongsaek (five Korean traditional colors) based on the Yin-Yang and the Five Elements ideology Particularly, after dividing the spatial elements appearing in Seyoenjeong into visual, synesthetic, symbolic/cognitive spatial element, we further distinguished the visual space into positions and directions of the of the spaces and the scenery of the season; the synesthetic space into seasons, time and five senses; and the symbolic/cognitive space into chiljeong (or the seven passions) and sadan (or the four clues). Then we carried out the study by analyzing the correlation between the intention of the garden creation and the meaning of the spaces, through the analysis of ojeongsaek system for each spatial element. Firstly, spatial structure and format that appear in Seyeonjeong can be divided into two directional axes of southeast and northwest according to the flat form of the Seyeongjeong's rectangular palace, with Seyeongjoeng as the center. Secondly, in spatial component element, the frequencies of appearance of the traditional colors of Seyoenjeong are 33.2% for white, 20.8% for blue, 20.8% for black, 18.7% for red and 6.3% for yellow. Thirdly, based on the analysis of the traditional colors the most frequent appearance of 'white' left a room for interpretation like the creation of Seyeonjeong was to enjoy secular living without lingering political feelings so that the high mountains remain clear and clean. Also, the predominant frequency of appearance of blue, similar frequency of appearance of black and red, and the least frequent appearance of yellow is in agreement with or can be at least interpreted related to Yun Seon-do's intention for creating Seyeonjeong not for political rank or power but as a place to enjoy nature, through which he can build on his knowledge, and to lead rest of his life as a noble being through plays, like dancing and writing poems. Fourthly, these interpretations of the analysis of the frequency of appearance of the traditional colors of Seyeongjong shows the reliability, validity, and consistency of the methodology of the analysis of the frequency of appearance of the traditional colors and the interpretation of the meanings in the context that the color white appears most frequently in Soswewon as well and that the background life of the Soswewon's creator Yangsanbo can be interpreted in a similarly way. Above all, this study is significant from the fact that we proposed a theory about the method of analysis and interpretation of the traditional colors in a traditional landscape space. Moreover, there is a great significance of discovering that traditional colors appear in traditional spaces and this can be used as a methodological framework to interpret things like, intention for creation of (buildings/architectures).

• Proceedings of the Korean DIstribution Association Conference
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• 2005.05a
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• pp.383-405
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• 2005

The traditional market is foremost a regionally positioned place, wherein the market directly represents regional and cultural centered traits while it plays an important role in the circulation of facilities through reciprocal, informative and cultural exchanges while sewing to form local communities. The traditional market in Korea is one of representative retail businesses and premodern marketing techniques by family owned business of less than five members such as product management, purchase method, and marketing patterns etc. Since the 1990s, the appearance of new circulation-type businesses and large discount convenience stores escalated the loss of traditional competitiveness, increased the living standard of customers, changed purchasing patterns, and expanded the ubiquity of the Internet. All of these changes in external circulation circumstances have led the traditional markets to lose their place in the economy. The traditional market should revive on a regional site basis through the formation of a community of regional neighbors and through knowledge-sharing that leads to the creation of wealth. For the purpose of creating a wealth in a place, the following components are necessary: 1) a facility suitable for the spatial place of the present, 2)trust built through exchanges within the changing market environment, which would simultaneously satisfy customer's desires, 3) international bench marking on cases such as regionally centered TCM (England), BID (USA), and TMO (Japan) so that the market unit of store placement transfers from a spot policy to a line policy, 4)conversion of communicative conception through a surface policy approach centered around a macro-region perspective. The budget of the traditional market funding policy was operational between 2001 and 2004, serving as a counter move to solve the problem of the old traditional market through government intervention in regional economies to promote national economic strength. This national treasury funding project was centered on environmental improvement, research corps, and business modernization through the expenditure of 3,853 hundred million won (Korean currency). However, the effectiveness of this project has yet to be to proven through investigation. Furthermore, in promoting this funding support project, a lack of professionalism among merchants in the market led to constant limitations in comprehensive striving strategies, reduced capabilities in middle-and long-term plan setup, and created reductions in voluntary merchant agreement solutions. The traditional market should go beyond mere physical place and ordinary products creative site strategies employing the communicative approach must accompany these strategies to make the market a new regional and spatial living place. Thus, regarding recent paradigm changes and the introduction of region-based site functions into the traditional market, acquiring a conversion of direction into the newly developed project is essential to reinvestigate the traditional market composed of cultural and economic meanings, for the purpose of the research. Excavating social policy demands through the comparative analysis of domestic and international cases as well as innovative and expert management leadership development for NPO or NGO civil entrepreneurs through advanced case research on present promotion methods is extremely important. Discovering the seeds of the cultural contents industry cored around regional resource usages, commercializing regionally reknowned products, and constructing complex cultural living places for regional networks are especially important. In order to accelerate these solutions, a comprehensive and systemized approach research operated within a mentor academy system is required, as research will reveal distinctive traits of the traditional market in the aging society.

• Journal of Intelligence and Information Systems
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• v.25 no.1
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• pp.21-41
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• 2019

Thanks to the rapid development of information technologies, the data available on Internet have grown rapidly. In this era of big data, many studies have attempted to offer insights and express the effects of data analysis. In the tourism and hospitality industry, many firms and studies in the era of big data have paid attention to online reviews on social media because of their large influence over customers. As tourism is an information-intensive industry, the effect of these information networks on social media platforms is more remarkable compared to any other types of media. However, there are some limitations to the improvements in service quality that can be made based on opinions on social media platforms. Users on social media platforms represent their opinions as text, images, and so on. Raw data sets from these reviews are unstructured. Moreover, these data sets are too big to extract new information and hidden knowledge by human competences. To use them for business intelligence and analytics applications, proper big data techniques like Natural Language Processing and data mining techniques are needed. This study suggests an analytical approach to directly yield insights from these reviews to improve the service quality of hotels. Our proposed approach consists of topic mining to extract topics contained in the reviews and the decision tree modeling to explain the relationship between topics and ratings. Topic mining refers to a method for finding a group of words from a collection of documents that represents a document. Among several topic mining methods, we adopted the Latent Dirichlet Allocation algorithm, which is considered as the most universal algorithm. However, LDA is not enough to find insights that can improve service quality because it cannot find the relationship between topics and ratings. To overcome this limitation, we also use the Classification and Regression Tree method, which is a kind of decision tree technique. Through the CART method, we can find what topics are related to positive or negative ratings of a hotel and visualize the results. Therefore, this study aims to investigate the representation of an analytical approach for the improvement of hotel service quality from unstructured review data sets. Through experiments for four hotels in Hong Kong, we can find the strengths and weaknesses of services for each hotel and suggest improvements to aid in customer satisfaction. Especially from positive reviews, we find what these hotels should maintain for service quality. For example, compared with the other hotels, a hotel has a good location and room condition which are extracted from positive reviews for it. In contrast, we also find what they should modify in their services from negative reviews. For example, a hotel should improve room condition related to soundproof. These results mean that our approach is useful in finding some insights for the service quality of hotels. That is, from the enormous size of review data, our approach can provide practical suggestions for hotel managers to improve their service quality. In the past, studies for improving service quality relied on surveys or interviews of customers. However, these methods are often costly and time consuming and the results may be biased by biased sampling or untrustworthy answers. The proposed approach directly obtains honest feedback from customers' online reviews and draws some insights through a type of big data analysis. So it will be a more useful tool to overcome the limitations of surveys or interviews. Moreover, our approach easily obtains the service quality information of other hotels or services in the tourism industry because it needs only open online reviews and ratings as input data. Furthermore, the performance of our approach will be better if other structured and unstructured data sources are added.

• Proceedings of the KOR-KST Conference
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• 1995.02a
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• pp.101-113
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• 1995

The objective of this research is to test the feasibility of developing a statewide truck traffic forecasting methodology for Wisconsin by using Origin-Destination surveys, traffic counts, classification counts, and other data that are routinely collected by the Wisconsin Department of Transportation (WisDOT). Development of a feasible model will permit estimation of future truck traffic for every major link in the network. This will provide the basis for improved estimation of future pavement deterioration. Pavement damage rises exponentially as axle weight increases, and trucks are responsible for most of the traffic-induced damage to pavement. Consequently, forecasts of truck traffic are critical to pavement management systems. The pavement Management Decision Supporting System (PMDSS) prepared by WisDOT in May 1990 combines pavement inventory and performance data with a knowledge base consisting of rules for evaluation, problem identification and rehabilitation recommendation. Without a r.easonable truck traffic forecasting methodology, PMDSS is not able to project pavement performance trends in order to make assessment and recommendations in the future years. However, none of WisDOT's existing forecasting methodologies has been designed specifically for predicting truck movements on a statewide highway network. For this research, the Origin-Destination survey data avaiiable from WisDOT, including two stateline areas, one county, and five cities, are analyzed and the zone-to'||'&'||'not;zone truck trip tables are developed. The resulting Origin-Destination Trip Length Frequency (00 TLF) distributions by trip type are applied to the Gravity Model (GM) for comparison with comparable TLFs from the GM. The gravity model is calibrated to obtain friction factor curves for the three trip types, Internal-Internal (I-I), Internal-External (I-E), and External-External (E-E). ~oth "macro-scale" calibration and "micro-scale" calibration are performed. The comparison of the statewide GM TLF with the 00 TLF for the macro-scale calibration does not provide suitable results because the available 00 survey data do not represent an unbiased sample of statewide truck trips. For the "micro-scale" calibration, "partial" GM trip tables that correspond to the 00 survey trip tables are extracted from the full statewide GM trip table. These "partial" GM trip tables are then merged and a partial GM TLF is created. The GM friction factor curves are adjusted until the partial GM TLF matches the 00 TLF. Three friction factor curves, one for each trip type, resulting from the micro-scale calibration produce a reasonable GM truck trip model. A key methodological issue for GM. calibration involves the use of multiple friction factor curves versus a single friction factor curve for each trip type in order to estimate truck trips with reasonable accuracy. A single friction factor curve for each of the three trip types was found to reproduce the 00 TLFs from the calibration data base. Given the very limited trip generation data available for this research, additional refinement of the gravity model using multiple mction factor curves for each trip type was not warranted. In the traditional urban transportation planning studies, the zonal trip productions and attractions and region-wide OD TLFs are available. However, for this research, the information available for the development .of the GM model is limited to Ground Counts (GC) and a limited set ofOD TLFs. The GM is calibrated using the limited OD data, but the OD data are not adequate to obtain good estimates of truck trip productions and attractions .. Consequently, zonal productions and attractions are estimated using zonal population as a first approximation. Then, Selected Link based (SELINK) analyses are used to adjust the productions and attractions and possibly recalibrate the GM. The SELINK adjustment process involves identifying the origins and destinations of all truck trips that are assigned to a specified "selected link" as the result of a standard traffic assignment. A link adjustment factor is computed as the ratio of the actual volume for the link (ground count) to the total assigned volume. This link adjustment factor is then applied to all of the origin and destination zones of the trips using that "selected link". Selected link based analyses are conducted by using both 16 selected links and 32 selected links. The result of SELINK analysis by u~ing 32 selected links provides the least %RMSE in the screenline volume analysis. In addition, the stability of the GM truck estimating model is preserved by using 32 selected links with three SELINK adjustments, that is, the GM remains calibrated despite substantial changes in the input productions and attractions. The coverage of zones provided by 32 selected links is satisfactory. Increasing the number of repetitions beyond four is not reasonable because the stability of GM model in reproducing the OD TLF reaches its limits. The total volume of truck traffic captured by 32 selected links is 107% of total trip productions. But more importantly, ~ELINK adjustment factors for all of the zones can be computed. Evaluation of the travel demand model resulting from the SELINK adjustments is conducted by using screenline volume analysis, functional class and route specific volume analysis, area specific volume analysis, production and attraction analysis, and Vehicle Miles of Travel (VMT) analysis. Screenline volume analysis by using four screenlines with 28 check points are used for evaluation of the adequacy of the overall model. The total trucks crossing the screenlines are compared to the ground count totals. L V/GC ratios of 0.958 by using 32 selected links and 1.001 by using 16 selected links are obtained. The %RM:SE for the four screenlines is inversely proportional to the average ground count totals by screenline .. The magnitude of %RM:SE for the four screenlines resulting from the fourth and last GM run by using 32 and 16 selected links is 22% and 31 % respectively. These results are similar to the overall %RMSE achieved for the 32 and 16 selected links themselves of 19% and 33% respectively. This implies that the SELINICanalysis results are reasonable for all sections of the state.Functional class and route specific volume analysis is possible by using the available 154 classification count check points. The truck traffic crossing the Interstate highways (ISH) with 37 check points, the US highways (USH) with 50 check points, and the State highways (STH) with 67 check points is compared to the actual ground count totals. The magnitude of the overall link volume to ground count ratio by route does not provide any specific pattern of over or underestimate. However, the %R11SE for the ISH shows the least value while that for the STH shows the largest value. This pattern is consistent with the screenline analysis and the overall relationship between %RMSE and ground count volume groups. Area specific volume analysis provides another broad statewide measure of the performance of the overall model. The truck traffic in the North area with 26 check points, the West area with 36 check points, the East area with 29 check points, and the South area with 64 check points are compared to the actual ground count totals. The four areas show similar results. No specific patterns in the L V/GC ratio by area are found. In addition, the %RMSE is computed for each of the four areas. The %RMSEs for the North, West, East, and South areas are 92%, 49%, 27%, and 35% respectively, whereas, the average ground counts are 481, 1383, 1532, and 3154 respectively. As for the screenline and volume range analyses, the %RMSE is inversely related to average link volume. 'The SELINK adjustments of productions and attractions resulted in a very substantial reduction in the total in-state zonal productions and attractions. The initial in-state zonal trip generation model can now be revised with a new trip production's trip rate (total adjusted productions/total population) and a new trip attraction's trip rate. Revised zonal production and attraction adjustment factors can then be developed that only reflect the impact of the SELINK adjustments that cause mcreases or , decreases from the revised zonal estimate of productions and attractions. Analysis of the revised production adjustment factors is conducted by plotting the factors on the state map. The east area of the state including the counties of Brown, Outagamie, Shawano, Wmnebago, Fond du Lac, Marathon shows comparatively large values of the revised adjustment factors. Overall, both small and large values of the revised adjustment factors are scattered around Wisconsin. This suggests that more independent variables beyond just 226; population are needed for the development of the heavy truck trip generation model. More independent variables including zonal employment data (office employees and manufacturing employees) by industry type, zonal private trucks 226; owned and zonal income data which are not available currently should be considered. A plot of frequency distribution of the in-state zones as a function of the revised production and attraction adjustment factors shows the overall " adjustment resulting from the SELINK analysis process. Overall, the revised SELINK adjustments show that the productions for many zones are reduced by, a factor of 0.5 to 0.8 while the productions for ~ relatively few zones are increased by factors from 1.1 to 4 with most of the factors in the 3.0 range. No obvious explanation for the frequency distribution could be found. The revised SELINK adjustments overall appear to be reasonable. The heavy truck VMT analysis is conducted by comparing the 1990 heavy truck VMT that is forecasted by the GM truck forecasting model, 2.975 billions, with the WisDOT computed data. This gives an estimate that is 18.3% less than the WisDOT computation of 3.642 billions of VMT. The WisDOT estimates are based on the sampling the link volumes for USH, 8TH, and CTH. This implies potential error in sampling the average link volume. The WisDOT estimate of heavy truck VMT cannot be tabulated by the three trip types, I-I, I-E ('||'&'||'pound;-I), and E-E. In contrast, the GM forecasting model shows that the proportion ofE-E VMT out of total VMT is 21.24%. In addition, tabulation of heavy truck VMT by route functional class shows that the proportion of truck traffic traversing the freeways and expressways is 76.5%. Only 14.1% of total freeway truck traffic is I-I trips, while 80% of total collector truck traffic is I-I trips. This implies that freeways are traversed mainly by I-E and E-E truck traffic while collectors are used mainly by I-I truck traffic. Other tabulations such as average heavy truck speed by trip type, average travel distance by trip type and the VMT distribution by trip type, route functional class and travel speed are useful information for highway planners to understand the characteristics of statewide heavy truck trip patternS. Heavy truck volumes for the target year 2010 are forecasted by using the GM truck forecasting model. Four scenarios are used. Fo~ better forecasting, ground count- based segment adjustment factors are developed and applied. ISH 90 '||'&'||' 94 and USH 41 are used as example routes. The forecasting results by using the ground count-based segment adjustment factors are satisfactory for long range planning purposes, but additional ground counts would be useful for USH 41. Sensitivity analysis provides estimates of the impacts of the alternative growth rates including information about changes in the trip types using key routes. The network'||'&'||'not;based GMcan easily model scenarios with different rates of growth in rural versus . . urban areas, small versus large cities, and in-state zones versus external stations. cities, and in-state zones versus external stations.

• 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.