• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• Korean Journal of Animal Reproduction
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• v.10 no.2
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• pp.192-203
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• 1986

Two experiments in this study were designed to compare the potential for in vitro capacitation and in vitro fertilization of ejaculated sperm among individual rabbit bucks. In experiment 1, for in vitro capacitation, the ejaculated sperm were preincubated in DM for 12 hr or 18 hr after HIS treatment, then 12 hr -or 18 hr- preincubated sperm were incubated with superovulated rabbit ova in a 5% CO2 incubator for 36 hr at 38$^{\circ}C$, and a part of cleaved ova was transferred to the recipient does for implantation of embryo. In experiment 2, effect of lysolecithin addition to preincubation medium on induction of accelerated in vitro capacitation and in vitro fertilization of individual rabbit sperm was studied. Experiment 1; 1. Percent acrosome reaction of sperm, noted after staining, after 12 hr or 18 hr preincubation ranged from 52.5 to 76.0% and from 67.5 to 90.0%, respectively and sperm motility index of these sperm ranged from 20.0 to 47.5 for 12 hr-preincubated sperm and from 15.0 to 37.5 for 18 hr- preincubated sperm. There was no a certain relation between percent acrosome reaction and sperm motility index. 2. In vitro fertilization rate (cleavage rate) of in vitro capacitated sperm varied widely among individual bucks, ranging from 0 to 47.8% for 12 hr - preincubated sperm and from 0 to 60.9% for 18 hr -prein- cubated sperm. Cleavage rate of 18 hr - preincubated sperm was higher and faster than that of 12 hr - preincubated sperm. 3. Eight of 44 in vitro fertilized embryos transferred into 6 recipients were implanted in 4 recipients (66.7%) up to day 15 and implnatation rate was 18.2%. Experiment 2; 1. The percent acrosome reaction of sperm before and after 4 hr preincubation in DM without lysolecithin varied significantly among individual bucks, ranging from 0.4 to 18.4% and from 1.7 to 37.4%, respectively and percent acrosome reaction of sperm at 30 min after addition of 60${\mu}$g/ml lysolecithin also was significantly different among bucks, ranging from 19.2 to 67.1%. 2. Effect of accelerated acrosome reaction following lysolecithin addition was more considerable in the individuals showed less percent acrosome reaction before and after 4 hr preincubation. Percentage of motile sperm and motility score showed a trendency towards a decrease with increase of preincubation time and time after lysolecithin addition. 3. In vitro fertilization rate (cleavage rate) at 24 hr postinesmination with pooled sperm were treated to 60 $\mu\textrm{g}$/ml lysolecithin for 30 min after 4 hr preincubation was 24.6%, a higher rate than 13.2% for control. While 80 $\mu\textrm{g}$/ml lysolecithin-added sperm showed a lower cleavage than control and 60$\mu\textrm{g}$/ml-added sperm at both 24 hr and 48 hr postinsemination. These results from 2 experiments suggest that more useful preincubation time for the in vitro capacitation of ejaculated rabbit sperm is 18 hr in DM after HIS treatment, although there is wide variation in vitro capacitation and in vitro fertilization rate among individual bucks, and lysolecithin addition to at least 4 hr - preincubated sperm in DM can result in almost same in vitro fertilization rate as that of 18 hr - preincubated sperm in the experiment 1.

• Health Policy and Management
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• v.14 no.1
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• pp.65-88
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• 2004

In general, empowerment is defined as the motivational concept of autonomy and self-efficacy. Recently, the concept of empowerment is applied to improve organizational staff's job satisfaction and organizational commitment in many organizations. Empower-ment in service organizations, i.e., hospitals, has certainly generated more publicity than any other organizations. The objectives of this study are, first, to measure the degree of hospital employees' empowerment using Spreitzer(1995)'s empowerment theory, second, to analyze the causal relationship of organizational and job characteristics, a degree of empowerment, and organizational performance(job satisfaction and organizational commitment), and third, to offer the strategy for the improvement of job satisfaction and organizational commitment. Spreitzer insists that the empowerment is composed of 4 dimensions(meaning, competence, self-determination, and impact). And he argues that various work-related characteristics is a direct cause of empowerment and the indirect cause of job satisfaction and organizational commitment, mediated by the empowerment latent variable. In order to perform this study, data were collected by self-administered questionnaires from hospital employees working in administrative department of 3 university hospitals in Inchon and Kyunggi-Do region. The number of cases is 181(response rate; 86%). The Collected data were analyzed with SPSS Ver. 10.0 and AMOSV Ver. 4.0. First, to test validity of variables, the factor analysis was used. Second, to test reliability, Cronbach's alpha coefficients was calculated. Cronbach's alpha of empowerment variable is 0.8323 showing that there's no problem in regard to the internal consistency. Also the Cronbach's alpha of other variables are 0.8301 of the degree of perceived control, 0.6705 of job characteristics, O.8787 of compensation, 0.9254 of job satisfaction, and 0.8389 of organizational commitment, respectively. Among the questions of job characteristics, two survey questions are deleted due to lowering the reliability. Third, to test multicollinearity and correlation of variables, the correlation analysis was performed. There was no problem of multicollinearity. Finally structural equation modelling (SEM) analysis was conducted to find the causal relationship of organizational and job Characteristics, empowerment, job satisfaction and organizational commitment. The 16 variables are included for the SEM analysis. The major results of this study are as follows: First, in the case of model fitness, the condition of x$^2$ statistic(92.187) is not fully satisfied, but the indices of GFI(0.912), AGFI(0.863), NFI(0.917) and CFI(0.928) are partially satisfied, which needs to upper 0.90. Second, in the result of hypotheses testing, all hypotheses are accepted and have a positive effect in 95% or 99% confidence interval(P<0.05 or P<0.001) except the effect of compensation variable on empowerment(P=0.082). Third, in regard to the direct, indirect, and total effect of variables, the direct effect of perceived control, task characteristics, and compensation on job satisfaction are 0.728, 2.264, 0.328 and on organizational commitment are 0.094, 1.411, 0.418, respectively. Also the indirect effect of perceived control, task characteristics, and compensation on job satisfaction are 0.311, 0.196, 0.028 and on organizational commitment are 0.210, 0.132, 0.019, respectively. Thus, these findings imply that various work-related factors are direct effect of empowerment and indirect effect of result variables, job satisfaction and organizational commitment. Also These results showed that the workplace empowerment is significant mediating factor of employee's job satisfaction and organizational commitment.

• Journal of The Korean Association For Science Education
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• v.33 no.1
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• pp.94-113
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• 2013

The purpose of this study was to examine the change in the classes of beginning science teachers through the collaborative mentoring program that induce reflective thinking practice. Participants in this study were three mentor-teachers, two teachers in doctor's or master's course, one university professor, and three mentee-teachers who have less than four years of teaching experience. We collected data such as video recordings of the mentee-teachers' classroom teaching and transcription, lesson plans, recording of one-on-one mentoring and transcription, mentor and mentee's journals, and RTOP classroom teaching observation reports. RTOP was used for the analysis of classroom teaching and mentee-teachers' recognition and changes in their classes were found out through journals and one-on-one mentoring interview materials. According to mentee-teachers' recognition and changes in their classes during the mentoring program, they themselves recognized their teacher-centered teaching style, misconception, and lack of content knowledge. Furthermore, there were changes in the mentee-teachers' classroom teaching through their reflective practice and improvement. As a result of this study, the interactions with mentor-teachers through collaborative mentoring program stimulated mentee-teacher's reflections on their teaching. Therefore, these reflections led to their reflective practice that showed progressive changes in their teaching behavioral activities. The extent of these changes varied according to the mentee-teachers' individual disposition toward reflection and the issue of whether mentee-teachers' reflective practice was in accordance with priorities in motivational ZDP or not. Also based on the results of this study, the teachers' reflection was not all accompanied by reflective practice even if the beginning science teachers made some partial changes in reflective practice through reflection. It means that it is hard to lead reflective practice for mentee-teachers through mentoring in a short period of time. Therefore, we consider that a systematic and long-term mentoring program is necessary for beginning science teachers.

• Asian-Australasian Journal of Animal Sciences
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• v.28 no.12
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• pp.1696-1702
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• 2015

The objective of this study was to compare the effects of body weight growth adjustment methods on genetic parameters of body growth and tissue among three pig breeds. Data collected on 101,820 Landrace, 281,411 Yorkshire, and 78,068 Duroc pigs, born in Korean swine breeder farms since 2000, were analyzed. Records included body weights on test day and amplitude (A)-mode ultrasound carcass measures of backfat thickness (BF), eye muscle area (EMA), and retail cut percentage (RCP). Days to 90 kg body weight (DAYS90), through an adjustment of the age based on the body weight at the test day, were obtained. Ultrasound measures were also pre-adjusted (ABF, EMA, AEMA, ARCP) based on their test day measures. The (co)variance components were obtained with 3 multi-trait animal models using the REMLF90 software package. Model I included DAYS90 and ultrasound traits, whereas model II and III accounted DAYS90 and pre-adjusted ultrasound traits. Fixed factors were sex (sex) and contemporary groups (herd-year-month of birth) for all traits among the models. Additionally, model I and II considered a linear covariate of final weight on the ultrasound measure traits. Heritability ($h^2$) estimates for DAYS90, BF, EMA, and RCP ranged from 0.36 to 0.42, 0.34 to 0.43, 0.20 to 0.22, and 0.39 to 0.45, respectively, among the models. The $h^2$ estimates of DAYS90 from model II and III were also somewhat similar. The $h^2$ for ABF, AEMA, and ARCP were 0.35 to 0.44, 0.20 to 0.25, and 0.41 to 0.46, respectively. Our heritability estimates varied mostly among the breeds. The genetic correlations ($r_G$) were moderately negative between DAYS90 and BF (-0.29 to -0.38), and between DAYS90 and EMA (-0.16 to -0.26). BF had strong $r_G$ with RCP (-0.87 to -0.93). Moderately positive $r_G$ existed between DAYS90 and RCP (0.20 to 0.28) and between EMA and RCP (0.35 to 0.44) among the breeds. For DAYS90, model II and III, its correlations with ABF, AEMA, and ARCP were mostly low or negligible except the $r_G$ between DAYS90 and AEMA from model III (0.27 to 0.30). The $r_G$ between AEMA and ABF and between AEMA and ARCP were moderate but with negative and positive signs, respectively; also reflected influence of pre-adjustments. However, the $r_G$ between BF and RCP remained non-influential to trait pre-adjustments or covariable fits. Therefore, we conclude that ultrasound measures taken at a body weight of about 90 kg as the test final should be adjusted for body weight growth. Our adjustment formulas, particularly those for BF and EMA, should be revised further to accommodate the added variation due to different performance testing endpoints with regard to differential growth in body composition.

• Korean Journal of Head & Neck Oncology
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• v.10 no.1
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• pp.13-24
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• 1994

Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

• Health Policy and Management
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• v.27 no.4
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• pp.273-275
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• 2017

It has been forty years since the implementation of National Health Insurance (NHI) in South Korea. Following the 1977 legislature mandating medical insurance for employees and dependents in firms with more than 500 employees, South Korea expanded its health insurance to urban residents in 1989. Resultantly, total expenses of the National Health Insurance Service (NHIS) have greatly increased from 4.5 billion won in 1977 to 50.89 trillion won in 2016. With multiple insurers merging into the NHI system in 2000, a single-payer healthcare system emerged, along with separation policy of prescribing and dispensing. Following such reform, an emerging financial crisis required injections from the National Health Promotion Fund. Forty years following the introduction of the NHI system, both praise and criticism have been drawn. In just 12 years, the NHI achieved the fastest health population coverage in the world. Current medical expenditure is not high relative to the rest of the Organization for Economic Cooperation and Development. The quality of acute care in Korea is one of the best in the world. There is no sign of delayed diagnosis and/or treatment for most diseases. However, the NHI has been under-insured, requiring high-levels of out-of-pocket money from patients and often causing catastrophic medical expenses. Furthermore, the current environmental circumstances of the NHI are threatening its sustainability. Low birth rate decline, as well as slow economic growth, will make sustainment of the current healthcare system difficult in the near future. An aging population will increase the amount of medical expenditure required, especially with the baby-boomer generation of those born between 1955 and 1965. Meanwhile, there is always the problem of unification for the Korean Peninsula, and what role the health insurance system will have to play when it occurs. In the presidential election, health insurance is a main issue; however, there is greater focus on expansion and expenditure than revenue. Many aspects of Korea's NHI system (1977) were modeled after the German (1883) and Japanese (1922) systems. Such systems were created during an era where infections disease control was most urgent and thus, in the current non-communicable disease (NCD) era, must be redesigned. The Korean system, which is already forty years old, must be redesigned completely. Although health insurance benefit expansion is necessary, financial measures, as well as moral hazard control measures, must also be considered. Ultimately, there are three aspects that we must consider when attempting redesign of the system. First, the health security system must be reformed. NHI and Medical Aid must be amalgamated into one system for increased effectiveness and efficiency of the system. Within the single insurer system of the NHI must be an internal market for maximum efficiency. The NHIS must be separated into regions so that regional organizers have greater responsibility over their actions. Although insurance must continue to be imposed nationally, risk-adjustment must be distributed regionally and assessed by different regional systems. Second, as a solution for the decreasing flow of insurance revenue, low premium level must be increased to an appropriate level. Likewise, the national reserve fund (No. 36, National Health Insurance Act) must be enlarged for re-unification preparation. Third, there must be revolutionary reform of benefit package. The current system built a focus on communicable diseases which is inappropriate in this NCD era. Medical benefits must not be one-time events but provide chronic disease management. Chronic care models, accountable care organization, patient-centered medical homes, and other systems that introduce various benefit packages for beneficiaries must be implemented. The reimbursement system of medical costs should be introduced to various systems for different types of care, as is the case with part C (Medicare Advantage Program) of America's Medicare system that substitutes part A and part B. Pay for performance must be expanded so that there is not only improvement in quality of care but also medical costs. Moreover, beneficiaries of the NHI system must be aware of the amount of their expenditure through a deductible payment system so that spending can be profiled and monitored. The Moon Jae-in Government has announced its plans to expand the NHI system; however, it is important that a discussion forum is created so that more accurate analysis of the NHI, its environments, and current status of health care system, can take place for reforming NHI.

• Journal of KIISE:Software and Applications
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• v.30 no.1_2
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• pp.117-128
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• 2003

Software usability is a characteristic of the software that is decided based on learnability, effectiveness, and satisfaction when it is evaluated. The usability is a main factor of the software quality. A software has to be continuously improved by taking guidelines that comes from the usability evaluation. Usability factors may vary among the different software products and even for the same factor, the users may have different opinions according to their experience and knowledge. Therefore, a usability evaluation process must be developed with the consideration of many factors like various applications and users. Existing systems such as satisfaction evaluation and performance evaluation only evaluate the result and do not perform cause analysis. And also unified evaluation items and contents do not reflect the characteristics of the products. To address these problems, this paper presents a evaluation model that is based on the mental model of user and the problems, this paper presents a evaluation model that is based on the mental model of user and the emotion of users. This model uses evaluation factors of the user task which are extracted by analyzing usage of the target product. In the mental model approach, the conceptual model of designer and the mental model of the user are compared and the differences are taken as a gap also reported as a part to be improved in the future. In the emotional factor approach, the emotional factors are extracted for the target products and evaluated in terms of the emotional factors. With this proposed method, we can evaluate the software products with customized attributes of the products and deduce the guidelines for the future improvements. We also takes the GUI framework as a sample case and extracts the directions for improvement. As this model analyzes tasks of users and uses evaluation factors for each task, it is capable of not only reflecting the characteristics of the product, but exactly identifying the items that should be modified and improved.

• Korean Journal of Poultry Science
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• v.6 no.2
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• pp.75-81
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• 1979

This study was carried out to select superior dual purpose hens which could spread to poultry farming for subsidiary work and general farmhouse. Three hundred and fifty chicks of 7 kinds of 2-way crossbred from mating of Rhode Island Red, New Hampshire and Australorps were tested for dual purpose performance. The results obtained were as follows: 1. The average viability of brooding, rearing and laying Period hen were 92.3% 98.3% and 93.1% respectively. There was significant difference at 1% level among crossbreds for brooding viability, but other viabilitys were no significant difference. 2. The average body weight of 8 weeks was 854.41g, but there was no significant difference among crossbreds, respectively. Average body weight at 300 days, 500 days were 2507.15g, 2632.25g respectively, but there was significant difference at 1% level among crossbreds. 3. Sexual maturity of individual and 50% egg production were 173.7 days and 199.4 days, respectively. There was significant difference at 5% level among crossbreds. 4. The average hen day egg production was 65.3% and the highest was R.N crossbred (70.5%). There was significant difference at 5% level among crossbreds and average hen housed egg Production was 20.2 eggs and the highest was 220.4 eggs in R.A. crossbred. 5. The average egg weight was 57.36g and the highest was A.N crossbred (58.3g). Therc was no significant difference among crossbreds. 6. The average feed consumption per hen per day by stag. was 42.9g (brooding period), 83.7g (rearing period), 131.1g (laying period). Average feed requirement per 1kg. egg production was 3.79 and th. R.A. crossbred was superiority (3.42). 7. On the basis of the results of this study, the R.A and R.N crossbreds were best for superior dual commercial chicks under farming management conditions.

• Journal of Animal Science and Technology
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• v.55 no.5
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• pp.343-349
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• 2013

Data including 1,372,050 milk records pertaining to 438,019 cows from 1983 to 2011 collected during performance tests conducted by the National Livestock Cooperative Dairy Improvement Center were used to calculate milk income and profit of individuals and investigate the effects of production levels of early lactation (parity 1 and 2, respectively). Individuals with a moderate level of early lactation stayed longer in herds. Among parity 1, the 9,000 kg or higher group had a lower mean number of lactations than the overall mean of 3.13. The 7,000 kg or lower and 10,000 kg or higher groups had lower mean life time milking days than the overall mean of 1,076.8 days. Standard deviations of lifetime traits tended to decrease as production levels increased. For parity 2, the 11,000 kg or higher group had a lower mean number of lactation than the overall mean of 3.43. The lifetime milking days was highest in the 12,000 kg group (1,212.0 days), and generally smaller in the lower groups. Profit increased as the production level of groups increased for both parity 1 and 2. In groups with low production levels, profit of parity 1 was higher than that of parity 2, while the reverse was true in groups with high production levels. These results suggest that individuals in the low production groups had a greater likelihood to be culled due to reproductive or other problems. Furthermore, the accuracy of the prediction of lifetime profit of individuals with a milk yield of 305 days seems to be higher for parity 2 than parity 1; therefore, it is desirable to predict lifetime profit using the 305d milk yield of parity 2. In conclusion, breeding goals are based on many factors in functions for the estimation of profit; however, production levels during early lactation (parity 1 and 2) can be used as indicators of profit to extend profitability.