• Title/Summary/Keyword: stress factors

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Changes of Stress and Coping Strategy in Families of Schizophrenic Patients after Brief Program of Family Education (정신분열병 환자 가족의 단기 가족교육 후 대처전략 및 스트레스 변화에 대한 연구)

  • Seo, Seung-Woo;Yi, Ho-Taek;Paek, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.1
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    • pp.16-27
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    • 2001
  • Objectives : This study was aimed to investigate stress and coping strategy in the families of schizophrenic patient, and changes of knowledge, stress and coping strategy after brief program of family education compared with control group Methods : The education group consisted of twenty four people who were families with schizophrenic patients and attended the brief program of family education. The control group consisted of twenty two people with schizophrenic inpatients. Self-report questionnaires such as Family Coping Questionnaire(FCQ), Patient Rejection Scale(PRS), Worry Questionnaire, Knowledge Questionnaire, Beck Depression Inventory(BDI), and State-Trait Anxiety Inventory(STAI) were administered to the education group and the control group, twice at the pre-test and post-test. Results : 1) In the education group, scores of worry questionnaire, BDI and STAI-S at the post-test were significantly lower than those at the pre-test. Social interests score of FCQ and knowledge questionnaire score at the post-test were significantly higher than those at the pre-test. In FCQ factors, social interests associated with avoidance strategy score at the post-test was significantly higher than that at the pre-test. However, in the control group, there was no significant difference in all questionnaires. 2) In the education group, significant positive correlation existed between calculated differences of worry questionnaire and STAI-S, and between worry questionnaire and STAI-T, whereas significant negative correlation existed between positive communication of FCQ and PRS, and between knowledge questionnaire and STAI-S. In the control group, significant negative correlation existed between information of FCQ and PRS, and between positive communication of FCQ and PRS. 3) In the education group, significant positive correlation existed between calculated differences of worry questionnaire and age of patient, whereas significant negative correlation existed between knowledge questionnaire and duration of illness. However, in the control group, there was no significant correlation. Conclusion : The brief program of family education was effective in increasing knowledge about schizophrenia, decreasing worry and anxiety about the patients in families with schizophrenic patient. In the education group as knowledge about schizophrenia increased, anxiety about schizophrenic patient decreased, but there was no significant correlation in the control group. As relative's rejection feeling about schizophrenic patient decreased, positive communication strategy increased in both groups. However, the control group was more affected by rejection feeling than the education group.

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A Study on Load-carrying Capacity Design Criteria of Jack-up Rigs under Environmental Loading Conditions (환경하중을 고려한 Jack-up rig의 내하력 설계 기준에 대한 연구)

  • Park, Joo Shin;Ha, Yeon Chul;Seo, Jung Kwan
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.26 no.1
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    • pp.103-113
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    • 2020
  • Jack-up drilling rigs are widely used in the offshore oil and gas exploration industry. Although originally designed for use in shallow waters, trends in the energy industry have led to a growing demand for their use in deep sea and harsh environmental conditions. To extend the operating range of jack-up units, their design must be based on reliable analysis while eliminating excessive conservatism. In current industrial practice, jack-up drilling rigs are designed using the working(or allowable) stress design (WSD) method. Recently, classifications have been developed for specific regulations based on the load and resistance factor design (LRFD) method, which emphasises the reliability of the methods. This statistical method utilises the concept of limit state design and uses factored loads and resistance factors to account for uncertainly in the loads and computed strength of the leg components in a jack-up drilling rig. The key differences between the LRFD method and the WSD method must be identified to enable appropriate use of the LRFD method for designing jack-up rigs. Therefore, the aim of this study is to compare and quantitatively investigate the differences between actual jack-up lattice leg structures, which are designed by the WSD and LRFD methods, and subject to different environmental load-to-dead-load ratios, thereby delineating the load-to-capacity ratios of rigs designed using theses methods under these different enviromental conditions. The comparative results are significantly advantageous in the leg design of jack-up rigs, and determine that the jack-up rigs designed using the WSD and LRFD methods with UC values differ by approximately 31 % with respect to the API-RP code basis. It can be observed that the LRFD design method is more advantageous to structure optimization compared to the WSD method.

Reproductive Performance of Holstein Dairy Cows Grazing in Dry-summer Subtropical Climatic Conditions: Effect of Heat Stress and Heat Shock on Meiotic Competence and In vitro Fertilization

  • Pavani, Krishna;Carvalhais, Isabel;Faheem, Marwa;Chaveiro, Antonio;Reis, Francisco Vieira;da Silva, Fernando Moreira
    • Asian-Australasian Journal of Animal Sciences
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    • v.28 no.3
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    • pp.334-342
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    • 2015
  • The present study was designed to evaluate how environmental factors in a dry-summer subtropical climate in Terceira-Azores (situated in the North Atlantic Ocean: $38^{\circ}43^{\prime}N27^{\circ}12^{\prime}W$) can affect dairy cow (Holstein) fertility, as well as seasonal influence on in vitro oocytes maturation and embryos development. Impact of heat shock (HS) effects on in vitro oocyte's maturation and further embryo development after in vitro fertilization (IVF) was also evaluated. For such purpose the result of the first artificial insemination (AI) performed 60 to 90 days after calving of 6,300 cows were recorded for one year. In parallel, climatic data was obtained at different elevation points (n = 5) from 0 to 1,000 m and grazing points from 0 to 500 m, in Terceira island, and the temperature humidity index (THI) was calculated. For in vitro experiments, oocytes (n = 706) were collected weekly during all year, for meiotic maturation and IVF. Further, to evaluate HS effect, 891 oocytes were collected in the cold moths (December, January, February and March) and divided in three groups treated to HS for 24 h during in vitro maturation at: C (Control = $38.5^{\circ}C$), HS1 ($39.5^{\circ}C$) and HS2 ($40.5^{\circ}C$). Oocytes from each group were used for meiotic assessment and IVF. Cleavage, morula and blastocyst development were evaluated respectively on day 2, 6, and 9 after IVF. A negative correlation between cow's conception rate (CR) and THI in grazing points (-91.3%; p<0.001) was observed. Mean THI in warmer months (June, July, August and September) was $71.7{\pm}0.7$ and the CR ($40.2{\pm}1.5%$) while in cold months THI was $62.8{\pm}0.2$ and CR was $63.8{\pm}0.4%$. A similar impact was obtained with in vitro results in which nuclear maturation rate (NMR) ranged from 78.4% (${\pm}8.0$) to 44.3% (${\pm}8.1$), while embryos development ranged from 53.8% (${\pm}5.8$) to 36.3% (${\pm}3.3$) in cold and warmer months respectively. In vitro HS results showed a significant decline (p<0.05) on NMR of oocytes for every $1^{\circ}C$ rising temperature ($78.4{\pm}8.0$, $21.7{\pm}3.1$ and $8.9{\pm}2.2$, respectively for C, HS1, and HS2). Similar results were observed in cleavage rate and embryo development, showing a clear correlation (96.9 p<0.05) between NMR and embryo development with respect to temperatures. Results clearly demonstrated that, up to a THI of 70.6, a decrease in the CR occurs in first AI after calving; this impairment was confirmed with in vitro results.

Induction of Phase I, II and III Drug Metabolism/Transport by Xenobiotics

  • Xu Chang Jiang;Li Christina YongTao;Kong AhNg Tony
    • Archives of Pharmacal Research
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    • v.28 no.3
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    • pp.249-268
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    • 2005
  • Drug metabolizing enzymes (DMEs) play central roles in the metabolism, elimination and detoxification of xenobiotics and drugs introduced into the human body. Most of the tissues and organs in our body are well equipped with diverse and various DMEs including phase I, phase II metabolizing enzymes and phase III transporters, which are present in abundance either at the basal unstimulated level, and/or are inducible at elevated level after exposure to xenobiotics. Recently, many important advances have been made in the mechanisms that regulate the expression of these drug metabolism genes. Various nuclear receptors including the aryl hydrocarbon receptor (AhR), orphan nuclear receptors, and nuclear factor-erythoroid 2 p45-related factor 2 (Nrf2) have been shown to be the key mediators of drug-induced changes in phase I, phase II metabolizing enzymes as well as phase III transporters involved in efflux mechanisms. For instance, the expression of CYP1 genes can be induced by AhR, which dimerizes with the AhR nuclear translocator (Arnt) , in response to many polycyclic aromatic hydrocarbon (PAHs). Similarly, the steroid family of orphan nuclear receptors, the constitutive androstane receptor (CAR) and pregnane X receptor (PXR), both heterodimerize with the ret-inoid X receptor (RXR), are shown to transcriptionally activate the promoters of CYP2B and CYP3A gene expression by xenobiotics such as phenobarbital-like compounds (CAR) and dexamethasone and rifampin-type of agents (PXR). The peroxisome proliferator activated receptor (PPAR), which is one of the first characterized members of the nuclear hormone receptor, also dimerizes with RXR and has been shown to be activated by lipid lowering agent fib rate-type of compounds leading to transcriptional activation of the promoters on CYP4A gene. CYP7A was recognized as the first target gene of the liver X receptor (LXR), in which the elimination of cholesterol depends on CYP7A. Farnesoid X receptor (FXR) was identified as a bile acid receptor, and its activation results in the inhibition of hepatic acid biosynthesis and increased transport of bile acids from intestinal lumen to the liver, and CYP7A is one of its target genes. The transcriptional activation by these receptors upon binding to the promoters located at the 5-flanking region of these GYP genes generally leads to the induction of their mRNA gene expression. The physiological and the pharmacological implications of common partner of RXR for CAR, PXR, PPAR, LXR and FXR receptors largely remain unknown and are under intense investigations. For the phase II DMEs, phase II gene inducers such as the phenolic compounds butylated hydroxyanisol (BHA), tert-butylhydroquinone (tBHQ), green tea polyphenol (GTP), (-)-epigallocatechin-3-gallate (EGCG) and the isothiocyanates (PEITC, sul­foraphane) generally appear to be electrophiles. They generally possess electrophilic-medi­ated stress response, resulting in the activation of bZIP transcription factors Nrf2 which dimerizes with Mafs and binds to the antioxidant/electrophile response element (ARE/EpRE) promoter, which is located in many phase II DMEs as well as many cellular defensive enzymes such as heme oxygenase-1 (HO-1), with the subsequent induction of the expression of these genes. Phase III transporters, for example, P-glycoprotein (P-gp), multidrug resistance-associated proteins (MRPs), and organic anion transporting polypeptide 2 (OATP2) are expressed in many tissues such as the liver, intestine, kidney, and brain, and play crucial roles in drug absorption, distribution, and excretion. The orphan nuclear receptors PXR and GAR have been shown to be involved in the regulation of these transporters. Along with phase I and phase II enzyme induction, pretreatment with several kinds of inducers has been shown to alter the expression of phase III transporters, and alter the excretion of xenobiotics, which implies that phase III transporters may also be similarly regulated in a coordinated fashion, and provides an important mean to protect the body from xenobiotics insults. It appears that in general, exposure to phase I, phase II and phase III gene inducers may trigger cellular 'stress' response leading to the increase in their gene expression, which ultimately enhance the elimination and clearance of these xenobiotics and/or other 'cellular stresses' including harmful reactive intermediates such as reactive oxygen species (ROS), so that the body will remove the 'stress' expeditiously. Consequently, this homeostatic response of the body plays a central role in the protection of the body against 'environmental' insults such as those elicited by exposure to xenobiotics.

Correlation of serum total hydroperoxide levels and diseases of prematurity (미숙아 합병증 발생과 혈중 활성 산화물 농도와의 관계)

  • Kim, Shin-Hye;Hur, Hae Young;Lee, Kyu Hyoung;Moon, Ja Young;Chae, Kyu Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.8
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    • pp.746-752
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    • 2007
  • Purpose : Total hydroperoxide (TH), free radical-mediated oxidation product can be used as a measure of free radical injury. The aim of the present study was to see if preterm newborns are at increased risk for oxidative stress compared with term newborns, and to determine whether oxidative stress during postnatal first 1 week is associated with clinical outcomes in preterm infants. Methods : Serum TH levels of preterm infants (n=39) were compared with those of term infants (n=24) on the postnatal day 1. Among the preterm infants, serum TH levels of uncomplicated group (n=23) were also compared with those of complicated group (n=16) who developed oxygen radical related diseases on the postnatal day 1 and 7. Retrospective analysis was performed to find out risk factors for oxygen radical injuries based on birth history, laboratory data, neuroimaging findings and clinical progress in two preterm groups. Results : Serum TH levels on postnatal day 1 were higher in the preterm infant group than the term infant group. Serum TH levels on postnatal day 1 in the complicated preterm infant group were significantly higher compared with uncomplicated group, but there was no significant difference in serum TH levels on postnatal day 7. Also, there was no significant difference in serum TH levels between uncomplicated preterm infants and term infants. Serum TH level on postnatal day 1 was independently associated with higher morbidity after adjusting for gestational age, Apgar score (5 min), arterial blood gas analysis. Conclusion : Complicated preterm newborns are at increased risk for oxidative stress compared with uncomplicated newborns and term newborns. Oxidative injury during the prenatal or postnatal day 1 is associated with adverse outcomes in preterm infants. Elevated TH levels on postnatal day 1 may have a value to predict clinical outcomes in preterm infants.

Analysis of Putative Downstream Genes of Arabidopsis AtERF71/HRE2 Transcription Factor using a Microarray (마이크로어레이를 이용한 애기장대 AtERF71/HRE2 전사인자의 하위 유전자 분석)

  • Seok, Hye-Yeon;Lee, Sun-Young;Woo, Dong-Hyuk;Park, Hee-Yeon;Moon, Yong-Hwan
    • Journal of Life Science
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    • v.22 no.10
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    • pp.1359-1370
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    • 2012
  • Arabidopsis AtERF71/HRE2, a transcription activator, is located in the nucleus and is involved in the signal transduction of low oxygen and osmotic stresses. In this study, microarray analysis using AtERF71/HRE2-overexpressing transgenic plants was performed to identify genes downstream of AtERF71/HRE2. A total of 161 different genes as well as AtERF71/HRE2 showed more than a twofold higher expression in AtERF71/HRE2-overexpressing transgenic plants compared with wild-type plants. Among the 161 genes, 24 genes were transcriptional regulators, such as transcription factors and DNA-binding proteins, based on gene ontology annotations, suggesting that AtERF71/HRE2 is an upstream transcription factor that regulates the activities of various downstream genes via these transcription regulators. RT-PCR analysis of 15 genes selected out of the 161 genes showed higher expression in AtERF71/HRE2-overexpressing transgenic plants, validating the microarray data. On the basis of Genevestigator database analysis, 51 genes among the 161 genes were highly expressed under low oxygen and/or osmotic stresses. RT-PCR analysis showed that the expression levels of three genes among the selected 15 genes increased under low oxygen stress and another three genes increased under high salt stress, suggesting that these genes might be downstream genes of AtERF71/HRE2 in low oxygen or high salt stress signal transduction. Microarray analysis results indicated that AtERF71/HRE2 might also be involved in the responses to other abiotic stresses and also in the regulation of plant developmental processes.

Surrogate Model-Based Global Sensitivity Analysis of an I-Shape Curved Steel Girder Bridge under Seismic Loads (지진하중을 받는 I형 곡선거더 단경간 교량의 대리모델 기반 전역 민감도 분석)

  • Jun-Tai, Jeon;Hoyoung Son;Bu-Seog, Ju
    • Journal of the Society of Disaster Information
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    • v.19 no.4
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    • pp.976-983
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    • 2023
  • Purpose: The dynamic behavior of a bridge structure under seismic loading depends on many uncertainties, such as the nature of the seismic waves and the material and geometric properties. However, not all uncertainties have a significant impact on the dynamic behavior of a bridge structure. Since probabilistic seismic performance evaluation considering even low-impact uncertainties is computationally expensive, the uncertainties should be identified by considering their impact on the dynamic behavior of the bridge. Therefore, in this study, a global sensitivity analysis was performed to identify the main parameters affecting the dynamic behavior of bridges with I-curved girders. Method: Considering the uncertainty of the earthquake and the material and geometric uncertainty of the curved bridge, a finite element analysis was performed, and a surrogate model was developed based on the analysis results. The surrogate model was evaluated using performance metrics such as coefficient of determination, and finally, a global sensitivity analysis based on the surrogate model was performed. Result: The uncertainty factors that have the greatest influence on the stress response of the I-curved girder under seismic loading are the peak ground acceleration (PGA), the height of the bridge (h), and the yield stress of the steel (fy). The main effect sensitivity indices of PGA, h, and fy were found to be 0.7096, 0.0839, and 0.0352, respectively, and the total sensitivity indices were found to be 0.9459, 0.1297, and 0.0678, respectively. Conclusion: The stress response of the I-shaped curved girder is dominated by the uncertainty of the input motions and is strongly influenced by the interaction effect between each uncertainty factor. Therefore, additional sensitivity analysis of the uncertainty of the input motions, such as the number of input motions and the intensity measure(IM), and a global sensitivity analysis considering the structural uncertainty, such as the number and curvature of the curved girders, are required.

Antioxidant Activity of Native Korean Halophyte Extracts and Their Anti-biofilmActivity against Acinetobacter baumannii (한국 자생 염생식물 추출물의 항산화 활성 및 다재내성 Acinetobacter baumannii에 대한 항생물막 활성)

  • Eun Seong Lee;Jeong Woo Park;Ki Hwan Moon;Youngwan Seo
    • Journal of Life Science
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    • v.33 no.12
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    • pp.1015-1024
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    • 2023
  • Antibiotics have greatly contributed to the treatment and prevention of bacterial diseases in humans, animals, and fish. However, antibiotic misuse has led to the emergence and spread of multidrug-resistant bacteria. In addition to antibiotic discovery research, efforts are being made to combat such multidrug-resistant bacteria using antimicrobial agents, antioxidants, host immune enhancement, probiotics, and bacteriophages, as well as various symptomatic therapies. To discover novel bioactive compounds, it is crucial to adopt approaches that incorporate fresh ideas, new targets, innovative techniques, and untapped resources. Halophytes are plants that grow in high-salt soils and are known to adapt to salt-induced stress through unique metabolic processes that produce secondary metabolites. This study aimed to investigate the effects of extracts of halophytes native to Korea on oxidative stress and to determine whether they exert inhibitory activity against biofilms, which are major pathogenic factors of infectious bacteria. The Acinetobacter baumannii strain ATCC 17978, a representative drug-resistant bacterium, was used to measure anti-biofilm activity. The results showed that Aster spathulifolius, Carex kobomugi, Rosa rugosa, and Asparagus cochinchiensis exerted strong antioxidant and anti-biofilm effects without affecting bacterial growth itself. The halophytes used in this study are promising candidates for the development of pharmaceutical agents with antioxidant and antimicrobial properties.

Analysis on dynamic numerical model of subsea railway tunnel considering various ground and seismic conditions (다양한 지반 및 지진하중 조건을 고려한 해저철도 터널의 동적 수치모델 분석)

  • Changwon Kwak;Jeongjun Park;Mintaek Yoo
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.25 no.6
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    • pp.583-603
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    • 2023
  • Recently, the advancement of mechanical tunnel boring machine (TBM) technology and the characteristics of subsea railway tunnels subjected to hydrostatic pressure have led to the widespread application of shield TBM methods in the design and construction of subsea railway tunnels. Subsea railway tunnels are exposed in a constant pore water pressure and are influenced by the amplification of seismic waves during earthquake. In particular, seismic loads acting on subsea railway tunnels under various ground conditions such as soft ground, soft soil-rock composite ground, and fractured zones can cause significant changes in tunnel displacement and stress, thereby affecting tunnel safety. Additionally, the dynamic response of the ground and tunnel varies based on seismic load parameters such as frequency characteristics, seismic waveform, and peak acceleration, adding complexity to the behavior of the ground-tunnel structure system. In this study, a finite difference method is employed to model the entire ground-tunnel structure system, considering hydrostatic pressure, for the investigation of dynamic behavior of subsea railway tunnel during earthquake. Since the key factors influencing the dynamic behavior during seismic events are ground conditions and seismic waves, six analysis cases are established based on virtual ground conditions: Case-1 with weathered soil, Case-2 with hard rock, Case-3 with a composite ground of soil and hard rock in the tunnel longitudinal direction, Case-4 with the tunnel passing through a narrow fault zone, Case-5 with a composite ground of soft soil and hard rock in the tunnel longitudinal direction, and Case-6 with the tunnel passing through a wide fractured zone. As a result, horizontal displacements due to earthquakes tend to increase with an increase in ground stiffness, however, the displacements tend to be restrained due to the confining effects of the ground and the rigid shield segments. On the contrary, peak compressive stress of segment significantly increases with weaker ground stiffness and the effects of displacement restrain contribute the increase of peak compressive stress of segment.

Problems in the Korean National Family Planning Program (한국가족계획사업(韓國家族計劃事業)의 문제점(問題點))

  • Hong, Jong-Kwan
    • Clinical and Experimental Reproductive Medicine
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    • v.2 no.2
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    • pp.27-36
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    • 1975
  • The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.

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