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The Marketing Effect of Loyalty Program on Relational Market Behavior : Focusing in Franchise Membership Fitness Club (로열티 프로그램이 고객 참여와 소비자-브랜드 관계에 기초한 관계형 시장 행동에 미치는 영향 : 프랜차이즈 회원제 휘트니스클럽을 대상으로)

  • Yoon, Kyung-Goo;Shin, Geon-Cheol
    • Journal of Distribution Research
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    • v.17 no.2
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    • pp.1-28
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    • 2012
  • I. Introduction : The purpose of this study is to test empirically hypothetical causality among constructs used in previous studies to build the model of relational market behavior on customers' participation and consumer-brand relationship after introducing theories of relationship marketing, loyalty program, consumer-brand relationship, customers' participation in service marketing as previous studies with regard to relational market behavior, which Bagozzi(1995) and Peterson(1995) commented on constructs and definition suggested by Sheth and Parvatiyar (1995). For this purpose, loyalty program by the service provider, customers' participation and consumer-brand relationship as preceding variables explain relational market behavior defined by Sheth and Parvatiyar(1995). This study proposes that loyalty program as a tool of relationship marketing will be effective in that consumers' participation in marketing relationship results in a narrow range of choice(Sheth and Parvatiyar, 1995) because consumers think that their participation motive result in benefits(Peterson, 1995). Also, it is proposed that the quality of consumer-brand relationship explain the performance of relationship as well as the intermediary effect because the loyalty program could be evaluated based on relationship with customers. We reviewed the variables with regard to performance of relationship based on relation maintain in marketing literature, and then tested our hypotheses related to several performance variables including loyalty and intention of relation maintain based on the previous studies and constructs(Bendapudi and Berry, 1997 ; Bettencourt, 1997 ; Palmatier, Dant, Grewal and Evans, 2006 ; You Jae Yi and Soo Jin Lee, 2006). II. Study Model : Analyses about hypothetical causality were proceeded. The marketing effect of loyalty program on relational market behavior was empirically tested in study regarding a service provider. The research model in according to the path hypotheses (loyalty program ${\rightarrow}$ customers' participation ${\rightarrow}$ consumer-brand relationship ${\rightarrow}$ relational market behavior and loyalty program ${\rightarrow}$ consumer-brand relationship, and loyalty program ${\rightarrow}$ relational market behavior and customers' participation ${\rightarrow}$ consumer-brand relationship, and customers' participation ${\rightarrow}$ relational market behavior) proceeded as an activity for customer relation management was suggested. The main purpose of study is to see if relational market behavior could be brought as a result of developing relationship between consumers and a corporate into being stronger and more valuable when a corporate or a service provider try aggressively to build the relationship with customers (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006; Sheth and Parvatiyar, 1995). III. Conclusion : The results of research into the membership fitness club, one of service areas with high level of customer participation (Bitner, Faranda, Hubbert and Zeithaml, 1997; Chase, 1978; Kelley, Donnelly, Jr. and Skinner, 1990) are as follows: First, causalities in according to path hypotheses were tested, after the preceding variables affecting relational market behavior and conceptual frame were suggested. In study, all hypotheses were supported as expected. This result confirms the proposition suggested by Sheth and Parvatiyar(1995), who claimed that intention of consumer and corporate to participate in marketing relationship brings high level of marketing productivity. Also, as a corporate or a service provider try aggressively to build relationship with customers, the relationship between consumers and a corporate can be developed into stronger and more valuable one (Bettencourt, 1997; Palmatier, Dant, Grewal and Evans, 2006). This finding supports the logic of relationship marketing. Second, because the question regarding the path hypothesis of consumer-brand relationship ${\rightarrow}$ relational market behavior are still at issue, the further analyses were conducted. In particular, there existed the mediating effects of consumer-brand relationship toward relational market behavior. Also, multiple regressions were conducted to see if which one strongly influences relational market behavior among specific question items with regard to consumer-brand relationship. As a result, the influence between items composing consumer-brand relationship and ones composing relational market behavior was different. Among items composing consumer-brand relationship, intimacy was an influence of sustaining relationship, word of mouth, and recommendation, intimacy and interdependence were influences of loyalty, intimacy and self-connection were influences of tolerance and advice. Notably, commitment among items measuring consumer-brand relationship had the negative influence with relational market behavior. This means that bringing relational market behavior is not consumer-brand relationship without personal commitment, but effort to build customer relationship like intimacy, interdependence, and self-connection. This finding confirms the results of Breivik and Thorbjornsen(2008). They reported that six variables composing the quality of consumer-brand relationship have higher explanation in regression model directly affecting performance of consumer-brand relationship. As a result of empirical analysis, among the constructs with regard to consumer-brand relationship, intimacy(B=0.512), interdependence(B=0.196), and quality of partner(B=0.153) had the effects on relation maintain. On the contrary, self-connection, love and passion, and commitment had little effect and did not show the statistical significance(p<0.05). On the other hand, intimacy(B=0.668) and interdependence(B=0.181) had the high regression estimates on word of mouth and recommendation. Regarding the effect on loyalty, explanation level of the model was high(R2=0.515), intimacy(0.538), interdependence(0.223), and quality of partner(0.177) showed the statistical significance(p<0.05). Furthermore, intimacy(0.441) had the strong effect as well as self-connection(0.201) and interdependence (0.163) had the effect on tolerance and forgive. And these three variables showed effects even on advice and suggestion, intimacy(0.373), self-connection(0.270), interdependence (0.155) respectively. Third, in study with regard to the positive effect(loyalty program ${\rightarrow}$ customers' participation, loyalty program ${\rightarrow}$ consumer-brand relationship, loyalty program ${\rightarrow}$ relational market behavior, customers' participation ${\rightarrow}$ consumer-brand relationship, customers' participation ${\rightarrow}$ relational market behavior, consumer-brand relationship ${\rightarrow}$ relational market behavior), the path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship, was supported. The fact that path hypothesis of customers' participation ${\rightarrow}$ consumer-brand relationship was supported confirms assertion by Bitner(1995), Fournier(1994), Sheth and Parvatiyar(1995) about consumer relationship to participate in marketing relationship.

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Optimum Radiotherapy Schedule for Uterine Cervical Cancer based-on the Detailed Information of Dose Fractionation and Radiotherapy Technique (처방선량 및 치료기법별 치료성적 분석 결과에 기반한 자궁경부암 환자의 최적 방사선치료 스케줄)

  • Cho, Jae-Ho;Kim, Hyun-Chang;Suh, Chang-Ok;Lee, Chang-Geol;Keum, Ki-Chang;Cho, Nam-Hoon;Lee, Ik-Jae;Shim, Su-Jung;Suh, Yang-Kwon;Seong, Jinsil;Kim, Gwi-Eon
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.143-156
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    • 2005
  • Background: The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. Materials and Methods: The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of $23.4\~59.4$ Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-IBT) was also peformed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of $14.4\~43.2$ Gy (Median 36.0) of EBRT in 495 patients, while In the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder & rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ($\alpha/\beta$=10) and late-responding tissues ($\alpha/\beta$=3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED $Gy_3$ and the risk of complication was assessed using serial multiple logistic regression models. The associations between R-BED $Gy_3$ and rectal complications and between V-BED $Gy_3$ and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED $Gy_{10}$, and the treatment duration. Results: The overall complication rate for RTOG Grades $1\~4$ toxicities was $33.1\%$. The 5-year actuarial pelvic control rate for ail 743 patients was $83\%$. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 $Gy_{10}$ (median 93.0) for tumors and from 93.6 to 187.3 $Gy_3$ (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED $Gy_3$) and bladder Point BED (V-BED $Gy_3$) were 118.7 $Gy_3$ (range $48.8\~265.2$) and 126.1 $Gy_3$ (range: $54.9\~267.5$), respectively. MD-BED $Gy_3$ showed a good correlation with rectal (p=0.003), but not with bladder complications (p=0.095). R-BED $Gy_3$ had a very strong association (p=<0.0001), and was more predictive of rectal complications than A-BED $Gy_3$. B-BED $Gy_3$ also showed significance in the prediction of bladder complications in a trend test (p=0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. Conclusion: The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences In tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder reference dosing therefore, vaginal gauze packing might be very Important. To maintain the BED dose to less than the threshold resulting in complication, early midline shielding, the HDR-ICBT total dose and fractional dose reduction should be considered.

A Comparison of Tiotropium 18㎍, Once Daily and Ipratropium 40㎍, 4 Times Daily in a Double-Blind, Double-Dummy, Efficacy and Safety Study in Adults with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 Tiotropium 1일 1회, 1회 18㎍ 요법과 Ipratropium 1일 4회, 1회 40㎍ 요법의 치료효과 및 안전성 비교)

  • Kim, Seung Joon;Kim, Myung Sook;Lee, Sang Haak;Kim, Young Kyoon;Moon, Hwa Sik;Park, Sung Hak;Lee, Sang Yeub;In, Kwang Ho;Lee, Chang Youl;Kim, Young Sam;Kim, Hyung Jung;Ahn, Chul Min;Kim, Sung Kyu;Kim, Kyung Rok;Cha, Seung Ick;Jung, Tae Hoon;Kim, Mi Ok;Park, Sung Soo;Choi, Cheon Woong;Yoo, Jee Hong;Kang, Hong Mo;Koh, Won Jung;Ham, Hyoung Suk;Kang, Eun Hae;Kwon, O Jung;Lee, Yang Deok;Lee, Heung Bum;Lee, Yong Chul;Rhee, Yang Keun;Shin, Won Hyuk;Kwon, Sung Yeon;Kim, Woo Jin;Yoo, Chul Gyu;Kim, Young Whan;Shim, Young Soo;Han, Sung Koo;Park, Hye Kyung;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew;Kim, Mi Hye;Lee, Won Yeon;Yong, Suk Joong;Shin, Kye Chul;Choi, Byoung Whui;Oh, Yeon Mok;Lim, Chae Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Jung, Sung Soo;Kim, Ju Ock;Ko, Young Chun
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.498-506
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    • 2005
  • Background : This study compared the bronchodilator efficacy and safety of tiotropium inhalation capsules ($18{\mu}g$ once daily) with a ipratropium metered dose inhaler (2 puffs of $20{\mu}g$ q.i.d.) in patients with chronic obstructive pulmonary disease (COPD). Method : After the initial screening assessment and a two-week run-in period, patients received either tiotropium $18{\mu}g$ once daily or ipratropium $40{\mu}g$ four times daily over a period of 4 weeks in a double blind, double dummy, parallel group study. The outcome measures were the lung function, the daily records of the peak expiratory flow rate (PEFR), the patients' questionnaire, and the use of concomitant salbutamol. The forced expiratory volume in one second ($FEV_1$) and the forced vital capacity (FVC) were measured 5 minutes before inhalation, and 0.5, 1, 2 and 3 hours after inhaling the study drug on days 0, 14 and 28. Result : In 16 centers, 134 patients with a mean (SD) age of 66 (7) years and a predicted $FEV_1$ of 42 (12)% were analyzed. The trough $FEV_1$ response was significantly higher in the tiotropium group than in the ipratropium group after a four-week treatment period. The weekly mean morning PEFR of the tiotropium group was consistently higher than that of the ipratropium group during the 4-week treatment period with differences ranging from 12.52 to 13.88 l/min, which were statistically significant. Tiotropium was well tolerated by the COPD patients during the 4-week treatment period and had a similar safety profile to ipratropium. Conclusion : This study shows that tiotropium administrated once daily has a superior bronchodilator effect with a similar safety profile in treating COPD patients compared with ipratropium, inhaled four times daily.

The effects of aqueous extracts of plant roots on germination of seeds and growth of seedings (식물근의 추출물질이 종자발아 및 유식물의 생장에 미치는 영향)

  • Chan-Ho Park
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.4 no.1
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    • pp.1-23
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    • 1968
  • This study aimed at contributing to the improvement of cropping systems after finding out the effects of excrements and components of crop root influence on other crops as well as themselves. The following forage crops suitable for our country were selected for the present study. Aqueous extracts of fresh roots, aqueous extracts of rotting roots and aqueous solutions of excrements of red clover, orchard grass and brome grass were studied for the effects influencing the germination and growth of seedlings of red clover, ladino clover, lespedeza, soybean, orchard grass, Italian ryegrass, brome grass, barley, wheat, sorghum, corn and Hog-millet. In view of the possibility that the organic acid might be closely related to the excrements and components of crop root connected with soil sickness, the acid components of three species of roots were analysed by paper chromatography and gas chromatography method. The following results were obtained: 1. Effects of Aqueous Extracts of Fresh Roots : Aqueous extracts of red clover: The extracts inhibited the growth of seedlings of the ladino clover and lespedeza and also inhibited the development of most crops except that of sorghum among the Graminaceae. Aqueous extracts of orchard grass: The extracts promoted the seedlings growth of red clover and soybean, while it inhibited the germination and growth of orchard grass. There were no noticeable effects influencing other crops while it inhibited the growth of barley and Hog-millet. Aqueous extracts of brome grass: There was no effect on Italian ryegrass but there was an inhibiting effect on the other crops. 2. Effects of Aqueous Extracts of Rotting Roots : Aqueous extracts of red clover: The extracts promoted the seedling growth of red clover. But it reflected the inhibiting effects on other crops except sorghum. Aqueous extracts of orchard grass: The extracts promoted the growth of red clover, ladino clover, soybean and sorghun, while it inhibited the germination and rooting of barley and Hog-millet. Aqueous extracts of brome grass: The extracts gave the promotive effects to the growth of red clover, soybean and sorghum, but caused inhibiting effects on orchard grass, brome grass, barley and Hog-millet. 3. Effects of Aqueous Solutions of Excrements : The aqueous solution of excrements of red clover reflected the inhibition effects to the growth of Graminaceae, while the aqueous solutions of excrements of orchard grass and Italian ryegrass caused the promotive effects on the growth of red clover. 4. Results of Organic Acid Analysis : The oxalic acid, citric acid, tartaric acid, malonic acid, malic acid and succinic acid were included in the roots of red clover as unvolatile organic acid, and in the orchard grass and brome grass there were included the oxalic acid, citric acid, tartaric acid and malic acid. And formic acid was confirmed in the red clover, orchard grass and brome grass as volatile organic acid. In consideration of the results mentioned in above the effects of excrements and components of roots found in this studies may be summarized as follows. 1) The red clover generally gave a disadvantageous effect on the Graminaceae. Such trend was considered chiefly caused by the presence of many organic acids, namely oxalic, citric, tartaric, malonic, malic, succinic and formic acid. 2) The orchard grass generally gave an advantageous effect on the Leguminosae. This may be due to a few kinds of organic acid contained in the root, namely oxalic, citric, tartaric, malic and formic acid. Furthermore a certain of promotive materials for growth was noted. 3) As long as the root of brome grass are not rotten, it gave a disadvantageous effect on the Leguminosae and Graminaceae. This may be due to the fact that several unidentified volatile organic acid were also included besides the confirmed organic acid, namely oxalic, citric, tartaric, malic and formic acid. 5. Effects of Components in Roots to the Soil Sickness : 1) It was considered that the cause of alleged red clover's soil sickness did not result from the toxic components of the roots. 2) It was recognized that the toxic components of roots might be the cause of soil sickness in case the orchard grass and brome grass were put into the long-term single cropping. 6. Effects of Rooted Components to the Companion Crops in the Cropping System : a) In case of aqueous extracts of fresh roots and aqueous excrements (Inter cropping and mixed cropping) : 1) Advantageous combinations : Orchard grass->Red clover, Soybean, Italian ryegrass->Red clover, 2) Disadvantageous combinations : Red clover->Ladino clover, Lespedeza, Orchard grass, Italian ryegrass, Fescue Ky-31, Brome grass, Barley, Wheat, Corn and Hog.millet, Orchard grass->Lespedeza, Orchard grass, Barley and Hog-millet, Brome grass->Red clover, Ladino clover, Lespedeza, Soybean, Orchard grass, Brome grass, Barley, Wheat, Sorghum, Corn and Hog-millet, 3) Harmless combinations : Red clover->Red clover, Soybean and Sorghum, Orchard grass->Ladino clover, Italian ryegrass, Brome grass, Wheat, Sorghum and Corn, Brome grass->Italian ryegrass, b) In case of aquecus extracts of rotting roots(After cropping) : 1) Advantageous combinations : Red clover->Red clover and Sorghum, Orchard grass->Red clover, Ladino clover, Soybean, Sorghum, and Corn, Brome grass->Red clover, Soybean and Sorghum, 2) Disadvantageous combinations : Red clover->Lespedeza, Orchard grass, Italian ryegrass, Brome grass, Barley, Wheat, and Hog-millet Orchard grass->Barley and Hog-millet, Brome grass->Orchard grass, Brome grass, Barley and Hog-millet, 3) Harmless combinations : Red clover->Ladino clover, Soybean and Corn, Orchard grass->Lespedeza, Orchard grass, Italian ryegrass, Brome grass and Wheat Brome gass->Ladino clover, Lespedeza, Italian ryegrass and Wheat.

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Studies on the growth duration and hybrid sterility in remote cross breeding of cultivated rice (수도원연품종간잡종에 있어서의 생육일수와 불임에 관한 연구)

  • Mun-Hue Heu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.4 no.1
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    • pp.31-71
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    • 1968
  • To clarify the breeding behavior of the hybrids between tropical and temperate area rice varieties, investigations were made on heading days and grain sterility. In this study, crosses were made in half way diallel involving 7 varieties: 2 photoperied sensitive Indicas, 2 less sensitive intermediate Indicas, 1 Ponlai Japonica and 2 high temperature sensitive Japonicas. The parents and $F_1$s were grown under 10 hours and 14 hours daylength controlled conditions at both IRRI(International Rice Research Institute, N$14^{\circ}$17') and Suwon(N$37^{\circ}$16'). F2s with their parents were grown at IRRI in the short day season, and at Suwon under natural conditions. Fa lines with their parents were grown at Suwon under natural conditions. Observations were made for heading days and sterility. The results are summarized as follow; 1. Heading days : 1. For the $F_1$s, earliness showed dominance or overdominance to lateness under the 10 hours condition, and dominance or partial dominance under the 14 hours conditions, at both IRRI and Suwon. 2. For the $F_2$s grown at IRRI during the shortday season earliness appeared to be dominant over lateness and segregation was not distinct and continuous. In the early season culture of $F_2$s at Suwon earliness showed partial dominance or was intermediate. In the proper season culture of $F_2$s lateness showed partial dominance or was intermediate. 3. In the combinations between late parental varieties which do not head at Suwon, transgressive segregants bearing effective panicles were obtained. 4. The crosses of parental varieties having long basic vegetative growth duration showed bigger variance in heading days, and significant correlation was found between of parental varieties and the mean coefficient of variance for parental arrays. 5. The means of heading days of F2 populations were significantly correlated with those of $F_1$ or mid-parents. The means of F 8 lines were also highly correlated with the means of $F_2$s, but, the means of $F_3$ lines grown at Suwon and of their parental $F_2$ individual, grown at IRRI were not correlated. 6. A faint heritability was calculated from the regression of $F_3$ lines grown at Suwon on the $F_2$ individuals grown at IRRI for most combinations, especially in the combinations involving shortday sensitive varieties. This implies low efficiency for the selection of heading days of $F_2$ individuals at IRRI to be grown in lines at Suwon. 7. No significant reciprocal effects were measured for $F_1$ and $F_2$ mean heading days. 8. Partitioning the observed photoperiod sensitivity. into two components, parental array mean md the deviation from this array mean, the parental photoperiod sensitivity contributing to the hybrids was measured in terms of general and specific combining ability for photoperiod sensitivity. 9. The photoperiod sensitivity of $F_1$s was higher than that of the parents, and it decreased as the generation progressed in most combinations of tested varieties. 10. The response of heading days to difference of temperature was weaker for $F_1$ hybrids than for the parents. The differences of temperature responses between the longday and shortday treatments were specific for the variety. 2. Sterility : 1. The $F_1$ sterility was specific for the combinations and not correlated to the parental sterility. The sterility of $F_1$s grown under the 10 hours condition was higher than of those grown under 14 hours. These results were the same at both locations, IRRI and Suwon. 2. The high sterile combinations in $F_1$ showed high sterility in $F_2$. The combinations between a high photoperiod sensitive variety and a high temperature sensitive variety showed high sterility and wider variance. 3. The mean sterility of $F_2$s was lower than of $F_1$s and the mean of $F_3$ lines was lower than of $F_2$s. Sterility decreased as the generation progressed, and the differences of $F_3$ sterility of different combinations were not significant. 4. A faint correlation between grain sterility and pollen sterility was observed in $F_2$ populations. 5. No significant reciprocal effects were measured in $F_1$ and $F_2$ sterility. 6. Following Griffing's method, specific combining ability effects were higher than general combining ability effects, especially in the combinations between highly photoperiod sensitive varieties and highly temperature sensitive varieties. 7. No distinct correlations were found between $F_2$ individual sterility grown at IRRI and $F_3$ line sterility grown at Suwon. 8. No distinct correlations were observed between heading days and sterility of $F_2$ individuals.

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축산식품중(畜産食品中)의 Cholestrerol에 관(關)한 고찰(考察)

  • Han, Seok-Hyeon
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 1995.11a
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    • pp.1-48
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    • 1995
  • 식생활은 인간 생활의 주체이고 먹는다는 것은 그 수단이다. 그중 중요한 하나의 명제는 인간이 놓여진 여러 환경에서 어떻게 건강을 유지하고 그 개체가 소유하고 있는 능력을 최대치까지 생리적으로 성장 발전시킴과 동시에 최대한 수명을 연장시키기 위한 식물 섭취방법을 마이크로 레벨까지 해명하는데 있다. 인간은 일생동안 엄청난 양의 음식물을 먹는다(70세 수명일 경우 200만 파운드 즉 체중의 1,400배). 그러나 먹기는 먹되 자신의 건강과 장수를 위하여 어떤 음식을 어떻게 선택하여 어떻게 먹어야 하는 문제가 매우 중요하다. 최근 우리나라도 국민 소득이 늘면서 식생활은 서구화 경향으로 기우는 듯하다. 공해를 비롯한 수입식품 등 여러 가지 문제점이 제기됨에 따라 자연식과 건강식을 주장하는 소리가 높이 일고 있다. 그중에는 축산 식품이 콜레스테롤 함량이 다른 식품에 비하여 높게 함유하고 있다는 것으로 심혈관질환의 주범인양 무차별 강조하는 나머지 육식공포 내지는 계란 등의 혐오감 마저 불러 일으키는 경향까지 있는 듯하다. 따라서 본논고에서는 축산식품중의 콜레스테롤 함량수준이 과연 성인병의 주범인지 아니면 다른 지방산과 관련해서 올바르게 평가하고 그 문제점과 대책을 개관해 보고 요약하면 다음과 같다. 1. 사람은 유사이래 본능적으로 주변의 식물이나 동물의 고기를 먹고 성장하여 자손을 증식시키고 어느 사이에 늙으면 죽음을 맞이 하는 싸이클을 반복하면서 기나긴 세월동안 진화를 하여 오늘날의 인간으로서의 자태를 이루었다. 유인원과 같은 인류의 선조들은 수렵을 통해 육식을 많이 하였을 것이므로 인간은 원래 육식동물이 아닐까? 구석기시대의 유물을 보면 많은 뼈가 출토되고 “얄타미라”나 “라스코” 동굴벽화가 선명하게 묘사되고 있다. 2. 우리나라 선조 승구족의 일파가 백두산을 비롯한 만주 송화강 유역에 유입되면서 수렵과 목축을 주요 식품획득의 수단으로 식품문화권을 형성하면서 남하하여 한반도 민족의 조상인 맥족(貊族)으로 맥적(貊炙)이라고 하는 요리(오늘날의 불고기)를 먹었다는 기록이 있다. 3. 인간의 수명을 1900년대로 거슬러 올라가서 뉴질랜드가 세계최장수국(호주는 2위)로서 평균수명은 남자 58세, 여자 69세인 반면 일본과 한국은 당시 남자 36세, 여자 37세이던 것이 일본은 1989년에 이르러 세계 최장수국으로 등장했으나 1990년 당시 뉴질랜드${\cdot}$호주 등은 목축 및 밀(小麥) 생산국가였기 때문이라는 것과 일본은 오늘날 합리적인 식생활 국가라는 것을 간과해서는 안된다. 4. 우리나라 10대 사망원인중 (1994년도) 뇌혈관질환이 1위, 교통사고 2위, 암이 3위 순위로서 연령별로는 10~30대의 불의의 사고(교통사고), 40~60대는 암, 70대 이상은 뇌혈관질환이 가장 많다. 구미${\cdot}$일 7개국 정상국가들은 심질환 사망이 가장 높다. 5. 식생활의 변화에 있어서 우리나라는 주식으로 섭취해 왔던 곡류는 70년 대비 94년에는 0.7배 감소된 반면 육류 5배, 계란 2.4배, 우유는 무려 29.3배 증가되었다. 식생활 패턴이 서구화 경향으로 바뀌는 것 같다. 6. 71년도 우리나라의 지질섭취량은 국민 1인당 1일 평균 13.1g에 섭취에너지의 5.7%수준이었으나 92년도에는 34.5g으로서 총에너지 섭취량의 16.6%에 달하고 총섭취 지방질중 동물성 섭취 비율은 47%를 차지 한다. 국민 평균 혈청콜레스테롤 농도는 80년에 비해 88년에는 11%가 증가되었고 80년에 210mg/dl 이상 되는 콜레스테롤 혈증인 사람의 비율이 5%에서 88년에는 23%로 크게 증가했다. 7. 세계 정상국가들의 단백질 즉 축산식품의 섭취는 우리나라보다 적게는 2배, 많게는 6~7배 더 섭취하고 90년도 우리나라의 지질섭취량은 일본의 1/3수준에 불과하다. 8. 콜레스테롤은 인체를 비롯한 모든 동물체에 필수적으로 분포하고 있는 것으로 체내 존재하고 있는 총량은 90~150g, 이중 혈청콜레스테롤은 4%(6g)를 차지하고 있음에도 불구하고 이 아주 적은 콜레스테롤에 일희일비(一喜一悲) 논쟁은 60~70년 끄러오고 있다. 9. 콜레스테롤의 생체내 기능으로서는 (1) 세포벽의 지지물질 (2) 신경세포 보호막물질 (3) 담즙산의 합성 (4) 비타민 D의 합성 (5) 임신시에 반듯이 필요한 분자 (6) 기타 여러 가지 기능을 수행하는 것으로 필수적인 물질이다. 10. 우리가 식이를 통해서 섭취 콜레스테롤을 550mg정도를 섭취한다고 하더라도 이 정도의 양은 배설 소모되는 양과 거의 맞먹는 양이다. 피부와 땀샘에서 소실되는 양만도 100~300mg에 달하기 때문에 미국농무성에서 섭취량을 300mg로 제한하는 것은 무의미하다. 11. 콜레스테롤 운반체로서의 지단백질은 그 밀도가 낮은 것으로부터 킬로미크론(chylomicron), 초저밀도 지단백질(VLDL), 저밀도 지단백질(LDL) 및 고밀도 지단백질(HDL)으로 나누는데 LDL은 혈청콜레스테롤 중 약 70%, HDL은 약20%를 함유한다. 12. 혈중 콜레스테롤 수준에 영향을 미치는 요인을 열거하여 보면 다음과 같다. 1) 음식을 통해서 섭취되는 콜레스테롤 중 단지 10~40%정도가 흡수되고, 체내에서 합성되는 콜레스테롤이 증가할수록 식이콜레스테롤은 실제 혈청콜레스테롤 수준에 거의 영향을 미치지 않으므로 식이중함량에 대하여 공포를 느끼고 기피할 필요가 없다. 2) 고도불포화지방산, 단가불포화지방산, 포화지방산의 비 즉 P/M/S의 비가 균형되도록 권장한다. 3) 동맥경화를 비롯한 성인병의 원인이 되는 혈전증에는 EPA의 양을 높여줌으로서 성인병을 예방할 수 있다. 4) 오메가6지방산 아라키도닉산과 오메가3지방산인 EPA로 유도되는 에이코사에노이드 또는 프로스타노이드는 오메가6와 3지방산을 전구체로 하여 생합성되는 중요한 생리활성 물질이다. 5) 사람은 일반적으로 20세에서 60세까지 나이를 먹어감에 따라 혈중 콜레스테롤 수준이 증가하고 60세 이후부터는 일정한 수준을 유지하며 심장보호성 HDL-콜레스테롤은 감소하는 반면에 죽상경화성 LDL콜레스테롤은 증가한다. 6) 높은 HDL콜레스테롤 수준이 심장병 발생 위험요인을 감소시키는 기능을 갖고 있기 때문에 좋은 HDL이라 부르고, LDL은 나쁜 콜레스테롤이라 부르기도 하는데, 이것은 유전적 요인보다도 환경적 요인이 보다 큰 영향을 미친다. 7) 이것은 생활 형태와 영양섭취상태를 포함해서 개인적 생활패턴에 영향을 받는다. 8) 많은 실험에서 혈중 콜레스테롤 상승은 노년의 가령(加齡)에 적응하기 위한 자연적 또는 생리적인 세포의 생화학적이고 대사적인 기능을 위해 필수적일 수 있다는 것을 간과해서는 안될 것이다. 이 점으로 미루어 노년의 여성들을 위한 콜레스테롤 농도를 200mg/dl이 가장 알맞은 양이 아닌 듯하다. 9) 스트레스는 두가지 모양으로 유발되는데 해로은 스트레스(negative), 이로운 스트레스(positive)로서 긴장완화는 혈중 콜레스테롤 농도를 10% 떨어진다. 10) 자주 운동을 하는 사람들은 혈중 HDL콜레스테롤치가 운동을 하지 않는 사람보다 높다. 육체적인 운동의 정도와 혈중 HDL콜레스테롤 농도와는 정비례한다. 11) 흡연은 지방을 흡착시키므로 혈전증의 원이이 되며 혈관속의 HDL농도를 감소시킨다. 12) 에너지의 과잉섭취에 의한 체중 증가느 일반적으로 지단백질대사에 영향을 미치고, 간에서는 콜레스테롤 과잉 생산과 더불어 VLDL콜레스테롤의 LDL콜레스테롤 혈증을 나타냄으로 운동과 더불어 비만이 되지 않도록 하여야 한다. 13. 콜레스테롤 함량에 대한 조절기술 1) 식품의 우열을 평가할 때 단순히 동물성 또는 식물성 식품으로 분류해서 총괄적으로 논한다는 것은 지양되어야 한다. 이것은 그 식품에 함유하고 있는 지방산의 종류에 따라서 다르기 때문이다. 2) 인체의 원할한 기능 유지를 위해서는 P /M /S비율 뿐만 아니라 섭취 지방질의 오메가6 /오메가3계 지방산의 비율이 모두 적절한 범위에 있어야 하며 한두가지 지방산만이 과량일 때는 또 다른 불균형을 일으킬 수 있다는 점을 알아야 한다. 3) 닭고기는 오메가6지방산 함량을 높이기 위하여 사료중에 등푸른 생선이나 어분이나 어유를 첨가하여 닭고기는 첨가수준에 따라 증가됨을 알 수 있다. 4) 오늘날 계란내의 지방산 조성을 변화시켜 난황내의 오메가 3계열 지방산 함량을 증가시킨 계란의 개발이 활발해졌다. 14. 계란 콜레스테롤에 대한 소비자들의 부정적 인식을 불식시키고자 계란의 클레스테롤 함량을 낮추는 과제가 등장하면서 그 기술개발이 여러모로 시도되고 있으나 아직 실용 단계에 이르지 못했다. 15. 계란의 콜레스테롤 문제에 대한 대책으로서 난황의 크기를 감소시키는 방법에 대한 연구도 필요하다. 16. 계란 중 콜레스테롤 함량 분석치는 표현 방식에 따라서 소비자들을 혼란시킬 가능성이 있다. 또한 과거에는 비색법으로 분석했으나 오늘날은 효소법으로 분석하면 분석치에 상당한 차이가 있다. 17. 소비자의 요구를 만족시키고 버터 소비를 촉진시키기 위해 콜레스테롤을 감소시키는 물리적${\cdot}$생물학적 방식이 제안되어 있으나 현장적용이 가능한 것은 아직 없다. 18. 우리나라에서 이미 시판되고 있는 DHA우유가 선보였고 무콜레스테롤 버터의 경우 트란스(trans)형 지방산에 관해서는 논란의 여지가 많을 것이다. 끝으로 국가 목표의 하나는 복지사회 건설에 있고 복지국가 실현에는 국민 기본 욕망의 하나인 식생활 합리화가 선행되어야 한다. 소득이 늘고 국가가 발전해감에 따라 영양식${\cdot}$건강식 및 기호식을 추구하게 됨을 매우 당연한 추세라 하겠다. 우리의 식생활이 날로 향상되어 지난날의 당질 위주에서 점차 축산물쪽으로 질적 개선이 이루어진다는 것은 고무적임에 틀림없다. 이 축산물을 통한 풍요로운 식의 문화를 창출하면서 건강과 장수 그리고 후손에 이르기까지 번영하고 국가 경쟁력 강화에 심혈을 기우려야 할 때이다.

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Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

  • Ji, Seong-Goo;Lee, Ihn-Goo
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.1-24
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    • 2010
  • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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Comparisons of Unicortical and Bicortical Lateral Mass Screws in the Cervical Spine : Safety vs Strength (경추부의 후관절 나사못 고정술에서 단피질삽입법과 양피질 삽입법 간의 특성에 관한 비교)

  • Park, Choon-Keun;Hwang, Jang-Hoe;Ji, Chul;Lee, Jae Un;Sung, Jae Hoon;Choi, Seung-Jin;Lee, Sang-Won;Seybold, Eric;Park, Sung-Chan;Cho, Kyung-Suok;Park, Chun-Kun;Kang, Joon-Ki
    • Journal of Korean Neurosurgical Society
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    • v.30 no.10
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    • pp.1210-1219
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    • 2001
  • Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.

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Studies of nutrient composition of transitional human milk and estimated intake of nutrients by breast-fed infants in Korean mothers (한국인 수유부의 수유초기 이행유의 모유성분 분석과 영아의 섭취량 추정 연구)

  • Choi, Yun Kyung;Kim, Nayoung;Kim, Ji-Myung;Cho, Mi Sook;Kang, Bong Soo;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.48 no.6
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    • pp.476-487
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    • 2015
  • Purpose: This study was conducted to examine the concentration of nutrients in transitional breast milk from Korean lactating mothers and to evaluate daily intakes of their infants based on the Dietary Reference Intakes for Koreans 2010 (KDRIs 2010). Methods: Breast milk samples were collected at 5~15 days postpartum from 100 healthy lactating Korean mothers. Macro- and micro-nutrients, and immunoglobulin (Igs) concentrations in breast milk were analyzed. Results: The mean energy, protein, fat, and carbohydrate concentrations in breast milk were $59.99{\pm}8.01kcal/dL$, $1.47{\pm}0.27g/dL$, $2.88{\pm}0.89g/dL$, and $6.72{\pm}0.22g/dL$. The mean linoleic acid (LA), a-linolenic acid (ALA), arachidonic acid (AA), and docosahexaenoic acid (DHA) concentrations were $181.44{\pm}96.41mg/dL$, $28.15{\pm}8.89mg/dL$, $5.67{\pm}1.86mg/dL$, and $5.74{\pm}2.57mg/dL$. The mean vitamin A, vitamin D, vitamin E, vitamin $B_1$, vitamin $B_2$, vitamin $B_{12}$, and folate concentrations were $2.75{\pm}1.75{\mu}g/dL$, $2.31{\pm}1.12ng/dL$, $0.74{\pm}1.54mg/dL$, $3.02{\pm}1.84mg/dL$, $7.51{\pm}20.96{\mu}g/dL$, $61.78{\pm}26.78{\mu}g/dL$, $63.71{\pm}27.19ng/dL$, and $0.52{\pm}0.26{\mu}g/dL$. The mean concentrations of calcium, iron, potassium, sodium, zinc, and copper were $20.71{\pm}3.34mg/dL$, $0.59{\pm}0.86mg/dL$, $66.71{\pm}10.35mg/dL$, $27.72{\pm}10.16mg/dL$, $0.44{\pm}0.41mg/dL$, and $70.48{\pm}30.41{\mu}g/dL$. The mean IgA and total IgE concentrations were $61.85{\pm}31.97mg/dL$ and $235.00{\pm}93.00IU/dL$. The estimated daily intakes of infants for protein, vitamin D, vitamin E, vitamin $B_2$, vitamin $B_{12}$, iron, potassium, sodium, zinc, and copper were sufficient compared to KDRIs 2010 adjusted by transitory milk intakes. The estimated infants' intakes of energy, fat, carbohydrate, vitamin A, vitamin C, vitamin $B_1$, folate, and calcium did not meet KDRIs 2010 adjusted by transitory milk intakes. Conclusion: In general most estimated nutrient intakes of Korean breast-fed infants in transitory breast milk were sufficient, however some nutrient intakes were not sufficient based on KDRIs 2010. These results warrant conduct of future studies for investigation of important dietary factors associated with nutrients in breast milk to improve the quality of breast milk, which may contribute to understanding nutrition in early life and promoting growth and development of breast-fed infants.