• Title/Summary/Keyword: Literature review study

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Proposed Sustainability Risk Framework through the Analysis of Advanced Donor Countries' International Development Cases (선진 공여국의 국제개발 사례 분석 기반 지속가능성 리스크 프레임워크 제안)

  • Lee, Kyung-Tae;Kim, Ju-Hyung
    • Korean Journal of Construction Engineering and Management
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    • v.24 no.6
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    • pp.12-23
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    • 2023
  • The goal of international development projects is to assist sustainable development in recipient countries through foreign aid from donor countries. However, despite the need for both countries to negotiate and work together from the initial stages to maintain sustainability after the project, clear guidelines or standards have not been established. Additionally, despite the need for donor countries, which are relatively advanced, to understand the situation of recipient countries, many projects are donor-centric and fail to prioritize the value of sustainability. Therefore, this study extracted economic, social, and environmental risks that threaten sustainability through literature review and proposed a sustainability framework based on these criteria. To validate framework, actual international development cases conducted by advanced donor countries such as Australia, the United States, and Japan, in collaboration with South Korea, were analyzed by applying content analysis with the reports, which covers the overall contents from the planning stage to the operation stage. Analysis of sustainability perspectives focused on economy, society and the environment, advanced donor countries emphasized (1) the importance of pre-assessment, (2) the need for coordination with the local population and communities despite the existence of donor-specific values, and (3) addressing economic considerations such as pre-operational and maintenance costs, social communication with the local population, and environmental considerations starting from the initial stages of construction regarding the treatment of pollutants as values to be improved. Compared to other advanced donor countries, the Republic of Korea should also focus on consultation with local residents to achieve social integration, and improve sustainability by deployment the managers in local sites for better negotiation.The proposed framework in this study will serve as a tool to enhance communication among the countries and the locals, with the expectation of increasing project efficiency and sustainability.

Establishment of Safety Factors for Determining Use-by-Date for Foods (식품의 소비기한 참고치 설정을 위한 안전계수)

  • Byoung Hu Kim;Soo-Jin Jung;June Gu Kang;Yohan Yoon;Jae-Wook Shin;Cheol-Soo Lee;Sang-Do Ha
    • Journal of Food Hygiene and Safety
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    • v.38 no.6
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    • pp.528-536
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    • 2023
  • In Korea, from January 2023, the Act on Labeling and Advertising of Food was revised to reflect the use-by-date rather than the sell-by-date. Hence, the purpose of this study was to establish a system for calculating the safety factor and determining the recommended use-by-date for each food type, thereby providing a scientific basis for the recommended use-by-date labels. A safety factor calculation technique based on scientific principles was designed through literature review and simulation, and opinions were collected by conducting surveys and discussions including industry and academia, among others. The main considerations in this study were pH, Aw, sterilization, preservatives, packaging for storage improvement, storage temperature, and other external factors. A safety factor of 0.97 was exceptionally applied for frozen products and 1.0 for sterilized products. In addition, a between-sample error value of 0.08 was applied to factors related to product and experimental design. This study suggests that clearly providing a safe use-by-date will help reduce food waste and contribute to carbon neutrality.

Development of a Tool to Measure Knowledge of Clinical Dental Hygienists on Precautions for Dental Treatment of Dementia Patients (임상 치과위생사의 치매 환자 치과 진료 시 주의 사항에 관한 지식측정 도구 개발)

  • Nahyun Kim;So-Jung Mun;Hie-Jin Noh;Sun-Young Han
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.79-89
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    • 2023
  • Background and Objectives: The prevalence of dementia is steadily increasing each year, and preceding studies continue to explore the association between dementia and oral health. Dental hygienists require specialized competencies to provide appropriate dental healthcare services, necessitating the development of a tool for the objective measurement of their knowledge levels. This study aimed to develop a knowledge assessment tool for dental hygienists concerning considerations for dental care for patients with dementia. Methods: The study constructed preliminary items based on a literature review and then conducted expert validation, a pilot survey, and the main survey. The main survey was conducted among 220 dental hygienists. Validity and reliability analyses were conducted with the collected data to select the final items, and the correctness rates for each selected item were verified. Results: As a result of the analysis of the collected data, 18 items were eliminated out of a total of 40 preliminary items, leaving a total of 6 factors and 22 items. The Cronbach's α value for the selected items was 0.791. The six factors are as follows: 'Considerations during dental treatment for dementia patients' (5 items), 'medication side effects in dementia patients' (4 items), 'oral care methods for dementia patients' (4 items), 'communication with dementia patients' (4 items), 'psychological reactions of dementia patients' (3 items), and 'guidance for dementia patients' (2 items). The item with the highest correctness rate was item 2 of the 'guidance for dementia patients' category at 98.6%, while the item with the lowest correctness rate was item 2 of the 'psychological reactions of dementia patients' category at 5.9%. Conclusion: This study validated the reliability and validity of the knowledge assessment tool, which lays the foundation for future research on dental hygienists and dementia. It contributes essential data for ongoing education, development of educational programs, and establishing operational guidelines in healthcare institutions.

The Development and Validation of a Core Competency Scale for Startup Talent : Focusing on ICT Sector Employees (스타트업 핵심인재 역량 척도 개발 및 타당화 : 정보통신기술(ICT)분야 종사자를 대상으로)

  • Han, Chae-yeon;Ha, Gyu-young
    • Journal of Venture Innovation
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    • v.7 no.3
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    • pp.183-228
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    • 2024
  • This study aimed to develop a competency evaluation scale tailored to the specific needs of key talent in the ICT startup sector. Existing competency assessment tools are mostly designed for environments in large corporations or traditional small and medium-sized enterprises, failing to adequately reflect the dynamic requirements of rapidly evolving startups. For startups, where a small number of individuals directly impact company success, key talent is a critical asset. Accordingly, this study sought to create a scale that measures the competencies suited to the challenges and opportunities faced by startups, helping domestic startups establish more effective talent management strategies. The research initially selected 71 items through a literature review and in-depth interviews. Based on expert feedback that emphasized the need for more precise and clear descriptions, the item descriptions were revised, and a total of 65 items were developed through four rounds of content validation. Following preliminary and main surveys, a final set of 58 items was developed. The main survey conducted further factor analysis based on the three broad competency factors?knowledge, skills, and attitude?identified in the preliminary survey. As a result, 10 latent factors emerged: 6 items for task comprehension, 6 items for practical experience (tacit knowledge), 6 items for collaboration, 9 items for management and problem-solving, 9 items for practical skills, 4 items for self-direction, 5 items for goal orientation, 5 items for adaptability, 5 items for relationship orientation, and 3 items for organizational loyalty. The developed scale comprehensively covers the multifaceted nature of competencies, allowing for a thorough evaluation of essential skills such as technical ability, teamwork, innovation, and leadership, which are critical for startups. Therefore, the scale provides a tool that helps startup managers objectively and accurately assess candidates' competencies. It also supports the growth of employees within startups, maximizing the overall organizational performance. By utilizing this tool, startups can build a strong internal talent pool and continuously enhance employees' competencies, thereby strengthening organizational competitiveness. In conclusion, the competency evaluation scale developed in this study is a customized tool that aligns with the characteristics of startups and plays a crucial role in securing sustainable competitiveness in rapidly changing market environments. Additionally, it offers practical guidance to support the successful growth of domestic startups and help them maintain their competitive edge in the market, contributing to the development of the startup ecosystem and the growth of the national economy.

Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Seeking a Better Place: Sustainability in the CPG Industry (추심경호적지방(追寻更好的地方): 유포장적소비품적산업적가지속발전(有包装的消费品的产业的可持续发展))

  • Rapert, Molly Inhofe;Newman, Christopher;Park, Seong-Yeon;Lee, Eun-Mi
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.199-207
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    • 2010
  • For us, there is virtually no distinction between being a responsible citizen and a successful business... they are one and the same for Wal-Mart today." ~ Lee Scott, al-Mart CEO after the 2005 Katrina disaster; cited in Green to Gold (Esty and Winston 2006). Lee Scott's statement signaled a new era in sustainability as manufacturers and retailers around the globe watched the world's largest mass merchandiser confirm its intentions with respect to sustainability. For decades, the environmental movement has grown, slowly bleeding over into the corporate world. Companies have been born, products have been created, academic journals have been launched, and government initiatives have been undertaken - all in the pursuit of sustainability (Peattie and Crane 2005). While progress has been admittedly slower than some may desire, the emergence and entrance of environmentally concerned mass merchandisers has done much to help with sustainable efforts. To better understand this movement, we incorporate the perspectives of both executives and consumers involved in the consumer packaged goods (CPG) industry. This research relies on three underlying themes: (1) Conceptual and anecdotal evidence suggests that companies undertake sustainability initiatives for a plethora of reasons, (2) The number of sustainability initiatives continues to increase in the consumer packaged goods industries, and (3) That it is, therefore, necessary to explore the role that sustainability plays in the minds of consumers. In light of these themes, surveys were administered to and completed by 143 college students and 101 business executives to assess a number of variables in regards to sustainability including willingness-to-pay, behavioral intentions, attitudes, willingness-to-pay, and preferences. Survey results indicate that the top three reasons why executives believe sustainability to be important include (1) the opportunity for profitability, (2) the fulfillment of an obligation to the environment, and (3) a responsibility to customers and shareholders. College students identified the top three reasons as (1) a responsibility to the environment, (2) an indebtedness to future generations, and (3) an effective management of resources. While the rationale for supporting sustainability efforts differed between college students and executives, the executives and consumers reported similar responses for the majority of the remaining sustainability issues. Furthermore, when we asked consumers to assess the importance of six key issues (healthcare, economy, education, crime, government spending, and environment) previously identified as important to consumers by Gallup Poll, protecting the environment only ranked fourth out of the six (Carlson 2005). While all six of these issues were identified as important, the top three that emerged as most important were (1) improvements in education, (2) the economy, and (3) health care. As the pursuit and incorporation of sustainability continues to evolve, so too will the expected outcomes. New definitions of performance that reflect the social/business benefits as well as the lengthened implementation period are relevant and warranted (Ehrenfeld 2005; Hitchcock and Willard 2006). We identified three primary categories of outcomes based on a literature review of both anecdotal and conceptual expectations of sustainability: (1) improvements in constituent satisfaction, (2) differentiation opportunities, and (3) financial rewards. Within each of these categories, several specific outcomes were identified resulting in eleven different outcomes arising from sustainability initiatives. Our survey results indicate that the top five most likely outcomes for companies that pursue sustainability are: (1) green consumers will be more satisfied, (2) company image will be better, (3) corporate responsibility will be enhanced, (4) energy costs will be reduced, and (5) products will be more innovative. Additionally, to better understand the interesting intersection between the environmental "identity" of a consumer and the willingness to manifest that identity with marketplace purchases, we extended prior research developed by Experian Research (2008). Accordingly, respondents were categorized as one of four types of green consumers (Behavioral Greens, Think Greens, Potential Greens, or True Browns) to garner a better understanding of the green consumer in addition to assisting with a more effective interpretation of results. We assessed these consumers' willingness to engage in eco-friendly behavior by evaluating three options: (1) shopping at retailers that support environmental initiatives, (2) paying more for products that protect the environment, and (3) paying higher taxes so the government can support environmental initiatives. Think Greens expressed the greatest willingness to change, followed by Behavioral Greens, Potential Greens, and True Browns. These differences were all significant at p<.01. Further Conclusions and Implications We have undertaken a descriptive study which seeks to enhance our understanding of the strategic domain of sustainability. Specifically, this research fills a gap in the literature by comparing and contrasting the sustainability views of business executives and consumers with specific regard to preferences, intentions, willingness-to-pay, behavior, and attitudes. For practitioners, much can be gained from a strategic standpoint. In addition to the many results already reported, respondents also reported than willing to pay more for products that protect the environment. Other specific results indicate that female respondents consistently communicate a stronger willingness than males to pay more for these products and to shop at eco-friendly retailers. Knowing this additional information, practitioners can now have a more specific market in which to target and communicate their sustainability efforts. While this research is only an initial step towards understanding similarities and differences among practitioners and consumers regarding sustainability, it presents original findings that contribute to both practice and research. Future research should be directed toward examining other variables affecting this relationship, as well as other specific industries.

Development of a Measuring Tool for Spiritual Care Performance of Hospice Team Members (호스피스 팀원들의 영적 돌봄 수행도 측정 도구 개발)

  • Yoo, Yang-Sook;Han, Sung-Suk;Lee, Sun-Mi;Seo, Min-Jeong;Hong, Jin-Ui
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.86-92
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    • 2006
  • Purpose: This study was conducted to develop a measuring tool for spiritual care performance of hospice team members. The tool may be utilized for providing hospice patients with more systematic and standardized spiritual tares. Methods: The concept and questions of the tool were developed, and then its validity and reliability were tested. For the validity and reliability tests, a self-reported questionnaire comprising 33 questions with 4 point scale ($1{\sim}4$), was developed, and the data were collected from 192 hospice team members from December 2005 to February 2006. Results: Thirty three questions, drafted through literature review and professional consultation, were reviewed by 20 professionals for their validity, were revised and supplemented resulted in the final 33 questions. The questions with a correlation coefficient grater than .30 were selected: all the 33 questions were selected based on this criterion. The reliability coefficient, Cronbarh's ${\alpha}$, was 0.95. The 33 questions were analyzed for factors, and six factors were extracted: relationship formation and communication, encouragement and promotion of spiritual growth, linking with spiritual resources, preparation of death, evaluation and quality control for spiritual intervention, Intervention, and spiritual assessment for intervention. Conclusion: The tool developed in this study includes six factors and has high level of reliability. This tool Will greatly contribute to assess and improve hospice care services, providing systematic and standardized spiritual cares for terminally ill patients and their families.

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The Relationship among Country of Origin, Brand Equity and Brand Loyalty: Comparison among USA, China and Korea (원산지효과, 상표자산 및 상표충성 간의 관계에 관한 연구: 미국, 중국, 한국의 비교분석)

  • Ko, Eun-Ju;Kim, Kyung-Hoon;Kim, Sook-Hyun;Li, Guo-Feng;Zou, Peng;Zhang, Hao
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.1
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    • pp.47-58
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    • 2009
  • The marketing environment has become competitive to an extent that requires firms to target their products at markets that span national boundaries. However, competitive clout cannot be achieved in global consumer markets unless firms thoroughly understand and adequately respond to the core values and needs of those consumers. Brand equity is one of the most important assets to a company. Especially in sportswear markets, brand equity is the crucial value added to a product by its brand name. Factors such as country of origin also influence customer's attitude towards brand equity. Therefore, this paper discusses the relationship between country of origin effect and brand equity, and how they influence consumers' loyalty for respective brands. This paper focused on the sports shoes market, because it is an increasing area of opportunity for world manufacturers. The objectives of this study were the following. (1) Test the effect of country of origin on brand equity. (2) Test how brand equity influences consumers' brand loyalty. (3) Find whether there are differences in the effects of country of origin and brand equity among the three countries. (4) Find whether there are differences in the effects of country of origin and brand equity among the different lifestyles. Based on the review of literature results, the hypotheses are concluded as the following: H1-a: Country image has positive influence on country of origin. H1-b: Product perception has positive influence on country of origin. H2-a: Perceived quality has positive effect on brand equity. H2-b: Perceived price has positive effect on brand equity. H3: Country of origin has positive effect on brand equity. H4: Brand equity has a positive impact on brand loyalty. Research model was constructed (see Fig. 1). After data analysis, the following results were concluded: sports shoes purchase behavior showed significant differences among Korean, Chinese, and American consumers for favorite brand, purchased brand, purchased place, information usage, and favorite sports games. The results of this study also extend the research of the relationship among country of origin, brand equity and brand loyalty to the sports shoes market. Brand equity was proven to have a significant relationship with brand loyalty for all countries. The factors which can influence brand equity are different for different countries. The third finding of this paper is that we identified different three lifestyles, adventurer, follower, and laggard, for Korean, Chinese and American consumers. Without the nationality boundary, seeing the emergence of a new group of consumers who have similar preferences and buy similar brands is more important. All of the consumers consider brand equity to keep their brand loyalty. Perceived price is the only factor which can influence brand equity for adventurers; brand is more important for them. The laggards were not influenced by any factor. All of the factors expect perceived price are important for the followers. Marketing managers should consider brand equity when introducing their brand into a new market. Also localization is the basic strategy that all the sports shoes companies should understand. But as a global brand, understanding the same characteristics for each country is more important to build global strategy.

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Marketing Standardization and Firm Performance in International E.Commerce (국제전자상무중적영소표준화화공사표현(国际电子商务中的营销标准化和公司表现))

  • Fritz, Wolfgang;Dees, Heiko
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.37-48
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    • 2009
  • The standardization of marketing has been one of the most focused research topics in international marketing. The term "global marketing" was often used to mean an internationally standardized marketing strategy based on similarities between foreign markets. Marketing standardization was discussed only within the context of traditional physical marketplaces. Since then, the digital "marketspace" of the Internet had emerged in the 90's, and it became one of the most important drivers of the globalization process opening new opportunities for the standardization of global marketing activities. On the other hand, the opinion that a greater adoption of the Internet by customers may lead to a higher degree of customization and differentiation of products rather than standardization is also quite popular. Considering this disagreement, it is notable that comprehensive studies which focus upon the marketing standardization especially in the context of global e-commerce are missing to a high degree. On this background, the two basic research questions being addressed in this study are: (1) To what extent do companies standardize their marketing in international e-commerce? (2) Is there an impact of marketing standardization on the performance (or success) of these companies? Following research hypotheses were generated based upon literature review: H 1: Internationally engaged e-commerce firms show a growing readiness for marketing standardization. H 2: Marketing standardization exerts positive effects on the success of companies in international e-commerce. H 3: In international e-commerce, marketing mix standardization exerts a stronger positive effect on the economic as well as the non-economic success of companies than marketing process standardization. H 4: The higher the non-economic success in international e-commerce firms, the higher the economic success. The data for this research were obtained from a questionnaire survey conducted from February to April 2005. The international e-commerce companies of various industries in Germany and all subsidiaries or headquarters of foreign e-commerce companies based in Germany were included in the survey. 118 out of 801 companies responded to the questionnaire. For structural equation modelling (SEM), the Partial-Least. Squares (PLS) approach in the version PLS-Graph 3.0 was applied (Chin 1998a; 2001). All of four research hypotheses were supported by result of data analysis. The results show that companies engaged in international e-commerce standardize in particular brand name, web page design, product positioning, and the product program to a high degree. The companies intend to intensify their efforts for marketing mix standardization in the future. In addition they want to standardize their marketing processes also to a higher degree, especially within the range of information systems, corporate language and online marketing control procedures. In this study, marketing standardization exerts a positive overall impact on company performance in international e-commerce. Standardization of marketing mix exerts a stronger positive impact on the non-economic success than standardization of marketing processes, which in turn contributes slightly stronger to the economic success. Furthermore, our findings give clear support to the assumption that the non-economic success is highly relevant to the economic success of the firm in international e-commerce. The empirical findings indicate that marketing standardization is relevant to the companies' success in international e-commerce. But marketing mix and marketing process standardization contribute to the firms' economic and non-economic success in different ways. The findings indicate that companies do standardize numerous elements of their marketing mix on the Internet. This practice is in part contrary to the popular concept of a "differentiated standardization" which argues that some elements of the marketing mix should be adapted locally and others should be standardized internationally. Furthermore, the findings suggest that the overall standardization of marketing -rather than the standardization of one particular marketing mix element - is what brings about a positive overall impact on success.

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A RURAL HEALTH SERVICE MODEL FOR KOREA BASED OH A PRIMARY CARE NURSING SERVICE SYSTEM

  • Hong, Yeo-Shin
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.5-8
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    • 1981
  • This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

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