• Journal of Global Scholars of Marketing Science
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• v.18 no.1
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• pp.33-58
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• 2008

Previous research has presupposed that the evaluation of consumer who received any recovery after experiencing product failure should be better than the evaluation of consumer who did not receive any recovery. The major purposes of this article are to examine impacts of product defect failures rather than service failures, and to explore effects of recovery on postrecovery product attitudes. First, this article deals with the occurrence of severe and unsevere failure and corresponding service recovery toward tangible products rather than intangible services. Contrary to intangible services, purchase and usage are separable for tangible products. This difference makes it clear that executing an recovery strategy toward tangible products is not plausible right after consumers find out product failures. The consumers may think about backgrounds and causes for the unpleasant events during the time gap between product failure and recovery. The deliberation may dilutes positive effects of recovery efforts. The recovery strategies which are provided to consumers experiencing product failures can be classified into three types. A recovery strategy can be implemented to provide consumers with a new product replacing the old defective product, a complimentary product for free, a discount at the time of the failure incident, or a coupon that can be used on the next visit. This strategy is defined as "a rewarding effort." Meanwhile a product failure may arise in exchange for its benefit. Then the product provider can suggest a detail explanation that the defect is hard to escape since it relates highly to the specific advantage to the product. The strategy may be called as "a strengthening effort." Another possible strategy is to recover negative attitude toward own brand by giving prominence to the disadvantages of a competing brand rather than the advantages of its own brand. The strategy is reflected as "a weakening effort." This paper emphasizes that, in order to confirm its effectiveness, a recovery strategy should be compared to being nothing done in response to the product failure. So the three types of recovery efforts is discussed in comparison to the situation involving no recovery effort. The strengthening strategy is to claim high relatedness of the product failure with another advantage, and expects the two-sidedness to ease consumers' complaints. The weakening strategy is to emphasize non-aversiveness of product failure, even if consumers choose another competitive brand. The two strategies can be effective in restoring to the original state, by providing plausible motives to accept the condition of product failure or by informing consumers of non-responsibility in the failure case. However the two may be less effective strategies than the rewarding strategy, since it tries to take care of the rehabilitation needs of consumers. Especially, the relative effect between the strengthening effort and the weakening effort may differ in terms of the severity of the product failure. A consumer who realizes a highly severe failure is likely to attach importance to the property which caused the failure. This implies that the strengthening effort would be less effective under the condition of high product severity. Meanwhile, the failing property is not diagnostic information in the condition of low failure severity. Consumers would not pay attention to non-diagnostic information, and with which they are not likely to change their attitudes. This implies that the strengthening effort would be more effective under the condition of low product severity. A 2 (product failure severity: high or low) X 4 (recovery strategies: rewarding, strengthening, weakening, or doing nothing) between-subjects design was employed. The particular levels of product failure severity and the types of recovery strategies were determined after a series of expert interviews. The dependent variable was product attitude after the recovery effort was provided. Subjects were 284 consumers who had an experience of cosmetics. Subjects were first given a product failure scenario and were asked to rate the comprehensibility of the failure scenario, the probability of raising complaints against the failure, and the subjective severity of the failure. After a recovery scenario was presented, its comprehensibility and overall evaluation were measured. The subjects assigned to the condition of no recovery effort were exposed to a short news article on the cosmetic industry. Next, subjects answered filler questions: 42 items of the need for cognitive closure and 16 items of need-to-evaluate. In the succeeding page a subject's product attitude was measured on an five-item, six-point scale, and a subject's repurchase intention on an three-item, six-point scale. After demographic variables of age and sex were asked, ten items of the subject's objective knowledge was checked. The results showed that the subjects formed more favorable evaluations after receiving rewarding efforts than after receiving either strengthening or weakening efforts. This is consistent with Hoffman, Kelley, and Rotalsky (1995) in that a tangible service recovery could be more effective that intangible efforts. Strengthening and weakening efforts also were effective compared to no recovery effort. So we found that generally any recovery increased products attitudes. The results hint us that a recovery strategy such as strengthening or weakening efforts, although it does not contain a specific reward, may have an effect on consumers experiencing severe unsatisfaction and strong complaint. Meanwhile, strengthening and weakening efforts were not expected to increase product attitudes under the condition of low severity of product failure. We can conclude that only a physical recovery effort may be recognized favorably as a firm's willingness to recover its fault by consumers experiencing low involvements. Results of the present experiment are explained in terms of the attribution theory. This article has a limitation that it utilized fictitious scenarios. Future research deserves to test a realistic effect of recovery for actual consumers. Recovery involves a direct, firsthand experience of ex-users. Recovery does not apply to non-users. The experience of receiving recovery efforts can be relatively more salient and accessible for the ex-users than for non-users. A recovery effort might be more likely to improve product attitude for the ex-users than for non-users. Also the present experiment did not include consumers who did not have an experience of the products and who did not perceive the occurrence of product failure. For the non-users and the ignorant consumers, the recovery efforts might lead to decreased product attitude and purchase intention. This is because the recovery trials may give an opportunity for them to notice the product failure.

• Cartoon and Animation Studies
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• s.33
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• pp.597-616
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• 2013

Character industry is not only knowledge-based industry chiefly with copyrights but also motive power for creative economy to take a role functionally over the fields of industries because it has industrial characteristic as complement product to promote sale value in manufacturing industry and service industry and increase profit on sales. Since 2003, the national policy related to character has aimed to maximize effect among connected industries, extend its business abroad, enforce copyrights through the improvement of marketing system, develop industrial infrastructure through raising quality of character products. With the result of this policy, the successful cases of connected contents have been crystallized and domestic character industry has stepped up methodically since 2007. It is needed to reset the scales of character industry and industrial stats because there are more know-how of self industry promotion and more related characters through strategy of market departmentalization starting with cartoon, animation, games, novels, movies and musicals. Especially, The Korea government set our target for 'Global Top Five Character Power' since 2009 and has started to carry out to find global star characters, support to establish network among connected industries, diversify promotion channels, and develop licensing business. Particularly, since 2013, There have been prospered the indoor character theme park with time management just like character experimental marketing or Kids cafes using characters, the demand market of digital character focusing on SNS emoticon, and the performance market for character musical consistently. Moreover, The domestic and foreign illegal black markets on off-line have been enlarged, so we need another policy alternative. To prepare for the era of exploding character demand market and diversifying platform, it is needed to set up a solid strategy that is required the elements of policy changes in character industry to vitalize character industry and support new character design and connected contents. the following shows that the elements of policy changes related to the existing policy, the current position of market. Nowadays, the elements of policy changes in domestic character industry are that variety of consumers in the digital character market according to platform diversification, Convergence contents of character goods for the Korean waves, legalization of the illegal black contents market, and controling the tendency of consumers in departmentalized market. This can help find the policy issue entirely deferent with the existing character powers like US, Japan or Europe. In its final analysis, the alternatives are the promotion of models with contract copyrights of domestic and foreign connected contents, the diversification of profit models of platform economy, the additive development of target market related to enlarging the Korean waves, and the strategy of character market for the age-specific tendency according to developing character demand market.

• Journal of agricultural medicine and community health
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• v.13 no.1
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• pp.3-18
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• 1988

The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

• Journal of Global Scholars of Marketing Science
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• v.19 no.3
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• pp.28-36
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• 2009

While existing literature has focused extensively on the strengths and weaknesses of the Chaebol and their ownership and governance, there have been few studies of Korean non-Chaebol firms. However, Lee, Lee and Pennings (2001) did not specifically investigate the competitive strategies that non-Chaebol firms use to survive against the Chaebol in the domestic Korean market. The motivation of this paper is to document, through four exploratory case studies, the successful competitive strategies of non-Chaebol Korean companies against the Chaebol and then offer some propositions that may be useful to other entrepreneurial firms as well as public policy makers. Competition and cooperation as conceptualized by product similarity and cooperative inter.firm relationship respectively, are major dimensions of firm.level marketing strategy. From these two dimensions, we develop the following $2{\times}2$ matrix, with 4 types of competitive strategies for non-Chaebol companies against the Chaebol (Fig. 1.). The non-Chaebol firm in Cell 1 has a "me-too" product for the low-end market while conceding the high-end market to a Chaebol. In Cell 2, the non-Chaebol firm partners with a Chaebol company, either as a supplier or complementor. In Cell 3, the non-Chaebol firm engages in direct competition with a Chaebol. In Cell 4, the non-Chaebol firm targets an unserved part of the market with an innovative product or service. The four selected cases such as E.Rae Electronics Industry Company (Co-exister), Intops (Supplier), Pantech (Competitor) and Humax (Niche Player) are analyzed to provide each strategy with richer insights. Following propositions are generated based upon our conceptual framework: Proposition 1: Non-Chaebol firms that have a cooperative relationship with a Chaebol will perform better than firms that do not. Proposition 1a; Co-existers will perform better than Competitors. Proposition 1b: Partners (suppliers or complementors) will perform better than Niche players. Proposition 2: Firms that have no product similarity with a Chaebol will perform better than firms that have product similarity. Proposition 2a: Partners (suppliers or complementors) will perform better than Co.existers. Proposition 2b: Niche players will perform better than Competitors. Proposition 3: Niche players should perform better than Co-existers. Proposition 4: Performance can be rank.ordered in descending order as Partners, Niche Players, Co.existers, Competitors. A team of experts was constituted to categorize each of these 216 non-Chaebol companies into one of the 4 cells in our typology. Simple Analysis of Variance (ANOVA) in SPSS statistical software was used to test our propositions. Overall findings are that it is better to have a cooperative relationship with a Chaebol and to offer products or services differentiated from a Chaebol. It is clear that the only profitable strategy, on average, to compete against the Chaebol is to be a partner (supplier or complementor). Competing head on with a Chaebol company is a costly strategy not likely to pay off for a non-Chaebol firm. Strategies to avoid head on competition with the Chaebol by serving niche markets with differentiated products or by serving the low-end of the market ignored by the Chaebol are better survival strategies. This paper illustrates that there are ways in which small and medium Korean non-Chaebol firms can thrive in a Chaebol environment, though not without risks. Using different combinations of competition and cooperation firms may choose particular positions along the product similarity and cooperative relationship dimensions to develop their competitive strategies-co-exister, competitor, partner, niche player. Based on our exploratory case-study analysis, partner seems to be the best strategy for non-Chaebol firms while competitor appears to be the most risky one. Niche players and co-existers have intermediate performance, though the former do better than the latter. It is often the case with managers of small and medium size companies that they tend to view market leaders, typically the Chaebol, with rather simplistic assumptions of either competition or collaboration. Consequently, many non-Chaebol firms turn out to be either passive collaborators or overwhelmed competitors of the Chaebol. In fact, competition and collaboration are not mutually exclusive, and can be pursued at the same time. As suggested in this paper, non-Chaebol firms can actively choose to compete and collaborate, depending on their environment, internal resources and capabilities.

• Journal of the Korean Society of Food Science and Nutrition
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• v.43 no.11
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• pp.1774-1784
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• 2014

The purpose of this study was to determine obstructive factors and performance level of the HACCP system among elementary schools in Gyeongbuk province. E-mail survey targeted 320 dieticians, and recovery rate was 74.1%. Consequently, 227 responses were analyzed. The questionnaire was composed of 58 items under four sections (general characteristics, dieticians' perceived HACCP performance level, dieticians' perceived CCP performance level, and obstructive factors of HACCP system implementation). The item with the highest rate of HACCP performance level was 'HACCP training for foodservice employees in schools ($4.02{\pm}0.70$)' while the lowest counterpart was 'implementation of HACCP team meeting, reporting, and maintenance ($2.74{\pm}0.99$)'. The performance level of the item 'HACCP training for foodservice employees in schools' was perceived as highest when the number of students eating school meals was greater than 1,101 (P<0.05). Moreover, CCP 4 ($4.44{\pm}0.53$) and CP 5 ($4.44{\pm}0.51$) showed the best performance, whereas CCP 1 showed the lowest performance level ($3.90{\pm}0.60$). Therefore, reinforcement of hygiene instruction in menu planning is perceived as necessary. CCP 1, CCP 6 (P<0.05), and CCP 3 (P<0.001) showed significant differences in performance based on the number of students eating school meals. Further, according to results regarding obstructive factors of HACCP system execution, 'general factor' was the most severe obstructive factor in the application of HACCP ($3.46{\pm}0.62$). Among the 'factors pertaining to dieticians', the item 'hardship of proper monitoring and micro-management due to overwhelming workload' was most influential ($3.46{\pm}0.96$). Furthermore, the item 'low budget allocation by educational offices ($3.90{\pm}0.88$)' was influential among the 'factors pertaining to school administrations'. In conclusion, the results of this research can help solve obstructive factors of elementary school food services and provide knowledge that is essential for the proper implementation of HACCP.

• Journal of Korean Society of Forest Science
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• v.107 no.3
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• pp.237-244
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• 2018

This study was carried out in order to secure basic data of seedling mass propagation technique of Rhododendron mucronulatum which is the native tree species of Korea by surveying the characteristics of its fruit and seed. The fruits were collected at Mt. Goryeo in Ganghwa-gun on different dates in 2013; August 26th, September 5th, September 12th, October 4th. The seed germination test was carried out at 5, 10, 15, 20, 25 and $30^{\circ}C$. Moisture content of the fruit was highest (54.5%) in the fruit collected on September 5th. Number of the seeds in a fruit was 91.3 to 116.3, regardless of the collection date. Seed length was highest ($1947.4{\mu}m$) in the seeds collected on October 4th and seed width was highest ($727.3{\mu}m$) in the seeds collected on September 12th. Germination rate of the seeds was highest at $25^{\circ}C$ regardless of the seed collection date, which showed the highest value(27.3%) in the seeds collected September 12th. Meanwhile, the seeds were not germinated not at all at 5, 10 and $30^{\circ}C$. $T_{50}$ and mean germination time of the seeds got shorter at the higher temperature. Germination uniformity got lower when the collection date got later. Germination speed of the seeds was fastest at $25^{\circ}C$. According to the results of this study, it seems that the appropriate time to collect fruit and seed is between September 12th and October 4th, and the appropriate temperature for the seed germination is $25^{\circ}C$.

• Asia pacific journal of information systems
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• v.21 no.4
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• pp.45-62
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• 2011

The notion of information systems (IS) continuance has recently emerged as one of the most important research issues in the field of IS. A great deal of research has been conducted thus far on the basis of theories adapted from various disciplines including consumer behaviors and social psychology, in addition to theories regarding information technology (IT) acceptance. This previous body of knowledge provides a robust research framework that can already account for the determination of IS continuance; however, this research points to other, thus-far-unelucidated determinant factors such as habit, which were not included in traditional IT acceptance frameworks, and also re-emphasizes the importance of emotion-related constructs such as satisfaction in addition to conscious intention with rational beliefs such as usefulness. Experiences should also be considered one of the most important factors determining the characteristics of information system (IS) continuance and the features distinct from those determining IS acceptance, because more experienced users may have more opportunities for IS use, which would allow them more frequent use than would be available to less experienced or non-experienced users. Interestingly, experience has dual features that may contradictorily influence IS use. On one hand, attitudes predicated on direct experience have been shown to predict behavior better than attitudes from indirect experience or without experience; as more information is available, direct experience may render IS use a more salient behavior, and may also make IS use more accessible via memory. Therefore, experience may serve to intensify the relationship between IS use and conscious intention with evaluations, On the other hand, experience may culminate in the formation of habits: greater experience may also imply more frequent performance of the behavior, which may lead to the formation of habits, Hence, like experience, users' activation of an IS may be more dependent on habit-that is, unconscious automatic use without deliberation regarding the IS-and less dependent on conscious intentions, Furthermore, experiences can provide basic information necessary for satisfaction with the use of a specific IS, thus spurring the formation of both conscious intentions and unconscious habits, Whereas IT adoption Is a one-time decision, IS continuance may be a series of users' decisions and evaluations based on satisfaction with IS use. Moreover. habits also cannot be formed without satisfaction, even when a behavior is carried out repeatedly. Thus, experiences also play a critical role in satisfaction, as satisfaction is the consequence of direct experiences of actual behaviors. In particular, emotional experiences such as enjoyment can become as influential on IS use as are utilitarian experiences such as usefulness; this is especially true in light of the modern increase in membership-based hedonic systems - including online games, web-based social network services (SNS), blogs, and portals-all of which attempt to provide users with self-fulfilling value. Therefore, in order to understand more clearly the role of experiences in IS continuance, analysis must be conducted under a research framework that includes intentions, habits, and satisfaction, as experience may not only have duration-based moderating effects on the relationship between both intention and habit and the activation of IS use, but may also have content-based positive effects on satisfaction. This is consistent with the basic assumptions regarding the determining factors in IS continuance as suggested by Oritz de Guinea and Markus: consciousness, emotion, and habit. The principal objective of this study was to explore and assess the effects of experiences in IS continuance, with special consideration given to conscious intentions and unconscious habits, as well as satisfaction. IN service of this goal, along with a review of the relevant literature regarding the effects of experiences and habit on continuous IS use, this study suggested a research model that represents the roles of experience: its moderating role in the relationships of IS continuance with both conscious intention and unconscious habit, and its antecedent role in the development of satisfaction. For the validation of this research model. Korean university student users of 'Cyworld', one of the most influential social network services in South Korea, were surveyed, and the data were analyzed via partial least square (PLS) analysis to assess the implications of this study. In result most hypotheses in our research model were statistically supported with the exception of one. Although one hypothesis was not supported, the study's findings provide us with some important implications. First the role of experience in IS continuance differs from its role in IS acceptance. Second, the use of IS was explained by the dynamic balance between habit and intention. Third, the importance of satisfaction was confirmed from the perspective of IS continuance with experience.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.30 no.1
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• pp.135-145
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• 2012

Traditional village forests called Dangsan forests and Bibo forests in Korea represent an unique cultural landscape with a history of more than several hundred years. Feng-shui forest in China, Satoyama and Shinto shrine forest in Japan are recognized internationally as 'traditional ecological landscapes'. Dangsan forests and Bibo forests have been preserved through generations in the villages, and are no less valuable than Feng-shui forest, and Satoyama. However, the names of Dangsan forest and Bibo forest have not been well recognized worldwide. Dangsan forest in Seoseong-ri, Wando-gun is located on a mountain slope at a riparian forest. It consists of an evergreen broadleaf forest and Carpinus laxiflora forest. The characteristics of Dangsan forest in Seoseong-ri could be found at 10 sacrifice offering places. Two Dangsan trees on the coastal area are included in the sacrifice offering places. Cultural heritage can retain their value when they are fully sustained. Additional construction, demolition or modification should be banned. Furthermore, all means must be taken to facilitate the preservation of monuments and the value and meanings pertaining to them should not be distorted. In a respect of authenticity, Dangsan forest in Seoseong-ri, Wando-gun seems to have original Dangsan culture based on animism with a philosophic background, where a religious service for the mountain god is held at rock of mountain god, and Dangsan ritual is held at shrine on January 8 at 4:00 am by lunar calendar. Relating to the conservation and management of cultural heritage in international discussion, the importance is that whether there is sustainability on the right to the enjoyment of cultural heritage. Dangsan forest in Seoseong-ri is leaved alone to the public. The forest need a social mechanism to support the recovery of deformed shrine and to heighten public awareness of Dangsan forest in order to claim the value as a unique traditional ecological landscape in Korea.

• Journal of the Society of Disaster Information
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• v.17 no.4
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• pp.722-732
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• 2021

Purpose: Due to the coronavirus infection-19 (COVID) pendemics, all educational institutions were required to provide full non-face-to-face real-time education, and fire officials were required to provide fire-fighting education by applying non-face-to-face education. In this difficult situation, the National Fire Service Academy tries to find the direction of the non-face-to-face real-time education and suggest ways to improve it through a survey of the status of non-face-to-face real-time education conducted by the NFSA to fire officials. Method: A survey was conducted on fire officials under the theme of "Consciousness Survey for Improving the Quality and Specialization of Non-face-to-face Real-Time Remote Education" and an in-depth analysis was conducted based on the results. Result & Conclusion: First, professors or educational operators shall actively utilize remote education programs suitable for educational characteristics by utilizing various programs. Second, a dedicated notebook for non-face-to-face training should be provided to provide an educational environment where all learners can participate in the training without difficulty. Third, in the case of education and training that requires the use of equipment due to the nature of fire officials' education and training, it is necessary to consider it as a non-face-to-face training place by arranging educational equipment at each fire station. Fourth, it is hard to expect a satisfactory educational effect to cope with practical education with theoretical education. Therefore, facilities and programs that enable non-face-to-face real-time hands-on training should be developed. It is worth considering the proper combination of face-to-face education while maintaining the social distance as much as possible until such non-face-to-face training is possible. Fifth, non-face-to-face education is considered to have high eye fatigue due to the light and electromagnetic waves of the computer screen, and as time goes by, the concentration level decreases. Therefore, it is necessary to form an education time to reduce the eye fatigue of learners and increase concentration through proper class and rest time. Finally, professors should operate a learner participation-oriented education that allows professors and learners to interact rather than one-sided knowledge transfer education. In addition, technical problems of non-face-to-face remote education should be thoroughly prepared through preliminary system checks to ensure that education is not disrupted.

• Journal of Preventive Medicine and Public Health
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• v.20 no.1 s.21
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• pp.165-203
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• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.