• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.269-276
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• 1996

A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

• Journal of Intelligence and Information Systems
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• v.24 no.4
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• pp.171-196
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• 2018

With the development of the web, two-way communication and evaluation became possible and marketing paradigms shifted. In order to meet the needs of consumers, web design trends are continuously responding to consumer feedback. As the web becomes more and more important, both academics and businesses are studying consumer emotions and satisfaction on the web. However, some consumer characteristics are not well considered. Demographic characteristics such as age and sex have been studied extensively, but few studies consider psychological characteristics such as regulatory focus (i.e., emotional regulation). In this study, we analyze the effect of web style on consumer emotion. Many studies analyze the relationship between the web and regulatory focus, but most concentrate on the purpose of web use, particularly motivation and information search, rather than on web style and design. The web communicates with users through visual elements. Because the human brain is influenced by all five senses, both design factors and emotional responses are important in the web environment. Therefore, in this study, we examine the relationship between consumer emotion and satisfaction and web style and design. Previous studies have considered the effects of web layout, structure, and color on emotions. In this study, however, we excluded these web components, in contrast to earlier studies, and analyzed the relationship between consumer satisfaction and emotional indexes of web-style only. To perform this analysis, we collected consumer surveys presenting 40 web style themes to 204 consumers. Each consumer evaluated four themes. The emotional adjectives evaluated by consumers were composed of 18 contrast pairs, and the upper emotional indexes were extracted through factor analysis. The emotional indexes were 'softness,' 'modernity,' 'clearness,' and 'jam.' Hypotheses were established based on the assumption that emotional indexes have different effects on consumer satisfaction. After the analysis, hypotheses 1, 2, and 3 were accepted and hypothesis 4 was rejected. While hypothesis 4 was rejected, its effect on consumer satisfaction was negative, not positive. This means that emotional indexes such as 'softness,' 'modernity,' and 'clearness' have a positive effect on consumer satisfaction. In other words, consumers prefer emotions that are soft, emotional, natural, rounded, dynamic, modern, elaborate, unique, bright, pure, and clear. 'Jam' has a negative effect on consumer satisfaction. It means, consumer prefer the emotion which is empty, plain, and simple. Regulatory focus shows differences in motivation and propensity in various domains. It is important to consider organizational behavior and decision making according to the regulatory focus tendency, and it affects not only political, cultural, ethical judgments and behavior but also broad psychological problems. Regulatory focus also differs from emotional response. Promotion focus responds more strongly to positive emotional responses. On the other hand, prevention focus has a strong response to negative emotions. Web style is a type of service, and consumer satisfaction is affected not only by cognitive evaluation but also by emotion. This emotional response depends on whether the consumer will benefit or harm himself. Therefore, it is necessary to confirm the difference of the consumer's emotional response according to the regulatory focus which is one of the characteristics and viewpoint of the consumers about the web style. After MMR analysis result, hypothesis 5.3 was accepted, and hypothesis 5.4 was rejected. But hypothesis 5.4 supported in the opposite direction to the hypothesis. After validation, we confirmed the mechanism of emotional response according to the tendency of regulatory focus. Using the results, we developed the structure of web-style recommendation system and recommend methods through regulatory focus. We classified the regulatory focus group in to three categories that promotion, grey, prevention. Then, we suggest web-style recommend method along the group. If we further develop this study, we expect that the existing regulatory focus theory can be extended not only to the motivational part but also to the emotional behavioral response according to the regulatory focus tendency. Moreover, we believe that it is possible to recommend web-style according to regulatory focus and emotional desire which consumers most prefer.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.10 no.2
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• pp.97-114
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• 1977

The fresh water prawn, Macrobrachium rosenbergi(de Man) is a very common species in Indopacific region, which inhaits both fresh and brackish water in low land area, most of rivers and especially aboundant in the lower reaches which are influenced by sea water. It is one of the largest and commercial species of genus Macrobrachium, which is commonly larger than $18\~21cm$ in body length, from the basis of eye-stalked to the distal of telson. As a part of the researches in order to investigate the possibilities on transplantation and propagation of this species, this work dealt with the problems on the effects of chlorinities upon zoeal larvae and post-larvae 1). metamorphosis rate and optimum chlorinity for metamorphosis to post-larve, 2). tolerance and comparative survival rate on various chlorinties, from fresh water to sea water $(19.38\%_{\circ}\;Cl)$, which reared for six days upon each stage of zoeal larvae, 3). accomodation rate on chlonities which reared for twelve days after transmigration into variant chlorinities of the range from $3.68\%_{\circ}$ Cl to $1.53\%_{\circ}$ Cl in the way of rearing of the range from $3.82\%_{\circ}$ Cl to $11.05\%_{\circ}$ upon each stage of zoea, 4). tolerance on both of fresh and sea water upon zoeal larva and post-larva under the condition of $28^{\circ}C{\pm}1$ in temperature and feeding on Artenia salina nauplii, 5). relationship between various chlorinities and grwth of post-larvae under the condition of $28^{\circ}C$ in tmperature and feeding on meat of clam. Thus these investigations were performed in order to grope for a comfortable method on seedmass production. Up to the present, the study on the effects of chlorinity upon earlier zoeal larvae and post-larvae of Macrobrachium species has been scarcely performed by workers with the exception of Lewis(1961) and Ling (1962,, 1967), even so their works were not so detailed. On the other hand, larvae of several species of this genus were reared at the water which mixed sea water so as to carry out complete metamorphosis to post-larva by workers in order to investigate on earlier 1 arval and earlier post-larval development, such as Macrobrachium lamerrei (Rajyalakshmi, 1961), M. rosenbergi and M. nipponense (Uno and Kwoa, 1969; Kwon and Uno, 1969), M. acanthurs (Choudhury, 1970; Dobkin, 1971), M. carcinus(Choudhury, 1970), M. formosense(Shokita, 1970), M. olfersii (Duggei et al., 1975), M. novaehallandiae (Greenwood et al., 1976), M. japonicum (Kwon, 1974) and M. lar (Shokita, personal communication), and there fore it is regarded that chlorinity is, generally, one of absolute factors to rear zoeal larvae of brackish species of Macrobrachium genus. Synthetic results on this work is summarized as the follwings: 1) Zoeal larvae required different chlorinities to grow according to each stage, and generally, it is regarded that optimum range of living and growing is from $7.63\%_{\circ}Cl\to\;7.63\%_{\circ}Cl$, and while differences of metamorphsis rate, from first zoea to post-larva, is rarely found in this range, and however it occurs apparently in both of situation at $7.63\%_{\circ}Cl$ below and $16.63\%_{\circ}Cl$ above and moreover, metamorphosis rate is delayed somewhat in case of lower chlorinity as compared with high chlorinity in these situations. 2) Accomodation in each chlorinity on the range, from fresh water to sea water, is different according to larval stages and while the best of it is, generally, on the range from $14.24\%_{\circ}Cl$ to $8.28\%_{\circ}Cl$ and favorite chlorinity of zoea have a tendency to remove from high chlorinity to lower chlorinity in order to advance larval age throughout all zoeal stages, setting a conversional stage for eighta zoea stage. 3) Optimum chlorinity of living and growth upon postlarvae is on the range of $4.25\%_{\circ}Cl$ below, and in proportion as approach to fresh water, growth rate is increased. 4) Post-large are able to live better in fresh water in comparison with zoeal larvae, which are only able to live within fifteen hours, and by contraries, post-larvae are merely able to live for one day as compared with ?미 larvar, which are able to live for six days more in sea water $19.38\%_{\circ}Cl\;above$. 5) Also, in case of transmigration into higher and lower chlorinities in the way of rearing in the initial chlorinities $ 3.82\%_{\circ}Cl,\;7.14%_{\circ}Cl\;and\;11.05%_{\circ}Cl$, accoodation rate is a follow: accomodation capacity in ease of removing into higher chlorinities from lower chlorinities is increased in proportion as earlier stages, setting a conversional stage for eighth zoea stage, and by contraries, in case of advanced stages from eighth zoea it is incraesed in proportion as approach to post-larva stage in the case of transmigration into lower chlorinity from higher chlorinity. On the other hand, it is interesting that in case of reciprocal transmigration between two different chlorinitiess, each survival rate is different, and in this case, also, its accomodation in each zoea stage has a tendency to vary according to larval stages as described above, setting a conversional stage for eighth zoea stage. 6) It is likely that expension of radish pigments on body surface is directly proportional to chlorinity during the period of zoea rearing, and therefore it seems like all body surfacts of zoea larvae be radish coloured in case of higher chlorinity. 7) By the differences that each zoeal larvae, postlarvae, juvaniles and adult prawn are required different chlorinity for inhabiting in each, it is regarded that this species migrats from up steam to near the estuary of the river which the prawns inhabits commonly in natural field for spawning and growth migration. 8) It had better maintainning chlorinities according to zoeal stage for a comfortable method on seed-mass production that earlier larva stages than eighth zoea are maintained on the range from $8\%_{\circ}Cl\;to\;12\%_{\circ}Cl$ to rear, and later larva stages than eighth zoea, by contraries, are gradually regula ted-to love chlorininity of the range from $7\%_{\circ}Cl\;to\;4\%_{\circ}Cl$ according to advance for post-larva stage.

• 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.