• Title/Summary/Keyword: Practice management

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Successful Management and Operating System of a UNESCO World Heritage Site - A Case Study on the Wadi Al-Hitan of Egypt - (유네스코 세계자연유산의 성공적인 관리와 운영체계 - 『이집트 Wadi Al-Hitan』의 사례 -)

  • Lim, Jong Deock
    • Korean Journal of Heritage: History & Science
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    • v.44 no.1
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    • pp.106-121
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    • 2011
  • The number of World Natural Heritage Sites is smaller than that of World Cultural Heritage Sites. As of 2010, the total number of natural sites was 180, which is less than 1/3 of all cultural sites. The reason why the number of natural sites is smaller can be attributed to the evaluating criteria of OUV(outstanding universal value). Only 9 fossil related sites were designated as World Heritage Sites among 180 Natural Sites. This study compares their OUVs including the academic value and characteristics of the 9 World Heritage Sites to provide data and reference for KCDC(Korean Cretaceous Dinosaur Coast) to apply as a World Natural Heritage Site. This study was carried out to obtain information and data on the Wadi Al-Hitan of Egypt which was designated as a World Natural Heritage Site. The study includes field investigation for whale fossils, interviews of site paleontologists and staff, and inspections of facilities. Three factors can likely be attributed to its successful management and operating system. First, there is a system for comprehensive research and a monitoring plan. Secondly, experts have been recruited and hired and professional training for staff members has been done properly. Finally, the Wadi Al-Hitan has developed local resources with specialized techniques for conservation and construction design, which matched well with whale fossils and the environment at the site. The Wadi Al-Hitan put a master plan into practice and achieved goals for action plans. To designate a future World Natural Heritage Site in Korea, it is important to be recognized by international experts including IUCN specialists as the best in one's field with OUV. Full-time regular-status employees for a research position are necessary from the preparation stage for the UNESCO World Heritage Site. Local government and related organizations must do their best to control monitoring plans and to improve academic value after the UNESCO World Heritage Site designation. As we experienced during the designation process of Jeju Volcanic Island and Lava Tubes as the first Korean World Natural Heritage Site, participation by various scholars and specialists need to be in harmony with active endeavors from local governments and NGOs.

Mediating Effect of Ease of Use and Customer Satisfaction in the Relationship between Mobile Shopping Mall of Service Quality and Repurchase Intention of University Student consumer (모바일쇼핑몰 서비스품질과 대학생 고객의 재구매의도 관계에서 사용용이성과 고객만족도의 매개효과)

  • Kim, Sun-A;Park, Ji-Eun;Park, Song-Choon
    • Management & Information Systems Review
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    • v.38 no.1
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    • pp.201-223
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    • 2019
  • The purpose of this study is to verify empirically the causal relationship between service quality, ease of use, customer satisfaction, and repurchase intention of mobile shopping mall. And this study is to investigate the ease of use and customer satisfaction mediating effect of between service quality and repurchase intention. Therefore, 323 university students in Jeonnam area were surveyed and the structural equation model was derived based on previous research. Service quality of mobile shopping mall make a significant effect on using easiness, purchasing satisfaction and repurchase intention. However, among service quality of mobile shopping mall, service scape like mobile interface and site design made a positive effect on purchasing satisfaction, but did not any effect on repurchase intention. In other words, service quality factors that make positive effects on customer's pleasant using and repurchase intention make a positive effect on repurchase intention when providing and using the service customer wants faithfully rather than external part of the site and mutually influencing attitude or behavior well. The implications suggested by this study are as follows. First, service quality of mobile shopping mall makes a significant effect on repurchase intention, so it's necessary to improve CS service system so as to treat customers' inquiries or inconveniences actively during mobile shopping and return and refund of defective products quickly and conveniently. And, in addition to the finally used factors in analysis process, benefits using customers' grade by number of purchases, such as various events, coupons, reserve, etc. and active contents marketing strategies providing more various pleasures and values of shopping are necessary. Second, satisfaction of mobile shopping mall makes a positive effect on repurchase intention, so visiting of site and repurchasing of product are continuously done as customers' satisfaction on shopping mall is increasing. Therefore, shopping mall site requires differentiation of contents, exact plan and practice of service, marketing, etc. so that customers can feel more satisfaction. This study is significant as it systematically analyzed concepts of components that service quality of mobile shopping mall makes an effect on using easiness, purchasing satisfaction, and repurchase intention, verified the relations, systematized it by theoretical structure, and widened the understanding of effects making an effect on repurchase intention.

Early Growth Performance of Zelkova serrata Trees According to Seedling Age and Planting Density (묘령 및 식재밀도에 따른 느티나무 조림목의 초기 생육 특성)

  • Noh, Nam Jin;Cho, Min Seok
    • Journal of Korean Society of Forest Science
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    • v.109 no.4
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    • pp.390-399
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    • 2020
  • We investigated the effect of seedling age and planting density on early growth performance of Zelkova serrata trees. Containerized Z. serrata seedlings, 1-year-old and 2-year-old, were planted according to two different planting densities (3,000 and 5,000 trees ha-1) at the end of March, 2017. Three plots were established for each treatment (2 seedling ages × 2 planting densities). We calculated the survival rate (%) of out-planted seedlings as well as the stem volume based on the root collar diameter (RCD) and height (H) in September of each year, from 2017 to 2019. Seedling age and planting density did not affect survival rate of the out-planted trees. Planting density did not affect height of the trees, whereas the treatment significantly affected RCD and the H/D ratio for 2-year-old seedlings in 2019. The stem volume per tree was highest in the plot of 2-year-old seedlings at 5,000 trees ha-1 and lowest in the 1-year-old seedlings at 3,000 trees ha-1. In addition, the tree height in both 1-year-old and 2-year-old Z. serrata trees was greater in the 5,000 trees ha-1 plot than in the 3,000 trees ha-1 plot. There was no interactive effect between seedling age and planting density on stem volume; however, as seedling age and planting density increased, stem volume of Z. serrata trees increased. The values for stem volume per hectare are 85%, 68%, and 300% higher in 1-year-old 5,000 trees ha-1, 2-year-old 3,000 trees ha-1, and 2-year-old 5,000 trees ha-1 plots, respectively, compared to the values in 1-year-old 3,000 trees ha-1. This result shows that high planting density (close planting) affects tree growth differently based on seedling age, and suggests that the planting density of 5,000 trees ha-1 is suitable for 2-year-old seedlings to improve early growth field performance.

Business Incubator Manager's Competency Characteristics Affect Organizational Commitment and Work Performance : Focused on the Manager's Self-Efficacy (창업보육센터 매니저의 역량 특성이 조직몰입과 업무성과에 미치는 영향 : 매니저의 자기효능감을 중심으로)

  • Park, Sang-Ho;Kang, Shin-Cheol
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.16 no.1
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    • pp.71-85
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    • 2021
  • Representative domestic start-up support organizations include the Business Incubator(BI), Korea Institute of Startup & Entrepreneurship Development(KISED), Techno Park(TP), and Center of Creative Economy Innovation(CCEI), and there are about 260 Business incubator nationwide. The Business incubator is operated by universities, research institutes, and private foundations or associations. The organization consists of the center director and the incubating professionals (hereinafter referred to as "manager"), etc., and performs tasks such as center operation management and incubation support services for tenant companies. Until now, research on the operation of Business Incubator has been mainly focused on the performance of tenant companies. Studies on whether the manager's competency characteristics directly or indirectly affect the performance of the tenant companies through psychological mediators such as self-efficacy and organizational commitment were very scarce. The purpose of this study is to explore various factors influencing organizational commitment and job performance by the competence characteristics of Business incubator managers, and to explain the causal relationship among those factors. In particular, the difference in perception was investigated by a manager's survey that influences organizational commitment and work performance at the Business incubator. Through this, we intend to present practical implications for the role of managers in the operation of Business incubators. This study is an exploratory study, and the subject of the study was a survey of about 600 managers working at Business incubator nationwide, of which 116 responses were analyzed. Data analysis included descriptive statistics, exploratory factor analysis, and reliability. Structural equation model analysis was performed for hypothesis tests. As a result of the analysis, it was found that the cognitive characteristics of the Business incubator manager, communication, and situational response as the behavioral characteristics had a positive effect on the manager's self-efficacy, and the behavioral characteristics had a greater effect on the self-efficacy. It was also found that the manager's cognitive and behavioral characteristics, and self-efficacy had a positive effect on organizational commitment and work performance. In particular, a manager's self-efficacy has a positive effect on organizational commitment and work performance. This result showed that the manager's competency characteristics increase the manager's self-efficacy as a mediating factor rather than directly affecting organizational commitment and work performance. This study explains that the manager's competency characteristics are transferred to organizational commitment and work performance. The results of the study are expected to reflect the job standard of the National Competency Standards (NCS) and basic vocational competency to the job competency of managers, and it also provides a guideline for the effective business incubator operation in terms of human resource management. In practice, it is expected that the results of the study can reflect the vocational basic skills of the Business Incubator manager's job competency in the National Competency Standards(NCS) section, and suggest directions for the operation of the Business Incubator and the manager's education and training.

An Empirical Investigation of Relationship Between Interdependence and Conflict in Co-marketing Alliance (공동마케팅제휴에 있어 상호의존성과 갈등의 관계에 대한 연구)

  • Yi, Ho Taek;Cho, Young Wook;Kim, Ju Young
    • Asia Marketing Journal
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    • v.13 no.3
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    • pp.79-102
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    • 2011
  • Researchers in channel dyads have devoted much attention to relationship between interdependence (i.e. interdependence enymmetry and total interdependence) and conflict that promote channel performance. In social science, in spite of the inconsistent results in marketing practice, there are two contradictory theories explain the relationship between interdependence and conflict - bilateral deterrence theory and conflict spiral theory. The authors apply these theories to co-marketing alliance situation in terms that this relationship is also incorporated both company's dependence, either from one company's perspective or each partner about its respective dependence. Using survey data and archival data from 181 companies enlisted in a telecommunication membership program, the authors find out the relationship between interdependence and conflict as well as investigate the antecedents of interdependence - transaction age, transaction frequency, the numbers of alliance partner, and co-marketing alliance specific assets according to previous researches. Using PLS analysis, the authors demonstrate that, with increasing total interdependence in a telecommunication membership program, two co-marketing partners' conflict level is increased in accord with the author's conflict spiral theory predictions. As expected, higher interdependence asymmetry has negative value to level of conflict even though this result is not statistically significant. Other findings can be summarized as follows. In the perspective of telecommunication company, transaction age, transaction frequency, and co-marketing alliance specific assets have influence on its dependence on a partner as independent variables. To the contrary, in a partner's perspective, transaction frequency, co-marketing alliance specific assets and the numbers of alliance partner have significantly impact on its dependence on a telecommunication company. In direct effect analysis, it is shown that transaction age, frequency and co-marketing alliance specific assets have direct influence on conflict. This results suggest that it is more useful for a telecommunication company to select a co-marketing partner which is frequently used by customers and earned high rates of mileage. In addition, the results show that dependence of a telecommunication company on a co-marketing partner is more significantly effected to co-marketing alliance conflict than partner's one. It provide an effective conflict management strategy to a telecommunication company for controling customer's usage rate or having the co-marketing partner deposit high level of alliance specific investment (i.e. mileage). To a co-marketing partner of telecommunication company, it is required control the percentage of co-marketing sales in total sales revenue or seek various co-marketing partners in order for co-marketing conflict management. The research implications, limitation and future research of these results are discussed.

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A Study on Air Operator Certification and Safety Oversight Audit Program in light of the Convention on International Civil Aviation (시카고협약체계에서의 항공안전평가제도에 관한 연구)

  • Lee, Koo-Hee;Park, Won-Hwa
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.1
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    • pp.115-157
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    • 2013
  • Some contracting States of the Convention on International Civil Aviation (commonly known as the Chicago Convention) issue FAOC(Foreign AOC and/or Operations Specifications) and conduct various safety audits for the foreign operators. These FAOC and safety audits on the foreign operators are being expanded to other parts of the world. While this trend is the strengthening measure of aviation safety resulting in the reduction of aircraft accident, it is the source of concern from the legal as well as economic perspectives. FAOC of the USA doubly burdens the other contracting States to the Chicago Convention because it is the requirement other than that prescribed by the Chicago Convention of which provisions are faithfully observed by almost all the contracting States. The Chicago Convention in its Article 33 stipulates that each contracting State recognize the validity of the certificates of airworthiness and licenses issued by other contracting States as long as they meet the minimum standards of the ICAO. Consequently, it is submitted that the unilateral action of the USA, China, Mongolia, Australia, and the Philippines issuing the FOAC to the aircraft of other States is against the Convention. It is worry some that this breach of international law is likely to be followed by the European Union which is believed to be in preparation for its own unilateral application. The ICAO established by the Chicago Convention to be in charge of safe and orderly development of the international civil aviation has been in hard work to both upgrade and emphasize the safe operation of aircraft. As the result of these endeavors, it prepared a new Annex 19 to the Chicago Convention with the title of "Safety Management" and with the applicable date 14 November 2013. It is this Annex and other ICAO documents relevant to the safety that the contracting States to the Chicago Convention have to observe. Otherwise, it is the economical burden due to probable delay in issuing the FOAC and bureaucracies combined with many different paperworks and regulations depending on where the aircraft is flown. It is exactly to avoid this type of confusion and waste that the Chicago Convention aimed at when it was adopted in 1944. The State of the operator shall establish a system for both the certification and the continued surveillance of the operator in accordance with ICAO SARPs to ensure that the required standards of operations are maintained. Certainly the operator shall meet and maintain the requirements established by the States in which it operate. The authority of a State stops where the authority of another State intervenes or where the former has yielded its power by an international agreement for the sake of international cooperation. Hence, it is not within the realm of the State to issue FAOC towards foreign operators for the reason that these foreign operators are flying in and out of the State. Furthermore, there are other safety audits such as ICAO USOAP, IATA IOSA, FAA IASA, and EU SAFA that assure the safe operation of the aircraft, but within the limit of their power and in compliance with the ICAO SARPs. If the safety level of any operator is not satisfactory, the operator could be banned to operate in the contracting States with watchful eyes until the ICAO SARPs are met. This time-honoured practice has been applied without any serious problems. Besides, we have the new Annex 19 to strengthen and upgrade with easy reference for contracting States. We don't have no reason to introduce additional burden to the States by unilateral actions of some States. These actions have to be corrected. On the other hand, when it comes to the carriage of the Personal or Pilot Log Book, the Korean regulation requiring it is in contrast with other relevant provisions of USA, USOAP, IOSA, and SAFA. The Chicago Convention requires in its Articles 29 and 34 only the carriage of the Journey Log Book and some other certificates, but do not mention the Personal Log Book at all. Paragraph 5.1.1.1 of Annex 1 to the Chicago Convention even makes it clear that the carriage in the aircraft of the Personal Log Book is not required on international flights. The unique Korean regulation in this regards giving the unnecessary burden to the national flag air carriers has to be lifted at once.

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The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

A Study on improvement of curriculum in Nursing (간호학 교과과정 개선을 위한 조사 연구)

  • 김애실
    • Journal of Korean Academy of Nursing
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    • v.4 no.2
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    • pp.1-16
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    • 1974
  • This Study involved the development of a survey form and the collection of data in an effort-to provide information which can be used in the improvement of nursing curricula. The data examined were the kinds courses currently being taught in the curricula of nursing education institutions throughout Korea, credits required for course completion, and year in-which courses are taken. For the purposes of this study, curricula were classified into college, nursing school and vocational school categories. Courses were directed into the 3 major categories of general education courses, supporting science courses and professional education course, and further subdirector as. follows: 1) General education (following the classification of Philip H. phoenix): a) Symbolics, b) Empirics, c) Aesthetics. 4) Synthetics, e) Ethics, f) Synoptic. 2) Supporting science: a) physical science, b) biological science, c) social science, d) behavioral science, e) Health science, f) Educations 3) Professional Education; a) basic courses, b) courses in each of the respective fields of nursing. Ⅰ. General Education aimed at developing the individual as a person and as a member of society is relatively strong in college curricula compared with the other two. a) Courses included in the category of symbolics included Korean language, English, German. Chines. Mathematics. Statics: Economics and Computer most college curricula included 20 credits. of courses in this sub-category, while nursing schools required 12 credits and vocational school 10 units. English ordinarily receives particularly heavy emphasis. b) Research methodology, Domestic affair and women & courtney was included under the category of empirics in the college curricula, nursing and vocational school do not offer this at all. c) Courses classified under aesthetics were physical education, drill, music, recreation and fine arts. Most college curricula had 4 credits in these areas, nursing school provided for 2 credits, and most vocational schools offered 10 units. d) Synoptic included leadership, interpersonal relationship, and communications, Most schools did not offer courses of this nature. e) The category of ethics included citizenship. 2 credits are provided in college curricula, while vocational schools require 4 units. Nursing schools do not offer these courses. f) Courses included under synoptic were Korean history, cultural history, philosophy, Logics, and religion. Most college curricular 5 credits in these areas, nursing schools 4 credits. and vocational schools 2 units. g) Only physical education was given every Year in college curricula and only English was given in nursing schools and vocational schools in every of the curriculum. Most of the other courses were given during the first year of the curriculum. Ⅱ. Supporting science courses are fundamental to the practice and application of nursing theory. a) Physical science course include physics, chemistry and natural science. most colleges and nursing schools provided for 2 credits of physical science courses in their curricula, while most vocational schools did not offer t me. b) Courses included under biological science were anatomy, physiologic, biology and biochemistry. Most college curricula provided for 15 credits of biological science, nursing schools for the most part provided for 11 credits, and most vocational schools provided for 8 units. c) Courses included under social science were sociology and anthropology. Most colleges provided for 1 credit in courses of this category, which most nursing schools provided for 2 creates Most vocational school did not provide courses of this type. d) Courses included under behavioral science were general and clinical psychology, developmental psychology. mental hygiene and guidance. Most schools did not provide for these courses. e) Courses included under health science included pharmacy and pharmacology, microbiology, pathology, nutrition and dietetics, parasitology, and Chinese medicine. Most college curricula provided for 11 credits, while most nursing schools provide for 12 credits, most part provided 20 units of medical courses. f) Courses included under education included educational psychology, principles of education, philosophy of education, history of education, social education, educational evaluation, educational curricula, class management, guidance techniques and school & community. Host college softer 3 credits in courses in this category, while nursing schools provide 8 credits and vocational schools provide for 6 units, 50% of the colleges prepare these students to qualify as regular teachers of the second level, while 91% of the nursing schools and 60% of the vocational schools prepare their of the vocational schools prepare their students to qualify as school nurse. g) The majority of colleges start supporting science courses in the first year and complete them by the second year. Nursing schools and vocational schools usually complete them in the first year. Ⅲ. Professional Education courses are designed to develop professional nursing knowledge, attitudes and skills in the students. a) Basic courses include social nursing, nursing ethics, history of nursing professional control, nursing administration, social medicine, social welfare, introductory nursing, advanced nursing, medical regulations, efficient nursing, nursing english and basic nursing, College curricula devoted 13 credits to these subjects, nursing schools 14 credits, and vocational schools 26 units indicating a severe difference in the scope of education provided. b) There was noticeable tendency for the colleges to take a unified approach to the branches of nursing. 60% of the schools had courses in public health nursing, 80% in pediatric nursing, 60% in obstetric nursing, 90% in psychiatric nursing and 80% in medical-surgical nursing. The greatest number of schools provided 48 crudites in all of these fields combined. in most of the nursing schools, 52 credits were provided for courses divided according to disease. in the vocational schools, unified courses are provided in public health nursing, child nursing, maternal nursing, psychiatric nursing and adult nursing. In addition, one unit is provided for one hour a week of practice. The total number of units provided in the greatest number of vocational schools is thus Ⅲ units double the number provided in nursing schools and colleges. c) In th leges, the second year is devoted mainly to basic nursing courses, while the third and fourth years are used for advanced nursing courses. In nursing schools and vocational schools, the first year deals primarily with basic nursing and the second and third years are used to cover advanced nursing courses. The study yielded the following conclusions. 1. Instructional goals should be established for each courses in line with the idea of nursing, and curriculum improvements should be made accordingly. 2. Course that fall under the synthetics category should be strengthened and ways should be sought to develop the ability to cooperate with those who work for human welfare and health. 3. The ability to solve problems on the basis of scientific principles and knowledge and understanding of man society should be fostered through a strengthening of courses dealing with physical sciences, social sciences and behavioral sciences and redistribution of courses emphasizing biological and health sciences. 4. There should be more balanced curricula with less emphasis on courses in the major There is a need to establish courses necessary for the individual nurse by doing away with courses centered around specific diseases and combining them in unified courses. In addition it is possible to develop skill in dealing with people by using the social setting in comprehensive training. The most efficient ratio of the study experience should be studied to provide more effective, interesting education Elective course should be initiated to insure a man flexible, responsive educational program. 5. The curriculum stipulated in the education law should be examined.

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An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • 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.

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A survey of foodservice satisfaction and menu preference of high school boarding students in Jeju (제주지역 고등학생의 기숙사급식 만족도 및 급식메뉴 기호도 조사)

  • Kim, Kyung-Ja;Chae, In-Sook
    • Journal of Nutrition and Health
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    • v.47 no.1
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    • pp.77-88
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    • 2014
  • Purpose: This study analyzed the foodservice satisfaction and menu preference of 506 high school boarding students in Jeju surveyed from July 2-30, 2012 with the aim of providing basic data for improving the quality of boarding food-service management. Methods: The data were analyzed using descriptive analysis, t-test, and Pearson's correlation coefficients, using the SPSS Win program (version 12.0). Results: Regarding satisfaction with dormitory foodservice, the satisfaction scores for service and hygiene were 3.46 (out of 5 scales), whereas the score for menu quality was 3.26 points. In terms of satisfaction by meal, dinner showed the highest score, at 3.70 (out of 5 scales). The satisfaction scores for breakfast were significantly higher in girls (3.36) than boys (2.93). Regarding intake of meals provided, dinner showed the highest score, at 3.96 (out of 5 scales), whereas breakfast showed the lowest score, at 3.63 points. Intake of lunch and dinner was significantly higher in boys (4.12, 4.17, respectively) than girls (3.72, 3.76, respectively). Regarding the requirements of subjects for dormitory foodservice, 43.4% of subjects selected improvement of food taste and 36.6% of girls chose menu diversity. In terms of menu preferences for main dishes, the students preferred noodles (4.06) and one-dish cooked rice (3.92) to cooked rice (3.66). The subjects preferred beef rib soup (4.10) and Kimchi stew (3.99) in soups and stews. With regard to the menu preferences for side dishes, steamed foods showed the highest score, at 3.95 (out of 5 scales), whereas seasoned foods showed the lowest score, at 2.89 points. The students preferred beef, pork, and chicken to fish and vegetables. The students preferred dessert the most with fruit juices (4.52). Bread and rice cake were more favored by girls, showing significant differences between boys and girls (p < 0.05, p < 0.01, respectively). Conclusion: Development of a systematic nutrition education program that can encourage practice of proper eating habits is needed. In addition improvement of the quality of boarding school meals through the service of various menus is needed.