• Journal of Distribution Research
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• v.17 no.2
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• pp.29-62
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• 2012

As distribution environment is changing rapidly and competition is more intensive in the channel of distribution, the importance of retailer image and retailer equity is increasing as a different competitive advantages. Also, consumers are not functionally oriented and that their behavior is significantly affected by the symbols such as retailer image which identify retailer in the market place. That is, consumers do not choose products or retailers for their material utilities but consume the symbolic meaning of those products or retailers as expressed in their self images. The concept of self-image congruence has been utilized by marketers and researchers as an aid in better understanding how consumers identify themselves with the brands they buy and the retailer they patronize. Although self-image congruity theory has been tested across many product categories, the theory has not been tested extensively in the retailing. Therefore, this study attempts to investigate the impact of self image congruence between retailer image and self image of consumer on retailer equity such as retailer awareness, retailer association, perceived retailer quality, and retailer loyalty. The purpose of this study is to find out whether retailer-self image congruence can be a new antecedent of retailer equity. In addition, this study tries to examine how four-dimensional retailer equity constructs (retailer awareness, retailer association, perceived retailer quality, and retailer loyalty) affect customers' repatronage intention. For this study, data were gathered by survey and analyzed by structural equation modeling. The sample size in the present study was 254. The reliability of the all seven dimensions was estimated with Cronbach's alpha, composite reliability values and average variance extracted values. We determined whether the measurement model supports the convergent validity and discriminant validity by Exploratory factor analysis and Confirmatory Factor Analysis. For each pair of constructs, the square root of the average variance extracted values exceeded their correlations, thus supporting the discriminant validity of the constructs. Hypotheses were tested using the AMOS 18.0. As expected, the image congruence hypotheses were supported. The greater the degree of congruence between retailer image and self-image, the more favorable were consumers' retailer evaluations. The all two retailer-self image congruence (actual self-image congruence and ideal self-image congruence) affected customer based retailer equity. This result means that retailer-self image congruence is important cue for customers to estimate retailer equity. In other words, consumers are often more likely to prefer products and retail stores that have images similar to their own self-image. Especially, it appeared that effect for the ideal self-image congruence was consistently larger than the actual self-image congruence on the retailer equity. The results mean that consumers prefer or search for stores that have images compatible with consumer's perception of ideal-self. In addition, this study revealed that customers' estimations toward customer based retailer equity affected the repatronage intention. The results showed that all four dimensions (retailer awareness, retailer association, perceived retailer quality, and retailer loyalty) had positive effect on the repatronage intention. That is, management and investment to improve image congruence between retailer and consumers' self make customers' positive evaluation of retailer equity, and then the positive customer based retailer equity can enhance the repatonage intention. And to conclude, retailer's image management is an important part of successful retailer performance management, and the retailer-self image congruence is an important antecedent of retailer equity. Therefore, it is more important to develop and improve retailer's image similar to consumers' image. Given the pressure to provide increased image congruence, it is not surprising that retailers have made significant investments in enhancing the fit between retailer image and self image of consumer. The enhancing such self-image congruence may allow marketers to target customers who may be influenced by image appeals in advertising.

• Journal of Global Scholars of Marketing Science
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• v.20 no.1
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• pp.89-97
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• 2010

This study researches the effects of common features on a no-choice option with respect to regulatory focus theory. The primary interest is in three factors and their interrelationship: common features, no-choice option, and regulatory focus. Prior studies have compiled vast body of research in these areas. First, the "common features effect" has been observed bymany noted marketing researchers. Tversky (1972) proposed the seminal theory, the EBA model: elimination by aspect. According to this theory, consumers are prone to focus only on unique features during comparison processing, thereby dismissing any common features as redundant information. Recently, however, more provocative ideas have attacked the EBA model by asserting that common features really do affect consumer judgment. Chernev (1997) first reported that adding common features mitigates the choice gap because of the increasing perception of similarity among alternatives. Later, however, Chernev (2001) published a critically developed study against his prior perspective with the proposition that common features may be a cognitive load to consumers, and thus consumers are possible that they are prone to prefer the heuristic processing to the systematic processing. This tends to bring one question to the forefront: Do "common features" affect consumer choice? If so, what are the concrete effects? This study tries to answer the question with respect to the "no-choice" option and regulatory focus. Second, some researchers hold that the no-choice option is another best alternative of consumers, who are likely to avoid having to choose in the context of knotty trade-off settings or mental conflicts. Hope for the future also may increase the no-choice option in the context of optimism or the expectancy of a more satisfactory alternative appearing later. Other issues reported in this domain are time pressure, consumer confidence, and alternative numbers (Dhar and Nowlis 1999; Lin and Wu 2005; Zakay and Tsal 1993). This study casts the no-choice option in yet another perspective: the interactive effects between common features and regulatory focus. Third, "regulatory focus theory" is a very popular theme in recent marketing research. It suggests that consumers have two focal goals facing each other: promotion vs. prevention. A promotion focus deals with the concepts of hope, inspiration, achievement, or gain, whereas prevention focus involves duty, responsibility, safety, or loss-aversion. Thus, while consumers with a promotion focus tend to take risks for gain, the same does not hold true for a prevention focus. Regulatory focus theory predicts consumers' emotions, creativity, attitudes, memory, performance, and judgment, as documented in a vast field of marketing and psychology articles. The perspective of the current study in exploring consumer choice and common features is a somewhat creative viewpoint in the area of regulatory focus. These reviews inspire this study of the interaction possibility between regulatory focus and common features with a no-choice option. Specifically, adding common features rather than omitting them may increase the no-choice option ratio in the choice setting only to prevention-focused consumers, but vice versa to promotion-focused consumers. The reasoning is that when prevention-focused consumers come in contact with common features, they may perceive higher similarity among the alternatives. This conflict among similar options would increase the no-choice ratio. Promotion-focused consumers, however, are possible that they perceive common features as a cue of confirmation bias. And thus their confirmation processing would make their prior preference more robust, then the no-choice ratio may shrink. This logic is verified in two experiments. The first is a $2{\times}2$ between-subject design (whether common features or not X regulatory focus) using a digital cameras as the relevant stimulus-a product very familiar to young subjects. Specifically, the regulatory focus variable is median split through a measure of eleven items. Common features included zoom, weight, memory, and battery, whereas the other two attributes (pixel and price) were unique features. Results supported our hypothesis that adding common features enhanced the no-choice ratio only to prevention-focus consumers, not to those with a promotion focus. These results confirm our hypothesis - the interactive effects between a regulatory focus and the common features. Prior research had suggested that including common features had a effect on consumer choice, but this study shows that common features affect choice by consumer segmentation. The second experiment was used to replicate the results of the first experiment. This experimental study is equal to the prior except only two - priming manipulation and another stimulus. For the promotion focus condition, subjects had to write an essay using words such as profit, inspiration, pleasure, achievement, development, hedonic, change, pursuit, etc. For prevention, however, they had to use the words persistence, safety, protection, aversion, loss, responsibility, stability etc. The room for rent had common features (sunshine, facility, ventilation) and unique features (distance time and building state). These attributes implied various levels and valence for replication of the prior experiment. Our hypothesis was supported repeatedly in the results, and the interaction effects were significant between regulatory focus and common features. Thus, these studies showed the dual effects of common features on consumer choice for a no-choice option. Adding common features may enhance or mitigate no-choice, contradictory as it may sound. Under a prevention focus, adding common features is likely to enhance the no-choice ratio because of increasing mental conflict; under the promotion focus, it is prone to shrink the ratio perhaps because of a "confirmation bias." The research has practical and theoretical implications for marketers, who may need to consider common features carefully in a practical display context according to consumer segmentation (i.e., promotion vs. prevention focus.) Theoretically, the results suggest some meaningful moderator variable between common features and no-choice in that the effect on no-choice option is partly dependent on a regulatory focus. This variable corresponds not only to a chronic perspective but also a situational perspective in our hypothesis domain. Finally, in light of some shortcomings in the research, such as overlooked attribute importance, low ratio of no-choice, or the external validity issue, we hope it influences future studies to explore the little-known world of the "no-choice option."

• KDI Journal of Economic Policy
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• v.12 no.1
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• pp.31-68
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• 1990

The concentration of economic power takes the form of one or a few firms controlling a substantial portion of the economic resources and means in a certain economic area. At the same time, to the extent that these firms are owned by a few individuals, resource allocation can be manipulated by them rather than by the impersonal market mechanism. This will impair allocative efficiency, run counter to a decentralized market system and hamper the equitable distribution of wealth. Viewed from the historical evolution of Western capitalism in general, the concentration of economic power is a paradox in that it is a product of the free market system itself. The economic principle of natural discrimination works so that a few big firms preempt scarce resources and market opportunities. Prominent historical examples include trusts in America, Konzern in Germany and Zaibatsu in Japan in the early twentieth century. In other words, the concentration of economic power is the outcome as well as the antithesis of free competition. As long as judgment of the economic system at large depends upon the value systems of individuals, therefore, the issue of how to evaluate the concentration of economic power will inevitably be tinged with ideology. We have witnessed several different approaches to this problem such as communism, fascism and revised capitalism, and the last one seems to be the only surviving alternative. The concentration of economic power in Korea can be summarily represented by the "jaebol," namely, the conglomerate business group, the majority of whose member firms are monopolistic or oligopolistic in their respective markets and are owned by particular individuals. The jaebol has many dimensions in its size, but to sketch its magnitude, the share of the jaebol in the manufacturing sector reached 37.3% in shipment and 17.6% in employment as of 1989. The concentration of economic power can be ascribed to a number of causes. In the early stages of economic development, when the market system is immature, entrepreneurship must fill the gap inherent in the market in addition to performing its customary managerial function. Entrepreneurship of this sort is a scarce resource and becomes even more valuable as the target rate of economic growth gets higher. Entrepreneurship can neither be readily obtained in the market nor exhausted despite repeated use. Because of these peculiarities, economic power is bound to be concentrated in the hands of a few entrepreneurs and their business groups. It goes without saying, however, that the issue of whether the full exercise of money-making entrepreneurship is compatible with social mores is a different matter entirely. The rapidity of the concentration of economic power can also be traced to the diversification of business groups. The transplantation of advanced technology oriented toward mass production tends to saturate the small domestic market quite early and allows a firm to expand into new markets by making use of excess capacity and of monopoly profits. One of the reasons why the jaebol issue has become so acute in Korea lies in the nature of the government-business relationship. The Korean government has set economic development as its foremost national goal and, since then, has intervened profoundly in the private sector. Since most strategic industries promoted by the government required a huge capacity in technology, capital and manpower, big firms were favored over smaller firms, and the benefits of industrial policy naturally accrued to large business groups. The concentration of economic power which occured along the way was, therefore, not necessarily a product of the market system. At the same time, the concentration of ownership in business groups has been left largely intact as they have customarily met capital requirements by means of debt. The real advantage enjoyed by large business groups lies in synergy due to multiplant and multiproduct production. Even these effects, however, cannot always be considered socially optimal, as they offer disadvantages to other independent firms-for example, by foreclosing their markets. Moreover their fictitious or artificial advantages only aggravate the popular perception that most business groups have accumulated their wealth at the expense of the general public and under the behest of the government. Since Korea stands now at the threshold of establishing a full-fledged market economy along with political democracy, the phenomenon called the concentration of economic power must be correctly understood and the roles of business groups must be accordingly redefined. In doing so, we would do better to take a closer look at Japan which has experienced a demise of family-controlled Zaibatsu and a success with business groups(Kigyoshudan) whose ownership is dispersed among many firms and ultimately among the general public. The Japanese case cannot be an ideal model, but at least it gives us a good point of departure in that the issue of ownership is at the heart of the matter. In setting the basic direction of public policy aimed at controlling the concentration of economic power, one must harmonize efficiency and equity. Firm size in itself is not a problem, if it is dictated by efficiency considerations and if the firm behaves competitively in the market. As long as entrepreneurship is required for continuous economic growth and there is a discrepancy in entrepreneurial capacity among individuals, a concentration of economic power is bound to take place to some degree. Hence, the most effective way of reducing the inefficiency of business groups may be to impose competitive pressure on their activities. Concurrently, unless the concentration of ownership in business groups is scaled down, the seed of social discontent will still remain. Nevertheless, the dispersion of ownership requires a number of preconditions and, consequently, we must make consistent, long-term efforts on many fronts. We can suggest a long list of policy measures specifically designed to control the concentration of economic power. Whatever the policy may be, however, its intended effects will not be fully realized unless business groups abide by the moral code expected of socially responsible entrepreneurs. This is especially true, since the root of the problem of the excessive concentration of economic power lies outside the issue of efficiency, in problems concerning distribution, equity, and social justice.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.2
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• pp.205-212
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• 2012

This study was performed to investigate the prevalence of metabolic syndrome (MS) and assess nutrient intake levels for the purpose of improving MS risk factors. The participants in this study were 512 adults consisting of 271 men and 241 women aged 30 and over, who visited a public health center for a medical check up. The diagnosis of MS subjects was adapted from the NCEP-ATPIII guidelines and the WHO Asia-Pacific Area criteria for obesity. The MS group was defined as subjects displaying three or more risk factors, and the non MS group was defined as those displaying two or less risk factors. A dietary survey was conducted using the 24-hour recall method. The number of subjects displaying MS syndrome factors was 158 (30.9%), broken down into, 89 men and 69 women. Regarding risk factors in the MS group, the prevalence of waist circumference was 40.5%, hypertension 34.2%, hyperglycemia 31.0%, low HDL-cholesterol 24.7%, and hypertriglycemia 19.6%. BMI, sistolic blood pressure, blood glocose, blood triglyceride, and blood HCL-cholesterol of the MS group were significantly higher compared to the non MS group. Male subjects in the MS group reported high intakes of cereals, sugar, fruits, meat and poultry, oil and fats, and beverages and total food intake was significantly higher compared to the non MS group. Women in the MS group reported high intakes of meat and poultry, milk and dairy products, beverages, and seasonings, and total food intake was higher compared to the non MS group. Dietary diversity score (DDS) was 3.82~4.04, which was not significant among the groups. In men, dietary variety score (DVS) was 16.3 in the MS group and 19.4 in the non MS group, whereas in women, the DVS was 15.2 in the non MS group and 17.0 in the MS group. In GMVDF pattern, 11111 pattern was 30.7%, followed by 01111 for men and 11101 for women. Calorie, fat, and cholesterol intakes in men as well as, calorie, fat, and folate intakes in women in the MS group were higher compared to the non MS group. Intakes of protein, P, Fe, Na, vitamin $B_1$, vitamin $B_2$, niacin, vitamin E, and Zn were higher than the KDRIs. On the other hand, intakes of Ca, K, fiber, vitamin $B_2$, and vitamin C were below the KDRIs. Intakes of lipids, animal food, Na, and cholesterol in the MS group were higher compared to the non MS group, whereas intake of dietary fiber was lower. Our results indicate that continuous, systematic nutritional education program must implemented to reduce the risk factors associated with MS.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.317-325
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• 2006

Purpose : This study was carried out to elucidate the effects of nitric oxide synthase(NOS) inhibitor, NG-monomethyl-L-arginine(L-NMMA) and nitric oxide precursor, L-arginine(L-Arg) on cerebral hemodynamics and energy metabolism during reoxygenation-reperfusion(RR) after hypoxia-ischemia(HI) in newborn piglets. Methods : Twenty-eight newborn piglets were divided into 4 groups; Sham normal control(NC), experimental control(EC), L-NMMA(HI & RR with L-NMMA), and L-Arg(HI & RR with L-Arg) groups. HI was induced by occlusion of bilateral common carotid arteries and simultaneously breathing with 8 percent oxygen for 30 mins, and followed RR by release of carotid occlusion and normoxic ventilation for one hour. All groups were monitored with cerebral hemodynamics and cytochrome $aa_3$ (Cyt $aa_3$) using near infrared spectroscopy(NIRS). $Na^+$, $K^+$-ATPase activity, lipid peroxidation products, and tissue high energy phosphate levels were determined biochemically in the cerebral cortex. Results : In experimental groups, mean arterial blood pressure, $PaO_2$, and pH decreased, and base excess and blood lactate level increased after HI compared to NC group(P<0.05). These variables subsequently returned to baseline after RR except pH. There were no differences among the experimental groups. In NIRS, oxidized hemoglobin($HbO_2$) decreased and hemoglobin(Hb) increased during HI(P<0.05) but returned to base line immediately after RR; 40 min after RR, the $HbO_2$ had decreased significantly compared to NC group(P<0.05). Changes of Cyt $aa_3$ decreased significantly compared to NC after HI and recovered at the end of the experiment. Significantly reduced cerebral cortical cell membrane $Na^+$, $K^+$-ATPase activity and increased lipid peroxidation products(P<0.05) were not improved with L-NMMA or L-Arg. Conclusion : These findings suggest that NO is not involved in the mechanism of HI and RR brain damage during the early acute phase of RR.

• Journal of Chest Surgery
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• v.40 no.4 s.273
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• pp.280-287
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• 2007

Background: We retrospectively evaluated the clinical results of surgically managing patients with Ebstein's anomaly. Material and Method: Between Feb. f 984 and June 2006, 50 patients who underwent surgical treatment for Ebstein's anomaly at Yonsei Cardiovascular Center were retrospectively reviewed. The mean age of the patients was 26.9 years and 19 patients were male, Associated anomalies included atrial septal defect (33), patent ductus arteriosus (2), ventricular septal defect (1), and pulmonary stenosis (4), and 90%, (45/50) of the patients had more than a moderate degree of tricuspid regurgitation. Carpentier type A was present in 6 patients, type B in 26, type C in 14 and type D in 4. Ten patients were associated with WPW syndrome. Conservative surgery was possible in 31 patients (tricuspid annuloplasty, plication of the atrialized RV), Fontan's operation was peformed in 4 patients, tricuspid valve replacement was done in 12 and palliative surgery was done in 2 patients. Thirteen patients were associated with hi-directional cavopulmonary shunt (BCPS: one and a half ventricular repairs): 10 patients with WPW syndrome and 4 patients with atrial fibrillation underwent concomitant ablation. Result: The postoperative median NYHA functional class $(3{\rightarrow}1)$ and the mean cardio-thoracic ratio $(0.65{\rightarrow}0.59)$ were decreased significantly (p<0.001, p=0.014). The mean oxygen saturation $(86.6{\rightarrow}94.1%)$, and median TR grade $(4{\rightarrow}1)$ were also significantly improved (p=0.004, p<0.001). For comparison of BCPS and conservative surgery, the preoperative right ventricular pressure (33.0 vs. 41.3 mmHg), the ICU stay (2.80 vs. 1.89 days), the hospital say (10.6 vs. 16.8 days), and the left ventricular ejection fraction (64.3 vs. 72.8%) were statistically different. Postoperative mortality occurred in 3 patients (6%) due to biventricular failure in 2 patients and sepsis in the other patient. The mean follow up duration was 101.5 months, and one patient died of Fontan failure and 6 patients required reoperation (bioprosthetic degenerative change (2) and Fontan conversion (4)). The overall survival rate at 10 years was 90.2%, the freedom from reoperation rate and rate of cardiac related events were 78.9% and 49.2%, respectively. Conclusion: Surgical management of Ebstein's anomaly can be performed safely, and the associated BCPS may be helpful for high-risk patients. Adequate application of surgical management may increase the long-term survival with a reduced rate of reoperation.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.192-197
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• 2009

Background: Despite the benefits of home oxygen therapy in patients suffering chronic respiratory failure, previous reports in Korea revealed lower compliance to oxygen therapy and a shorter time for oxygen use than expected. However, these papers were published before oxygen therapy was covered by the national insurance system. Therefore, this study examined whether there were some changes in compliance, using time and other clinical features of home oxygen therapy after insurance coverage. Methods: This study reviewed the medical records of patients prescribed home oxygen therapy in our hospital from November 1, 2006 to September 31, 2008. The patients were interviewed either in person or by telephone to obtain information related to oxygen therapy. Results: During study period, a total 105 patients started home oxygen therapy. The mean age was 69 and 60 (57%) were male. The mean oxygen partial pressure in the arterial blood was 54.5 mmHg and oxygen saturation was 86.3%. Primary diseases that caused hypoxemia were COPD (n=64), lung cancer (n=14), Tb destroyed lung (n=12) and others. After oxygen therapy, more than 50% of patients experienced relief of their subjective dyspnea. The mean daily use of oxygen was 9.8${\pm}$7.3 hours and oxygen was not used during activity outside of their home (mean time, 5.4${\pm}$3.7 hours). Twenty four patients (36%) stopped using oxygen voluntarily 7${\pm}$4.7 months after being prescribed oxygen and showed a less severe pulmonary and right heart function. The causes of stopping were subjective symptom relief (n=11), inconvenience (n=6) and others (7). Conclusion: The prescription of home oxygen has increased since national insurance started to cover home oxygen therapy. However, the mean time for using oxygen is still shorter than expected. During activity of outside their home, patients could not use oxygen due to the absence of portable oxygen. Overall, continuous education to change the misunderstandings about oxygen therapy, more economic support from national insurance and coverage for portable oxygen are needed to extend the oxygen use time and maintain oxygen usage.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.1 no.1
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• pp.53-68
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• 1981

Most clays under sustained load exhibit time-dependent deformation because of creep movement of soil particles and many investigators have attempted to relate their findings to the creep behavior of natural ground and to the long-term stability of slopes. Since the creep behavior of clays may assume a variety of forms depending on such factors as soil plasticity, activity and water content, it is difficult and complicated to analyse the creep behavior of clays. Rheological models composed of linear springs in combination with linear or nonlinear dashpots and sliders, are generally used for the mathematical description of the time-dependent behavior of soils. Most rheological models, however, have been proposed to simulate the behavior of secondary compression for saturated clays and few definitive data exist that can evaluate the behavior of non-saturated clays under the action of sustained stress. The clays change gradually from a solid state through plastic state to a liquid state with increasing water content, therefore, the rheological models also change. On the other hand, creep is time-dependent, and also the effect of thixotropy is time-function. Consequently, there may be certain correlations between creep behavior and the effects of thixotropy in compacted clays. In addition, the states of clay depend on water content and hence the height of the specimen under drained conditions. Futhermore, based on present and past studies, because immediate elastic deformation occurs instantly after the pressure increment without time-delayed behavior, the factor representing immediate elastic deformations in the rheological model is necessary. The investigation described in this paper, based on rheological model, is designed to identify the immediate elastic deformations and the effects of thixotropy and height of clay specimens with varing water content and stress level on creep deformations. For these purposes, the uniaxial drain-type creep tests were performed. Test results and data for three compacted clays have shown that a linear top spring is needed to account for immediate elastic deformations in the rheological model, and at lower water content below the visco-plastic limit, the effects of thixotropy and height of clay specimens can be represented by the proposed rheological model not considering the effects. Therefore, the rheological model does not necessitate the other factors representing these effects. On the other hand, at water content higher than the visco-plastic limit, although the state behavior of clays is visco-plastic or viscous flow at the beginning of the test, the state behavior, in the case of the lower height sample, does not represent the same behavior during the process of the test, because of rapid drainage. In these cases, the rheological model does not coincide with the model in the case of the higher specimens.

• Journal of Nutrition and Health
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• v.47 no.5
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• pp.330-341
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• 2014

Purpose: The purpose of this study was to evaluate dietary habits, food intakes, nutrient intakes, and diet quality of non-alcoholic fatty liver disease in a health screening and promotion center. Methods: The total number of study subjects was 10,111 adults, where 3087 subjects (30.5%) were diagnosed as NAFLD. The dietary intakes were obtained using a food frequency questionnaire. They were then compared with the dietary reference intakes could be used in the future for development of diet and nutrition guidelines s (KDRIs). Results: Mean age of subjects in the normal group was $52.9{\pm}10.3yrs$ and body mass index (BMI) was $22.4{\pm}2.6kg/m^2$, and those of the NAFLD group were $55.1{\pm}9.2yrs$ and $25.4{\pm}2.9kg/m^2$. BMI, blood pressure of the NAFLD group were significantly higher than those of the normal group. The rates of skipping breakfast, overeating, and eating out were significantly could be used in the future for development of diet and nutrition guidelines er in the NAFLD group (p < 0.05, p < 0.000, p < 0.000 respectively). The speed of eating was fast in the NAFLD group (p < 0.000). The NAFLD group consumed significantly higher amounts of grains, meats, fish, seaweeds, kimchies, sugars, sweets, coffee, teas, and oils compared to the normal group (p < 0.05). Meanwhile, intakes of starch products, fruits, milk, and milk products were significantly lower in the NAFLD group compared with those of the normal group (p < 0.05). Riboflavin, calcium, and dietary fiber nutrient adequacy ratio (NAR) of the NAFLD group were significantly lower than those of the normal group. The Korean's dietary diversity score (KDDS) of the NAFLD group was lower than that of the normal group. Conclusion: In conclusion, we suggest that diet guidelines, such as increasing the intake of calcium and dietary fiber, reducing the intake of energy, fat, and simple carbohydrates, are necessary to improvement of NAFLD. The results could be used in the future for development of diet and nutrition guidelines for NAFLD.

• The Korean Nurse
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• v.29 no.2
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• pp.48-65
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• 1990

The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.