• Title/Summary/Keyword: Quality of outcome

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Promotional Strategies of Local Drugstores

  • Kim, Seung-Mi;Lee, Sang-Yoon;Kim, Pan-Jin;Kim, Nam-Myun;Youn, Myoung-Kil
    • The Journal of Industrial Distribution & Business
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    • v.1 no.1
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    • pp.5-12
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    • 2010
  • The retail business of drugstore was introduced to Korea for the first time 10 years ago. Since Olive Young introduced a retail store in the name of drugstore in 1999 for the first time in Korea, new distribution channel combining drugstore, cosmetic products and dairy products, etc has been made. At initial stage, the new distribution channel grew up slowly because of low specialty and economic stagnation. However, the three big distribution channels, that is to say, Olive Young (CJ), Watsons (GS) and W Store (Kolon Well Care), etc, were established to produce new distribution system following large-scaled discount stores as well as convenience stores. The purpose of the study is to investigate ways making Korean style drugstore be new retail business in addition to traditional markets, department stores, E-Mart and other general super markets and to examine problems preventing the drugstore from being promoted and to find out solutions. The speciality retailers that is called a category killer attacking department stores as well as marts is expanding market quickly. New consumption trend that gives priority to wellbeing is being expanded in accordance with high level of standards of living life: The drugstore is thought to be new alternative of distribution because it keeps special products. Young ladies who are main customers of drugstores respond to the trend sensitively to have more buying power that is thought to be promising. And, consumers' desire has become concrete and special. This is because consumers want not only convenient shopping but also special shopping system that is current trend. These days, so called Multi-shop and Total shop and other special shops have been recently opened. Special multi-shop has been concentrated on fashion product and miscellaneous goods so far: Health total wellbeing shop shall be popular in accordance with wellbeing trends. Drugstores can play an important role. Drugstores were opened for the first time ten years ago. In particular, Olive Young succeeded in going into the black after making efforts for a long time by many persons. Drugstores could succeed in the business owing to many persons in the past as well as customers who liked drugstores. However, drugstores once lost ways and recorded poor business results. The three drugstores, that is to say, Olive Young, Watsons making efforts to go into the black and W-Store pursuing traditional drugstore shall compete each other and make effort to satisfy customers' desire. In that way, the three drugstores can be assured of present business as well as future business. The consumers' demand trend has become special at sub-division so that drugstores that can satisfy the demand can succeed in the business. Large businesses may be more interested in the 4th generation retail business to produce good income and to have bright future. Drugstore business and market are likely to expand and develop owing to large business' participation in drugstore business. Drugstores expanded shop at Seoul and Gyeonggi-do until middle of 2000. Drugstore business at station sphere in Seoul and Gyeonggi-do that have high ratio of temporary population has low customer loyalty to have limitation on continuous growth. Since 2009, drugstores have opened new shops at local towns: From the year of 2010, drugstores need to establish multiple shop strategy by accelerating business speed and to allow customers to drop in the shop anywhere in the nation and to enter consumers' life deeply, so that they can strengthen business base definitely. Drugstores need to have price competitiveness to have multiple shop opening strategy and to satisfy consumers and to supply high quality services that is future subject to solve. And, Olive Young and Watsons that are Korean style drugstore need to keep system in order and to strengthen substance as Korean style drugstore and to expand marketing, so that they can get business outcome within 5 years that was done 10 years before and they become the 4th generation retail business. The study had difficulties at collecting material from the three drugstore because of poor cooperation. And, the author had great difficulty at collecting statistical material that was made in disorder. Further effort is needed considering such problems.

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Exploiting the Maximum Productive Potential of Spent Laying Hens with Various Metabolizable Energy and Protein Levels after Induced Molting (강제환우시킨 산란노계에서 생산성 제고를 위한 대사에너지와 단백질 수준의 탐색)

  • Akram, M.;Park, J. H.;Ryu, M. S.;Shin, K.H.;Ryu, K. S.
    • Journal of Animal Science and Technology
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    • v.45 no.3
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    • pp.369-376
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    • 2003
  • This experiment was conducted to investigate the influence of different levels of metabolizable energy (ME) and crude protein (CP) on post-molt performance and egg quality of spent laying hens. Four hundred and thirty two, ISA Brown hens at sixty six weeks of age after molt induction were fed six experimental diets containing three ME (2,750, 2,800, 2,850 kcal/kg) with two CP (15, 17%) levels in a factorial design. The influence of ME and CP were evaluated on egg production, egg weight and feed intake throughout 24 weeks of production. Egg mass and feed conversion ratio (FCR) were measured during the experimental period. Haugh unit, yolk color and eggshell breaking strength were measured at 5%, 50%, peak, post peak and end stage of egg production. The hens fed 2800 kcal/kg diet along with 15% CP recorded the highest outcome of egg production (P<0.05). The egg weight has been shown to increase with hens receiving 2,800 kcal/kg ME. Daily egg mass tended to increase in hens fed with 15% CP and 2,800 kcal/kg ME. Feed intake decreased significantly with the level of ME and CP in the diet increased (P<0.05). Yolk color was improved significantly in eggs laid by the hens receiving 17% CP than 15% diet. It also tended to be higher in 17% CP with 2,800 or 2,850 kcal/kg ME diet treatments. Egg shell breaking strength increased with hens receiving diets of 15% CP and 2,800 kcal/kg. From this experiment it can be concluded that the ME level of 2,800 kcal/kg coupled with 15% CP could be used to achieve the higher egg production and better eggshell strength in induced molting hens.

Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients (소아 백혈병 환자의 동종 조혈모세포이식 전처치로서 전신방사선 조사 포함군과 비포함군의 비교)

  • Kim, Sang-Jeong;Han, Dong-Kyun;Baek, Hee-Jo;Kim, Dong-Yeon;Nam, Taek-Keun;Hwang, Tai-Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.538-547
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    • 2010
  • Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%; $P$=0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%; $P$=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life.

Glomerular Filtration Rate Test Methods and Guidelines (Glomerular Filtration Rate 검사방법 및 가이드라인)

  • Park, Min-Ho;Lee, Ha-Young;Ryu, Hwa-Jin;Yoo, Tae-Min;Noh, Gyeong-Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.2
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    • pp.97-100
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    • 2018
  • Purpose The glomerular filtration rate (GFR) test is an important indicator of glomerular filtration and has been used to test renal function and the extent of its function. The GFR test is performed by intravenous injection of radioactive medicines made of $^{51}Cr$-EDTA, and blood concentration is measured by taking blood according to the elapsed time. also, PET-CT, bone scan, transfusion and so on will affect the outcome. Therefore, we will improve the quality of the test by providing guidelines for the GFR test for more accurate testing. Materials and Methods 5 mL of physiological saline solution and 2 mL of $^{51}Cr$-EDTA solution are used to make 5 mL of the radiopharmaceutical solution to be injected into the patient. First, the syringe weight is measured before the injection, and then the radioactive medicine is injected into the patient's vein and the syringe weight is measured after the injection. Blood sampling is performed twice in total. In adults, blood is collected 3 hours / 5 hours after injection and in children 2 hours / 5 hours after injection. The blood sample is centrifuged at 3300 rpm for 5 minutes. Standard solution is prepared by filling diluent water up to the scale indicated in the 200-mL volumetric flask, discarding $500{\mu}L$, injecting $500{\mu}L$ of GFR reagent and mixing well. $500{\mu}L$ each of the standard solution is dispensed into two test tubes, and $500{\mu}L$ of each of the plasma samples collected in time is dispensed into two test tubes and measured with a Cobra Counter. Results At present, the reference range applied in this study is $119.5{\pm}30.3ml/min/1.73m2$ for males and $125.2{\pm}28.2ml/min/1.73m^2$ for females. Conclusion The GFR test is conducted using radioactive medical products. GFR testing is performed as a scheduled test, but PET-CT, dialysis and transfusion, which may affect GFR testing, may be scheduled during GFR testing. Therefore, we could get accurate GFR test results by notifying the ward and department beforehand when booking.

The Effects of Global Entrepreneurship and Social Capital Within Supply Chain on the Export Performance (글로벌 기업가정신과 공급사슬 내 사회적 자본이 수출성과에 미치는 영향)

  • Yoon, Heon-Deok;Kwak, Ki-Young;Seo, Ri-Bin
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.3
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    • pp.1-16
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    • 2012
  • Under the international business circumstance, global supply chain management is considered a vital strategic challenge to small and medium-sized enterprises(SMEs) suffering from deficient resources and capabilities to exploit overseas markets comparing with large corporations. That is because they can expand their business domains into overseas markets by establishing strategic alliances with global supply chain partners. Although a wide range of previous researches have emphasized the cooperative networks in the chain, most are ignoring the importance of developing relational characteristics such as trust and reciprocity with the partners. Besides, verifying the relational factors influencing firms' export performances, some studies proposed different and inconsistent factors. According to the social capital theory, which is the social quality and networks facilitating close cooperation of inter-individual and inter-organization, provides the integrated view to identify the relational characteristics in the aspects of network, trust and reciprocal norm. Meanwhile, a number of researchers shows that global entrepreneurship is the internal and intangible resource necessary to promote SMEs' internationalization. Upon closer examination, however, they cannot explain clearly its influencing mechanism in the inter-firm cooperative relationships. This study is to verify the effect of social capital accumulated within global supply chain on SMEs' qualitative and quantitative export performance. In addition, we shed new light on global entrepreneurship expected to be concerned with the formation of social capital and the enhancement of export performances. For this purpose, the questionnaires, developed through literature review, were collected from 192 Korean SMEs affiliated in Korean Medium Industries Association and Global Chief Executive Officer's Club focusing on their memberships' international business. As a result of multi-regression analysis, the social capital - network, trust and reciprocal norm shared with global supply chain partner - as well as global entrepreneurship - innovativeness, proactiveness and risk-taking - have positive effect on SMEs' export performances. Also global entrepreneurship affects positively social capital which has mediating effect partially in the relationship between global entrepreneurship and performances. These results means that there is a structural process - global entrepreneurship(input), social capital(output), and export performances(outcome). In other words, a firm should consistently invest in and develop the social capital with global supply chain partners in order to achieve common goals, establish strategic collaborations and obtain long-term export performances. Furthermore, it is required to foster the global entrepreneurship in an organization so as to build up the social capital. More detailed practical issues and discussion are made in the conclusion.

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TACT Productivity Management for Finish Works of Residential Buildings using Productivity Achievement Ratio (PAR) (공동주택 마감공사 TACT 기법 생산성 관리 - Productivity Achievement Ratio를 활용한 생산성 관리 -)

  • Joo, Seonu;Park, Moonseo;Lee, Hyun-Soo;Lee, Kwang-Pyo
    • Korean Journal of Construction Engineering and Management
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    • v.16 no.3
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    • pp.36-48
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    • 2015
  • To complete various types of finish works with higher quality in much less time, TACT, which was mostly used for high-rise buildings, has been adapted to meet the needs for systematic schedule management in construction sites. However, the effectiveness of adapting TACT has not been shown as expected due to the different perspectives on productivity from both general contractor and subcontractors based on unforeseen conditions according to the types of site. Furthermore, not enough theoretical backgrounds, empirical data, and systematic approaches to solve the fundamental problems caused by each participants' different views on productivity has produced obstacles for establishing effective solutions. Therefore, this research aims to analyze the possible main reasons for having different point of views regarding productivity among various participants of residential building sites using TACT based on literature review, site survey, and interviews. Also, case study was conducted to propose obtainable productivity (OP) regression equation and productivity achievement ratio (PAR) with reduction factors (RFs) and actual productivity (AP) data from an actual construction site. The proposed outcome may assist general contractors converting output management with PPC to productivity management with actual data using PAR. On the other hand, subcontractors would be able to estimate theory-based maximum productivity of construction sites with TACT by using OP. The PAR will enhance the communication between general and sub-contractors for their decision making process. Finally, the main RFs derived from PAR could be used as essential keys for productivity management to increase the economical and operational effectiveness of the construction project.

A Study on the Variable Factors for Brain Perfusion SPECT(Diamox) Scan (Brain Perfusion SPECT(Diamox) 검사의 수행결과에 영향을 주는 요인)

  • Lee, Jin-Hyeong;Kim, Sang-Eon;Park, Hyeon-Soo;Park, Yeoung-Jae;Lee, In-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.99-103
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    • 2011
  • Purpose: Head movement during brain perfusion SPECT (Diamox) scan is a one of important issues which decreases image quality. It also causes repeated scans. This study was designed to evaluate variable factors causing scan failures. Materials and Methods: 676 patients (359 men, 317 women, age average $54.5{\pm}18.4$) for brain perfusion SPECT (Diamox) scan from March, 2010 to Feb. 2011 were used as a subject. Age data and the kind of disease(Moyamoya disease (MMD), None moyamoya disease (NMMD), Cerebral infarction (CI)), test performance outcome (success,failure) were collected. The head movement factors(gender, disease, age, head fixation device) were evaluated by chi-square test and logistic regression analysis Results: The result showed that men had higher scan failure rate than women. Seniors in seventies(men 3.4%, women 1.5%) showed the most highest failure rate. Using head fixation device increased scan success rate up to 94.4~97.7%. The scan success rate is dependent upon gender, head fixation device by chi-square test(${\chi}^2$=3.8 (df=1, p<0.05), ${\chi}^2$=10.4 (df=1, p<0.001)) Gender, disease(CI), head fixation device showed very effective result in logistic regression analysis.(Wald=3.3 (p<0.07), Wald=3.7 (p<0.05), Wald=9.3 (p<0.05) Conclusion: It is demonstrated that gender, disease, using head fixation device is statistically very useful factors. Especially, head fixation device is a main key minimizing repeated scan.

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Analysis of Forestry Structure and Induced Output Based on Input - output Table - Influences of Forestry Production on Korean Economy - (산업관련표(産業關聯表)에 의(依)한 임업구조분석(林業構造分析)과 유발생산액(誘發生産額) -임업(林業)이 한국경제(韓國經濟)에 미치는 영향(影響)-)

  • Lee, Sung-Yoon
    • Journal of the Korean Wood Science and Technology
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    • v.2 no.4
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    • pp.4-14
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    • 1974
  • The total forest land area in Korea accounts for some 67 percent of the nation's land total. Its productivity, however, is very low. Consequently, forest production accounts for only about 2 percent of the gross national product and a minor proportion of no more than about 5 percent versus primary industry. In this case, however, only the direct income from forestry is taken into account, making no reference to the forestry output induced by other industrial sectors. The value added Or the induced forestry output in manufacturing the primary wood products into higher quality products, makes a larger contribution to the economy than direct contribution. So, this author has tried to analyze the structure of forestry and compute the repercussion effect and the induced output of primary forest products when utilized by other industries for their raw materials, Hsing the input-output table and attached tables for 1963 and 1966 issued by the Bank of Korea. 1. Analysis of forestry structure A. Changes in total output Durng the nine-year period, 1961-1969, the real gross national product in Korea increased 2.1 times, while that of primary industries went up about 1. 4 times. Forestry which was valued at 9,380 million won in 1961, was picked up about 2. 1 times to 20, 120 million won in 1969. The rate of the forestry income in the GNP, accordingly, was no more than 1.5 percent both in 1961 and 1962, whereas its rate in primary industries increased 3.5 to 5.4 percent. Such increase in forestry income is attributable to increased forest production and rise in timber prices. The rate of forestry income, nonetheless, was on the decrease on a gradual basis. B. Changes in input coefficient The input coefficient which indicates the inputs of the forest products into other sectors were up in general in 1966 over 1963. It is noted that the input coefficient indicating the amount of forest products supplied to such industries closely related with forestry as lumber and plywood, and wood products and furniture, showed a downward trend for the period 1963-1966. On the other hand, the forest input into other sectors was generally on the increase. Meanwhile, the input coefficient representing the yolume of the forest products supplied to the forestry sector itself showed an upward tendency, which meant more and more decrease in input from other sectors. Generally speaking, in direct proportion to the higher input coefficient in any industrial sector, the reinput coefficient which denotes the use of its products by the same sector becomes higher and higher. C. Changes in ratio of intermediate input The intermediate input ratio showing the dependency on raw materials went up to 15.43 percent m 1966 from 11. 37 percent in 1963. The dependency of forestry on raw materials was no more than 15.43 percent, accounting for a high 83.57 percent of value added. If the intermediate input ratio increases in any given sector, the input coefficient which represents the fe-use of its products by the same sector becomes large. D. Changes in the ratio of intermediate demand The ratio of the intermediate demand represents the characteristics of the intermediary production in each industry, the intermediate demand ratio in forestry which accunted for 69.7 percent in 1963 went up to 75.2 percent in 1966. In other words, forestry is a remarkable industry in that there is characteristics of the intermediary production. E. Changes in import coefficient The import coefficient which denotes the relation between the production activities and imports, recorded at 4.4 percent in 1963, decreased to 2.4 percent in 1966. The ratio of import to total output is not so high. F. Changes in market composition of imported goods One of the major imported goods in the forestry sector is lumber. The import value increased by 60 percent to 667 million won in 1966 from 407 million won in 1963. The sales of imported forest products to two major outlets-lumber and plywood, and wood products and furniture-increased to 343 million won and 31 million won in 1966 from 240million won and 30 million won in 1963 respectively. On the other hand, imported goods valued at 66 million won were sold to the paper products sector in 1963; however, no supply to this sector was recorded in 1963. Besides these major markets, primary industries such as the fishery, coal and agriculture sectors purchase materials from forestry. 2. Analysis of repercussion effect on production The repercussion effect of final demand in any given sector upon the expansion of the production of other sectors was analyzed, using the inverse matrix coefficient tables attached to the the I.O. Table. A. Changes in intra-sector transaction value of inverse matrix coefficient. The intra-sector transaction value of an inverse matrix coefficient represents the extent of an induced increase in the production of self-support products of the same sector, when it is generated directly and indirectly by one unit of final demand in any given sector. The intra-sector transaction value of the forestry sector rose from 1.04 in 1963 to 1, 11 in 1966. It may well be said, therefore, that forestry induces much more self-supporting products in the production of one unit of final demand for forest products. B. Changes in column total of inverse matrix coefficient It should be noted that the column total indicates the degree of effect of the output of the corresponding and related sectors generated by one unit of final demand in each sector. No changes in the column total of the forestry sector were recorded between the 1963 and 1966 figures, both being the same 1. 19. C. Changes in difference between column total and intra-sector transaction amount. The difference between the column total and intra-sector transaction amount by sector reveals the extent of effect of output of related industrial sector induced indirectly by one unit of final demand in corresponding sector. This change in forestry dropped remarkable to 0.08 in 1966 from 0.15 in 1963. Accordingly, the effect of inducement of indirect output of other forestry-related sectors has decreased; this is a really natural phenomenon, as compared with an increasing input coefficient generated by the re-use of forest products by the forestry sector. 3. Induced output of forestry A. Forest products, wood in particular, are supplied to other industries as their raw materials, increasng their value added. In this connection the primary dependency rate on forestry for 1963 and 1966 was compared, i. e., an increase or decrease in each sector, from 7.71 percent in 1963 to 11.91 percent in 1966 in agriculture, 10.32 to 6.11 in fishery, 16.24 to 19.90 in mining, 0.76 to 0.70 in the manufacturing sector and 2.79 to 4.77 percent in the construction sector. Generally speaking, on the average the dependency on forestry during the period 1963-1966 increased from 5.92 percent to 8.03 percent. Accordingly, it may easily be known that the primary forestry output induced by primary and secondary industries increased from 16, 109 million won in 1963 to 48, 842 million won in 1966. B. The forest products are supplied to other industries as their raw materials. The products are processed further into higher quality products. thus indirectly increasing the value of the forest products. The ratio of the increased value added or the secondary dependency on forestry for 1963 and 1966 showed an increase or decrease, from 5.98 percent to 7.87 percent in agriculture, 9.06 to 5.74 in fishery, 13.56 to 15.81 in mining, 0.68 to 0.61 in the manufacturing sector and 2.71 to 4.54 in the construction sector. The average ratio in this connection increased from 4.69 percent to 5.60 percent. In the meantime, the secondary forestry output induced by primary and secondary industries rose from 12,779 million Wall in 1963 to 34,084 million won in 1966. C. The dependency of tertiary industries on forestry showed very minor ratios of 0.46 percent and 0.04 percent in 1963 and 1966 respectively. The forestry output induced by tertiary industry also decreased from 685 million won to 123 million won during the same period. D. Generally speaking, the ratio of dependency on forestry increased from 17.68 percent in 1963 to 24.28 percent in 1966 in primary industries, from 4.69 percent to 5.70 percent in secondary industries, while, as mentioned above, the ratio in the case of tertiary industry decreased from 0.46 to 0.04 percent during the period 1963-66. The mining industry reveals the heaviest rate of dependency on forestry with 29.80 percent in 1963 and 35.71 percent in 1966. As it result, the direct forestry income, valued at 8,172 million won in 1963, shot up to 22,724 million won in 1966. Its composition ratio lo the national income rose from 1.9 percent in 1963 to 2.3 per cent in 1966. If the induced outcome is taken into account, the total forestry production which was estimated at 37,744 million won in 1963 picked up to 105,773 million won in 1966, about 4.5 times its direct income. It is further noted that the ratio of the gross forestry product to the gross national product. rose significantly from 8.8 percent in 1963 to 10.7 percent in 1966. E. In computing the above mentioned ratio not taken into consideration were such intangible, indirect effects as the drought and flood prevention, check of soil run-off, watershed and land conservation, improvement of the people's recreational and emotional living, and maintenance and increase in the national health and sanitation. F. In conclusion, I would like to emphasize that the forestry sector exercices an important effect upon the national economy and that the effect of induced forestry output is greater than its direct income.

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An Empirical Study in Relationship between Franchisor's Leadership Behavior Style and Commitment by Focusing Moderating Effect of Franchisee's Self-efficacy (가맹본부의 리더십 행동유형과 가맹사업자의 관계결속에 관한 실증적 연구 - 가맹사업자의 자기효능감의 조절효과를 중심으로 -)

  • Yang, Hoe-Chang;Lee, Young-Chul
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.49-71
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    • 2010
  • Franchise businesses in South Korea have contributed to economic growth and job creation, and its growth potential remains very high. However, despite such virtues, domestic franchise businesses face many problems such as the instability of franchisor's business structure and weak financial conditions. To solve these problems, the government enacted legislation and strengthened franchise related laws. However, the strengthening of laws regulating franchisors had many side effects that interrupted the development of the franchise business. For example, legal regulations regarding franchisors have had the effect of suppressing the franchisor's leadership activities (e.g. activities such as the ability to advocate the franchisor's policies and strategies to the franchisees, in order to facilitate change and innovation). One of the main goals of the franchise business is to build cooperation between the franchisor and the franchisee for their combined success. However, franchisees can refuse to follow the franchisor's strategies because of the current state of franchise-related law and government policy. The purpose of this study to explore the effects of franchisor's leadership style on franchisee's commitment in a franchise system. We classified leadership styles according to the path-goal theory (House & Mitchell, 1974), and it was hypothesized and tested that the four leadership styles proposed by the path-goal theory (i.e. directive, supportive, participative and achievement-oriented leadership) have different effects on franchisee's commitment. Another purpose of this study to explore the how the level of franchisee's self-efficacy influences both the franchisor's leadership style and franchisee's commitment in a franchise system. Results of the present study are expected to provide important theoretical and practical implications as to the role of franchisor's leadership style, as restricted by government regulations and the franchisee's self-efficacy, which could be needed to improve the quality of the long-term relationship between the franchisor and franchisee. Quoted by Northouse(2007), one problem regarding the investigation of leadership is that there are almost as many different definitions of leadership as there are people who have tried to define it. But despite the multitude of ways in which leadership has been conceptualized, the following components can be identified as central to the phenomenon: (a) leadership is a process, (b) leadership involves influence, (c) leadership occurs in a group context, and (d) leadership involves goal attainment. Based on these components, in this study leadership is defined as a process whereby franchisor's influences a group of franchisee' to achieve a common goal. Focusing on this definition, the path-goal theory is about how leaders motivate subordinates to accomplish designated goals. Drawing heavily from research on what motivates employees, path-goal theory first appeared in the leadership literature in the early 1970s in the works of Evans (1970), House (1971), House and Dessler (1974), and House and Mitchell (1974). The stated goal of this leadership theory is to enhance employee performance and employee satisfaction by focusing on employee motivation. In brief, path-goal theory is designed to explain how leaders can help subordinates along the path to their goals by selecting specific behaviors that are best suited to subordinates' needs and to the situation in which subordinates are working (Northouse, 2007). House & Mitchell(1974) predicted that although many different leadership behaviors could have been selected to be a part of path-goal theory, this approach has so far examined directive, supportive, participative, and achievement-oriented leadership behaviors. And they suggested that leaders may exhibit any or all of these four styles with various subordinates and in different situations. However, due to restrictive government regulations, franchisors are not in a position to change their leadership style to suit their circumstances. In addition, quoted by Northouse(2007), ssubordinate characteristics determine how a leader's behavior is interpreted by subordinates in a given work context. Many researchers have focused on subordinates' needs for affiliation, preferences for structure, desires for control, and self-perceived level of task ability. In this study, we have focused on the self-perceived level of task ability, namely, the franchisee's self-efficacy. According to Bandura (1977), self-efficacy is chiefly defined as the personal attitude of one's ability to accomplish concrete tasks. Therefore, it is not an indicator of one's actual abilities, but an opinion of the extent of how one can use that ability. Thus, the judgment of maintain franchisee's commitment depends on the situation (e.g., government regulation and policy and leadership style of franchisor) and how it affects one's ability to mobilize resources to deal with the task, so even if people possess the same ability, there may be differences in self-efficacy. Figure 1 illustrates the model investigated in this study. In this model, it was hypothesized that leadership styles would affect the franchisee's commitment, and self-efficacy would moderate the relationship between leadership style and franchisee's commitment. Theoretically, quoted by Northouse(2007), the path-goal approach suggests that leaders need to choose a leadership style that best fits the needs of subordinates and the work they are doing. According to House & Mitchell (1974), the theory predicts that a directive style of leadership is best in situations in which subordinates are dogmatic and authoritarian, the task demands are ambiguous, and the organizational rule and procedures are unclear. In these situations, franchisor's directive leadership complements the work by providing guidance and psychological structure for franchisees. For work that is structured, unsatisfying, or frustrating, path-goal theory suggests that leaders should use a supportive style. Franchisor's Supportive leadership offers a sense of human touch for franchisees engaged in mundane, mechanized activity. Franchisor's participative leadership is considered best when a task is ambiguous because participation gives greater clarity to how certain paths lead to certain goals; it helps subordinates learn what actions leads to what outcome. Furthermore, House & Mitchell(1974) predicts that achievement-oriented leadership is most effective in settings in which subordinates are required to perform ambiguous tasks. Marsh and O'Neill (1984) tested the idea that organizational members' anger and decline in performance is caused by deficiencies in their level of effort and found that self-efficacy promotes accomplishment, decreases stress and negative consequences like depression and emotional instability. Based on the extant empirical findings and theoretical reasoning, we posit positive and strong relationships between the franchisor's leadership styles and the franchisee's commitment. Furthermore, the level of franchisee's self-efficacy was thought to maintain their commitment. The questionnaires sent to participants consisted of the following measures; leadership style was assessed using a 20 item 7-point likert scale developed by Indvik (1985), self-efficacy was assessed using a 24 item 6-point likert scale developed by Bandura (1977), and commitment was assessed using a 6 item 5-point likert scale developed by Morgan & Hunt (1994). Questionnaires were distributed to Korean optical franchisees in Seoul. It took about 20 days to complete the data collection. A total number of 140 questionnaires were returned and complete data were available from 137 respondents. Results of multiple regression analyses testing the relationships between the each of the four styles of leadership shown by the franchisor as independent variables and franchisee's commitment as the dependent variable showed that the relationship between supportive leadership style and commitment ($\beta$=.13, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.07, p<.001)were significant. However, when participants divided into high and low self-efficacy groups, results of multiple regression analyses showed that only the relationship between achievement-oriented leadership style and commitment ($\beta$=.14, p<.001) was significant in the high self-efficacy group. In the low self-efficacy group, the relationship between supportive leadership style and commitment ($\beta$=.17, p<.001),and the relationship between participative leadership style and commitment ($\beta$=.10, p<.001) were significant. The study focused on the franchisee's self-efficacy in order to explore the possibility that regulation, originally intended to protect the franchisee, may not be the most effective method to maintain the relationships in a franchise business. The key results of the data analysis regarding the moderating role of self-efficacy between leadership behavior style as proposed by path-goal and commitment theory were as follows. First, this study proposed that franchisor should apply the appropriate type of leadership behavior to strengthen the franchisees commitment because the results demonstrated that supportive and participative leadership styles by the franchisors have a positive influence on the franchisee's level of commitment. Second, it is desirable for franchisor to validate the franchisee's efforts, since the franchisee's characteristics such as self-efficacy had a substantial, positive effect on the franchisee's commitment as well as being a meaningful moderator between leadership and commitment. Third, the results as a whole imply that the government should provide institutional support, namely to put the franchisor in a position to clearly identify the characteristics of their franchisees and provide reasonable means to administer the franchisees to achieve the company's goal.

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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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