Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction (고령의 급성 심근경색증 환자에서 성별에 따른 영향)
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- The Korean Journal of Medicine
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- v.94 no.1
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- pp.96-106
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- 2019
Background/Aims: It is well known that gender differences are associated with clinical outcomes in patients with acute myocardial infarction (AMI). However, it is not clear whether gender differences affect the prognosis of elderly patients with AMI. Methods: We analyzed the incidence of in-hospital complications and mortality in the Korea Acute Myocardial Infarction Registry-National Institutes of Health from November 2011 to June 2015. This study included elderly patients (≥ 75 years) diagnosed with AMI. Results: A total of 2,953 patients were eligible for this study. Among them, 1,529 (51.8%) patients were female, and the mean age of the female group was older than that of the male group (80.7 ± 4.4 vs. 79.6 ± 4.0 years, respectively, p < 0.001). Elderly females utilized emergency medical services less frequently compared with elderly males (11.5 vs. 15.4%, respectively, p < 0.001). Elderly female AMI patients had a similar rate of in-hospital mortality compared with elderly males (7.1 vs. 8.4%, respectively, p = 0.196). The rate of major cardiac adverse events (MACEs) was lower in elderly females than males during a 12-month follow-up (hazard ratio [HR] 1.19, 95% confidence interval [CI] 1.00-1.41, p = 0.045). According to multivariate analysis, the male gender is an independent factor for predicting 1-year MACEs (HR 1.37, 95% CI 1.14-1.65, p < 0.001). Conclusions: No significant differences in peri-procedural complications or in-hospital mortality were observed between male and female elderly patients with AMI. However, elderly female patients had a more favorable prognosis than male patients during a 1-year clinical follow-up.
Since financial crisis of IMF resulted in intensive competitiveness and adverse management environment, many hotel industries have responded it with restructuring. Since this restructuring is accompanied by reduction of employees, hence comes the recognition of justice in the procedure of restructuring. When the surviving employees in the restructuring process recognize unfairness in the procedure and practical operations, organization effectiveness can not be maintained due to losing trust of their employers. In this paper I will examine the relationship between validity of restructuring and compensatory programs for layoffs and surviving employees' trust of the employers. Also I will find out the relationship between remaining employees' trust of the employers and their job satisfaction and organization commitment. Through this relationship, we can prepare an alternative to reduce negative effect of restructuring. The hypotheses of this study are proposed as follows: H1: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their trust with a manager of the company is. H2: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their trust with a manager of the company is. H3: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their job satisfaction is. H4: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their job satisfaction is. H5: The higher surviving employees' recognition of procedural justice in restructuring process is, the higher their organization commitment is. H6: The higher surviving employees' recognition of distributive justice in restructuring process is, the higher their organization commitment is. H7: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their job satisfaction is. H8: The higher surviving employees' trust with a manager of the company in restructuring process is, the higher their organization commitment is. For the purposes of this study, employees working in luxury hotels located in Seoul were targeted. Self-administered questionnaires were distributed to those who consented with the investigation after explaining the purpose of the survey. A total of 500 questionnaires were distributed and 450 questionnaire were returned to the researcher for analysis. 430 of the returned questionnaires were used for analysis. As for the education for this survey, 250 junior college graduates or under (58.1%), 143 college graduates (33.3%) and 37 graduate school graduates (8.6%). As for the marital status, 315 persons (73.3%) are single and 115 are married (26.7%). As for the monthly income, 49 people (11.48%) are less than 2 million won, 148 (34.4%) are between 2 million and less than 2.5 million won, 153 (35.6%) are between 2.5 million to less than 3 million won, 80 (18.6%) are more than 3 million won. As for the workplace, 293 people (68.1%) work for the F&B department, 73 (17.0%) for rooms department, 41 (9.5%) for operation/ marketing department, 23 (5.3%) for account/ general affair department. As for the period of employment, 85 people (19.8%) are less than 5 years, 150 (34.9%) are between 6 to 9 years, 143 (33.3%) are between 10 to 14 years. and 52 (3.%) are more than 15 years. An exploratory factor analysis was used to survey validity and reliability of calculating tool on perceived values. This study used correlation between individual items and whole items and Cronbach's alpha value of multiple-item scale which is usually used to assess scale and reliability. Reliability of conceptual sub-dimension was assessed by basing on repeated procedure of correlation between individual items and whole items and factor loading. 1. Verification of correlation between validity of restructuring and trust This research showed that procedural and distributive justice of restructuring affects trust positively. The path coefficient between procedural justice of restructuring and trust is 0.719(t=10.135, p=0.000), and thereby the higher procedural justice results in higher trust. The path coefficient between distributive justice of restructuring and trust is 0.160(t=3.291, p=0.001), and thereby the higher distributive justice results in higher trust. Hence H1 and H2 are accepted. 2. Verification of correlation between validity of restructuring and job satisfaction The path coefficient between procedural justice of restructuring and job satisfaction is 0.179(t=2.202, p=0.028), and thereby the higher procedural justice results in higher job satisfaction. The path coefficient between distributive justice of restructuring and job satisfaction is 0.074(t=1.620, p=0.105), and thereby distributive justice of restructuring has no relationship with job satisfaction. Hence H3 is accepted, but H4 is removed. 3. Verification of correlation between validity of restructuring and organization commitment The path coefficient between procedural justice of restructuring and organization commitment is 0.188(t=2.466, p=0.014), and thereby the higher procedural justice results in higher organization commitment. The path coefficient between distributive justice of restructuring and organization commitment is 0.118(t=2.720, p=0.007), and thereby the higher distributive justice results in higher organization commitment. Hence H5 and H6 are accepted. 4. Verification of correlation between trust and job satisfaction The path coefficient between trust and job satisfaction is 0.610(t=6.736, p=0.000), and thereby the correlation has a meaningful result. Since the higher trust of the employer results in higher job satisfaction, H7 is accepted. 5. Verification of correlation between trust and organization commitment The path coefficient between procedural justice of restructuring and job satisfaction is 0.446(t=5.547 p=0.000), and thereby the higher trust of the employer results in higher organization commitment. Hence H8 is accepted. This research aimed to help the employers of hotel industries by analyzing the effects of validity of restructuring on employees' trust, job satisfaction and organization commitment. The research found that employer's validity of restructuring has significant affects on the degree of employee's trust with a manager, thereby reducing the negative effects of restructuring and enhancing organization commitment and job satisfaction. The principal purpose of this research is to confirm the correlation between employees' perceived validity of restructuring and their trust with a manager. Also whether this correlation results in competitive edge of the company is also investigated. It is also pointed out that employees had to participated the procedure of restructuring, sharing the philosophy and reason of restructuring. This participation and furthermore compensatory methods can reduce employees' anxiety of organization operations. Variable of trust appeared to have impact on intermediation effect between perceived variable of validity and job satisfaction, organization commitment, so that increase of trust with a manager plays an crucial role in increasing organization effectiveness. Since this research did not cover whole hotel industries which underwent restructuring, it showed a limit. Unlike previous studies which dealt with validity and trust of superior bosses, this research focussed on employers. Also the organization citizenship which is not considered in this study will be dealt with in the future study.
Festivals are an indispensable feature of cultural tourism(Formica & Uysal, 1998). Cultural tourism festivals are increasingly being used as instruments promoting tourism and boosting the regional economy. So much research related to festivals is undertaken from a variety of perspectives. Plans to revisit a particular festival have been viewed as an important research topic both in academia and the tourism industry. Therefore festivals have frequently been leveled as cultural events. Cultural tourism festivals have become a crucial component in constituting the attractiveness of tourism destinations(Prentice, 2001). As a result, a considerable number of tourist studies have been carried out in diverse cultural tourism festivals(Backman et al., 1995; Crompton & Mckay, 1997; Park, 1998; Clawson & Knetch, 1996). Much of previous literature empirically shows the close linkage between tourist satisfaction and behavioral intention in festivals. The main objective of this study is to investigate the effects of evaluation attributes of cultural tourism festivals on satisfaction and behavioral intention. accomplish the research objective, to find out evaluation items of cultural tourism festivals through the literature study an empirical study. Using a varimax rotation with Kaiser normalization, the research obtained four factors in the 18 evaluation attributes of cultural tourism festivals. Some empirical studies have examined the relationship between behavioral intention and actual behavior. To understand between tourist satisfaction and behavioral intention, this study suggests five hypotheses and hypothesized model. In this study, the analysis is based on primary data collected from visitors who participated in '2006 Gwangju Kimchi Festival'. In total, 700 self-administered questionnaires were distributed and 561 usable questionnaires were obtained. Respondents were presented with the 18 satisfactions item on a scale from 1(strongly disagree) to 7(strongly agree). Dimensionality and stability of the scale were evaluated by a factor analysis with varimax rotation. Four factors emerged with eigenvalues greater than 1, which explained 66.40% of the total variance and Cronbach' alpha raging from 0.876 to 0.774. And four factors named: advertisement and guides, programs, food and souvenirs, and convenient facilities. To test and estimate the hypothesized model, a two-step approach with an initial measurement model and a subsequent structural model for Structural Equation Modeling was used. The AMOS 4.0 analysis package was used to conduct the analysis. In estimating the model, the maximum likelihood procedure was used.In this study Chi-square test is used, which is the most common model goodness-of-fit test. In addition, considering the literature about the Structural Equation Modeling, this study used, besides Chi-square test, more model fit indexes to determine the tangibility of the suggested model: goodness-of-fit index(GFI) and root mean square error of approximation(RMSEA) as absolute fit indexes; normed-fit index(NFI) and non-normed-fit index(NNFI) as incremental fit indexes. The results of T-test and ANOVAs revealed significant differences(0.05 level), therefore H1(Tourist Satisfaction level should be different from Demographic traits) are supported. According to the multiple Regressions analysis and AMOS, H2(Tourist Satisfaction positively influences on revisit intention), H3(Tourist Satisfaction positively influences on word of mouth), H4(Evaluation Attributes of cultural tourism festivals influences on Tourist Satisfaction), and H5(Tourist Satisfaction positively influences on Behavioral Intention) are also supported. As the conclusion of this study are as following: First, there were differences in satisfaction levels in accordance with the demographic information of visitors. Not all visitors had the same degree of satisfaction with their cultural tourism festival experience. Therefore it is necessary to understand the satisfaction of tourists if the experiences that are provided are to meet their expectations. So, in making festival plans, the organizer should consider the demographic variables in explaining and segmenting visitors to cultural tourism festival. Second, satisfaction with attributes of evaluation cultural tourism festivals had a significant direct impact on visitors' intention to revisit such festivals and the word of mouth publicity they shared. The results indicated that visitor satisfaction is a significant antecedent of their intention to revisit such festivals. Festival organizers should strive to forge long-term relationships with the visitors. In addition, it is also necessary to understand how the intention to revisit a festival changes over time and identify the critical satisfaction factors. Third, it is confirmed that behavioral intention was enhanced by satisfaction. The strong link between satisfaction and behavioral intentions of visitors areensured by high quality advertisement and guides, programs, food and souvenirs, and convenient facilities. Thus, examining revisit intention from a time viewpoint may be of a great significance for both practical and theoretical reasons. Additionally, festival organizers should give special attention to visitor satisfaction, as satisfied visitors are more likely to return sooner. The findings of this research have several practical implications for the festivals managers. The promotion of cultural festivals should be based on the understanding of tourist satisfaction for the long- term success of tourism. And this study can help managers carry out this task in a more informed and strategic manner by examining the effects of demographic traits on the level of tourist satisfaction and the behavioral intention. In other words, differentiated marketing strategies should be stressed and executed by relevant parties. The limitations of this study are as follows; the results of this study cannot be generalized to other cultural tourism festivals because we have not explored the many different kinds of festivals. A future study should be a comparative analysis of other festivals of different visitor segments. Also, further efforts should be directed toward developing more comprehensive temporal models that can explain behavioral intentions of tourists.
The expansion of the Changjiang Diluted Water (CDW) plume during summer is known to be a major factor influencing phytoplankton diversity, community structure, and the regional marine environment of the northern East China Sea (ECS). The discharge of the CDW plume was very high in the summer of 2020, and cruise surveys and stationary monitoring were conducted to understand the dynamics of changes in environmental characteristics and the impact on phytoplankton diversity and community structure. A cruise survey was conducted from August 16 to 17, 2020, using R/V Eardo, and a stay survey at the Ieodo Ocean Research Station (IORS) from August 15 to 21, 2020, to analyze phytoplankton diversity and community structure. The southwestern part of the survey area exhibited low salinity and high chlorophyll a fluorescence under the influence of the CDW plume, whereas the southeastern part of the survey area presented high salinity and low chlorophyll a fluorescence under the influence of the Tsushima Warm Current (TWC). The total chlorophyll a concentrations of surface water samples from 12 sampling stations indicated that nano-phytoplankton (20-3 ㎛) and micro-phytoplankton (> 20 ㎛) were the dominant groups during the survey period. Only stations strongly influenced by the TWC presented approximately 50% of the biomass contributed by pico-phytoplankton (< 3 ㎛). The size distribution of phytoplankton in the surface water samples is related to nutrient supplies, and areas where high nutrient (nitrate) supplies were provided by the CDW plume displayed higher biomass contribution by micro-phytoplankton groups. A total of 45 genera of nano- and micro-phytoplankton groups were classified using morphological analysis. Among them, the dominant taxa were the diatoms Guinardia flaccida and Nitzschia spp. and the dinoflagellates Gonyaulax monacantha, Noctiluca scintillans, Gymnodinium spirale, Heterocapsa spp., Prorocentrum micans, and Tripos furca. The sampling stations affected by the TWC and low in nitrate concentrations presented high concentrations of photosynthetic pico-eukaryotes (PPE) and photosynthetic pico-prokaryotes (PPP). Most sampling stations had phosphate-limited conditions. Higher Synechococcus concentrations were enumerated for the sampling stations influenced by low-nutrient water of the TWC using flow cytometry. The NGS analysis revealed 29 clades of Synechococcus among PPP, and 11 clades displayed a dominance rate of 1% or more at least once in one sample. Clade II was the dominant group in the surface water, whereas various clades (Clades I, IV, etc.) were found to be the next dominant groups in the SCM layers. The Prochlorococcus group, belonging to the PPP, observed in the warm water region, presented a high-light-adapted ecotype and did not appear in the northern part of the survey region. PPE analysis resulted in 163 operational taxonomic units (OTUs), indicating very high diversity. Among them, 11 major taxa showed dominant OTUs with more than 5% in at least one sample, while Amphidinium testudo was the dominant taxon in the surface water in the low-salinity region affected by the CDW plume, and the chlorophyta was dominant in the SCM layer. In the warm water region affected by the TWC, various groups of haptophytes were dominant. Observations from the IORS also presented similar results to the cruise survey results for biomass, size distribution, and diversity of phytoplankton. The results revealed the various dynamic responses of phytoplankton influenced by the CDW plume. By comparing the results from the IORS and research cruise studies, the study confirmed that the IORS is an important observational station to monitor the dynamic impact of the CDW plume. In future research, it is necessary to establish an effective use of IORS in preparation for changes in the ECS summer environment and ecosystem due to climate change.
Corporate social responsibility (CSR) activities have been shown to be potential factors that can improve corporate image and increase the ability of corporations to compete. However, most previous studies related to CSR activities investigated how these activities influence product and corporate evaluation, as well as corporate image. In addition, some researchers treated consumers' perceptions of corporate motives as moderator variables in evaluating the relationship between corporate social responsibilities and consumer response. However, motive-based theories have some weaknesses. Corporate social responsibility activities cause two motives(egoistic vs. altruistic) for consumers, but recently, Vlachos et al. (2008) argued that these motives should be segmented. Thus, it is possible to transform the original theory into a modified theory model (persuasion knowledge model, PKM). Vlachos et al. (2008) segmented corporate social responsibility motives into four types and compared the effects of these motives on customer loyalty. Prior studies have proved that CSR activities with positive motives have positive influences on customer loyalty. However, the psychological reasons underlying this finding have not been determined empirically. Thus, the objectives of this research are twofold. First, we attempt to determine why most customers favor companies that they feel have positive motives for their corporate social responsibility activities. Second, we attempt to measure the effects of consumers' reciprocity when society benefits from corporate social responsibility activities. The following research hypotheses are constructed. H1: Values-driven motives for corporate social responsibility activities have a positive influence on the perceived reciprocity. H2: Stakeholder-driven motives for corporate social responsibility activities have a negative influence on the perceived reciprocity. H3: Egoistic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H4: Strategic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H5: Perceived reciprocity for corporate social responsibility activities has a positive influence on consumer loyalty. A single company is selected as a research subject to understand how the motives behind corporate social responsibility influence consumers' perceived reciprocity and customer loyalty. A total sample of 200 respondents was selected for a pilot test. In addition, to ensure a consistent response, we ensured that the respondents were older than 20 years of age. The surveys of 172 respondents (males-82, females-90) were analyzed after 28 invalid questionnaires were excluded. Based on our cutoff criteria, the model fit the data reasonably well. Values-driven motives for corporate social responsibility activities had a positive effect on perceived reciprocity (t = 6.75, p < .001), supporting H1. Morales (2005) also found that consumers appreciate a company's social responsibility efforts and the benefits provided by these efforts to society. Stakeholder-driven motives for corporate social responsibility activities did not affect perceived reciprocity (t = -.049, p > .05). Thus, H2 was rejected. Egoistic-driven motives (t = .3.11, p < .05) and strategic-driven (t = -4.65, p < .05) motives had a negative influence on perceived reciprocity, supporting H3 and H4, respectively. Furthermore, perceived reciprocity had a positive influence on consumer loyalty (t = 4.24, p < .05), supporting H5. Thus, compared with the general public, undergraduate students appear to be more influenced by egoistic-driven motives. We draw the following conclusions from our research findings. First, value-driven attributions have a positive influence on perceived reciprocity. However, stakeholder-driven attributions have no significant effects on perceived reciprocity. Moreover, both egoistic-driven attributions and strategic-driven attributions have a negative influence on perceived reciprocity. Second, when corporate social responsibility activities align with consumers' reciprocity, the efforts directed towards social responsibility activities have a positive influence on customer loyalty. In this study, we examine whether the type of motivation affects consumer responses to CSR, and in particular, we evaluate how CSR motives can influence a key internal factor (perceived reciprocity) and behavioral consumer outcome (customer loyalty). We demonstrate that perceived reciprocity plays a mediating role in the relationship between CSR motivation and customer loyalty. Our study extends the research on consumer CSR-inferred motivations, positing them as a direct indicator of consumer responses. Furthermore, we convincingly identify perceived reciprocity as a sub-process mediating the effect of CSR attributions on customer loyalty. Future research investigating the ultimate behavior and financial impact of CSR should consider that the impacts of CSR also stem from perceived reciprocity. The results of this study also have important managerial implications. First, the central role that reciprocity plays indicates that managers should routinely measure how much their socially responsible actions create perceived reciprocity. Second, understanding how consumers' perceptions of CSR corporate motives relate to perceived reciprocity and customer loyalty can help managers to monitor and enhance these consumer outcomes through marketing initiatives and management of CSR-induced attribution processes. The results of this study will help corporations to understand the relative importance of the four different motivations types in influencing perceived reciprocity.
The objective of this study was to investigate the impacts of large-scale timber harvesting on the environment of a mature hardwood forest. To achieve the objective, the effects of harvesting on forest environmental factors were analyzed quantitatively using the field data measured in the study sites of Seoul National University Research Forests [(Mt.) Paekunsan] for two years(1993-1994) following timber harvesting. The field data include information on vegetation, soil mesofauna, physicochemical characteristics of soil, surface water runoff, water quality in the stream, and hillslope erosion. For comparison, field data for each environmental factor were collected in forest areas disturbed by logging and undisturbed, separately. The results of this study were as follows : The diversity of vegetational species increased in the harvested sites. However, the similarity index value of species between harvested and non-harvested sites was close to each other. Soil bulk density and soil hardness were increased after timber harvesting, respectively. The level of organic matter, total-N, avail
The success of the family planning program in Korea is reflected in the decrease in the growth rate from 3.0% in 1962 to 2.0% in 1971, and in the decrease in the fertility rate from 43/1,000 in 1960 to 29/1,000 in 1970. However, it would be erroneous to attribute these reductions entirely to the family planning program. Other socio-economic factors, such as the increasing age at marriage and the increasing use of induced abortions, definitely had an impact on the lowered growth and fertility rate. Despite the relative success of the program to data in meeting its goals, there is no room for complacency. Meeting the goal of a further reduction in the population growth rate to 1.3% by 1981 is a much more difficult task than any one faced in the past. Not only must fertility be lowered further, but the size of the target population itself will expand tremendously in the late seventies; due to the post-war baby boom of the 1950's reaching reproductive ages. Furthermore, it is doubtful that the age at marriage will continue to rise as in the past or that the incidence of induced abortion will continue to increase. Consequently, future reductions in fertility will be more dependent on the performance of the national family planning program, with less assistance from these non-program factors. This paper will describe various approaches to help to the solution of these current problems. 1. PRACTICE RATE IN FAMILY PLANNING In 1973, the attitude (approval) and knowledge rates were quite high; 94% and 98% respectively. But a large gap exists between that and the actual practice rate, which is only 3695. Two factors must be considered in attempting to close the KAP-gap. The first is to change social norms, which still favor a larger family, increasing the practice rate cannot be done very quickly. The second point to consider is that the family planning program has not yet reached all the eligible women. A 1973 study determineded that a large portion, 3096 in fact, of all eligible women do not want more children, but are not practicing family planning. Thus, future efforts to help close the KAP-gap must focus attention and services on this important large group of potential acceptors. 2. CONTINUATION RATES Dissatisfaction with the loop and pill has resulted in high discontinuation rates. For example, a 1973 survey revealed that within the first six months initial loop acceptance. nearly 50% were dropouts, and that within the first four months of inital pill acceptance. nearly 50% were dropouts. These discontinuation rates have risen over the past few years. The high rate of discontinuance obviously decreases the contraceptive effectiveness. and has resulted in many unwanted births which is directly related to the increase of induced abortions. In the future, the family planning program must emphasize the improved quality of initial and follow-up services. rather than more quantity, in order to insure higher continuation rates and thus more effective contraceptive protection. 3. INDUCED ABORTION As noted earlier. the use of induced abortions has been increase yearly. For example, in 1960, the average number of abortions was 0.6 abortions per women in the 15-44 age range. By 1970. that had increased to 2 abortions per women. In 1966. 13% of all women between 15-44 had experienced at least one abortion. By 1971, that figure jumped to 28%. In 1973 alone, the total number of abortions was 400,000. Besides the ever incre.sing number of induced abortions, another change has that those who use abortions have shifted since 1965 to include- not. only the middle class, but also rural and low-income women. In the future. in response to the demand for abortion services among rural and low-income w~men, the government must provide and support abortion services for these women as a part of the national family planning program. 4. TARGET SYSTIi:M Since 1962, the nationwide target system has been used to set a target for each method, and the target number of acceptors is then apportioned out to various sub-areas according to the number of eligible couples in each area. Because these targets are set without consideration for demographic factors, particular tastes, prejudices, and previous patterns of acceptance in the area, a high discontinuation rate for all methods and a high wastage rate for the oral pill and condom results. In the future. to alleviate these problems of the methodbased target system. an alternative. such as the weighted-credit system, should be adopted on a nation wide basis. In this system. each contraceptive method is. assigned a specific number of points based upon the couple-years of protection (CYP) provided by the method. and no specific targets for each method are given. 5. INCREASE OF STERILIZA.TION TARGET Two special projects. the hospital-based family planning program and the armed forces program, has greatly contributed to the increasing acceptance in female and male sterilization respectively. From January-September 1974, 28,773 sterilizations were performed. During the same time in 1975, 46,894 were performed; a 63% increase. If this trend continues, by the end of 1975. approximately 70,000 sterilizations will have been performed. Sterilization is a much better method than both the loop and pill, in terms of more effective contraceptive protection and the almost zero dropout rate. In the future, the. family planning program should continue to stress the special programs which make more sterilizations possible. In particular, it should seek to add the laparoscope techniques to facilitate female sterilization acceptance rates. 6. INCREASE NUMBER OF PRIVATE ACCEPTORS Among the current family planning users, approximately 1/3 are in the private sector and thus do not- require government subsidy. The number of private acceptors increases with increasing urbanization and economic growth. To speed this process, the government initiated the special hospital based family planning program which is utilized mostly by the private sector. However, in the future, to further hasten the increase of private acceptors, the government should encourage doctors in private practice to provide family planning services, and provide the contraceptive supplies. This way, those do utilize the private medical system will also be able to receive family planning services and pay for it. Another means of increasing the number of private acceptors, IS to greatly expand the commercial outlets for pills and condoms beyond the existing service points of drugstores, hospitals, and health centers. 7. IE&C PROGRAM The current preferred family size is nearly twice as high as needed to achieve a stable poplation. Also, a strong boy preference hinders a small family size as nearly all couples fuel they must have at least one or more sons. The IE&C program must, in the future, strive to emphasize the values of the small family and equality of the sexes. A second problem for the IE&C program to work. with in the: future is the large group of people who approves family planning, want no more children, but do not practice. The IE&C program must work to motivate these people to accept family planning And finally, for those who already practice, an IE&C program in the future must stress continuation of use. The IE&C campaign, to insure highest effectiveness, should be based on a detailed factor analysis of contraceptive discontinuance. In conclusion, Korea faces a serious unfavorable sociodemographic situation- in the future unless the population growth rate can be curtailed. And in the future, the decrease in fertility will depend solely on the family planning program, as the effect of other socio-economic factors has already been maximumally felt. A second serious factor to consider is the increasing number of eligible women due to the 1950's baby boom. Thus, to meet these challenges, the program target must be increased and the program must improve the effectiveness of its current activities and develop new programs.
1. Introduction Today Internet is recognized as an important way for the transaction of products and services. According to the data surveyed by the National Statistical Office, the on-line transaction in 2007 for a year, 15.7656 trillion, shows a 17.1%(2.3060 trillion won) increase over last year, of these, the amount of B2C has been increased 12.0%(10.2258 trillion won). Like this, because the entry barrier of on-line market of Korea is low, many retailers could easily enter into the market. So the bigger its scale is, but on the other hand, the tougher its competition is. Particularly due to the Internet and innovation of IT, the existing market has been changed into the perfect competitive market(Srinivasan, Rolph & Kishore, 2002). In the early years of on-line business, they think that the main reason for success is a moderate price, they are awakened to its importance of on-line service quality with tough competition. If it's not sure whether customers can be provided with what they want, they can use the Web sites, perhaps they can trust their products that had been already bought or not, they have a doubt its viability(Parasuraman, Zeithaml & Malhotra, 2005). Customers can directly reserve and issue their air tickets irrespective of place and time at the Web sites of travel agencies or airlines, but its empirical studies about these Web sites for reserving and issuing air tickets are insufficient. Therefore this study goes on for following specific objects. First object is to measure service quality and service recovery of Web sites for reserving and issuing air tickets. Second is to look into whether above on-line service quality and on-line service recovery have an impact on overall service quality. Third is to seek for the relation with overall service quality and customer satisfaction, then this customer satisfaction and loyalty intention. 2. Theoretical Background 2.1 On-line Service Quality Barnes & Vidgen(2000; 2001a; 2001b; 2002) had invented the tool to measure Web sites' quality four times(called WebQual). The WebQual 1.0, Step one invented a measuring item for information quality based on QFD, and this had been verified by students of UK business school. The Web Qual 2.0, Step two invented for interaction quality, and had been judged by customers of on-line bookshop. The WebQual 3.0, Step three invented by consolidating the WebQual 1.0 for information quality and the WebQual2.0 for interactionquality. It includes 3-quality-dimension, information quality, interaction quality, site design, and had been assessed and confirmed by auction sites(e-bay, Amazon, QXL). Furtheron, through the former empirical studies, the authors changed sites quality into usability by judging that usability is a concept how customers interact with or perceive Web sites and It is used widely for accessing Web sites. By this process, WebQual 4.0 was invented, and is consist of 3-quality-dimension; information quality, interaction quality, usability, 22 items. However, because WebQual 4.0 is focusing on technical part, it's usable at the Website's design part, on the other hand, it's not usable at the Web site's pleasant experience part. Parasuraman, Zeithaml & Malhorta(2002; 2005) had invented the measure for measuring on-line service quality in 2002 and 2005. The study in 2002 divided on-line service quality into 5 dimensions. But these were not well-organized, so there needed to be studied again totally. So Parasuraman, Zeithaml & Malhorta(2005) re-worked out the study about on-line service quality measure base on 2002's study and invented E-S-QUAL. After they invented preliminary measure for on-line service quality, they made up a question for customers who had purchased at amazon.com and walmart.com and reassessed this measure. And they perfected an invention of E-S-QUAL consists of 4 dimensions, 22 items of efficiency, system availability, fulfillment, privacy. Efficiency measures assess to sites and usability and others, system availability measures accurate technical function of sites and others, fulfillment measures promptness of delivering products and sufficient goods and others and privacy measures the degree of protection of data about their customers and so on. 2.2 Service Recovery Service industries tend to minimize the losses by coping with service failure promptly. This responses of service providers to service failure mean service recovery(Kelly & Davis, 1994). Bitner(1990) went on his study from customers' view about service providers' behavior for customers to recognize their satisfaction/dissatisfaction at service point. According to them, to manage service failure successfully, exact recognition of service problem, an apology, sufficient description about service failure and some tangible compensation are important. Parasuraman, Zeithaml & Malhorta(2005) approached the service recovery from how to measure, rather than how to manage, and moved to on-line market not to off-line, then invented E-RecS-QUAL which is a measuring tool about on-line service recovery. 2.3 Customer Satisfaction The definition of customer satisfaction can be divided into two points of view. First, they approached customer satisfaction from outcome of comsumer. Howard & Sheth(1969) defined satisfaction as 'a cognitive condition feeling being rewarded properly or improperly for their sacrifice.' and Westbrook & Reilly(1983) also defined customer satisfaction/dissatisfaction as 'a psychological reaction to the behavior pattern of shopping and purchasing, the display condition of retail store, outcome of purchased goods and service as well as whole market.' Second, they approached customer satisfaction from process. Engel & Blackwell(1982) defined satisfaction as 'an assessment of a consistency in chosen alternative proposal and their belief they had with them.' Tse & Wilton(1988) defined customer satisfaction as 'a customers' reaction to discordance between advance expectation and ex post facto outcome.' That is, this point of view that customer satisfaction is process is the important factor that comparing and assessing process what they expect and outcome of consumer. Unlike outcome-oriented approach, process-oriented approach has many advantages. As process-oriented approach deals with customers' whole expenditure experience, it checks up main process by measuring one by one each factor which is essential role at each step. And this approach enables us to check perceptual/psychological process formed customer satisfaction. Because of these advantages, now many studies are adopting this process-oriented approach(Yi, 1995). 2.4 Loyalty Intention Loyalty has been studied by dividing into behavioral approaches, attitudinal approaches and complex approaches(Dekimpe et al., 1997). In the early years of study, they defined loyalty focusing on behavioral concept, behavioral approaches regard customer loyalty as "a tendency to purchase periodically within a certain period of time at specific retail store." But the loyalty of behavioral approaches focuses on only outcome of customer behavior, so there are someone to point the limits that customers' decision-making situation or process were neglected(Enis & Paul, 1970; Raj, 1982; Lee, 2002). So the attitudinal approaches were suggested. The attitudinal approaches consider loyalty contains all the cognitive, emotional, voluntary factors(Oliver, 1997), define the customer loyalty as "friendly behaviors for specific retail stores." However these attitudinal approaches can explain that how the customer loyalty form and change, but cannot say positively whether it is moved to real purchasing in the future or not. This is a kind of shortcoming(Oh, 1995). 3. Research Design 3.1 Research Model Based on the objects of this study, the research model derived is
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70. 3.2 Hypotheses 3.2.1 The Hypothesis of On-line Service Quality and Overall Service Quality shows, Step 1 and Step 2 are significant, and mediation variable has a significant effect on dependent variables and so does independent variables at Step 3, too. And there needs to prove the partial mediation effect, independent variable's estimate ability at Step 3(Standardized coefficient
shows, Step 1 and Step 2 are significant, and mediation variable has a significant effect on dependent variables and so does independent variables at Step 3, too. And there needs to prove the partial mediation effect, independent variable's estimate ability at Step 3(Standardized coefficient
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