• Title/Summary/Keyword: Total Physical Response

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Levels of Physicians' Self-assessment of Life Satisfaction and Associated Factors (임상의사의 삶의 만족도 자가평가 수준과 관련 요인)

  • Jong Sun Ok;Hyeongsu Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.1
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    • pp.28-40
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    • 2023
  • Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

A Study on Hoslital Nurses' Preferred Duty Shift and Duty Hours (병원 간호사의 선호근무시간대에 관한 연구)

  • Lee, Gyeong-Sik;Jeong, Geum-Hui
    • The Korean Nurse
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    • v.36 no.1
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    • pp.77-96
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    • 1997
  • The duty shifts of hospital nurses not only affect nurses' physical and mental health but also present various personnel management problems which often result in high turnover rates. In this context a study was carried out from October to November 1995 for a period of two months to find out the status of hospital nurses' duty shift patterns, and preferred duty hours and fixed duty shifts. The study population was 867 RNs working in five general hospitals located in Seoul and its vicinity. The questionnaire developed by the writer was used for data collection. The response rate was 85.9 percent or 745 returns. The SAS program was used for data analysis with the computation of frequencies, percentages and Chi square test. The findings of the study are as follows: 1. General characteristics of the study population: 56 percent of respondents was (25 years group and 76.5 percent were "single": the predominant proportion of respondents was junior nursing college graduates(92.2%) and have less than 5 years nursing experience in hospitals(65.5%). For their future working plan in nursing profession, nearly 50% responded as uncertain The reasons given for their career plan was predominantly 'personal growth and development' rather than financial reasons. 2. The interval for rotations of duty stations was found to be mostly irregular(56.4%) while others reported as weekly(16.1%), monthly(12.9%), and fixed terms(4.6%). 3. The main problems related to duty shifts particularly the evening and night duty nurses reported were "not enough time for the family, " "afraid of security problems after the work when returning home late at night." and "lack of leisure time". "problems in physical and physiological adjustment." "problems in family life." "lack of time for interactions with fellow nurses" etc. 4. The forty percent of respondents reported to have '1-2 times' of duty shift rotations while all others reported that '0 time'. '2-3 times'. 'more than 3 times' etc. which suggest the irregularity in duty shift rotations. 5. The majority(62.8%) of study population found to favor the rotating system of duty stations. The reasons for favoring the rotation system were: the opportunity for "learning new things and personal development." "better human relations are possible. "better understanding in various duty stations." "changes in monotonous routine job" etc. The proportion of those disfavor the rotating 'system was 34.7 percent. giving the reasons of"it impedes development of specialization." "poor job performances." "stress factors" etc. Furthermore. respondents made the following comments in relation to the rotation of duty stations: the nurses should be given the opportunity to participate in the. decision making process: personal interest and aptitudes should be considered: regular intervals for the rotations or it should be planned in advance. etc. 6. For the future career plan. the older. married group with longer nursing experiences appeared to think the nursing as their lifetime career more likely than the younger. single group with shorter nursing experiences ($x^2=61.19.{\;}p=.000;{\;}x^2=41.55.{\;}p=.000$). The reason given for their future career plan regardless of length of future service, was predominantly "personal growth and development" rather than financial reasons. For further analysis, the group those with the shorter career plan appeared to claim "financial reasons" for their future career more readily than the group who consider the nursing job as their lifetime career$(x^2$= 11.73, p=.003) did. This finding suggests the need for careful .considerations in personnel management of nursing administration particularly when dealing with the nurses' career development. The majority of respondents preferred the fixed day shift. However, further analysis of those preferred evening shift by age and civil status, "< 25 years group"(15.1%) and "single group"(13.2) were more likely to favor the fixed evening shift than > 25 years(6.4%) and married(4.8%)groups. This differences were statistically significant ($x^2=14.54, {\;}p=.000;{\;}x^2=8.75, {\;}p=.003$). 7. A great majority of respondents(86.9% or n=647) found to prefer the day shifts. When the four different types of duty shifts(Types A. B. C, D) were presented, 55.0 percent of total respondents preferred the A type or the existing one followed by D type(22.7%). B type(12.4%) and C type(8.2%). 8. When the condition of monetary incentives for the evening(20% of salary) and night shifts(40% of. salary) of the existing duty type was presented. again the day shift appeared to be the most preferred one although the rate was slightly lower(66.4% against 86.9%). In the case of evening shift, with the same incentive, the preference rates for evening and night shifts increased from 11.0 to 22.4 percent and from 0.5 to 3.0 percent respectively. When the age variable was controlled. < 25 yrs group showed higher rates(31.6%. 4.8%) than those of > 25 yrs group(15.5%. 1.3%) respectively preferring the evening and night shifts(p=.000). The civil status also seemed to operate on the preferences of the duty shifts as the single group showed lower rate(69.0%) for day duty against 83. 6% of the married group. and higher rates for evening and night duties(27.2%. 15.1%) respectively against those of the married group(3.8%. 1.8%) while a higher proportion of the married group(83. 6%) preferred the day duties than the single group(69.0%). These differences were found to be statistically all significant(p=.001). 9. The findings on preferences of three different types of fixed duty hours namely, B, C. and D(with additional monetary incentives) are as follows in order of preference: B type(12hrs a day, 3days a wk): day shift(64.1%), evening shift(26.1%). night shift(6.5%) C type(12hrs a day. 4days a wk) : evening shift(49.2%). day shift(32.8%), night shift(11.5%) D type(10hrs a day. 4days a wk): showed the similar trend as B type. The findings of higher preferences on the evening and night duties when the incentives are given. as shown above, suggest the need for the introductions of different patterns of duty hours and incentive measures in order to overcome the difficulties in rostering the nursing duties. However, the interpretation of the above data, particularly the C type, needs cautions as the total number of respondents is very small(n=61). It requires further in-depth study. In conclusion. it seemed to suggest that the patterns of nurses duty hours and shifts in the most hospitals in the country have neither been tried for different duty types nor been flexible. The stereotype rostering system of three shifts and insensitiveness for personal life aspect of nurses seemed to be prevailing. This study seems to support that irregular and frequent rotations of duty shifts may be contributing factors for most nurses' maladjustment problems in physical and mental health. personal and family life which eventually may result in high turnover rates. In order to overcome the increasing problems in personnel management of hospital nurses particularly in rostering of evening and night duty shifts, which may related to eventual high turnover rates, the findings of this study strongly suggest the need for an introduction of new rostering systems including fixed duties and appropriate incentive measures for evenings and nights which the most nurses want to avoid, In considering the nursing care of inpatients is the round-the clock business. the practice of the nursing duty shift system is inevitable. In this context, based on the findings of this study. the following are recommended: 1. The further in-depth studies on duty shifts and hours need to be undertaken for the development of appropriate and effective rostering systems for hospital nurses. 2. An introduction of appropriate incentive measures for evening and night duty shifts along with organizational considerations such as the trials for preferred duty time bands, duty hours, and fixed duty shifts should be considered if good quality of care for the patients be maintained for the round the clock. This may require an initiation of systematic research and development activities in the field of hospital nursing administration as a part of permanent system in the hospital. 3. Planned and regular intervals, orientation and training, and professional and personal growth should be considered for the rotation of different duty stations or units. 4. In considering the higher degree of preferences in the duty type of "10hours a day, 4days a week" shown in this study, it would be worthwhile to undertake the R&D type studies in large hospital settings.

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Clinical aspects of chronic urticaria in children (소아 만성 두드러기의 임상 양상 및 경과)

  • Kang, Hye Seon;Shin, Mee Yong
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.205-212
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    • 2009
  • Purpose : Chronic urticaria is a disorder characterized by the appearance of wheals for more than 6 weeks; in most cases, the etiology is unknown. This study was aimed to discover the clinical aspects, the etiologic factors, and the course of chronic urticaria. Methods : 51 children who were diagnosed with chronic urticaria in the past 4 years, and who had had follow-ups more than 6 months after diagnosis in the pediatric department of Soonchunhyang University Hospital in Bucheon, were enrolled in the study. The laboratory findings, clinical aspects, and courses were retrospectively investigated by medical record review and telephone interview. Results : The median age of children with chronic urticaria was 4 years (8 months to 16 years) and the ratio of male to female was 1.4:1. Of the total, 39.2% of patients had a history of atopy. Angioedema occurred concurrently with urticaria in 11.8% of patients, and dermographism was seen in 41.2%. Results of thyroid function tests were normal and thyroid autoantibodies were absent in all cases. Regarding etiology, most cases (74.5%) were forms of idiopathic urticaria. Urticaria was induced by physical factors in 19.6% of patients. Open challenge tests revealed that 3 patients were allergic to food additives (glutamate 2, glutamate, and sulfite 1). In this study, most of the patients reported good response after medication of 1st- or 2nd-generation antihistamines alone. Follow-up at 6 months revealed that 70.6% of patients had experienced remission, and 84.8% of children who had follow-up at 1 year presented remission. Conclusion : Chronic urticaria in most patients was idiopathic. Remission occurred within 1 year of diagnosis, in most cases so chronic urticaria in children seems to have good prognosis.

Analysis of Wind Vorticity and Divergence in the High-latitude Lower Thermosphere: Dependence on the Interplanetary Magnetic Field (IMF) (고위도 하부 열권 바람의 소용돌이도와 발산 분석: 행성간 자기장(IMF)에 대한 의존도)

  • Kwak, Young-Sil;Lee, Jae-Jin;Ahn, Byung-Ho;Hwang, Jung-A;Kim, Khan-Hyuk;Cho, Kyung-Seok
    • Journal of Astronomy and Space Sciences
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    • v.25 no.4
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    • pp.405-414
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    • 2008
  • To better understand the physical processes that control the high-latitude lower thermospheric dynamics, we analyze the divergence and vorticity of the high-latitude neutral wind field in the lower thermosphere during the southern summertime for different IMF conditions. For this study the National Center for Atmospheric Research Thermosphere-Ionosphere Electrodynamics General Circulation Model (NCAR-TIEG CM) is used. The analysis of the large-scale vorticity and divergence provides basic understanding flow configurations to help elucidate the momentum sources that ulti-mately determine the total wind field in the lower polar thermosphere and provides insight into the relative strengths of the different sources of momentum responsible for driving winds. The mean neutral wind pattern in the high-latitude lower thermosphere is dominated by rotational flow, imparted primarily through the ion drag force, rather than by divergent flow, imparted primarily through Joule and solar heating. The difference vorticity, obtained by subtracting values with zero IMF from those with non-zero IMF, in the high-latitude lower thermosphere is much larger than the difference divergence for all IMF conditions, indicating that a larger response of the thermospheric wind system to enhancement in the momentum input generating the rotational motion with elevated IMF than the corresponding energy input generating the divergent motion. the difference vorticity in the high-latitude lower thermosphere depends on the direction of the IMF. The difference vorticity for negative and positive $B_y$ shows positive and negative, respectively, at higher magnetic latitudes than $-70^{\circ}$. For negative $B_z$, the difference vorticities have positive in the dusk sector and negative in the dawn sector. The difference vorticities for positive $B_z$ have opposite sign. Negative IMF $B_z$ has a stronger effect on the vorticity than does positive $B_z$.

The association of snack consumption, lifestyle factors, and pediatric obesity with dietary behavior patterns in male adolescents (남자 청소년의 식행동 패턴에 따른 간식 섭취, 생활 습관 요인 및 비만과의 연관성 연구)

  • Kim, Min-Ji;Song, SuJin;Park, So Hyun;Song, YoonJu
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.228-235
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    • 2015
  • Purpose: Along with the adaptation of a Western dietary pattern and low physical activity, pediatric obesity is increasing in Korea, especially for boys. The aim of this study was to identify dietary behavior patterns and examine the snack consumption, dietary habit, and pediatric obesity by pattern groups. Methods: Boys aged 15~19 years were recruited from one high school in Seoul. A questionnaire including dietary behaviors and lifestyle factors was administered and height and weight were measured. A total of 932 boys participated except boys who had missing or incomplete response (n = 30). Three dietary behavior patterns were identified by cluster analysis; 'Healthy pattern', 'Mixed pattern' and 'Unhealthy pattern'. Results: Snack consumption differed according to dietary behavior patterns group. The healthy and mixed patterns showed higher frequencies of white milk and fruit consumption while the unhealthy pattern as well as the mixed patterns showed higher frequencies of sweetened snack and ice cream consumption. Food availability at home of each food differed according to pattern groups but showed a similar trend with food consumption. Regarding dietary habits, the mixed pattern showed higher proportion of taking dietary supplement and eating dessert while the unhealthy pattern showed lower proportion of eating regular meals and appropriate amount of meals. When the healthy pattern was set as a reference group, the odds ratio of pediatric obesity was 1.11 (CI 0.65-1.87) in the mixed pattern group and 1.88 (CI 1.14-3.10) in the unhealthy pattern group. Conclusion: In conclusion, dietary behaviors including snack consumption and lifestyle factors were connected. Unbalanced diet and undesirable dietary practice are important determinants in pediatric obesity.

Effects of Exercise Training and Selenium on MCT1 and MCT4 Protein Levels in Skeletal Muscles of Diabetic Goto-Kakizaki Rats (지구성 운동과 셀레니움 투여가 당뇨 Goto-kakizaki 쥐의 골격근의 MCT1과 MCT4단백질 발현수준에 미치는 효과)

  • Kim, Seung-Seok;Kang, Eun-Bum;Eum, Hyun-Sub;Kim, Bum-Su;Lim, Yea-Hyun;Park, Joon-Young;Cho, In-Ho;Oh, Yoo-Sung;Kwak, Yi-Sub;Cho, Joon-Yong
    • Journal of Life Science
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    • v.18 no.1
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    • pp.1-8
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    • 2008
  • The purpose of this study was to determine the possible additive effects of endurance exercise training (EXER) and selenium (SELE) on the improvements of glucose and lactate transport capacities in diabetic Goto-kakizaki rats. Animals either remained sedentary control (SED) or performed EXER or received SELE [$5{\mu}mol$ kg body wt (-1) day (-1)], or underwent both EXER and SELE (COMBI), which lasted for 6 wk. Compared with sedentary control, EXER alone or the SELE alone group, or the combined treatment group had significant reduction in glucose response measured at 90 min and 120 min during an intraperitoneal glucose tolerance test (IPGTT) and body weight after 6week treatment. EXER alone, or combined group individually had significantly higher glycogen contents in liver compared with SED or SELE groups. EXER alone increased glycogen content in soleus and plantaris compared with SED, and this parameter was increased to greatest extent in the combined treatment groups compared with SED or SELE groups. EXER alone, SELE alone or COMBI, caused significant decreases in the plasma lactates, serum glucose, insulin, total cholesterol and HOMA-IR along with a significant increase in high-density lipoprotein cholesterol compared with SED. In addition, EXER or COMBI individually had significantly lower serum triacylglycerol compared with SED or SELE. With respect to protein expression related to glucose and lactate transport capacities, EXER alone, SELE alone, or COMBI increased in MCT1 and MCT4 protein level in soleus and plantaris. Furthermore, EXER alone, SELE alone or COMBI caused significant increases in mt MCT1 protein level in soleus and plantaris. The findings of the current study suggest that endurance exercise training and selenium treatment may provide therapeutic values to type II diabetic patients with peripheral insulin resistance and hyperlactatecemia by improving glucose and lactate transport capacities, leading to improvements in plasma lactate, serum glucose, insulin and lipid profiles (TC, TG, HDL).

Effects of Organic Amendments on Introducing Pioneer Herbaceous Plants in the Abandoned Zinc Mine Soil Revegetation (아연 폐광산에 식생도입을 위한 유기성 토양 개량제의 처리효과)

  • Kim Dae-Yeon;Lee Sang-Hwan;Jung Jin-Ho;Kim Jeong-Gyu
    • Journal of Soil and Groundwater Environment
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    • v.11 no.3
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    • pp.43-51
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    • 2006
  • Generally abandoned mine soils have serious problems for introducing vegetation such as nutrient deficiency, poor physical properties, and phytotoxicity due to high levels of heavy metals. It is required to improve soil amenity for revegetation. One of its strategies is using organic materials such as compost manure and sludge. The pot experiments was conducted to evaluate the effects of pig manure and municipal sewage sludge on revegetation of mining area soil surface with Artemisia princeps and Zoysia japonica. Application rate of pig manure and municipal sewage sludge was $75{\sim}225$ Mg/ha and $150{\sim}450$ Mg/ha, respectively. The results showed that the application of manure and sludge increased organic matter about two-fold and total nitrogen contents about five-fold of mine soil and improved the growth of plants in all treatments compared to the control. The result of plant tissue analysis showed that both plants accumulate Cd, Cu and Zn in root tissue rather than shoot tissues. Increased sludge application reduced Zn accumulation in both plant tissue. Sequential extraction results indicated that addition of soil amendment induced increment of organically bound fractions of Cu and Zn. Organically bound fraction of Zn was significantly increased from 7.84% to 13.58% in Artemisia princeps planted soil and from 7.84% to 14.16% in Zoysia japonica planted soil, thereby bioavailability of heavy metals was reduced. The results suggested that application of organic materials to mine soil can reduce phytotoxicity of heavy metals and be helpful in introducing successful revegetation.

A survey of the Necessity and Perceptions of Character Education of Health Science and Non-health Science University Students (일개 보건계열 및 비보건계열 학생들의 인성교육에 대한 필요성 및 인식도 조사)

  • Choi, Yong-Keum;Oh, Tae-Jin;Lee, Hyun;Lim, Kun-Ok;Hong, Ji-Heon;Kim, Eun-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.344-351
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    • 2019
  • The purpose of this study was to obtain the basic data for developing more advanced courses on character education by surveying and analyzing the perception and demands of character education of university students and further, to provide useful information for creating institutional protocol on character education. The study was conducted from April 2018 to May 2018 on students attending the departments of non-health science and health science university students. A total of 206 students participated in this study, and all the students in the non-health science and health science departments were found to be highly aware of the need for character education, its importance and the possibility of personality development through learning. Students from all the departments showed high levels on average in terms of self-understanding according to their personality abilities, and especially their high levels of 'consideration' and 'responsibility'. For the differences in perception of self-efficacy, the lowest level of recognition was for 'will' and the average values were not high. In their response to personality level, all students answered that their personality was 'high' (42.1%), and that the personality education courses at the schools they are currently attending were 'not satisfied' with both the non-health science and health science students. As a result, there were higher results overall for the health science students than that for the non-health science students, but there were not many significant differences. To this end, education institutes will have to prepare conditions for university students to cultivate their expertise in character, while at the same time helping them grow into human beings with the qualities demanded by society. In addition, the government should establish curriculums and content by accurately identifying the needs of character education and devising concrete measures for their implementation, and by more faithfully considering quantitative and qualitative context types for the content base of character education.

Factors Affecting the Registration and Access Levels of the Pilot Project for the General Physician System among People with Disabilities (장애인 건강주치의 시범사업 수요자의 등록 및 이용수준 영향 요인 분석)

  • Eunhee Choe;Yeojeong Gu;Seungji Lim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.185-195
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    • 2024
  • Background: Disabled people have particularly restricted access to health care. In response to this, the pilot project for the general physician (GP) system for disabled people was implemented in 2018, based on the rights of people with disability to the Health Act in South Korea. However, its participants were 0.2% among the total of those with severe disabilities in 2021. Therefore, this study examined the factors related to registering with a GP and the access level to its services to suggest implications for activating the participation of disabled people. Methods: We analyzed factors affecting the registration with a GP and the number of using the services among the participants of the GP system during May 2018 and December 2021 by conducting hierarchical logistic regression and hierarchical regression. The data were linked with the national health insurance data to examine various predictors, including disability types, socioeconomic status, health status, and GP registration. Results: As a result of analyzing the factors affecting whether or not to register for the pilot project, those with disabilities (physical disabilities, brain lesions, visual, intellectual, mental, and autistic disability) eligible for disability care (odds ratio [OR], 4.157) than other disability, and those living in metropolitan (OR, 4.330) or cities (OR, 3.332) than rural residences were highly likely to enroll the pilot study. Health-related variables also predicted the registration status of the pilot project. The predictors related to GP enrollment types (membership type: general health or disability care, GP's affiliation: clinics or hospitals) significantly influenced levels of access to services. Conclusion: It is necessary to develop the GP project for disabled people by considering the variation in types of disability, residences, and health. Further study will be needed to investigate the impact of GPs on the level of participation among disabled people.

Interpreting Bounded Rationality in Business and Industrial Marketing Contexts: Executive Training Case Studies (집행관배훈안례연구(阐述工商业背景下的有限合理性):집행관배훈안례연구(执行官培训案例研究))

  • Woodside, Arch G.;Lai, Wen-Hsiang;Kim, Kyung-Hoon;Jung, Deuk-Keyo
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.49-61
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    • 2009
  • This article provides training exercises for executives into interpreting subroutine maps of executives' thinking in processing business and industrial marketing problems and opportunities. This study builds on premises that Schank proposes about learning and teaching including (1) learning occurs by experiencing and the best instruction offers learners opportunities to distill their knowledge and skills from interactive stories in the form of goal.based scenarios, team projects, and understanding stories from experts. Also, (2) telling does not lead to learning because learning requires action-training environments should emphasize active engagement with stories, cases, and projects. Each training case study includes executive exposure to decision system analysis (DSA). The training case requires the executive to write a "Briefing Report" of a DSA map. Instructions to the executive trainee in writing the briefing report include coverage in the briefing report of (1) details of the essence of the DSA map and (2) a statement of warnings and opportunities that the executive map reader interprets within the DSA map. The length maximum for a briefing report is 500 words-an arbitrary rule that works well in executive training programs. Following this introduction, section two of the article briefly summarizes relevant literature on how humans think within contexts in response to problems and opportunities. Section three illustrates the creation and interpreting of DSA maps using a training exercise in pricing a chemical product to different OEM (original equipment manufacturer) customers. Section four presents a training exercise in pricing decisions by a petroleum manufacturing firm. Section five presents a training exercise in marketing strategies by an office furniture distributer along with buying strategies by business customers. Each of the three training exercises is based on research into information processing and decision making of executives operating in marketing contexts. Section six concludes the article with suggestions for use of this training case and for developing additional training cases for honing executives' decision-making skills. Todd and Gigerenzer propose that humans use simple heuristics because they enable adaptive behavior by exploiting the structure of information in natural decision environments. "Simplicity is a virtue, rather than a curse". Bounded rationality theorists emphasize the centrality of Simon's proposition, "Human rational behavior is shaped by a scissors whose blades are the structure of the task environments and the computational capabilities of the actor". Gigerenzer's view is relevant to Simon's environmental blade and to the environmental structures in the three cases in this article, "The term environment, here, does not refer to a description of the total physical and biological environment, but only to that part important to an organism, given its needs and goals." The present article directs attention to research that combines reports on the structure of task environments with the use of adaptive toolbox heuristics of actors. The DSA mapping approach here concerns the match between strategy and an environment-the development and understanding of ecological rationality theory. Aspiration adaptation theory is central to this approach. Aspiration adaptation theory models decision making as a multi-goal problem without aggregation of the goals into a complete preference order over all decision alternatives. The three case studies in this article permit the learner to apply propositions in aspiration level rules in reaching a decision. Aspiration adaptation takes the form of a sequence of adjustment steps. An adjustment step shifts the current aspiration level to a neighboring point on an aspiration grid by a change in only one goal variable. An upward adjustment step is an increase and a downward adjustment step is a decrease of a goal variable. Creating and using aspiration adaptation levels is integral to bounded rationality theory. The present article increases understanding and expertise of both aspiration adaptation and bounded rationality theories by providing learner experiences and practice in using propositions in both theories. Practice in ranking CTSs and writing TOP gists from DSA maps serves to clarify and deepen Selten's view, "Clearly, aspiration adaptation must enter the picture as an integrated part of the search for a solution." The body of "direct research" by Mintzberg, Gladwin's ethnographic decision tree modeling, and Huff's work on mapping strategic thought are suggestions on where to look for research that considers both the structure of the environment and the computational capabilities of the actors making decisions in these environments. Such research on bounded rationality permits both further development of theory in how and why decisions are made in real life and the development of learning exercises in the use of heuristics occurring in natural environments. The exercises in the present article encourage learning skills and principles of using fast and frugal heuristics in contexts of their intended use. The exercises respond to Schank's wisdom, "In a deep sense, education isn't about knowledge or getting students to know what has happened. It is about getting them to feel what has happened. This is not easy to do. Education, as it is in schools today, is emotionless. This is a huge problem." The three cases and accompanying set of exercise questions adhere to Schank's view, "Processes are best taught by actually engaging in them, which can often mean, for mental processing, active discussion."

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