Objectives: Currently, Korea's medical services are divided into Western medicine and Korean medicine, and people who are not satisfied with the existing treatments are looking for complementary and alternative medicine(CAM). Therefore, this study attempted to confirm patients' perception of the ongoing collaborative treatment and integrated medical service that added CAM to collaborative treatment based on tertiary hospital users. So that we can confirm the expected advantage and disadvantage of integrated medical service system and the necessity of supporting medical expenses for it. Methods: The survey was conducted on 100 people who experienced tertiary hospital treatment and other 100 people who experienced both tertiary hospital treatment and Korean medicine treatment at the same period. The survey was conducted until the number of respondents in both group reached 100. The survey was conducted through e-mail and was conducted from September 27, 2021 to October 8, 2021. Results: For the advantages of collaborative treatment 'increased in psychological stability,' and for disadvantages 'longer time spent for treatment' were the most common. If integrated medical services are implemented in the future, expected advantages include 'consideration of various treatments.' and expected disadvantages include 'increased medical cost.' The needs to expand support for health insurance for integrated medical services were 75.5% among responders. Conclusions: We were able to find out the (expected) advantages and disadvantages of the collaborative medical care and the integrated medical system that medical users experienced or expected, also confirmed positive answers to the expansion of health insurance support for the integrated medical system.
Citizens' needs for urban green spaces are on the rise due to improved quality of life and increased interest in environments. The garden is noteworthy because it is small in size, making it less controversial to create in the city, and it is adjacent to the residential area, improving citizens' daily environment. Moreover, recently gardens is attracting attention as a tool for urban regeneration, such as being created in declining areas as part of a government project. Therefore, it is time to study the role and value of urban gardens in deteriorated areas in terms of space welfare. However, there are few studies that quantitatively evaluate the effects of gardens, and many prior studies are limited to focusing the green space larger than a certain size (e.g., parks and forests). Therefore, the aim of this study is to examine the effect of garden and gardening quantitatively, paying attention to social aspects such as life satisfaction and community of inhabitants. The study was conducted in an old row housing complex in Gojan1-dong, Ansan-si, Gyeonggi-do. In there, some of the dwellers voluntarily created outdoor gardens and engaged in gardening for a long time. In addition, after the 2017 Gyeonggi-do Garden Fair, several gardens have been maintained and used by residents there. For the first step, the field trip was done to research the status of the garden in the area, and then, a survey was conducted on whether or not gardening has an impact on the life satisfaction and community of residents. The results were analyzed by t-test and ANOVA. As a result, residents who are engaged in gardening are more active in the "neighborhood exchange" and "resident participation" than those who are not engaged in gardening. In addition, if residents voluntarily create a garden, the level of "satisfaction of life" is higher than those staying in the garden which is constructed by the government. And a resident who is gardening in the complex shows higher life satisfaction than those who garden outside of the complex. These results confirmed that the garden has positive effects promoting "exchanges with neighbors", "participation in the community", and "life satisfaction" of residents. It shows that it is important to ensure the right of residents to participate in the garden-making process as much as possible, and the garden's location should be paid attention to maximize the positive effect of gardens.
Objectives: Objectives: In this study, we define a medical service type that combines Western medicine, Korean medicine, and complementary and alternative medicine (CAM) as an integrated medical service. This study, as part of tertiary hospital-based integrated medical service model and clinical field application, aims to collect status and opinions on integrated medical service for medical staff in the field. Methods: This is a survey study, and was conducted on doctors from Kyung Hee University Hospital and Korean medicine doctors from Kyung Hee University Korean Medicine Hospital. Respondents were recruited on a first-come, first-served basis until the number of respondents reached 120. The investigation was conducted for a total of 16 days from October 4, 2021 to October 19, 2021 by e-mail. Results: Recognition of integrated medical services was confirmed to be 45.8%, and 49.2% responded positively to the necessity of it. As a group of diseases that require the establishment of integrated medical services in the future, 'disorders of musculoskeletal systems and connective tissues' was the highest. The most expected advantages of providing integrated medical services were 'increased satisfaction of patients and guardians' and 'increased treatment effects.' Conclusions: In this study, we investigated the perception of doctors and Korean medicine doctors on integrated medical services that combine Western medicine, Korean medicine, and CAM. It has been confirmed that medical staff generally have a positive perception of integrated medical services, and if the scientific basis for the effect of integrated medical services is supported, the rate of positive perception is expected to increase.
What attracts consumers to bloggers' reviews? Consumers would be attracted both by the Bloggers' expertise (i.e., knowledge and experience) and by his/her unbiased manner of delivering information. Expertise and trustworthiness are both virtues of information sources, particularly when there is uncertainty in decision-making. Noting this point, we postulate that consumers' motives determine the relative weights they place on expertise and trustworthiness. In addition, our hypotheses assume that tie strength moderates consumers' expectation on bloggers' expertise and trustworthiness: with expectation on expertise enhanced for power-blog user-group (weak-ties), and an expectation on trustworthiness elevated for personal-blog user-group (strong-ties). Finally, we theorize that the effect of credibility on willingness to accept a review is moderated by tie strength; the predictive power of credibility is more prominent for the personal-blog user-groups than for the power-blog user groups. To support these assumptions, we conducted a field survey with blog users, collecting retrospective self-report data. The "gourmet shop" was chosen as a target product category, and obtained data analyzed by structural equations modeling. Findings from these data provide empirical support for our theoretical predictions. First, we found that the purposive motive aimed at satisfying instrumental information needs increases reliance on bloggers' expertise, but interpersonal connectivity value for alleviating loneliness elevates reliance on bloggers' trustworthiness. Second, expertise-based credibility is more prominent for power-blog user-groups than for personal-blog user-groups. While strong ties attract consumers with trustworthiness based on close emotional bonds, weak ties gain consumers' attention with new, non-redundant information (Levin & Cross, 2004). Thus, when the existing knowledge system, used in strong ties, does not work as smoothly for addressing an impending problem, the weak-tie source can be utilized as a handy reference. Thus, we can anticipate that power bloggers secure credibility by virtue of their expertise while personal bloggers trade off on their trustworthiness. Our analysis demonstrates that power bloggers appeal more strongly to consumers than do personal bloggers in the area of expertise-based credibility. Finally, the effect of review credibility on willingness to accept a review is higher for the personal-blog user-group than for the power-blog user-group. Actually, the inference that review credibility is a potent predictor of assessing willingness to accept a review is grounded on the analogy that attitude is an effective indicator of purchase intention. However, if memory about established attitudes is blocked, the predictive power of attitude on purchase intention is considerably diminished. Likewise, the effect of credibility on willingness to accept a review can be affected by certain moderators. Inspired by this analogy, we introduced tie strength as a possible moderator and demonstrated that tie strength moderated the effect of credibility on willingness to accept a review. Previously, Levin and Cross (2004) showed that credibility mediates strong-ties through receipt of knowledge, but this credibility mediation is not observed for weak-ties, where a direct path to it is activated. Thus, the predictive power of credibility on behavioral intention - that is, willingness to accept a review - is expected to be higher for strong-ties.
Backgrounds/Aims: Pancreatoduodenectomy (PD) is recommended in fit patients with a carcinoma (PDAC) of the pancreatic head, and a delayed resection may affect survival. This study aimed to correlate the time from staging to PD with long-term survival, and study the impact of preoperative investigations (if any) on the timing of surgery. Methods: Data were extracted from the Recurrence After Whipple's (RAW) study, a multicentre retrospective study of PD outcomes. Only PDAC patients who underwent an upfront resection were included. Patients who received neoadjuvant chemo-/radiotherapy were excluded. Group A (PD within 28 days of most recent preoperative computed tomography [CT]) was compared to group B (> 28 days). Results: A total of 595 patents were included. Compared to group A (median CT-PD time: 12.5 days, interquartile range: 6-21), group B (49 days, 39-64.5) had similar one-year survival (73% vs. 75%, p = 0.6), five-year survival (23% vs. 21%, p = 0.6) and median time-to-death (17 vs. 18 months, p = 0.8). Staging laparoscopy (43 vs. 29.5 days, p = 0.009) and preoperative biliary stenting (39 vs. 20 days, p < 0.001) were associated with a delay to PD, but magnetic resonance imaging (32 vs. 32 days, p = 0.5), positron emission tomography (40 vs. 31 days, p > 0.99) and endoscopic ultrasonography (28 vs. 32 days, p > 0.99) were not. Conclusions: Although a treatment delay may give rise to patient anxiety, our findings would suggest this does not correlate with worse survival. A delay may be necessary to obtain further information and minimize the number of PD patients diagnosed with early disease recurrence.
Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance（P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.
HARN, Chang Yawl : Studies on the dimorphism and Fertility of Persicaria japonica (MEISSNER) Gross et Nakai. Kor Jour. Bot. 3(I) 1-15 1960 Numerous investigations, since the works of DARWIN, have been made regarding the heterostylous plants by JOST (1907), CORRENS (1924), LAIBACK (1924), LEWIS (1943), and many others. Studies on the heterostylous Polygomum, however, were not reported except for the buckwhent, Fagopyrum esculentum, which was investigated by SCHOCH-BODMER (1930), EAST (1934), FROLOVA & Co-Workers (1946), MORRIS (1947, 1951) TATEBE (1949, 1951, 1953), present author (1957), and others. It is because no heterostylous species, besides buckwheat, have been known to exist in the Polygonum family. The author, during his studies on both heterostylism and fertility of Polygonaceae, has found that the species, persicaria japonica (Meissner) Gross et Nakai, is not diecious as has been known in taxonomy, but in reality beterostylous both morphologically and physiologically. It was found that this plant, regarded by taxonomist, as a male plant setting no seed, actually set seed (botanical fruit) when legitimate combination was made. Since his brief report on the dimorphic phenomens of this plant in 1956, the author's further research on the manner of fertilization has revealed that this species is a peculiar type whose dimorphism has undergone extreme specialization structurally and physiologically, the short-styled individual behaving in nature as a male plant and the long-styled individual, as female, whereas in controllled pollination the plant shows highly differentiated typical dimorphism. When compared with the other dimorphous species of this family, F. esculentum and P. sentiosa. it has been clarified that these three species differ in the degree of differentiation of their dimorphism morphologically and physiologically. That is, P. japonica has developed such a high specialization as to mislead the taxonomists, while P. senticosa shows almost no noticeable difference between long- and shortstyled individuals retaining most of the inherent physiological character cmmon to the genus except for the fact that it has two forms of flowers. F. esculentum appears to have taken the intermediate position in every respect. The result obtained in the present experiment are summarized as follows: 1) P. japonica has two kinds of individuals, one long style-short stamened; the other, short style-long stamened. The floral structure of this plants shows typical characteristics of dimorphic heterostylism. The differentiation between the two forms of flower has proceeded so highly both in primary and secondary difference of flower structure that this may be regarded as the most specialized form of dimorphism. 2) The differences of floral structure between the long and short styled individuals are remarkable compared with the other dimorphic species of the family. 3) The stamens of long styled plants show the sign of deteriolation whereas those of the short styled flower are well-developed. 4) When legitimate combinations are made, both L- and S-styled individuals are fertilized well and set seed (fruit), while in the illegitimate combination no fertilization and seed setting occur. Physiologically this species exhibits the typical behavior of dimorphic plants. 5) The self-fertile character, so common in other species of the other non-heterostyle Polygonum family, has disappeared completely. 6) Under natural conditions, no or few seed setting is observed in short styled individuals that behave as if they were male plants. 7) In hand pollination, the combination of both
In a market where new and used cars are competing with each other, we would run the risk of obtaining biased estimates of cross elasticity between them if we focus on only new cars or on only used cars. Unfortunately, most of previous studies on the automobile industry have focused on only new car models without taking into account the effect of used cars' pricing policy on new cars' market shares and vice versa, resulting in inadequate prediction of reactive pricing in response to competitors' rebate or price discount. However, there are some exceptions. Purohit (1992) and Sullivan (1990) looked into both new and used car markets at the same time to examine the effect of new car model launching on the used car prices. But their studies have some limitations in that they employed the average used car prices reported in NADA Used Car Guide instead of actual transaction prices. Some of the conflicting results may be due to this problem in the data. Park (1998) recognized this problem and used the actual prices in his study. His work is notable in that he investigated the qualitative effect of new car model launching on the pricing policy of the used car in terms of reinforcement of brand equity. The current work also used the actual price like Park (1998) but the quantitative aspect of competitive price promotion between new and used cars of the same model was explored. In this study, I develop a model that assumes that the cross elasticity between new and used cars of the same model is higher than those amongst new cars and used cars of the different model. Specifically, I apply the nested logit model that assumes the car model choice at the first stage and the choice between new and used cars at the second stage. This proposed model is compared to the IIA (Independence of Irrelevant Alternatives) model that assumes that there is no decision hierarchy but that new and used cars of the different model are all substitutable at the first stage. The data for this study are drawn from Power Information Network (PIN), an affiliate of J.D. Power and Associates. PIN collects sales transaction data from a sample of dealerships in the major metropolitan areas in the U.S. These are retail transactions, i.e., sales or leases to final consumers, excluding fleet sales and including both new car and used car sales. Each observation in the PIN database contains the transaction date, the manufacturer, model year, make, model, trim and other car information, the transaction price, consumer rebates, the interest rate, term, amount financed (when the vehicle is financed or leased), etc. I used data for the compact cars sold during the period January 2009- June 2009. The new and used cars of the top nine selling models are included in the study: Mazda 3, Honda Civic, Chevrolet Cobalt, Toyota Corolla, Hyundai Elantra, Ford Focus, Volkswagen Jetta, Nissan Sentra, and Kia Spectra. These models in the study accounted for 87% of category unit sales. Empirical application of the nested logit model showed that the proposed model outperformed the IIA (Independence of Irrelevant Alternatives) model in both calibration and holdout samples. The other comparison model that assumes choice between new and used cars at the first stage and car model choice at the second stage turned out to be mis-specfied since the dissimilarity parameter (i.e., inclusive or categroy value parameter) was estimated to be greater than 1. Post hoc analysis based on estimated parameters was conducted employing the modified Lanczo's iterative method. This method is intuitively appealing. For example, suppose a new car offers a certain amount of rebate and gains market share at first. In response to this rebate, a used car of the same model keeps decreasing price until it regains the lost market share to maintain the status quo. The new car settle down to a lowered market share due to the used car's reaction. The method enables us to find the amount of price discount to main the status quo and equilibrium market shares of the new and used cars. In the first simulation, I used Jetta as a focal brand to see how its new and used cars set prices, rebates or APR interactively assuming that reactive cars respond to price promotion to maintain the status quo. The simulation results showed that the IIA model underestimates cross elasticities, resulting in suggesting less aggressive used car price discount in response to new cars' rebate than the proposed nested logit model. In the second simulation, I used Elantra to reconfirm the result for Jetta and came to the same conclusion. In the third simulation, I had Corolla offer $1,000 rebate to see what could be the best response for Elantra's new and used cars. Interestingly, Elantra's used car could maintain the status quo by offering lower price discount ($160) than the new car ($205). In the future research, we might want to explore the plausibility of the alternative nested logit model. For example, the NUB model that assumes choice between new and used cars at the first stage and brand choice at the second stage could be a possibility even though it was rejected in the current study because of mis-specification (A dissimilarity parameter turned out to be higher than 1). The NUB model may have been rejected due to true mis-specification or data structure transmitted from a typical car dealership. In a typical car dealership, both new and used cars of the same model are displayed. Because of this fact, the BNU model that assumes brand choice at the first stage and choice between new and used cars at the second stage may have been favored in the current study since customers first choose a dealership (brand) then choose between new and used cars given this market environment. However, suppose there are dealerships that carry both new and used cars of various models, then the NUB model might fit the data as well as the BNU model. Which model is a better description of the data is an empirical question. In addition, it would be interesting to test a probabilistic mixture model of the BNU and NUB on a new data set.
Previous studies of reward programs have generally focused on designing the best programs for consumers and suggested that consumers' perception of the value of reward programs can vary according to the type of reward program (e.g., hedonic vs. utilitarian and direct vs. indirect) and its timing (e.g., immediate vs. delayed). These studies have typically assumed that consumers' preference for reward programs has a positive effect on brand loyalty. However, Dowling and Uncles (1997) pointed out that this preference does not necessarily foster brand loyalty. In this regard, the present study verifies this assumption by examining the effects of consumers' perception of the value of reward programs on their brand loyalty. Although reward programs are widely used by online shopping malls, most studies have examined the conditions under which consumers are most likely to value loyalty programs in the context of offline shopping. In the context of online shopping, however, consumers' preferences may have little effect on their brand loyalty because they have more opportunities for comparing diverse reward programs offered by many online shopping malls. That is, in online shopping, finding attractive reward programs may require little effort on the part of consumers, who are likely to switch to other online shopping malls. Accordingly, this study empirically examines whether consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. Meanwhile, consumers seek utilitarian and/or hedonic value from their online shopping activity(Jones et al., 2006; Barbin et al., 1994). They visit online shopping malls to buy something necessary (utilitarian value) and/or enjoy the process of shopping itself (hedonic value). In this sense, reward programs may reinforce utilitarian as well as hedonic value, and their effect may vary according to the type of reward (utilitarian vs. hedonic). According to Chaudhuri and Holbrook (2001), consumers' perception of the value of a brand can influence their brand loyalty through brand trust and affect. Utilitarian value influences brand loyalty through brand trust, whereas hedonic value influences it through brand affect. This indicates that the effect of this perception on brand trust or affect may be moderated by the type of reward program. Specifically, this perception may have a greater effect on brand trust for utilitarian reward programs than for hedonic ones, whereas the opposite may be true for brand affect. Given the above discussion, the present study is conducted with three objectives in order to provide practical implications for online shopping malls to strategically use reward program for establishing profitable relationship with customers. First, the present study examines whether reward programs can be an effective marketing tool for increasing brand loyalty in the context of online shopping. Second, it investigates the paths through which consumers' perception of the value of reward programs influences their brand loyalty. Third, it analyzes the effects of this perception on brand trust and affect by considering the type of reward program as a moderator. This study suggests and empirically analyzes a new research model for examining how consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. The model postulates the following 10 hypotheses about the structural relationships between five constructs: (H1) Consumers' perception of the value of reward programs has a positive effect on their program loyalty; (H2) Program loyalty has a positive effect on brand loyalty; (H3) Consumers' perception of the value of reward programs has a positive effect on their brand trust; (H4) Consumers' perception of the value of reward programs has a positive effect on their brand affect; (H5) Brand trust has a positive effect on program loyalty; (H6) Brand affect has a positive effect on program loyalty; (H7) Brand trust has a positive effect on brand loyalty; (H8) Brand affect has a positive effect on brand loyalty; (H9) Consumers' perception of the value of reward programs is more likely to influence their brand trust for utilitarian reward programs than for hedonic ones; and (H10) Consumers' perception of the value of reward programs is more likely to influence their brand affect for hedonic reward programs than for utilitarian ones. To test the hypotheses, we considered a sample of 220 undergraduate students in Korea (male:113). We randomly assigned these participants to one of two groups based on the type of reward program (utilitarian: transportation card, hedonic: movie ticket). We instructed the participants to imagine that they were offered these reward programs while visiting an online shopping mall. We then asked them to answer some questions about their perception of the value of the reward programs, program loyalty, brand loyalty, brand trust, and brand affect, in that order. We also asked some questions about their demographic backgrounds and then debriefed them. We employed the structural equation modeling (SEM) method with AMOS 18.0. The results provide support for some hypotheses (H1, H3, H4, H7, H8, and H9) while providing no support for others (H2, H5, H6, H10) (see Figure 1). Noteworthy is that the path proposed by previous studies, "value perception → program loyalty → brand loyalty," was not significant in the context of online shopping, whereas this study's proposed path, "value perception → brand trust/brand affect → brand loyalty," was significant. In addition, the results indicate that the type of reward program moderated the relationship between consumers' value perception and brand trust but not the relationship between their value perception and brand affect. These results have some important implications. First, this study is one of the first to examine how consumers' perception of the value of reward programs influences their brand loyalty in the context of online shopping. In particular, the results indicate that the proposed path, "value perception → brand trust/brand affect → brand loyalty," can better explain the effects of reward programs on brand loyalty than existing paths. Furthermore, these results suggest that online shopping malls should place greater emphasis on the type of reward program when devising reward programs. To foster brand loyalty, they should reinforce the type of shopping value that consumers emphasize by providing them with appropriate reward programs. If consumers prefer utilitarian value to hedonic value, then online shopping malls should offer utilitarian reward programs and vice versa.
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,