As this study aimed to examine which influence the nonverbal communication of service provider has upon service performance in terms of service industry, the specific objectives are as follows. First, it tried to examine into the relationship between the nonverbal communication in the service provider, and the emotional attachment. Nonverbal communication is divided into 4 kinds such as physical language, proxemics, paralanguage, and physical appearance. Second, it aimed to examine the relationship between the customer's attachment to the service provider, and the social competence and trust in the service provider. Third, it tried to examine into the relationship of service provider's social competence and trust with the customer satisfaction and with the switching costs. Additionally, it examined the moderating effect in the service type and the service usage period in terms of the model that was presented in this study. Given examining the verified results in these research hypotheses, those are as follows. First, given seeing the relationship between the nonverbal communication and the emotional attachment, it was represented that the physical language, proxemics, and physical appearance, except paralanguage, have significantly positive(+) influence upon emotional attachment. Second, it was indicated that emotional attachment has significantly positive(+) influence upon the social competence and trust in the service provider. Third, the social competence in the service provider had no positive effect(+) on customer satisfaction, and was having significantly positive(+) influence upon the customer's perceived switching barrier. Fourth, it was represented that the customer satisfaction toward the service provider have significantly positive(+) influence upon the switching barrier. Finally, as a result of having verified whether or not the moderating effect in the service type and the service usage period, it was indicated to be produced the difference depending on the service type in the relationships between the physical language and the emotional attachment, between the paralanguage and the emotional attachment, between the emotional attachment and the trust, and between the trust and the switching barrier. Depending on the service usage period, the difference was represented, respectively, in the relationships between the physical language and the emotional attachment and between the physical appearance and the emotional attachment.
Against the backdrop of the increasing trend towards economic globalisation, many international firms are indicating that decisions on how to enter foreign markets remains one of the key strategic challenges confronting them. Despite the rich body of literature on the topic, the fact that these challenges have continued to dominate global marketing strategy discourses point to someevident lacunae. Accordingly, this paper considers the variables, categorised in terms of firm contexts (standardisation, market research, competition, structure, competitive advantage) and host country-contexts (economic development, cultural differences, regulation and political risk), which influence the degree of involvement of UK companies in overseas markets. Following hypotheses were drawn from literature review: H1: The greater the level of competition, the higher the degree of involvement in the overseas market. H2: The more centralised the firm's organisation structure, the higher the degree of involvement in the overseas market. H3a: The adoption of a low cost-approach to competitive advantage will lead to a higher degree of involvement. H3b: The adoption of an innovation-approach to competitive advantage will lead to a higher degree of involvement. H3c: The adoption of a market research approach to competitive advantages will lead to a higher degree of involvement. H3d: The adoption of a breadth of strategic target-approach to competitive advantage will lead to a lower degree of involvement. H4: The higher the degree of standardisation of the international marketing mix the higher the degree of involvement. H5: The greater the degree of economic development in the host market, the higher the degree of involvement. H6: The greater the cultural differences between home and host countries, the lower the degree of involvement. H7: The greater the difference in regulations between the home country and the host country, the lower the degree of involvement. H8: The higher the political risk in the host country, the lower the degree of involvement. A questionnaire instrument was constructed using, wherever possible, validated measures of the concepts to serve the aims of this study. Following two sets of mailings, 112 usable completed questionnaires were returned. Correlation analysis and multiple regression analysis were used to analyze data. Statistically, the paper suggests that factors relating to the level of competition, competitive advantages and economic development are strong in influencing foreign market involvements. On the other hand, unexpectedly, cultural factors (especially individualism/collectivism and low and high power distance dimensions) proved to have weak moderating effects. The reason for this, in part, is due to the pervading forces of globalisation and the attendant effect on global marketing. This paper has contributed to the general literature in a way that point to two mainimplications. First, with respect to research on national systems, the study may hold out some important lessons especially for developing nations. Most of these nations are known to be actively seeking to understand what it takes to attract foreign direct investment, expand domestic market and move their economies from the margin to the mainstream global economy. Second, it should be realised that competitive conditions remain in constant flux (even in mature industries and mature economies). This implies that a range of home country factors may be as important as host country factors in explaining firms' strategic moves and the degree of foreign market involvement. Further research can consider the impact of the home country environment on foreign market involvement decisions. Such an investigation will potentially provide further perspectives not only on the influence of national origin but also how home country effects are confounded with industry effects.
This study identified the impact of childhood cancer on the Korean family. The purpose was to contribute knowledge for family nursing and pediatric hospice care practice with sick children and their families. This descriptive study was conducted during a 6 month period with children who were being treated for cancer at six university hospitals in Seoul. The data were gathered from members of 68 families ; 24(Group A), with a child newly diagnosed with cancer : 27(Group B), with a child under treatment and without complications, and 17 (Group C), with a child in relapse. Medical records, structured questionnaires and interviews were used for data collection. The questionnaires and interview schedules had been used previously in Martinson's research in the USA and China. The findings, conclusions, and suggestions are as follows. 1. The impact of childhood cancer on the family. Members of the family experienced fear, helplessness, guilty feelings, and anger at the time of the initial diagnosis and at relapse. Mothers complained of headache, anorexia and poor appetite, weight loss, sleep disturbance, and bad dreams. Many of the fathers either lost or changed jobs, and all working mothers stopped working. Half the parents reported changes in their marital relationships such as frequent quarrels but also stronger unity. Family members perceived cancer as the most frightening disease. Change in their world view was expressed as living on faith understanding suffering, determining to live a better life, wanting to live an upright life and valuing health as the most important. Religious activities are found most helpful through this difficult experience. Financial debt due to the treatment and care of the sick child, burdened 22 families. The above mentioned impact was most evidant in Group B(those presently undergoing treatment) and Group C(those in relapse). Findings indicate that nursing care should embrace the family of a child who is being treated for cancer. 2. Characteristics of the child with cancer The majority of the children in this sample had a diagnosis of leukemia. Their mean age was 6.8 and the ratio of boys to girls was 1.12 ; 1. The mean hospitalization frequency was 13.5 times and the mean duration of illness was 16.8 months. Most of 1.he children perceived cancer as the most frightening disease ; 32.7% of the children described their sickness as serious. Children in Group C were hospitalized more frequently, stayed in hospital for longer periods, and expressed their sickness as quite serious more often than the other two groups. These findings indicate how much comprehensive pediatric hospice nursing care services are needed along with relevant research and nursing education. 3. Characteristics of the families. The mean age of the father was 39.5 and the mother, 36,6 ; they are in their most productive life period. Mothers especially expressed feelings of financial uneasiness and powerlessness about giving up their jobs, and guilty feelings for not providing enough care and concern to other children due to taking care of the sick one. The burden of caring for the sick child can bring negative changes in family dynamics which they think provoke potential health problems in members of the family These findings suggest a need for nursing support and counselling resources. Findings also suggest the need for ethical inquiry about such questions as who should give information to the child in regard to diagnosis and prognosis, when, and how. Other suggestions included : 1) Quality health care for childhood cancer such as home care and pediatric hospice programs should be established. 2) Special and practical consideration for long-term patients should be made in the present insurance coverage. The reimbursement period for long-term patients should be lengthened. 3) Further in-depth qualitative studies are needed. 4) Education programs including guided practice experience for pediatric hospice care practitioners are needed.
Craniofacial region is a musculodentoskeletal system that consists of many anatomical structures ; cranioskeletal structures, dental arches, and formation and functions of masticatory muscles have close correlations. Growth and development of craniofacial region are influenced by not only hereditory factors, but also environmental factors such as craniofacial muscles and surrounding tissues. On the contrary, however, study on changes in functions or adaptations of craniofacial muscles following changes of craniofacial skeletal structures has been somewhat insufficient. The author's purpose was to observe correlations between masticatory muscular functions and change patterns according to cranial skeletal structures and occlusion patterns, for this, comparative study of muscle activity changes of preand post- orthognathic surgery states in skeletal Cl III malocclusion patients was peformed. The selected sample groups were 15 normal male patients, 15 skeletal Cl III pre-orthognatic surgery patients and 15 skeletal Cl III post-orthognatic surgery patients. For each sample groups, cephalometric x-ray taking, masticatory efficiency test and measurements of muscle activities in anterior temporal muscle, masseter and upper lip in rest, clenching, chewing and swallowing were carried out. The following results were obtained : 1. In resting state of mandible, pre-surgery malocclusion group showed higher m. activities in ant. temporalis, masseter and upper lip than post-surgery group. Post-surg. malocc. group showed significantly high m. activity only in upper lip compared to the normal group. 2. In clenching state, post-surg. malocc. group showed higher m. activities in ut. temporalis, masseter and upper lip than pre-surg. malocc. group. 3. In chewing state, post-surg. malocc. group showed higher m. activities in ant. temporalis and masseter than pre-surg. malocc. group, on the other hand, decreased upper lip activity was noticed. 4. In swallowing state, post-surg. malocc. group showed lower upper lip activity than pre-surg. malocc. group but higher than that of the normal group. No significant difference in m. activities of ant, temporalis and masseter was noticed among the three groups. 5. Masticatory efficiency was lower in pre-surg. malocc. group than normal group, masticatory efficiency showed an increase in post-surg. malocc. group compared to the pre-surg. malocc. group. However, both groups showed significant differences compared to the normal group.
The purpose of this paper is to review two recently reported, long-term studies of several chemical methods to control gingivitis and decalcification in adolescent orthodontic patients. The first study(gingivitis study) was designed to determine whether conventional toothbrushing and twice daily use of a brush-on 0.4 per cent $SnF_2$ gel containing more than 90 per cent available $Sn^{2+}$ would be more effective for controlling plaque accumulation and gingivitis in the presence of orthodontic appliances than conventional toothbrushing alone. The second study(decalcification study) was designed to compare the effectiveness of controlling decalcification in orthodontic patients with either a II00 ppm F tooth paste used alone, this same toothpaste and a 0.05 percent NaF rinse or this toothpaste and a 0.4 percent $SnF_2$ gel. In the gingivitis study, sixty-five consecutively treated adolescents who were to receive full-mouth fixed orthodontic appliances were assigned to two groups according to age and sex criteria. In the decalcification study an additional 30 subjects(95 total) were similarly assigned to a third group. The first group(control, n=35) used only toothbrushing with a standard fluoride(1100 ppm F) toothpaste. The second group used toothbrushing with a similar dentifrice supplemented with a 0.4 percent $SnF_2$ gel($SnF_2$ gel group, n=30) used twice daily for the entire 18-month study period. The third group(in the decalcification study only) used a similar toothpaste and 0.05 percent NaF rinse(NgF rinse group, n=30). Clinical assessments of plaque accumulation using the Plaque Index, gingival inflammation using the Gingival Index, and coronal staining were completed single-blinded before appliances were placed and 1, 3, 6, 9, 12 and 18 months after appliances were placed. Decalcification was assessed single blind on all labial surfaces of all erupted teeth before appliances were placed and 3 months after appliances were removed. The results of the gingivitis study indicated that the $SnF_2$ gel gorup had significantly lower scores for the Plaque Index(p<0.01) and Gingival Index(p<0.001) at all examinations during orthodontic treatment than did the control group. In the $SnF_2$ gel group, one subject developed mild coronal staining and two subjects developed moderate staining. In the decalcification study, when pre-treatment levels of decalcification were subtracted from post-treatment values, significantly lower decalcification scores(p<0.05) were found for both whole mouth and first molars in the NaF rinse and gel groups as compared with the control gorup(toothpaste alone). Although the gel group consistently had less decalcification than the rinse group, this difference only approached statistical significance.
The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.
The purpose of this study is to evaluate the reproducibility and errors in landmark identification of conventional lateral cephalometric radiography and digital lateral cephalometric radiography. Fifteen conventional lateral cephalometric radiographs and fifteen digital lateral cephalometric radiographs were selected in adults with no considerations on sex and craniofacial forms. Each landmark was identified and expressed as the coordinate (x, y). The landmarks were classified into 3 groups. The landmarks of the first identification was T1, identification after one week was T2, and identification after one month was T3. The mean and standard deviation of identification errors between replicates were calculated according to the x and y coordinates. The errors between first identification and second identification were expressed as T2-T1(x), T2-T1(y) and those between first identification and third identification were expressed as T3-T1(x), T2-T1(y). Each was divided into conventional lateral cephalometric radiography and digital lateral cephalometric radiography. The independent t- test was used for statistical analysis of identification errors for the evaluation of reproducibility. The results of this study were as follows ; 1. Generally, the mean and standard deviation of landmark identification errors in digital lateral cephalometric radiography was smaller than those of conventional lateral cephalometric radiography. 2. Only a few landmarks showed statistically significant difference in identification error between conventional lateral cephalometric radiography and digital lateral cephalometric radiography. 3. The enhancement of image quality didn't guarantee decrease in landmark identification error and didn't affect tendency of landmark identification error.
The aim of this study was to investigate experimentally the mechanical and histological effect of drilling process on the stability of micro-implant used for the orthodontic anchorage. For this purpose, 32 micro-implants(Osas$^{(R)}$, Epoch medical, ${\phi}$1.6 mm) were inserted into maxilla, mandible and palate in two beagle dogs. 16 micro-implants(8 per dog) were inserted after drilling with pilot drilling bur (drill method group). 16 micro-implants(8 per dog) were inserted without drilling (drill-free method group). After 1 week, micro-implants were loaded by means of Ni-Ti coil spring (Ni-Ti springs-extension$^{(R)}$, Ormco) with 200-300 gm force. Following 12 weeks, the micro-implants and the surrounding bone were removed. Before sacrifice, the mobilities were tested with Periotest$^{(R)}$(Siemens). Undecalcified serial sections with the long axis were made and the histologic evaluations were done. The results of this study were as follow ; 1. The osseointegration was found in both of drill-free method group and drill method group 2. Two of drill method group and one of drill-free method group in 32 micro-implants were lost after loading. 3. The mobilities of drill-free method group were less than drill method group 4. The bone contact on surface of micro-implants in drill-free method group was more than drill method group but there was no significant difference between groups. 5. The bone density in threads of micro-implants in drill-free method group was more than drill method group and there was significant difference between groups. These results suggest that drill-free method in insertion of micro-implants is superior to drill method on the stabilities, bone remodeling and osseointegrations under early loading.
Studies for diagnostic analysis using three-dimensional (3D) CT images are recently in progress and needs for 3D craniofacial analysis are increasing in the fields of orthodontics. It is especially essential to analyze the facial soft tissue after orthodontic treatment and orthognathic surgery. In this study 3D CT images of adults with normal occlusion were taken to analyze the facial soft tissue. Norms were obtained from CT images of adults with normal occlusion (12 males, 11 females) using a computer program named V works 4.0 program. 3D coordinate planes were established using soft tissue Nasion as the reference point and a total of 20 reproducible landmarks of facial soft tissue were obtained using the multiple reconstructive sectional images (axial, sagittal and coronal images) of the V works 4.0 program: soft tissue Nasion, Pronasale, Subnasale, Upper lip center, Lower lip center, soft tissue B, soft tissue Pogonion, soft tissue Menton, Endocanthion (Rt/Lt), Alare lateralis (Rt/Lt), Cheilion (Rt/Lt), soft tissue Gonion (Rt/Lt), Tragus (Rt/Lt), and Zygomatic point (Rt/Lt). According to the established landmarks and measuring method, the 3D CT images of adults with normal occlusion were measured and the normal positional measurements and their Net (${\delta}=\sqrt{{X^2}+{Y^2}+{Z^2}}$) values were obtained using V surgery program, In the linear measurement between landmarks, there was a significant difference between males and females except Na' -Sn and En(Rt)-En(Lt). The normal ranges of Na'-Zy, Na'-Ch and Na'-Go' (facial depth) were obtained, which was difficult to measure by two-dimensional (2D) cephalometric analysis and facial photographs. These data may be used as references for 3D diagnosis and treatment planning for patients with malocclusion and dentofacial deformity.
This study was undertaken to investigate the distribution of the chewing side preference and variations in the maximum bite force and facial morphology according to chewing side preference since unilateral chewing may cause morphologic and functional anomalies. 50 dental students who had no signs or symptoms of masticatory system and Angle's Class I relationship in posterior segments were selected, and divided into two groups, that is, 25 in bilateral chewing group(19 male and 6 female) and 25 in unilateral chewing group(10 male and 15 female). Maximum bite force was estimated ana posteroanterior cephalogram were measured ana statistically analyzed. The results were as follows : 1. Their were more students with bilateral chewing side preference($68\%$) and unilateral chewing side group consisted of right side preference($68\%$) and left side preference($32\%$). 2. There was no significant difference in the strength of max. bite force between the right and left side in bilateral chewing group. The bite force of the chewing side nab greater in the unilateral chewing group but less in the non-chewing side compared to those of bilateral chewing group with Bo significant difference. Max. bite force of chewing side was greater than that of non-chewing side in the unilateral chewing group(Female p<0.05). Max. bite force of males was about twice in that of females in both groups(p<0.05). Max. bite force of chewing side of the unilateral chewing group was similar to that of the bilateral chewing group, but that of non-chewing side was less than that of the bilateral chewing group. 3. In comparison of the facial morphology, there was no statistically significant difference in the size between the right and left side of the bilateral chewing group and between chewing and non-chewing side of the unilateral chewing group.
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