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An experimental study on the impact of an agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers and enhance their self-confidence and satisfaction in maternal role performance (산욕초기 초산모의 간호목표달성방번 합의가 어머니 역할수행에 대한 자신감 및 만족도에 미치는 영향에 관한 실험적 연구)

  • 이영은
    • Journal of Korean Academy of Nursing
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    • v.22 no.1
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    • pp.81-115
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    • 1992
  • The problem addressed by this study was to determine the effect of nurse - patient agreement on the means to achieve nursing goals in the early postpartum period of primiparous mothers. It was hypothesized that the experimental treatment would result in hegher self-confidence and satisfaction in maternal role performance. This purpose was to contribute to the planning of nursing care to enhance self- confidence and satisfaction in maternal role performance and to the development of relevant nursing theory. Especially, the early postpartum period is crucial toward in recovery from childbirth and attainment of the maternal role. Maternal role attaintment is a complex social and cognitive process of stimulus -response accomplished by learning. Most women attain the maternal role sucessfully. But, some primiparous mothers experience difficultites in attainment of the maternal role due to lack of experience and knowledge. Self-confidence and satisfaction in maternal role performance are important factors in attainment and adjustment to the maternal role (Mercer, 1981a, 1981b ; Lederman, Weigarten, and Lederman, 1981 :Bobak and Jensen, 1985). Nursing is defined as behaviors of nurses add patients that attain nursing goals through action, reaction, interaction, and transaction. For attainment of nursing goals, active participating transactions must occur by agreement on the means to achieve those goals through nurse -patient mutual goal setting and establishment of their active relationships(King, 1981, Ha, 1977). Based on King's theory of goal attainment (1981), this stuy was planned as a non-equivalent control group, non -synchronized quasi -experimental design using agreement on the means to achieve nursing goals in early postpartum as the experimental treatment. The data were collected from July 20 to Sep. 1, 1991 by questionnaires with 60 primiparous mothers planing to breast feed after normal deliveries at W hospital in Pusan, Korea. The subjects were divided into a control group(conventional group) -those admitted from July 20 to Aug. 12, and an experimental group(agreement group) - those admitted from Aug. 13 to Sep. 1. The instument for agreement on the means to nursing goals in the early postpartum period included five steps - identification of disturbances of problems through action, reaction, and interaction with primiparous mothers : mutual early postpartal nursing goal setting : exploration of the means to achieve goals ; agreement on the means (self- care, ealry maternal -infant contact, performance of mothering behavior, and communicating about the infant's behavior and health condition) : implementation of the means. This instrument was developed on the basis of King's elements that lead to transactions in nurse-patient interactions. Lederman et al's (1981) scale for Confidence in ability to cope with tasks of motherhood and Lederman et al's(1981) scale for Mother's satisfaction with motherhood and infant care were used to measure self-confidence and satisfaction in maternal role performance ·with the subjects immediately after admission and on the day of discharge. Self-care performance in the experimental group was measured by self -evaluation tool developed by the investigator from the literature concerned. The tools to measure Pelf-confidence and satisfaction in maternal role performance, and the tool to measure self-evaluation of self-care performance were tested for internal reliability. Cronbach's Alphas were 0.94, 0.94, and 0.63. The data were analysed by using in S.P.S.S. computerized program and included percentage, x²-test, t-test, ANOVA, and Pearson Correlation Coefficient. The conclusions obtained from this study are summerized as follows : 1. The degree of self-confidence in maternal role performance of the total subjects group measured before the experimental treatment was above average with a mean score of 2.77(range 2.14-3.64). Out of 14 items, those with relatively high mean scores were ‘I would like to be a better mother than I am’(3.95), and ‘I have my doubts about whether I am a good mother’(2.87). Those with low mean scores were ‘I know that my baby wants most of the times’(2.28), ‘When the baby cries, I can tell what she /he wants’(2.37), and ‘I have confidence in my ability to care for the baby’(2;50). That is, the self - confidence of Primiparous mothers was considerably high in mothering, but rather low in activities concerning the infant care and understanding of the infant behavior. The degree of satisfaction in maternal role performance of the total subjects group measured before the experimental treatment was high with a mean score of 3.18(range 1.92-3.92). Out of 13 items, those with relatively high mean scores were ‘I am glad 1 had this baby now’(3.75), ‘I play with the baby between feedings when s/he is awake and quiet’(3.67), and ‘I enjoy being a mother’(3.27). Those with low mean scores were ‘I am upset about having too many responsibilities as a mother’(2.78), ‘It bothers me to get up for the baby at night’(2.82), and ‘I get annoyed if the baby frequently interrupts my activities’.(2.82), That is, the satisfaction of primiparous mothers was considerably high in mothering and infant care, but rather low in restraints in time or on the mother's self accomplishment and development. 2. Agreement on the means to achieve nursing goals in the early postpartum period included process of mutual goal setting, exploration of the means to achieve goals, and ahreement in concert means to achieve goals based on the mothers' condition, concerns, self-perception of the nurse - patient interactions. In the process of agreement, there was agreement that the means to achieve goals should be through trust and establishment of active relationships with the nurse through identification of problems according to planned nursing goals and active interaction, such as explanations, teaching, changing of opinions, acceptance or rejection of explanations, and proposing of questions. Therefore agreement on the means to achieve nursing goals in the early postpartum period appears to be an effective nursing intervention for primiparous mothers. 3. The degree of self- confidence in maternal role performance of the exprimental group was higher than that of the control group(t=3.95, p<0.01). Out of 14 items, those with higher score in the experimental group were ‘I would like to be a better mother than I am’(t=1.93, p<0.05), ‘I know that my baby wants most of the times’(t=2.75, p<0.01), ‘When the baby cries, 1 can tell what she/he wants’(t=2.10, p<0.05), ‘I have confidence in my ability to care for the baby’(t=3.72, p<0.01), ‘I trust my own judement in deciding how to care for the baby’(t=1.96, p<0.05), ‘I feel that I know my baby and what to do for him /her’(t=2.44, p<0.01), ‘I am concerned about being able to meet the baby's needs’(t=2.87, p<0.01), ‘I know what my baby likes and dislikes’(t=3.26, p<0.01), ‘I don't know to care for the baby as well as I should’(t=2.07, p<0.05), and ‘I am unsure about whether I give enough attention to the baby’(t=3.04, p<0.01), That is, the degree of self-confidence in mothering, activities concerning infant care, and understanding of infant behavior of the experimental group was higher than that of the control group. Therefore, the first hypothesis, that the degree of self-confidence in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=3.95, p<0.01). 4. The degree of satisfaction in the maternal role performance of the exprimental group was higer than that or the control group(t=2.31, p<0.05). Out of 13 items, those with higher score in the experimental group were ‘I am glad I had this baby now’(t=2.29, p<0.05), ‘I enjoy taking care of the baby’(t=2.4g, p<0.01), ‘It is boring for me to care for the baby and do the same thing over and over’(t=2.87, P<0.01), ‘I am unhappy with the amount of time I have for activities other than childcare’(t=2.51, p<0.01), and ‘When bathing and diapering the baby, I would like to be doing something else’(t=2.43, p<0.01). That is, the degree of satisfaction in mothering, infant care, and restraints in time of on the mother's self accomplishment and development in the experimental group was higher than that of the control group. Therefore, the second hypothesis, that the degree of satisfaction in maternal role performance of the experimental group would be higher than that of the control group, was supported(t=2.31, p<0.05). 5. The third hypothesis, that the higher the degree of satisfaction in materenal role performance, the higher the degree of self-confidence in materenal role performance in the experimental group, was supported (r=0.57, p<0.01)

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Research Framework for International Franchising (국제프랜차이징 연구요소 및 연구방향)

  • Kim, Ju-Young;Lim, Young-Kyun;Shim, Jae-Duck
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.61-118
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    • 2008
  • The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.

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The Effects of Perceived Quality Factors on the Customer Loyalty: Focused on the Analysis of Difference between PB and NB (지각된 품질요인이 고객충성도에 미치는 영향: PB와 NB간의 차이분석)

  • Ye, Jong-Suk;Jun, So-Yon
    • Journal of Distribution Research
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    • v.15 no.2
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    • pp.1-34
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    • 2010
  • Introduction As consumers' purchase behavior change into a rational and practical direction, the discount store industry came to have keen competition along with rapid external growth. Therefore as a solution, distribution businesses are concentrating on developing PB(Private Brand) which can realize differentiation and profitability at the same time. And as improvement in customer loyalty beyond customer satisfaction is effective in surviving in an environment with keen competition, PB is being used as a strategic tool to improve customer loyalty. To improve loyalty among PB users, it is necessary to develop PB by examining properties of a customer group, first of all, quality level perceived by consumers should be met to obtain customer satisfaction and customer trust and consequently induce customer loyalty. To provide results of systematic analysis on relations between antecedents influenced perceived quality and variables affecting customer loyalty, this study proposed a research model based on causal relations verified in prior researches and set 16 hypotheses about relations among 9 theoretical variables. Data was collected from 400 adult customers residing in Seoul and the Metropolitan area and using large scale discount stores, among them, 375 copies were analyzed using SPSS 15.0 and Amos 7.0. The findings of the present study followed as; We ascertained that the higher company reputation, brand reputation, product experience and brand familiarity, the higher perceived quality. The study also examined the higher perceived quality, the higher customer satisfaction, customer trust and customer loyalty. The findings showed that the higher customer satisfaction and customer trust, the higher customer loyalty. As for moderating effects between PB and NB in terms of influences of perceived quality factors on perceived quality, we can ascertain that PB was higher than NB in the influences of company reputation on perceived quality while NB was higher than PB in the influences of brand reputation and brand familiarity on perceived quality. These results of empirical analysis will be useful for those concerned to do marketing activities based on a clearer understanding of antecedents and consecutive factors influenced perceived quality. At last, discussions about academical and managerial implications in these results, we suggested the limitations of this study and the future research directions. Research Model and Hypotheses Test After analyzing if antecedent variables having influence on perceived quality shows any difference between PB and NB in terms of their influences on them, the relation between variables that have influence on customer loyalty was determined as Figure 1. We established 16 hypotheses to test and hypotheses are as follows; H1-1: Perceived price has a positive effect on perceived quality. H1-2: It is expected that PB and NB would have different influence in terms of perceived price on perceived quality. H2-1: Company reputation has a positive effect on perceived quality. H2-2: It is expected that PB and NB would have different influence in terms of company reputation on perceived quality. H3-1: Brand reputation has a positive effect on perceived quality. H3-2: It is expected that PB and NB would have different influence in terms of brand reputation on perceived quality. H4-1: Product experience has a positive effect on perceived quality. H4-2: It is expected that PB and NB would have different influence in terms of product experience on perceived quality. H5-1: Brand familiarity has a positive effect on perceived quality. H5-2: It is expected that PB and NB would have different influence in terms of brand familiarity on perceived quality. H6: Perceived quality has a positive effect on customer satisfaction. H7: Perceived quality has a positive effect on customer trust. H8: Perceived quality has a positive effect on customer loyalty. H9: Customer satisfaction has a positive effect on customer trust. H10: Customer satisfaction has a positive effect on customer loyalty. H11: Customer trust has a positive effect on customer loyalty. Results from analyzing main effects of research model is shown as

    , and moderating effects is shown as
    . Results This study is designed with 16 research hypotheses, Results from analyzing their main effects show that 9 of 11 hypotheses were supported and other 2 hypotheses were rejected. On the other hand, results from analyzing their moderating effects show that 3 of 5 hypotheses were supported and other 2 hypotheses were rejected. H1-1: (SPC: Standardized Path Coefficient)=-0.04, t-value=-1.04, p>. 05). H1-2: (${\Delta}\chi^2$=1.10, df=1, p> 0.05). H1-1 and H1-2 are rejected, so it is prove that perceived price is not a significant decision variable having influence on perceived quality and there is no significant variable between PB and NB in terms of influence of perceived price on perceived quality. H2-1: (SPC=0.31, t-value=3.74, p<. 001). H2-2: (${\Delta}\chi^2$=3.93, df=1, p< 0.05). H2-1 and H2-2 are supported, so it is proved that company reputation is a significant decision variable having influence on perceived quality and, in terms of influence of company reputation on perceived quality, PB has relatively stronger influence than NB. H3-1: (SPC=0.26, t-value=5.30, p< .001). H3-2: (${\Delta}\chi^2$=16.81, df=1, p< 0.01). H3-1 and H3-2 are supported, so it is proved that brand reputation is a significant decision variable having influence on perceived quality and, in terms of influence of brand reputation on perceived quality, NB has relatively stronger influence than PB. H4-1: (SPC=0.31, t-value=2.65, p< .05). H4-2: (${\Delta}\chi^2$=1.26, df=1, p> 0.05). H4-1 is supported, but H4-2 is rejected, Therefore, it is proved that product experience is a significant decision variable having influence on perceived quality and, on the other hand, there is no significant different between PB and NB in terms of influence of product experience on product quality. H5-1: (SPC=0.24, t-value=3.00, p<. 05). H5-2: (${\Delta}\chi^2$=5.10, df=1, p< 0.05). H5-1 and H5-2 are supported, so it is proved that brand familiarity is a significant decision variable having influence on perceived quality and, in terms of influence of brand familiarity on perceived quality, NB has relatively stronger influence than PB. H6: (SPC=0.91, t-value=19.06, p< .001). H6 is supported, so a fact that customer satisfaction increases as perceived quality increases is proved. H7: (SPC=0.81, t-value=7.44, p<. 001). H7 is supported, so a fact that customer trust increases as perceived quality increases is proved. H8: (SPC=0.57, t-value=7.87, p< .001). H8 is supported, so a fact that customer loyalty increases as perceived quality increases is proved. H9: (SPC=0.08, t-value=0.76, p> .05). H9 is rejected, so it is proved influence of customer satisfaction on customer trust is not significant. H10: (SPC=0.21, t-value=4.34, p< .001). H10 is supported, so a fact that customer loyalty increases as customer satisfaction increases is proved. H11: (SPC=0.40, t-value=5.68, p< .001). H11 is supported, so a fact that customer loyalty increases as customer trust increases is proved. Implications Although most of existing studies have used function, price, brand, design, service, brand name, store name as antecedent variables for perceived quality, this study used different antecedent variables in order to analyze and distinguish purchase group PB and NB through preliminary research. Therefore, this study may be used as preliminary data for a empirical study that is designed to be helpful for practical jobs. Also, this study is made to be easily applied to any practical job because SEM(Structural Equation Modeling), most strongly explaining the relation between observed variable and latent variable, is used for this study. This study suggests a new strategic point that, in order to increase customer loyalty, customer's perceived quality level should satisfied for inducing customer satisfaction, customer trust, and customer loyalty. Therefore, after finding an effective differentiating factors in perceived quality in order to increase customer loyalty through increasing perceived quality, this factor was made to be applied to PB and NB. Because perceived quality factors which is recognized as being important by consumers is different between PB and NB, this study suggests how to efficiently establish marketing strategy by enhancing a factor. Companies have mostly focused on profitability in terms of analyzing customer loyalty, but this study included positive WOM(word of mouth). Hence, this study suggests that it would be helpful for establishing customer loyalty when consumers have cognitive satisfaction and emotional satisfaction together. Limitations This study used variables perceived price, company reputation, brand reputation, product experience, brand familiarity in order to determine whether each constituent factor has different influence on perceived quality between purchase group PB and NB. These characteristic variables are made up on the basis of the preliminary research, but it is expected that more precise research result would be obtained if additional various variables are included in study. This study selected a practical product that is non-durable, low-priced and bestselling product in a discount store through the preliminary research because it can be easily estimated by consumers. Therefore. generalization of study would be more easily obtained if more various product characteristics is included. Regarding a sample used in this study, it was only based on consumers who purchase products in a large-scale discount store located in Seoul and in the capital area. Accordingly, this sample has some geographical limitation, If a study is expanded by including more areas, more representative research results may be produced. Because this study is only designed to analyze consumers who purchase a product in a large-scale discount store, some difference may be found according to characteristics of each business type. In other words, there is certainly some application limitation, so research result from this study may not be applied to other business types. Future research may have fruitful results if it adjusts a variable to each business type.

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  • Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

    • Loh, In-Kyu
      • Journal of agricultural medicine and community health
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      • v.1 no.1
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      • pp.5-9
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      • 1976
    • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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    The Characteristic of Laws on the Kind of Urban Green Spaces and the Legal Requirements for the Green Spaces of Urban Habitat in China (중국의 도시녹지 종류와 도시거주구 녹지의 설치 기준에 관한 법제도의 현황과 특성)

    • Shin, Ick-Soon
      • Journal of the Korean Institute of Landscape Architecture
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      • v.41 no.3
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      • pp.1-11
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      • 2013
    • This study investigated Chinese Laws on the kind of urban green spaces and the legal requirements for the green spaces of urban habitat and analyzed the specificities of them intending to provide basic data to suggest bringing in or not the relevant Chinese Laws to Korea. This study can be summarized as follows: First, the concept of Chinese urban green spaces(g.s.) classified by 5 kinds(park g.s., production g.s., protection g.s., attachment g.s., the others g.s.) placed the park and green spaces in the same category unlike the Korean urban green spaces that only distinguishes between park and green spaces. The Chinese Urban Park is classified by 4 kinds(composite park, community park, special park, linear park) at the 'Standard for urban green spaces classification' which is below in rank of the legal system. Second, in case of calculation for green spaces ratio of urban green spaces in China, the green rooftop landscaping area should not be included as a green spaces area except the rooftop of a basement or semi basement building to which residents have easy access. The green spaces requirements and compulsory secure ratio by 3 habitat kinds(habitat, small habit, minimum habitat) of when to act as a residential plan is regulated. Third, the green spaces system is obligated to establish at habitat green spaces plan and is specified to conserve and improve existing trees and green spaces. The green spaces ratio on reconstruction for old habitat is relaxed to be lower than for new habitat and a gradient of green spaces is peculiarly clarified. The details and requirements for establishment and the minimum area intending for each classes of the central green spaces(habitat park, children park, minimum habitat's green spaces) are regulated. Especially at a garden style of minimum habitat's green spaces, intervals between the south and north houses and a compulsory security for green spaces area classifying into two groups(closing type green spaces and open type green spaces) by a middle-rise or high-rise building are clarified. System of calculation for green spaces area is presented at a special regulation. Fourth, a general index(area/person) of public green spaces within habitat to achieve by 3 habitat kinds is determined, in this case, the index on reconstruction for a deterioration zone can be relaxed to be lower to the extent of a specified quantity. A location and scale, minimum width and minimum area per place of public green spaces are regulated. A space plot principle including adjacent to a road, greening area ratio against total area, security of open space and the shadow line boundary of sunshine are also regulated to intend for public green spaces. Fifth, the minimum horizontal distance between the underground cables and the surrounding greening trees are regulated as the considerable items for green spaces when setting up the underground cables. The principle to establish green spaces within public service facilities is regulated according to the kind of service contents. It shall be examined in order to import or not the special regulations that only exist in Chinese Laws but not in Korean Laws. The result of this study will contribute to gain the domestic landscape architect's' sympathy of the research related to Chinese urban green spaces laws requiring immediate attention and will be a good chance to advance into the internationalization of Korean Landscape Architectural Laws.

    Investigation on Daily Life and Consciousness of Longevous People in Korea - (II) On Social Life and Daily Life Habit of Longevous People in the Past - (우리나라 장수자(長壽者)의 생활(生活) 및 의식조사(意識調査)에 관한 연구(硏究) - 장수지역(長壽地域)의 과거(過去) 사회생활(社會生活)과 일상생활습관(日常生活習慣) -)

    • Choi, Jin-Ho;Pyeun, Jae-Hyeung;Rhim, Chae-Hwan;Yang, Jong-Soon;Kim, Soo-Hyun;Kim, Jeung-Han;Lee, Byeong-Ho;Woo, Soon-Im;Choe, Sun-Nam;Byun, Dae-Seok
      • Journal of the Korean Society of Food Culture
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      • v.1 no.3
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      • pp.183-196
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      • 1986
    • This study was designed to be link in the chain of the investigation on daily life and consciousness of longevous people in Korea, and to investigate the social life and daily life habit in the past of longevous people. The social life and daily life habit were surveyed on 379 subjects (male 121, female 258) of the aged who were above 80 years of age, from June to November in 1985. 1. 'Generally regular' in the rising time and bedtime between 40 and 60 years of longevous people had the highest figures of 81.8% and 63.1%, respectively. The longevous peoples of 59.4% got up by before 6 a.m., and 61.3% of these aged went to bed from 9 to 11 p.m. But there was no significant difference between male and female. 2. Of the occupation engaged in the longest term of longevous people, the self-management (86.3%) included farming, fishing and household affairs was the highest, whereas administrative position, small-scale management and white-collar worker were only 0.8%, 0.8% and 1.8%, respectively. Therefore, their work involved mainly physical labor (heavy 48.5%, light 47.2%), and mental work was only 2.8% of longevous people. It is believed that this fact was deeply related to the educational degree of them. 3. The longevous people of 58.3% retired from the occupation and household affairs abover 70 years of age, and especially 24.3% of them is including the aged above 80 years of age. 4. The longevous people of 57.2% were shared the role in the home after retirement from the occupation and household affairs, whereas 35.9% of them didn't share. Of the way in killing time in case having no role in the home, 'at home'(50.0%) was the highest, and decreased in the order of 'old people's home' (30.9%), 'ill in bed' (10.3%) and 'asylum for the aged' (8.8%). 5. The acquaintance frequency before retirement from the occupation and household affairs of longevous people showed in the order of 'wide' (38.5%), 'common' (38.0%) and 'narrow' (19.0%), and 56.5% of them had the acquaintance after retirement. 6. Only the longevous people of 38.5% had the hobby and recreation activities of 'more than once' after retirement from the occupation and household affairs, but 53.0% of them was none. Of the kinds of hobby and/or recreation, 'TV-watching' (79.2%) was the highest, and decreased in the order of 'talking with grandchild' (54.2 %), 'working at home' (35.4%), 'religion' (25.0%) and 'chess etc.' (18.1%).

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    Extension Method of Association Rules Using Social Network Analysis (사회연결망 분석을 활용한 연관규칙 확장기법)

    • Lee, Dongwon
      • Journal of Intelligence and Information Systems
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      • v.23 no.4
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      • pp.111-126
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      • 2017
    • Recommender systems based on association rule mining significantly contribute to seller's sales by reducing consumers' time to search for products that they want. Recommendations based on the frequency of transactions such as orders can effectively screen out the products that are statistically marketable among multiple products. A product with a high possibility of sales, however, can be omitted from the recommendation if it records insufficient number of transactions at the beginning of the sale. Products missing from the associated recommendations may lose the chance of exposure to consumers, which leads to a decline in the number of transactions. In turn, diminished transactions may create a vicious circle of lost opportunity to be recommended. Thus, initial sales are likely to remain stagnant for a certain period of time. Products that are susceptible to fashion or seasonality, such as clothing, may be greatly affected. This study was aimed at expanding association rules to include into the list of recommendations those products whose initial trading frequency of transactions is low despite the possibility of high sales. The particular purpose is to predict the strength of the direct connection of two unconnected items through the properties of the paths located between them. An association between two items revealed in transactions can be interpreted as the interaction between them, which can be expressed as a link in a social network whose nodes are items. The first step calculates the centralities of the nodes in the middle of the paths that indirectly connect the two nodes without direct connection. The next step identifies the number of the paths and the shortest among them. These extracts are used as independent variables in the regression analysis to predict future connection strength between the nodes. The strength of the connection between the two nodes of the model, which is defined by the number of nodes between the two nodes, is measured after a certain period of time. The regression analysis results confirm that the number of paths between the two products, the distance of the shortest path, and the number of neighboring items connected to the products are significantly related to their potential strength. This study used actual order transaction data collected for three months from February to April in 2016 from an online commerce company. To reduce the complexity of analytics as the scale of the network grows, the analysis was performed only on miscellaneous goods. Two consecutively purchased items were chosen from each customer's transactions to obtain a pair of antecedent and consequent, which secures a link needed for constituting a social network. The direction of the link was determined in the order in which the goods were purchased. Except for the last ten days of the data collection period, the social network of associated items was built for the extraction of independent variables. The model predicts the number of links to be connected in the next ten days from the explanatory variables. Of the 5,711 previously unconnected links, 611 were newly connected for the last ten days. Through experiments, the proposed model demonstrated excellent predictions. Of the 571 links that the proposed model predicts, 269 were confirmed to have been connected. This is 4.4 times more than the average of 61, which can be found without any prediction model. This study is expected to be useful regarding industries whose new products launch quickly with short life cycles, since their exposure time is critical. Also, it can be used to detect diseases that are rarely found in the early stages of medical treatment because of the low incidence of outbreaks. Since the complexity of the social networking analysis is sensitive to the number of nodes and links that make up the network, this study was conducted in a particular category of miscellaneous goods. Future research should consider that this condition may limit the opportunity to detect unexpected associations between products belonging to different categories of classification.

    Research on The Utility of Acquisition of Oblique Views of Bilateral Orbit During the Dacryoscintigraphy (눈물길 조영검사 시 양측 안 와 사위 상 획득의 유용성에 대한 연구)

    • Park, Jwa-Woo;Lee, Bum-Hee;Park, Seung-Hwan;Park, Su-Young;Jung, Chan-Wook;Ryu, Hyung-Gi;Kim, Ho-Shin
      • The Korean Journal of Nuclear Medicine Technology
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      • v.18 no.1
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      • pp.76-81
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      • 2014
    • Purpose: Diversity and the lachrymal duct deformities and the passage inside the nasal cavity except for anterior image such as epiphora happens during the test were able to express more precisely during the dacryoscintigraphy. Also, we thought about the necessity of a method to classify the passage into the naso-lachrymal duct from epiphora. Therefore, we are to find the validity of the method to obtain both oblique views except for anterior views. Materials and Methods: The targets of this research are 78 patients with epiphora due to the blockage at the lachrymal duct from January 2013 to August 2013. Average age was $56.96{\pm}13.36$. By using a micropipette, we dropped 1-2 drops of $^{99m}TcO4^-$ of 3.7 MBq (0.1 mCi) with $10{\mu}L$ of each drop into the inferior conjunctival fold, then we performed dynamic check for 20 minutes with 20 frames of each minute. In case of we checked the passage from both eyes to nasal cavity immediately after the dynamic check, we obtained oblique view immediately. If we didn't see the passage in either side of the orbit, we obtained oblique views of the orbit after checking the frontal film in 40 minutes. The instrument we used was Pin-hole Collimator with Gamma Camera(Siemens Orbiter, Hoffman Estates, IL, USA). Results: Among the 78 patients with dacryoscintigraphy, 35 patients were confirmed with passage into the nasal cavity from the anterior view. Among those 35 patients, 15 patients were confirmed with passage into the nasal cavity on both eyes, and it was able to observe better passage patterns through oblique view with a result of 8 on both eyes, 2 on left eye, and 1 on right eye. 20 patients had passage in left eye or right eye, among those patients 10 patients showed clear passage compared to the anterior view. 13 patients had possible passage, and 30 patients had no proof of motion of the tracer. To sum up, 21 patients (60%) among 35 patients showed clear pattern of passage with additional oblique views compared to anterior view. People responded obtaining oblique views though 5 points scale about the utility of passage identification helps make diagnoses the passage, passage delayed, and blockage of naso-lachrymal duct by showing the well-seen portions from anterior view. Also, when classifying passage to naso-lachrymal duct and flow to the skin, oblique views has higher chance of classification in case of epiphora (anterior:$4.14{\pm}0.3$, oblique:$4.55{\pm}0.4$). Conclusion: It is considered that if you obtain oblique views of the bilateral orbits in addition to anterior view during the dacryoscintigraphy, the ability of diagnose for reading will become higher because you will be able to see the areas that you could not observe from the anterior view so that you can see if it emitted after the naso-lachrymal duct and the flow of epiphora on the skin.

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    The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포 폐암에 대한 과분할 방사선 치료의 성적)

    • Hur, Won-Joo;Lee, Hyung-Sik;Kim, Jeong-Ki;Choi, Young-Min;Lee, Ho-Jun;Youn-Seon-Min;Kim, Jae-seok;Kim, Hyo-Jin;Woo-Jong-Soo;Choi, Pill-Jo;Lee, Ki-Nam
      • Radiation Oncology Journal
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      • v.16 no.3
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      • pp.275-282
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      • 1998
    • Purpose : The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis. Materials & Methods : We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively. Results : The overall survival rate was 53 1$\%$ in 1 year, 9.9$\%$ in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0$\%$ in 1 year, 8.9$\%$ in 2 years. Twenty two Patients were classified as complete responders to this treatment and their MST was 19.5 months When this was compared with that of partial responders (MST: 11 7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3$\%$, 2yr 16.8$\%$) than IIIB patients (1yr 43.3$\%$, 2yr 3.6$\%$), which was also statistically significant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3$\%$, 2yr 21.4$\%$) than that of squamous cell counterpart (1yr 49.4$\%$, 2yr 7.4$\%$), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis. Conclusion : Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.

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    Resolving the 'Gray sheep' Problem Using Social Network Analysis (SNA) in Collaborative Filtering (CF) Recommender Systems (소셜 네트워크 분석 기법을 활용한 협업필터링의 특이취향 사용자(Gray Sheep) 문제 해결)

    • Kim, Minsung;Im, Il
      • Journal of Intelligence and Information Systems
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      • v.20 no.2
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      • pp.137-148
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      • 2014
    • Recommender system has become one of the most important technologies in e-commerce in these days. The ultimate reason to shop online, for many consumers, is to reduce the efforts for information search and purchase. Recommender system is a key technology to serve these needs. Many of the past studies about recommender systems have been devoted to developing and improving recommendation algorithms and collaborative filtering (CF) is known to be the most successful one. Despite its success, however, CF has several shortcomings such as cold-start, sparsity, gray sheep problems. In order to be able to generate recommendations, ordinary CF algorithms require evaluations or preference information directly from users. For new users who do not have any evaluations or preference information, therefore, CF cannot come up with recommendations (Cold-star problem). As the numbers of products and customers increase, the scale of the data increases exponentially and most of the data cells are empty. This sparse dataset makes computation for recommendation extremely hard (Sparsity problem). Since CF is based on the assumption that there are groups of users sharing common preferences or tastes, CF becomes inaccurate if there are many users with rare and unique tastes (Gray sheep problem). This study proposes a new algorithm that utilizes Social Network Analysis (SNA) techniques to resolve the gray sheep problem. We utilize 'degree centrality' in SNA to identify users with unique preferences (gray sheep). Degree centrality in SNA refers to the number of direct links to and from a node. In a network of users who are connected through common preferences or tastes, those with unique tastes have fewer links to other users (nodes) and they are isolated from other users. Therefore, gray sheep can be identified by calculating degree centrality of each node. We divide the dataset into two, gray sheep and others, based on the degree centrality of the users. Then, different similarity measures and recommendation methods are applied to these two datasets. More detail algorithm is as follows: Step 1: Convert the initial data which is a two-mode network (user to item) into an one-mode network (user to user). Step 2: Calculate degree centrality of each node and separate those nodes having degree centrality values lower than the pre-set threshold. The threshold value is determined by simulations such that the accuracy of CF for the remaining dataset is maximized. Step 3: Ordinary CF algorithm is applied to the remaining dataset. Step 4: Since the separated dataset consist of users with unique tastes, an ordinary CF algorithm cannot generate recommendations for them. A 'popular item' method is used to generate recommendations for these users. The F measures of the two datasets are weighted by the numbers of nodes and summed to be used as the final performance metric. In order to test performance improvement by this new algorithm, an empirical study was conducted using a publically available dataset - the MovieLens data by GroupLens research team. We used 100,000 evaluations by 943 users on 1,682 movies. The proposed algorithm was compared with an ordinary CF algorithm utilizing 'Best-N-neighbors' and 'Cosine' similarity method. The empirical results show that F measure was improved about 11% on average when the proposed algorithm was used

    . Past studies to improve CF performance typically used additional information other than users' evaluations such as demographic data. Some studies applied SNA techniques as a new similarity metric. This study is novel in that it used SNA to separate dataset. This study shows that performance of CF can be improved, without any additional information, when SNA techniques are used as proposed. This study has several theoretical and practical implications. This study empirically shows that the characteristics of dataset can affect the performance of CF recommender systems. This helps researchers understand factors affecting performance of CF. This study also opens a door for future studies in the area of applying SNA to CF to analyze characteristics of dataset. In practice, this study provides guidelines to improve performance of CF recommender systems with a simple modification.


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