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Presenteeism in Agricultural, Forestry and Fishing Workers: Based on the 6th Korean Working Conditions Survey (농업, 임업 및 어업 종사자에서의 프리젠티즘: 제6차 근로환경조사를 바탕으로)

  • Sang-Hee Hong;Eun-Chul Jang;Soon-Chan Kwon;Hwa-Young Lee;Myoung-Je Song;Jong-Sun Kim;Mid-Eum Moon;Sang-Hyeon Kim;Ji-Suk Yun;Young-Sun Min
    • Journal of agricultural medicine and community health
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    • v.49 no.1
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    • pp.1-12
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    • 2024
  • Objectives: Presenteeism is known to be a much more economically damaging social cost than disease rest while going to work despite physical pain. Since COVID-19, social discussions on the sickness benefit have been taking place as a countermeasure against presenteeism, and in particular, farmers and fishermen do not have an institutional mechanism for livelihood support when a disease other than work occurs. This study attempted to examine the relationship between agricultural, fishing, and forestry workers and presenteeism using the 6th Korean Work Conditions Survey. Methods: From October 2020 to January 2021, data from the 6th working conditions survey conducted on 17 cities and provinces in Korea were used, and a total of 34,981 people were studied. Control variables were gender, age, self-health assessment, education level, night work, shift work, monthly income, occupation, working hours per week, and employment status. Results: As a result of the analysis, farmers and fishermen showed the characteristics of the self-employed and the elderly, and as a result of the regression analysis, when farmers and fishermen analyzed the relationship with presenteeism tendency compared to other industry workers, farmers and fishermen increased by 23% compared to other industry groups. Conclusion: This study is significant in that it has representation by utilizing the 6th working conditions survey and objectively suggests the need for a sickness benefit for farmers and fishermen who may be overlooked in the sickness benefit.

Thoracoscopic Diaphragmatic Plication Using Three 5 mm Ports (흉강경하 횡경막 주름성형술: 작업창없이 3개의 포트를 이용한 수술법)

  • Kim, Do-Hyung;Kim, Kil-Dong;Hwang, Jung-Joo;Choi, Jin-Ho;Lee, Jun-Wan
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.513-517
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    • 2010
  • Background: Diaphragmatic plication through a thoracoscopic approach has been an effective modality to treat diaphragmatic enventration. However, the conventional technique for thoracoscopic plication has some disadvantages. We have developed an improved and simplified technique with utilizing the head up position, $CO_2$ insufflation and figure-of-eight sutures. Material and Method: Between October 2005 and September 2009, 9 patients with diaphragmatic paralysis underwent repair using our modified technique. The mean patient age was $38.5{\pm}53.0$ years (range: 2~76 years). Result: The mean operation time was $46.7{\pm}15.9$ min (range: 30~85 min). None of the patients died due to this procedure, but there was one case of prolonged air leakage, and a case of re-expansion pulmonary edema, which required 3 days of ventilator support after the procedure. The mean hospital stay was $6.22{\pm}2.04$ days (range: 4~11 days). The mean follow-up duration was $27.2{\pm}11.6$ months (range: 2~43 months). All the patients had their symptoms relieved and there was no recurrence of eventration except for one patient who developed more than 2 cm elevation of the diaphragm compared to the immediate post-operation status. Conclusion: With our technique, thoracoscopic diaphragmatic plication was feasible via using only three 5 mm ports and without a working window and the midterm results were favorable. Therefore, we advocate thoracoscopic diaphragmatic plication as a preferred technique to the conventional open plication technique.

A study on comparison of predictive factors on happiness among male and female aged living alone (남녀 독거노인의 행복감 예측요인 비교 연구)

  • Hwang, Eun Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.8
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    • pp.392-402
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    • 2019
  • The purpose of this study is to determine the factors that predict happiness among aged males and females who live alone, and we focused on their satisfaction with their socio-physical environment, their social network, regular participation in social activities, their subjective health status and if they suffer from depression. A total of 2,76 people were the subjects of this study, their average age was 65 years old, they lived alone and all of them were selected from the '2017 Community Health Survey' data. The data was analyzed utilizing the Chi-square test, the Mann-Whitney test and multivariate logistic regression analysis. The subjects were 605 males (21.86%) and 2,163 females (78.14%). For the result of this study, the significant predictive factors of happiness for aged males living alone were monthly income (OR=2.363, 95% CI=1.473-3.791), basic livelihood rights (OR=1.903, 95% CI=1.144-3.167), trusting their neighbors (OR=2.018, 95% CI=1.263-3.225), religious activities (OR=2.098, 95% CI=1.314-3.349), subjective health (OR=2.753, 95% CI=1.217-6.228), and depression (OR=0.852, 95% CI=0.803-0.905). The significant predictive factors of happiness for aged females living alone were income (OR=2.407 95% CI=1.362-4.253), basic livelihood rights (OR=1.350, 95% CI=1.019-1.788), contact with friends (OR=1.879, 95% CI=1.323-2.669), religious activities (OR=1.372, 95% CI=1.124-1.676), recreation/leisure activities (OR=1.608, 95% CI=1.161-2.228), subjective health (OR=5.327, 95% CI=1.347-21.070), and depression (OR=0.864, 95% CI=0.840-0.890). In conclusion, programs to enhance happiness should be developed with considering the characteristics affecting the happiness of aged Korean males and females who live alone.

A COVID-19 Diagnosis Model based on Various Transformations of Cough Sounds (기침 소리의 다양한 변환을 통한 코로나19 진단 모델)

  • Minkyung Kim;Gunwoo Kim;Keunho Choi
    • Journal of Intelligence and Information Systems
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    • v.29 no.3
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    • pp.57-78
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    • 2023
  • COVID-19, which started in Wuhan, China in November 2019, spread beyond China in 2020 and spread worldwide in March 2020. It is important to prevent a highly contagious virus like COVID-19 in advance and to actively treat it when confirmed, but it is more important to identify the confirmed fact quickly and prevent its spread since it is a virus that spreads quickly. However, PCR test to check for infection is costly and time consuming, and self-kit test is also easy to access, but the cost of the kit is not easy to receive every time. Therefore, if it is possible to determine whether or not a person is positive for COVID-19 based on the sound of a cough so that anyone can use it easily, anyone can easily check whether or not they are confirmed at anytime, anywhere, and it can have great economic advantages. In this study, an experiment was conducted on a method to identify whether or not COVID-19 was confirmed based on a cough sound. Cough sound features were extracted through MFCC, Mel-Spectrogram, and spectral contrast. For the quality of cough sound, noisy data was deleted through SNR, and only the cough sound was extracted from the voice file through chunk. Since the objective is COVID-19 positive and negative classification, learning was performed through XGBoost, LightGBM, and FCNN algorithms, which are often used for classification, and the results were compared. Additionally, we conducted a comparative experiment on the performance of the model using multidimensional vectors obtained by converting cough sounds into both images and vectors. The experimental results showed that the LightGBM model utilizing features obtained by converting basic information about health status and cough sounds into multidimensional vectors through MFCC, Mel-Spectogram, Spectral contrast, and Spectrogram achieved the highest accuracy of 0.74.

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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Perception of School Foodservice Officials on Rice Bread as School Foodservice Menu (쌀빵에 대한 인식 및 학교급식 적용 가능성 분석: 교육청 학교급식 담당자를 중심으로)

  • Yang, Il-Sun;Lee, Min-A;Cha, Sung-Mi;Jo, Yoon-Hee;Lee, So-Young;Lee, So-Jung;Lee, Hae-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.37 no.6
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    • pp.729-737
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    • 2008
  • The purposes of this study were to investigate supporting status and subsidy for school food service and to analyze the perception of school food service officials at the educational board on using rice bread to the school food service menu. The questionnaire was developed by content analysis, situation analysis, in-depth interview and checked by the school food service officials at the educational board. The questionnaires were responded by 33 officials (respondent rate: 86.8%) during September 1 to October 26 in 2007. The major findings of this study were as follows: First, most of the respondents were women (93.9%), and worked an average of 104.36 months at school-related work. The metropolitan & provincial office of education had prevalently jurisdiction over 272.3 rural and self-operation type of elementary schools, 115.50 rural and self-operation type of middle schools and 73.0 rural and self-operation type of high schools. In the case of the district office of education, 23.3 urban and self-operation type of elementary schools, 11.6 urban and self-operation type of middle schools and 5.3 urban and contracted type of high schools were averagely managed. Second, all the respondents supported meal cost for low-income group and 50.5% provided reimbursement for organic environmental agricultural products. The highest subsidy was 16.8 billion won as meal cost for low-income group in metropolitan & provincial office and 1,050 million won as labor cost in district office. Third, the experience of performing policies for using rice was relatively lower than perception of rice bread application to school food service menu. Fourth, the advantages of using rice bread were acceleration of consuming rice (32.0%), excellence of nutrition (24.0%) and promotion of healthy image (22.7%). On the other hand, the difficulties of using rice bread were lack of facilities (72.7%), higher cost compared to wheat bread (54.5%), limitation of menu application and cooking method (15.7% each). Fifth, the opinion of utilizing rice and that of applying rice bread were significantly correlated (p<0.001). Desirability and willingness were correlated with reality for applying rice bread to the school food service menu (p<0.001). Also, comparative analysis between divided groups by perception of utilizing rice showed that willingness and experience were significantly different.

A Study on the Meaning and Strategy of Keyword Advertising Marketing

  • Park, Nam Goo
    • Journal of Distribution Science
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    • v.8 no.3
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    • pp.49-56
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    • 2010
  • At the initial stage of Internet advertising, banner advertising came into fashion. As the Internet developed into a central part of daily lives and the competition in the on-line advertising market was getting fierce, there was not enough space for banner advertising, which rushed to portal sites only. All these factors was responsible for an upsurge in advertising prices. Consequently, the high-cost and low-efficiency problems with banner advertising were raised, which led to an emergence of keyword advertising as a new type of Internet advertising to replace its predecessor. In the beginning of 2000s, when Internet advertising came to be activated, display advertisement including banner advertising dominated the Net. However, display advertising showed signs of gradual decline, and registered minus growth in the year 2009, whereas keyword advertising showed rapid growth and started to outdo display advertising as of the year 2005. Keyword advertising refers to the advertising technique that exposes relevant advertisements on the top of research sites when one searches for a keyword. Instead of exposing advertisements to unspecified individuals like banner advertising, keyword advertising, or targeted advertising technique, shows advertisements only when customers search for a desired keyword so that only highly prospective customers are given a chance to see them. In this context, it is also referred to as search advertising. It is regarded as more aggressive advertising with a high hit rate than previous advertising in that, instead of the seller discovering customers and running an advertisement for them like TV, radios or banner advertising, it exposes advertisements to visiting customers. Keyword advertising makes it possible for a company to seek publicity on line simply by making use of a single word and to achieve a maximum of efficiency at a minimum cost. The strong point of keyword advertising is that customers are allowed to directly contact the products in question through its more efficient advertising when compared to the advertisements of mass media such as TV and radio, etc. The weak point of keyword advertising is that a company should have its advertisement registered on each and every portal site and finds it hard to exercise substantial supervision over its advertisement, there being a possibility of its advertising expenses exceeding its profits. Keyword advertising severs as the most appropriate methods of advertising for the sales and publicity of small and medium enterprises which are in need of a maximum of advertising effect at a low advertising cost. At present, keyword advertising is divided into CPC advertising and CPM advertising. The former is known as the most efficient technique, which is also referred to as advertising based on the meter rate system; A company is supposed to pay for the number of clicks on a searched keyword which users have searched. This is representatively adopted by Overture, Google's Adwords, Naver's Clickchoice, and Daum's Clicks, etc. CPM advertising is dependent upon the flat rate payment system, making a company pay for its advertisement on the basis of the number of exposure, not on the basis of the number of clicks. This method fixes a price for advertisement on the basis of 1,000-time exposure, and is mainly adopted by Naver's Timechoice, Daum's Speciallink, and Nate's Speedup, etc, At present, the CPC method is most frequently adopted. The weak point of the CPC method is that advertising cost can rise through constant clicks from the same IP. If a company makes good use of strategies for maximizing the strong points of keyword advertising and complementing its weak points, it is highly likely to turn its visitors into prospective customers. Accordingly, an advertiser should make an analysis of customers' behavior and approach them in a variety of ways, trying hard to find out what they want. With this in mind, her or she has to put multiple keywords into use when running for ads. When he or she first runs an ad, he or she should first give priority to which keyword to select. The advertiser should consider how many individuals using a search engine will click the keyword in question and how much money he or she has to pay for the advertisement. As the popular keywords that the users of search engines are frequently using are expensive in terms of a unit cost per click, the advertisers without much money for advertising at the initial phrase should pay attention to detailed keywords suitable to their budget. Detailed keywords are also referred to as peripheral keywords or extension keywords, which can be called a combination of major keywords. Most keywords are in the form of texts. The biggest strong point of text-based advertising is that it looks like search results, causing little antipathy to it. But it fails to attract much attention because of the fact that most keyword advertising is in the form of texts. Image-embedded advertising is easy to notice due to images, but it is exposed on the lower part of a web page and regarded as an advertisement, which leads to a low click through rate. However, its strong point is that its prices are lower than those of text-based advertising. If a company owns a logo or a product that is easy enough for people to recognize, the company is well advised to make good use of image-embedded advertising so as to attract Internet users' attention. Advertisers should make an analysis of their logos and examine customers' responses based on the events of sites in question and the composition of products as a vehicle for monitoring their behavior in detail. Besides, keyword advertising allows them to analyze the advertising effects of exposed keywords through the analysis of logos. The logo analysis refers to a close analysis of the current situation of a site by making an analysis of information about visitors on the basis of the analysis of the number of visitors and page view, and that of cookie values. It is in the log files generated through each Web server that a user's IP, used pages, the time when he or she uses it, and cookie values are stored. The log files contain a huge amount of data. As it is almost impossible to make a direct analysis of these log files, one is supposed to make an analysis of them by using solutions for a log analysis. The generic information that can be extracted from tools for each logo analysis includes the number of viewing the total pages, the number of average page view per day, the number of basic page view, the number of page view per visit, the total number of hits, the number of average hits per day, the number of hits per visit, the number of visits, the number of average visits per day, the net number of visitors, average visitors per day, one-time visitors, visitors who have come more than twice, and average using hours, etc. These sites are deemed to be useful for utilizing data for the analysis of the situation and current status of rival companies as well as benchmarking. As keyword advertising exposes advertisements exclusively on search-result pages, competition among advertisers attempting to preoccupy popular keywords is very fierce. Some portal sites keep on giving priority to the existing advertisers, whereas others provide chances to purchase keywords in question to all the advertisers after the advertising contract is over. If an advertiser tries to rely on keywords sensitive to seasons and timeliness in case of sites providing priority to the established advertisers, he or she may as well make a purchase of a vacant place for advertising lest he or she should miss appropriate timing for advertising. However, Naver doesn't provide priority to the existing advertisers as far as all the keyword advertisements are concerned. In this case, one can preoccupy keywords if he or she enters into a contract after confirming the contract period for advertising. This study is designed to take a look at marketing for keyword advertising and to present effective strategies for keyword advertising marketing. At present, the Korean CPC advertising market is virtually monopolized by Overture. Its strong points are that Overture is based on the CPC charging model and that advertisements are registered on the top of the most representative portal sites in Korea. These advantages serve as the most appropriate medium for small and medium enterprises to use. However, the CPC method of Overture has its weak points, too. That is, the CPC method is not the only perfect advertising model among the search advertisements in the on-line market. So it is absolutely necessary that small and medium enterprises including independent shopping malls should complement the weaknesses of the CPC method and make good use of strategies for maximizing its strengths so as to increase their sales and to create a point of contact with customers.

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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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