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A Study on Dietary Habits and Nutrient Intakes by Skipping Meals of Elementary School Children in Incheon (인천 지역 초등학생의 결식에 따른 식습관과 영양 섭취 상태에 관한 연구)

  • Park, Sook-Kyoung;Kim, Myung-Hee;Choi, Mi-Kyeong
    • Journal of the East Asian Society of Dietary Life
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    • v.20 no.5
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    • pp.668-679
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    • 2010
  • The purpose of this study was to analyze the relations of children's skipping meals after researching eating habits and lifestyle, parents' appreciation in nutrition behavior and dietary intake, throughout the research based on 4th to 6th grade students, total of 362 children at an elementary school in Inchoen. There were 104 students in skipping meals group and 258 students in eating meals group, with the average ages of 10.9, and 10.8, respectively. The average height and weight were 144.5 cm, 38.6 kg for skipping meals group, and 145.7 cm, 39.3 kg for eating meals group. Parents' appreciation of importance in breakfast showed a significant difference in whether children skip the meals or not (p<0.01). 43.7% of parents in skipping meals group answered that they serve breakfast everyday, compared to eating meals group with the percentage of 94.9%, showing significant difference in frequency of serving breakfast for their children (p<0.001). The skipping meals group answered that the reason they do not have breakfast is because they do not have time, which showed the highest percentage of 41.2%. For the eating meals group, 40.5% of students answered that they do not have appetite, which also showed difference (p<0.001). The skipping meals group tended to wake up later than those who have breakfast in the morning(p<0.01). The breakfast time for skipping meals group was later than the eating meals group, and according to whether they have breakfast of not, it showed a difference as well(p<0.01). Total score of nutrition attitude in skipping meals group and eating meals group were 30.8 and 32.1, showing that eating meals group showed more good in nutrition attitude (p<0.05). Daily intakes of energy (p<0.01) and protein (p<0.01) in skipping meals group were significantly lower than those in eating meals group. Skipping meals group bad lower rates in INQs of protein (p<0.01) and zinc (p<0.01), showing that skipping meals group is having low quality meals in nutrition. In conclusion, this study revealed that students with skipping meals are more likely to have meals that lacks nutrition or have low quality meals, and the time of rising hour in the morning, frequency of eating snacks can also affect whether or not they skip meals.

Tuberculin Skin Test and Plasma Prostaglandin $E_2$ In Patients of New and Intractable Pulmonary Tuberculosis (초치료 및 난치 폐결핵 환자의 투베르쿨린 피부검사와 혈장 Prostaglandin $E_2$)

  • Kim, Ji-Hong;Choi, In-Hwan;Kim, Mee-Ae;Shin, Chul-Shik;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.669-676
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    • 1995
  • Background: The cell-mediated immunity is needed for eradicating the tubercle bacilli. Prostaglandin(PG), especially PG $E_2$, is involved in cellular immunosuppression. It is known that the PG $E_2$ is suppressed by indomethacin. For using indomethacin as a immunomodulator of intractable pulmonary tuberculosis(Tbc) patients, we measured the tuberculin skin test(TST) and the plasma PG $E_2$ levels. Method: The forty-eight inpatients with sputum positive acid-fast stain bacilli were classified into 6 groups according to antiTbc chemotherapy history(new and intractable cases), plain chest roetgenogram(minimal and far advanced cases), and TST reaction(nagative and positive cases). Except for one group(n=2; new, minimal, and negative cases of TST reaction) of the 6 groups, all subjects(n=46) were measured for the plasma PG $E_2$, levels with radioimmunoassay. Results: 1) There was no significant difference in the plasma PG $E_2$ levels among A group(far advanced and positive TST reaction cases, n=10, $11.22{\pm}2.86\;pg/ml$), B group(minimal and negative TST reaction cases, n=9, $11.35{\pm}2.20$) and C group(far advanced and positive TST reaction cases, n=7, $11.11{\pm}2.30$) in the new cases(p>0.05). 2) There was no significant difference in the plasma PG $E_2$ levels between positive(n=10, $9.25{\pm}2.21$) and negative(n=10, $8.25{\pm}1.13$) groups by TST in the intractable cases(p>0.05). 3) Comparing the plasma PG $E_2$ levels between new(n=26, $11.35{\pm}2.41$) and intractable(n=20, $8.75{\pm}1.78$) groups, the intractable group had significi- andy lower plasma PG $E_2$ levels(p<0.05). 4) There was no significant difference in the plasma PG $E_2$ levels between negative(n=19, $9.88{\pm}2.43$) and positive(n=27, $10.46{\pm}2.56$) groups by TST(p>0.05). 5) There was no significant difference in the plasma PG $E_2$ levels between male(n=32, $10.07{\pm}2.44$) and female(n=14, $10.56{\pm}2.70$)(p>0.05). 6) There was no significant difference in the plasma PG $E_2$ levels among 2nd(n=5, $10.21{\pm}2.86$), 3rd(n=9, $9.97{\pm}2.47$), 4th(n=13, $11.35{\pm}2.33$) and 5th(n=19, $9.57{\pm}2.48$) decades(p>0.05). 7) There was no significant correlation between the induration sizes of the TST and the plasma PG $E_2$ levels(r=0.054, p>0.05). Conclusion: From the above results, the plasma PG $E_2$ levels of intractable group are not higher as the authors had expected. There was no significant difference in the plasma PG $E_2$ levels by the lesion sizes of plain chest roentgenogram and the induration sizes of TST, so more study will be needed to use the indomethacin as a immunomodulator for intractable pulmonary tuberculosis patients.

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Culture Conditions of Aspergillus oryzae in Dried Food-Waste and the Effects of Feeding the AO Ferments on Nutrients Availability in Chickens (건조한 남은 음식물을 이용한 Aspergillus oryzae균주 배양조건과 그 배양물 급여가 닭의 영양소 이용률에 미치는 영향)

  • Hwangbo J.;Hong E. C.;Lee B. S.;Bae H. D.;Kim W.;Nho W. G.;Kim J. H.;Kim I. H.
    • Korean Journal of Poultry Science
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    • v.32 no.4
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    • pp.291-300
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    • 2005
  • Two experiments were carried out to assess the appropriate incubation conditions namely; duration, moisture content and the ideal microbial inoculant for fermented dried food waste(EW) offered to broilers. The nutrient utilization of birds fed the FW diets at varying dietary inclusion rates was also compared with a control diet. In Experiment 1, different moisture contents(MC) of 30, 40, 50 and $60\%$ respectively were predetermined to establish the ideal duration of incubation and the microbial inoculant. A 1mL Aspergillus oryzae(AO) $(1.33\times10^5\;CFU/mL)$ was used as the seed inoculant in FW. This results indicated that the ideal MC for incubation was $40\~50\%$ while the normal incubation time was > 72 hours. Consequently, AO seeds at 0.25, 0.50, 0.75 and 1.00mL were inoculated in FW to determine its effect on AO count. The comparative AO count of FW incubated for 12 and 96 hours, respectively showed no significant differences among varying inoculant dosage rates. The FW inoculated with lower AO seeds at 0.10, 0.05 and 0.01mL were likewise incubated for 72 and 96 hours, respectively and no changes in AO count was detected(p<0.05). The above findings indicated that the incubation requirements for FW should be $%40\~50\%$ for 72 hours with an AO seed incoulant dosage rate of 0.10mL. Consequently, in Experiment II, after determining the appropriate processing condition for the FW, 20 five-week old male Hubbard strain were used in a digestibility experiment. The birds were divided into 4 groups with 5 pens(1 bird per pen). The dietary treatments were; Treatment 1 : Control(Basal diet), Treatment 2 : $60\%$ Basal+4$40\%$ FW, Treatment 3 : $60\%$ $Basal+20\%\;FW+20\%$ AFW(Aspergillus oryzae inoculate dried food-waste diet) and Treatment 4: $60\%$ Basal+$40\%$ Am. Digestibility of treatment 2 was lowed on common nutrients and amino acids compared with control(p<0.05) and on crude fat and phosphorus compared with AFW treatments(T3, T4)(plt;0.05). Digestibility of treatment 3 and 4 increased on crude fiber and crude ash compared treatment 2 (p<0.05). Digestibility of control was high on agrinine, leucine, and phenylalnine of essential amino acids compared with treatment 3 and 4(p<0.05), and diestibility of treatment 3 and 4 was improved on arginine, lysine, and threonine of essential amino acids. Finally, despite comparable nutrient utilization among treatments, birds fed the dietary treatment containing AO tended to superior nutrient digestion to those fed the $60\%$ Basa1+$40\%$ FW.

Evaluation of the Radioimmunotherapy Using I-131 labeled Vascular Endothelial Growth Factor Receptor2 Antibody in Melanoma Xenograft Murine Model (흑색종에서의 I-131표지 혈관내피세포성장인자 수용체2항체를 이용한 방사면역치료 평가)

  • Kim, Eun-Mi;Jeong, Hwan-Jeong;Park, Eun-Hye;Cheong, Su-Jin;Lee, Chang-Moon;Jang, Kyu-Yun;Kim, Dong-Wook;Lim, Seok-Tae;Sohn, Myung-Hee
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.307-313
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    • 2008
  • Purpose: Vascular endothelial growth factor (VEGF) and its receptor, fetal liver kinase 1 (Flk-1), play an important role in vascular permeability and tumor angiogenesis. The aim of this study is to evaluate the therapeutic efficacy of $^{131}I$ labeled anti-Flk-1 monoclonal antibody (DC101) on the growth of melanoma tumor, which is known to be very aggressive in vivo. Materials and Methods: Balb/c nude mice were injected subcutaneously with melanoma cells in the right flank. Tumors were allowed to grow up to $200-250\;mm^3$ in volume. Gamma camera imaging and biodistribution studies were performed to identify an uptake of $^{131}I$-DC101 in various organs. Mice with tumor were randomly divided into five groups (10 mice per group) and injected intravenously; control PBS (group 1), $^{131}I$-DC101 $50\;{\mu}g/mouse$ (group 2), non-labeled DC101 $50\;{\mu}g/mouse$ (group 3), $^{131}I$-DC101 $30\;{\mu}g/mouse$ (group 4) and $15\;{\mu}g/mouse$ (group 5) every 3 or 4 days for 20 days. Tumor volume was measured with caliper twice a week. Results: In gamma camera images, the uptake of $^{131}I$-DC101 into tumor and thyroid was increased with time. Biodistribution results showed that the radioactivity of blood and other major organ was gradually decreased with time whereas tumor uptake was increased up to 48 hr and then decreased. After 4th injection of $^{131}I$-DC101, tumor volume of group 2 and 4 was significantly smaller than that group 1. After 5th injection, the tumor volume of group 5 also significantly reduced. Conclusion: These results indicated that delivery of $^{131}I$ to tumor using FlK-1 antibody, DC101, effectively blocks tumor growth in aggressive melanoma xenograft model.

A Study on Anjoon-gut Music in Daejeon - Focused on Sir Shin Seok-bong's Antaek-gut Music- (대전의 앉은굿 음악 연구 - 신석봉 법사의 안택굿을 중심으로 -)

  • Park, Hye-jeong
    • Korean Journal of Heritage: History & Science
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    • v.38
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    • pp.5-42
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    • 2005
  • Based on a field investigation of intangible cultural asset # 2, author Sir Shin Seok-bong of Daejeon Metropolitan Cityinvestigated the music of Antaek-gut, which is the base and core of Anjoon-gut, and found the following musical features: A Jang-gu(drum) and Kkoaengkwari(gong) were used to recitethe Sutra(kyungmoon) of Anjoon-gut. The Jang-gu, located on the right side, played an accompaniment role with regular beats when the Sutra was recited. The Kkoaengkwari, located on the left side, played the role of covering the caesura of the Sutra passages, so it is played with various rhythmic variations in accordance with Kojang(鼓杖). This is one way of playing Korean national classical music that has temporary caesuras, depending on the rector's bre! ath or the contents of a Sutra during the Sutra chanting, with the Jang-gu covering the pause with its variation. In other words, when being played in concert, the instruments that play the main melody are at rest while another instrument takes its turn to play the main melody as a form of prolonged sound. The rhythmic cycles of the sutras of Antaek-gut recited with this instrumental accompaniment consist of five types; a) Woemarch-jangdan (a single beat) of 4 meter by 3 bit, b) Dumarch-jangdan (two beats) of 8 meter by 3 bit, c) Saemarch-jangdan (three beats) of 4 meter by 3 bit with a fast tempo, d) Mak-gojang, uniform beats with a standardized rhythm, and e) incomplete beats deviated from the regular beats. Sir Shin Seok-bong chanted Chang (唱), a traditional native song which he called 'Cheong (淸)' with a cycle of 'Dumarch-jangdan' throughout the places of Antaek-gut. Only 'Toesonggyung' a chant for the gate that was the last location of the Antaek, was chanted with a cycle of 'Woemarch-jan! gdan'. In addition, 'Saemarch-jangdan' and 'Mak-gojang' that had comparatively faster tempos than the former two jangdans, were played without a chant when a female shaman was dancing and catching her spirit-invoking wand. The 'Saemarch-jangdan', particularly, was played while dancing began at a relatively slow tempo, then proceeded at a violent tempo and then back again to the slow tempo. This shows one of the representative tempos of our music with a slow-fast-slow tempo. The organizational tones were 'mi-la-do'-re'', and its key tones of 'mi-la-do'' were performed with perfect fourth and minor third, which was the same as those of Menari-tori. However, it did not show a typical Sigimse, an ornamental tone, of Menari-tory, whose first tone, 'mi', is vibrated and its Sigimse is gliding down from the tone 're' to 'do'. That is because the regional tone-tori of Chungcheong-do have a relatively weaker musical expression than that of Gyeongsang-do. In addition, the rhythmic types in accordance with the words of a song for the Antaek-gut music had a comparatively faster tempo than the other sutras. Also, it was only with 'Toesonggyeong' that the tone 'la' continuously appeared throughout the melody and showed 'a syllabic rhythm', while other places consisted of either a 'syncopation' or 'melismatic' rhythm. Finally, according to a brief investigation of the tone organization in accordance with each sutra, the tone 'la' was given more weight. The tone procedure showed a mainly ascending 'la-do'' and the descending 'la-mi' with minor third and perfect fourth. Also, the overall tempo proceeded with M.M.♩.=116-184, while the tempo for the Gut proceeded with M.M.♩.=120-140, which was suitable for reciting a Sutra.

The Effect of Customer Satisfaction on Corporate Credit Ratings (고객만족이 기업의 신용평가에 미치는 영향)

  • Jeon, In-soo;Chun, Myung-hoon;Yu, Jung-su
    • Asia Marketing Journal
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    • v.14 no.1
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    • pp.1-24
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    • 2012
  • Nowadays, customer satisfaction has been one of company's major objectives, and the index to measure and communicate customer satisfaction has been generally accepted among business practices. The major issues of CSI(customer satisfaction index) are three questions, as follows: (a)what level of customer satisfaction is tolerable, (b)whether customer satisfaction and company performance has positive causality, and (c)what to do to improve customer satisfaction. Among these, the second issue is recently attracting academic research in several perspectives. On this study, the second issue will be addressed. Many researchers including Anderson have regarded customer satisfaction as core competencies, such as brand equity, customer equity. They want to verify following causality "customer satisfaction → market performance(market share, sales growth rate) → financial performance(operating margin, profitability) → corporate value performance(stock price, credit ratings)" based on the process model of marketing performance. On the other hand, Insoo Jeon and Aeju Jeong(2009) verified sequential causality based on the process model by the domestic data. According to the rejection of several hypotheses, they suggested the balance model of marketing performance as an alternative. The objective of this study, based on the existing process model, is to examine the causal relationship between customer satisfaction and corporate value performance. Anderson and Mansi(2009) proved the relationship between ACSI(American Customer Satisfaction Index) and credit ratings using 2,574 samples from 1994 to 2004 on the assumption that credit rating could be an indicator of a corporate value performance. The similar study(Sangwoon Yoon, 2010) was processed in Korean data, but it didn't confirm the relationship between KCSI(Korean CSI) and credit ratings, unlike the results of Anderson and Mansi(2009). The summary of these studies is in the Table 1. Two studies analyzing the relationship between customer satisfaction and credit ratings weren't consistent results. So, in this study we are to test the conflicting results of the relationship between customer satisfaction and credit ratings based on the research model considering Korean credit ratings. To prove the hypothesis, we suggest the research model as follows. Two important features of this model are the inclusion of important variables in the existing Korean credit rating system and government support. To control their influences on credit ratings, we included three important variables of Korean credit rating system and government support, in case of financial institutions including banks. ROA, ER, TA, these three variables are chosen among various kinds of financial indicators since they are the most frequent variables in many previous studies. The results of the research model are relatively favorable : R2, F-value and p-value is .631, 233.15 and .000 respectively. Thus, the explanatory power of the research model as a whole is good and the model is statistically significant. The research model has good explanatory power, the regression coefficients of the KCSI is .096 as positive(+) and t-value and p-value is 2.220 and .0135 respectively. As a results, we can say the hypothesis is supported. Meanwhile, all other explanatory variables including ROA, ER, log(TA), GS_DV are identified as significant and each variables has a positive(+) relationship with CRS. In particular, the t-value of log(TA) is 23.557 and log(TA) as an explanatory variables of the corporate credit ratings shows very high level of statistical significance. Considering interrelationship between financial indicators such as ROA, ER which include total asset in their formula, we can expect multicollinearity problem. But indicators like VIF and tolerance limits that shows whether multicollinearity exists or not, say that there is no statistically significant multicollinearity in all the explanatory variables. KCSI, the main subject of this study, is a statistically significant level even though the standardized regression coefficients and t-value of KCSI is .055 and 2.220 respectively and a relatively low level among explanatory variables. Considering that we chose other explanatory variables based on the level of explanatory power out of many indicators in the previous studies, KCSI is validated as one of the most significant explanatory variables for credit rating score. And this result can provide new insights on the determinants of credit ratings. However, KCSI has relatively lower impact than main financial indicators like log(TA), ER. Therefore, KCSI is one of the determinants of credit ratings, but don't have an exceedingly significant influence. In addition, this study found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size, and on service companies than manufacturers. The findings of this study is consistent with Anderson and Mansi(2009), but different from Sangwoon Yoon(2010). Although research model of this study is a bit different from Anderson and Mansi(2009), we can conclude that customer satisfaction has a significant influence on company's credit ratings either Korea or the United State. In addition, this paper found that customer satisfaction had more meaningful impact on corporations of small asset size than those of big asset size and on service companies than manufacturers. Until now there are a few of researches about the relationship between customer satisfaction and various business performance, some of which were supported, some weren't. The contribution of this study is that credit rating is applied as a corporate value performance in addition to stock price. It is somewhat important, because credit ratings determine the cost of debt. But so far it doesn't get attention of marketing researches. Based on this study, we can say that customer satisfaction is partially related to all indicators of corporate business performances. Practical meanings for customer satisfaction department are that it needs to actively invest in the customer satisfaction, because active investment also contributes to higher credit ratings and other business performances. A suggestion for credit evaluators is that they need to design new credit rating model which reflect qualitative customer satisfaction as well as existing variables like ROA, ER, TA.

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A Study Concerning Health Needs in Rural Korea (농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究))

  • Lee, Sung-Kwan;Kim, Doo-Hie;Jung, Jong-Hak;Chunge, Keuk-Soo;Park, Sang-Bin;Choy, Chung-Hun;Heng, Sun-Ho;Rah, Jin-Hoon
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.1
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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An Intervention Study on Integration of Family Planning and Maternal/Infant Care Services in Rural Korea (가족계획과 모자보건 통합을 위한 조산원의 투입효과 분석 -서산지역의 개입연구 평가보고-)

  • Bang, Sook;Han, Seung-Hyun;Lee, Chung-Ja;Ahn, Moon-Young;Lee, In-Sook;Kim, Eun-Shil;Kim, Chong-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.20 no.1 s.21
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    • pp.165-203
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    • 1987
  • This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.

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A Study on the long-term Hemodialysis patient중s hypotension and preventation from Blood loss in coil during the Hemodialysis (장기혈액투석환자의 투석중 혈압하강과 Coil내 혈액손실 방지를 위한 기초조사)

  • 박순옥
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.83-104
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    • 1981
  • Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance(P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

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Shopping Value, Shopping Goal and WOM - Focused on Electronic-goods Buyers (쇼핑 가치 추구 성향에 따른 쇼핑 목표와 공유 의도 차이에 관한 연구 - 전자제품 구매고객을 중심으로)

  • Park, Kyoung-Won;Park, Ju-Young
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.2
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    • pp.68-79
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    • 2009
  • The interplay between hedonic and utilitarian attributes has assumed special significance in recent years; it has been proposed that consumption offerings should be viewed as experiences that stimulate both cognitions and feelings rather than as mere products or services. This research builds on previous work on hedonic versus utilitarian benefits, regulatory focus theory, customer satisfaction to address two question: (1) Is the shopping goal at the point of purchase different from the shopping value? and (2) Is the customer loyalty after the use different from the shopping value and shopping goal? We surveyed 345 peoples those who have bought the electronic-goods within 6 months. This research dealt with the shopping value which is consisted of 2 types, hedonic and utilitarian. Those who pursue the hedonic shopping value may prefer the pleasure of purchasing experience to the product itself. They tend to prefer atmosphere, arousal of the shopping experience. Consistent with previous research, we use the term "hedonic" to refer to their aesthetic, experiential and enjoyment-related value. On the contrary, Those who pursue the utilitarian shopping value may prefer the reasonable buying. It may be more functional. Consistent with previous research, we use the term "utilitarian" to refer to the functional, instrumental, and practical value of consumption offerings. Holbrook(1999) notes that consumer value is an experience that results from the consumption of such benefits. In the context of cell phones for example, the phone's battery life and sound volume are utilitarian benefits, whereas aesthetic appeal from its shape and color are hedonic benefits. Likewise, in the case of a car, fuel economics and safety are utilitarian benefits whereas the sunroof and the luxurious interior are hedonic benefits. The shopping goals are consisted of the promotion focus goal and the prevention focus goal, based on the self-regulatory focus theory. The promotion focus is characterized into focusing ideal self because they are oriented to wishes and vision. The promotion focused individuals are tend to be more risk taking. They are more sensitive to hope and achievement. On the contrary, the prevention focused individuals are characterized into focusing the responsibilities because they are oriented to safety. The prevention focused individuals are tend to be more risk avoiding. We wanted to test the relation among the shopping value, shopping goal and customer loyalty. Customers show the positive or negative feelings comparing with the expectation level which customers have at the point of the purchase. If the result were bigger than the expectation, customers may feel positive feeling such as delight or satisfaction and they would want to share their feelings with other people. And they want to buy those products again in the future time. There is converging evidence that the types of goals consumers expect to be fulfilled by the utilitarian dimension of a product are different from those they seek from the hedonic dimension (Chernev 2004). Specifically, whereas consumers expect the fulfillment of product prevention goals on the utilitarian dimension, they expect the fulfillment of promotion goals on the hedonic dimension (Chernev 2004; Chitturi, Raghunathan, and Majahan 2007; Higgins 1997, 2001) According to the regulatory focus theory, prevention goals are those that ought to be met. Fulfillment of prevention goals in the context of product consumption eliminates or significantly reduces the probability of a painful experience, thus making consumers experience emotions that result from fulfillment of prevention goals such as confidence and securities. On the contrary, fulfillment of promotion goals are those that a person aspires to meet, such as "looking cool" or "being sophisticated." Fulfillment of promotion goals in the context of product consumption significantly increases the probability of a pleasurable experience, thus enabling consumers to experience emotions that result from the fulfillment of promotion goals. The proposed conceptual framework captures that the relationships among hedonic versus utilitarian shopping values and promotion versus prevention shopping goals respectively. An analysis of the consequence of the fulfillment and frustration of utilitarian and hedonic value is theoretically worthwhile. It is also substantively relevant because it helps predict post-consumption behavior such as the promotion versus prevention shopping goals orientation. Because our primary goal is to understand how the post consumption feelings influence the variable customer loyalty: word of mouth (Jacoby and Chestnut 1978). This research result is that the utilitarian shopping value gives the positive influence to both of the promotion and prevention goal. However the influence to the prevention goal is stronger. On the contrary, hedonic shopping value gives influence to the promotion focus goal only. Additionally, both of the promotion and prevention goal show the positive relation with customer loyalty. However, the positive relation with promotion goal and customer loyalty is much stronger. The promotion focus goal gives the influence to the customer loyalty. On the contrary, the prevention focus goal relates at the low level of relation with customer loyalty than that of the promotion goal. It could be explained that it is apt to get framed the compliment of people into 'gain-non gain' situation. As the result, for those who have the promotion focus are motivated to deliver their own feeling to other people eagerly. Conversely the prevention focused individual are more sensitive to the 'loss-non loss' situation. The research result is consistent with pre-existent researches. There is a conceptual parallel between necessities-needs-utilitarian benefits and luxuries-wants-hedonic benefits (Chernev 2004; Chitturi, Raghunathan and Majaha 2007; Higginns 1997; Kivetz and Simonson 2002b). In addition, Maslow's hierarchy of needs and the precedence principle contends luxuries-wants-hedonic benefits higher than necessities-needs-utilitarian benefits. Chitturi, Raghunathan and Majaha (2007) show that consumers are focused more on the utilitarian benefits than on the hedonic benefits of a product until their minimum expectation of fulfilling prevention goals are met. Furthermore, a utilitarian benefit is a promise of a certain level of functionality by the manufacturer or the retailer. When the promise is not fulfilled, customers blame the retailer and/or the manufacturer. When negative feelings are attributable to an entity, customers feel angry. However in the case of hedonic benefit, the customer, not the manufacturer, determines at the time of purchase whether the product is stylish and attractive. Under such circumstances, customers are more likely to blame themselves than the manufacturer if their friends do not find the product stylish and attractive. Therefore, not meeting minimum utilitarian expectations of functionality generates a much more intense negative feelings, such as anger than a less intense feeling such as disappointment or dissatisfactions. The additional multi group analysis of this research shows the same result. Those who are unsatisfactory customers who have the prevention focused goal shows higher relation with WOM, comparing with satisfactory customers. The research findings in this article could have significant implication for the personal selling fields to increase the effectiveness and the efficiency of the sales such that they can develop the sales presentation strategy for the customers. For those who are the hedonic customers may be apt to show more interest to the promotion goal. Therefore it may work to strengthen the design, style or new technology of the products to the hedonic customers. On the contrary for the utilitarian customers, it may work to strengthen the price competitiveness. On the basis of the result from our studies, we demonstrated a correspondence among hedonic versus utilitarian and promotion versus prevention goal, WOM. Similarly, we also found evidence of the moderator effects of satisfaction after use, between the prevention goal and WOM. Even though the prevention goal has the low level of relation to WOM, those who are not satisfied show higher relation to WOM. The relation between the prevention goal and WOM is significantly different according to the satisfaction versus unsatisfaction. In addition, improving the promotion emotions of cheerfulness and excitement and the prevention emotion of confidence and security will further improve customer loyalty. A related potential further research could be to examine whether hedonic versus utilitarian, promotion versus prevention goals improve customer loyalty for services as well. Under the budget and time constraints, designers and managers are often compelling to choose among various attributes. If there is no budget or time constraints, perhaps the best solution is to maximize both hedonic and utilitarian dimension of benefits. However, they have to make trad-off process between various attributes. For the designers and managers have to keep in mind that without hedonic benefit satisfaction of the product it may hard to lead the customers to the customer loyalty.

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