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Analysis of Hospital Foodservice Management and Health Insurance Coverage of Inpatient Meals in Seoul (서울지역 의료기관의 급식서비스 및 환자식 급여화 현황 분석)

  • Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.16 no.4
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    • pp.378-396
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    • 2010
  • The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.

Korean Caregiver's Perceived Benefits and Costs of the Coresidence with the Elderly Parents - focused on Rural and Urban Difference - (부양의식, 형제자매 지원과 노부모 동거에 대한 혜택-비용 지각 - 도시와 농촌 비교를 중심으로 -)

  • 한경혜;이정화
    • Journal of the Korean Home Economics Association
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    • v.39 no.11
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    • pp.129-144
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    • 2001
  • In spite of rapid sociocultural changes and an increase in the number of nuclear families in recent years, quite many families in Korea still have taken the extended family form where daughter-in-law provides care for the elderly parents. Even though the nature of the inter-generational relationship in Korea is reciprocal in many regards, most of the studies looked at the burden or costs of coresidence with the elderly parents while relatively little attention has been given to the positive side of the coresidence. This study is an attempt to fill this gap in the area. The purpose of this study is to examine not only the costs but also benefits of the coresidence with the elderly parents. We also explore whether there is a rural-urban differences in costs and benefits of coresidence and related factors. For the purpose, data were gathered from 876 daughters-in-law of three generational family both in rural and urban area, using structured questionnaire. The statistical methods used for data analysis were descriptive statistics, cross tables, and regression analysis with SPSS/PC+ program. The major findings of this study were as follows: Marital and economic status of the elderly parents, age, job status and filial responsibility attitude of caregiver, sibling support, and coresidence duration were the significant variables predicting the level of perceived benefits. Marital status of elderly parents, income, job status, educational level, and filial responsibility altitude of caregiver, residence region affected the level of perceived costs. Rural-urban differences are found in many aspects of coresidence experiences and related factors. Rural caregivers receive higher level of the sibling support, have more traditional final responsibility altitude and perceived less costs and more benefit than urban caregivers. There also are differences in the factors influencing the level of perceived costs and benefits between rural and urban area. Level of sibling support and final responsibility attitude have significant impact on both the perceived costs and benefits. But there are differences in terms of that perceived costs and benefits of urban caregivers are affected by job status of caregivers while those of rural caregivers are affected by educational level of caregivers and marital status of elderly. The results confirm that Korean caregivers experience both positive and negative aspects of coresidence and shows that the nature of the inter-generational relationships differ between rural and urban Korea.

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Conscious sedation in dentistry: knowledge and practice among dental professionals in Tanzania

  • Sales, Nicco;Sohal, Karpal Singh;Moshy, Jeremiah Robert;Owibingire, Sira Stanslaus;Deoglas, David K;Laizer, Paulo J
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.6
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    • pp.557-564
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    • 2021
  • Background: Conscious sedation is a useful adjunct in the treatment of patients in dentistry; however, a lack of knowledge among the dental profession regarding sedation is a restricting factor in the practice of dental sedation. Therefore, this study was conducted to assess the knowledge and practice of sedation in dentistry among dental professionals in Tanzania. Methods: This was a cross-sectional study conducted for five months targeting all practicing dental professionals in Tanzania. A modified questionnaire contained 14 questions regarding knowledge about sedative agents and a section on the practice of sedation. The data obtained from this study were coded and entered into a computer program and analyzed using SPSS software version 23.0. The data are presented as frequencies and percentages in tables and charts. Statistical significance was set at P < 0.05. Results: The age range of participants was between 24 and 63 years (mean 36.6 ± 7.7 years). There were 107 men (78.1%), and the male-to-female ratio was 3.6:1. The majority (76.6%) of participants only had an undergraduate dental degree. Thirty-one percent of participants only worked in publicly owned health facilities. Slightly more than half (59.9%) of participants had satisfactory knowledge regarding sedation in dentistry. There was no statistically significant association between the level of sedation-related knowledge and the demographic characteristics of the participants. Only 21.9% reported using sedation in their practice, and the most commonly used sedative drug was diazepam. The reasons for not using dental sedation in clinical practice included a perceived lack of knowledge on sedation, lack of equipment, and cost. Conclusion: Most dental professionals in Tanzania have basic knowledge of sedation in dentistry, although knowledge regarding sedative agents is generally low. The practice of sedation in dentistry in Tanzania is very low compared to that in middle- and high-income countries. Inadequate knowledge, lack of equipment, and the cost of practicing sedation are the main reasons for not practicing sedation.

Positron Annihilation Spectroscopy of Active Galactic Nuclei

  • Doikov, Dmytry N.;Yushchenko, Alexander V.;Jeong, Yeuncheol
    • Journal of Astronomy and Space Sciences
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    • v.36 no.1
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    • pp.21-33
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    • 2019
  • This paper focuses on the interpretation of radiation fluxes from active galactic nuclei. The advantage of positron annihilation spectroscopy over other methods of spectral diagnostics of active galactic nuclei (therefore AGN) is demonstrated. A relationship between regular and random components in both bolometric and spectral composition of fluxes of quanta and particles generated in AGN is found. We consider their diffuse component separately and also detect radiative feedback after the passage of high-velocity cosmic rays and hard quanta through gas-and-dust aggregates surrounding massive black holes in AGN. The motion of relativistic positrons and electrons in such complex systems produces secondary radiation throughout the whole investigated region of active galactic nuclei in form of cylinder with radius R= 400-1000 pc and height H=200-400 pc, thus causing their visible luminescence across all spectral bands. We obtain radiation and electron energy distribution functions depending on the spatial distribution of the investigated bulk of matter in AGN. Radiation luminescence of the non-central part of AGN is a response to the effects of particles and quanta falling from its center created by atoms, molecules and dust of its diffuse component. The cross-sections for the single-photon annihilation of positrons of different energies with atoms in these active galactic nuclei are determined. For the first time we use the data on the change in chemical composition due to spallation reactions induced by high-energy particles. We establish or define more accurately how the energies of the incident positron, emitted ${\gamma}-quantum$ and recoiling nucleus correlate with the atomic number and weight of the target nucleus. For light elements, we provide detailed tables of all indicated parameters. A new criterion is proposed, based on the use of the ratio of the fluxes of ${\gamma}-quanta$ formed in one- and two-photon annihilation of positrons in a diffuse medium. It is concluded that, as is the case in young supernova remnants, the two-photon annihilation tends to occur in solid-state grains as a result of active loss of kinetic energy of positrons due to ionisation down to thermal energy of free electrons. The single-photon annihilation of positrons manifests itself in the gas component of active galactic nuclei. Such annihilation occurs as interaction between positrons and K-shell electrons; hence, it is suitable for identification of the chemical state of substances comprising the gas component of the investigated media. Specific physical media producing high fluxes of positrons are discussed; it allowed a significant reduction in the number of reaction channels generating positrons. We estimate the brightness distribution in the ${\gamma}-ray$ spectra of the gas-and-dust media through which positron fluxes travel with the energy range similar to that recorded by the Payload for Antimatter Matter Exploration and Light-nuclei Astrophysics (PAMELA) research module. Based on the results of our calculations, we analyse the reasons for such a high power of positrons to penetrate through gas-and-dust aggregates. The energy loss of positrons by ionisation is compared to the production of secondary positrons by high-energy cosmic rays in order to determine the depth of their penetration into gas-and-dust aggregations clustered in active galactic nuclei. The relationship between the energy of ${\gamma}-quanta$ emitted upon the single-photon annihilation and the energy of incident electrons is established. The obtained cross sections for positron interactions with bound electrons of the diffuse component of the non-central, peripheral AGN regions allowed us to obtain new spectroscopic characteristics of the atoms involved in single-photon annihilation.

Study on the status of food allergy management and importance-performance analysis about precautions of food allergy in school foodservice according to the school types in Jeonbuk area (전북지역 학교급식소 조리종사자의 학교유형에 따른 식품알레르기 관리실태 및 식품알레르기 예방관리에 대한 중요도와 수행도 분석)

  • Kim, Ji Yeon;Rho, Jeong Ok
    • Journal of Nutrition and Health
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    • v.53 no.3
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    • pp.329-345
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    • 2020
  • Purpose: This study examined the status of food allergy management and importance-performance analysis (IPA) between elementary, and middle and high school employees in school foodservice. Methods: The participants were employees in elementary (n = 171) and middle and high schools (n = 187) in the Jeonbuk area. The demographic characteristics, the status of food allergy management, food allergy education, and the importance and performance status were assessed using a self-administered questionnaire. Results: Approximately 55.0% of employees in elementary and 32.6% in middle and high schools recognized that the foods in menu tables induced allergies. Approximately 93.0% of employees in elementary and 85.0% in middle and high school thought that food allergy management was an important part of school foodservice because of the possibility of health emergencies. Elimination and replacement meals were provided more in middle and high schools than in elementary schools. Food allergy education from nutrition teachers had been given to 62.6% of employees in elementary and 50.3% in middle and high schools. To prevent food allergy accidents, 72.4% of employees in elementary schools and 65.2% in middle and high schools wanted more accurate information on students with food allergies. As a result of IPA, elementary, middle, and high school employees were aware of the importance and performed well: 'Strict control of allergy-inducing foods because of cross-contamination'. On the other hand, they were not aware of the importance and performed them insufficiently: 'Know how to use epinephrine to prepare for emergencies'. Conclusion: Therefore, it is necessary to improve the consciousness of nutrition teachers for the effective application of food allergy education, especially the recognition of allergy-inducing foods and emergency responsive ability.

GIS-based Market Analysis and Sales Management System : The Case of a Telecommunication Company (시장분석 및 영업관리 역량 강화를 위한 통신사의 GIS 적용 사례)

  • Chang, Nam-Sik
    • Journal of Intelligence and Information Systems
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    • v.17 no.2
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    • pp.61-75
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    • 2011
  • A Geographic Information System(GIS) is a system that captures, stores, analyzes, manages and presents data with reference to geographic location data. In the later 1990s and earlier 2000s it was limitedly used in government sectors such as public utility management, urban planning, landscape architecture, and environmental contamination control. However, a growing number of open-source packages running on a range of operating systems enabled many private enterprises to explore the concept of viewing GIS-based sales and customer data over their own computer monitors. K telecommunication company has dominated the Korean telecommunication market by providing diverse services, such as high-speed internet, PSTN(Public Switched Telephone Network), VOLP (Voice Over Internet Protocol), and IPTV(Internet Protocol Television). Even though the telecommunication market in Korea is huge, the competition between major services providers is growing more fierce than ever before. Service providers struggled to acquire as many new customers as possible, attempted to cross sell more products to their regular customers, and made more efforts on retaining the best customers by offering unprecedented benefits. Most service providers including K telecommunication company tried to adopt the concept of customer relationship management(CRM), and analyze customer's demographic and transactional data statistically in order to understand their customer's behavior. However, managing customer information has still remained at the basic level, and the quality and the quantity of customer data were not enough not only to understand the customers but also to design a strategy for marketing and sales. For example, the currently used 3,074 legal regional divisions, which are originally defined by the government, were too broad to calculate sub-regional customer's service subscription and cancellation ratio. Additional external data such as house size, house price, and household demographics are also needed to measure sales potential. Furthermore, making tables and reports were time consuming and they were insufficient to make a clear judgment about the market situation. In 2009, this company needed a dramatic shift in the way marketing and sales activities, and finally developed a dedicated GIS_based market analysis and sales management system. This system made huge improvement in the efficiency with which the company was able to manage and organize all customer and sales related information, and access to those information easily and visually. After the GIS information system was developed, and applied to marketing and sales activities at the corporate level, the company was reported to increase sales and market share substantially. This was due to the fact that by analyzing past market and sales initiatives, creating sales potential, and targeting key markets, the system could make suggestions and enable the company to focus its resources on the demographics most likely to respond to the promotion. This paper reviews subjective and unclear marketing and sales activities that K telecommunication company operated, and introduces the whole process of developing the GIS information system. The process consists of the following 5 modules : (1) Customer profile cleansing and standardization, (2) Internal/External DB enrichment, (3) Segmentation of 3,074 legal regions into 46,590 sub_regions called blocks, (4) GIS data mart design, and (5) GIS system construction. The objective of this case study is to emphasize the need of GIS system and how it works in the private enterprises by reviewing the development process of the K company's market analysis and sales management system. We hope that this paper suggest valuable guideline to companies that consider introducing or constructing a GIS information system.

Relationship Between Usage Needs Satisfaction and Commitment to Apparel Brand Communities: Moderator Effect of Apparel Brand Image (의류 브랜드 커뮤니티의 이용욕구 충족과 커뮤니티 몰입의 관계: 의류 브랜드 이미지의 조절효과)

  • Hong, Hee-Sook;Ryu, Sung-Min;Moon, Chul-Woo
    • Journal of Global Scholars of Marketing Science
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    • v.17 no.4
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    • pp.51-89
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    • 2007
  • INTRODUCTION Due to the high broadband internet penetration rate and its group-oriented culture, various types of online communities operate in Korea. This study use 'Uses and Gratification Approach, and argue that members' usage-needs satisfaction with brand community is an important factor for promoting community commitment. Based on previous studies identifying the effect of brand image on consumers' responses to various marketing stimuli, this study hypothesizes that brand image can be a moderate variable affecting the relationship between usage-needs satisfaction with brand community and members' commitment to brand community. This study analyzes the influence of usage-needs satisfaction on brand community commitment and how apparel brand image affects the relationships between usage-needs satisfactions and community commitments. The hypotheses of this study are proposed as follows. H1-3: The usage-needs satisfaction of apparel brand community (interest, transaction, relationship needs) influences emotional (H1), continuous (H2), and normative (H3) commitments to apparel brand communities. H4-6: Apparel brand image has a moderating effect on the relationship between usage-needs satisfaction and emotional (H4), continuous (H5), and normative (H6) commitments to apparel brand communities. METHODS Brand communities founded by non-company affiliates were excluded and emphasis was placed instead on communities created by apparel brand companies. Among casual apparel brands registered in 6 Korean portal sites in August 2003, a total of 9 casual apparel brand online communities were chosen, depending on the level of community activity and apparel brand image. Data from 317 community members were analyzed by exploratory factor analysis, moderated regression analysis, ANOVA, and scheffe test. Among 317 respondents answered an online html-type questionnaire, 80.5% were between 16 to 25 years old. There were a total of 150 respondents from apparel brand communities(n=3) recording higher-than-average brand image scores (Mean > 3.75) and a total of 162 respondents from apparel brand communities(n=6) recording lower-than-average brand image scores(Mean < 3.75). In this study, brand community commitment was measured by a 5-point Likert scale: emotional, continuous and normative commitment. The degree of usage-needs satisfaction (interest, transaction, relationship needs) was measured on a 5-point Likert scale. The level of brand image was measured by a 5-point Likert scale: strength, favorability, and uniqueness of brand associations. RESULTS In the results of exploratory factor analysis, the three usage-needs satisfactions with brand community were classified as interest, transaction, and relationship needs. Brand community commitment was also divided into the multi-dimensional factors: emotional, continuous, and normative commitments. The regression analysis (using a stepwise method) was used to test the influence of 3 independent variables (interest-needs satisfaction, transaction-needs, and relationship-needs satisfactions) on the 3 dependent variables (emotional, continuous and normative commitments). The three types of usage-needs satisfactions are positively associated with the three types of commitments to apparel brand communities. Therefore, hypothesis 1, 2, and 3 were significantly supported. Moderating effects of apparel brand image on the relationship between usage-needs satisfaction and brand community commitments were tested by moderated regression analysis. The statistics result showed that the influence of transaction-needs on emotional commitment was significantly moderated by apparel brand image. In addition, apparel brand image had moderating effects on the relationship between relationship-needs satisfaction and emotional, continuous and normative commitments to apparel brand communities. However, there were not significant moderate effects of apparel brand image on the relationships between interest-needs satisfaction and 3 types of commitments (emotional, continuous and normative commitments) to apparel brand communities. In addition, the influences of transaction-needs satisfaction on 2 types of commitments (continuous and normative commitments) were not significantly moderated by apparel brand image. Therefore, hypothesis 4, 5 and 6 were partially supported. To explain the moderating effects of apparel brand image, four cross-tabulated groups were made by averages of usage-needs satisfaction (interest-needs satisfaction avg. M=3.09, transaction-needs satisfaction avg. M=3.46, relationship-needs satisfaction M=1.62) and the average apparel brand image (M=3.75). The average scores of commitments in each classified group are presented in Tables and Figures. There were significant differences among four groups. As can be seen from the results of scheffe test on the tables, emotional commitment in community group with high brand image was higher than one in community group with low brand image when transaction-needs satisfaction was high. However, when transaction-needs satisfaction was low, there was not any difference between the community group with high brand image and community group with low brand image regarding emotional commitment to apparel brand communities. It means that emotional commitment didn't increase significantly without high satisfaction of transaction-needs, despite the high apparel brand image. In addition, when apparel brand image was low, increase in transaction-needs did not lead to the increase in emotional commitment. Therefore, the significant relationship between transaction-needs satisfaction and emotional commitment was found in only brand communities with high apparel brand image, and the moderating effect of apparel brand image on this relationship between two variables was found in the communities with high satisfaction of transaction-needs only. Statistics results showed that the level of emotional commitment is related to the satisfaction level of transaction-needs, while overall response is related to the level of apparel brand image. We also found that the role of apparel brand image as a moderating factor was limited by the level of transaction-needs satisfaction. In addition, relationship-needs satisfaction brought significant increase in emotional commitment in both community groups (high and low levels of brand image), and the effect of apparel brand image on emotional commitment was significant in both community groups (high and low levels of relationship-needs satisfaction). Especially, the effect of brand image was greater when the level of relationship-needs satisfaction was high. in contrast, increase in emotional commitment responding to increase in relationship-needs satisfaction was greater when apparel brand image is high. The significant influences of relationship-needs satisfaction on community commitments (continuous and normative commitments) were found regardless of apparel brand image(in both community groups with low and high brand image). However, the effects of apparel brand image on continuous and normative commitments were found in only community group with high satisfaction level of relationship-needs. In the case of communities with low satisfaction levels of relationship needs, apparel brand image marginally increases continuous and normative commitments. Therefore, we could not find the moderating effect of apparel brand image on the relationship between relationship-needs satisfaction and continuous and normative commitments in community groups with low satisfaction levels of relationship needs, CONCLUSIONS AND IMPLICATIONS From the results of this study, we draw several conclusions; First, the increases in usage-needs satisfactions through apparel brand communities result in the increases in commitments to apparel brand communities, wheres the degrees of such relationship depends on the level of apparel brand image. That is, apparel brand image is a moderating factor strengthening the relationship between usage-needs satisfaction and commitment to apparel brand communities. In addition, the effect of apparel brand image differs, depending on the level and types of community usage-needs satisfactions. Therefore, marketers of apparel brand companies must determine the appropriate usage-needs, depending on the type of commitment they wish to increase and the level of their apparel brand image, to promote member's commitments to apparel brand communities. Especially, relationship-needs satisfaction was very important factor for increasing emotional, continuous and normative commitments to communities. However the level of relationship-needs satisfaction was lower than interest-needs and transaction-needs. satisfaction. According to previous study on apparel brand communities, relationship-need satisfaction was strongly related to member's intention of participation in their communities. Therefore, marketers need to develope various strategies in order to increase the relationship- needs as well as interest and transaction needs. In addition, despite continuous commitment was higher than emotional and normative commitments, all types of commitments to apparel brand communities had scores lower than 3.0 that was mid point in 5-point scale. A Korean study reported that the level of members' commitment to apparel brand community influenced customers' identification with a brand and brand purchasing behavior. Therefore, marketers should try to increase members' usage-needs satisfaction and apparel brand image as the necessary conditions for bringing about community commitments. Second, marketers should understand that they should keep in mind that increasing the level of community usage needs (transaction and relationship) is most effective in raising commitment when the level of apparel brand image is high, and that increasing usage needs (transaction needs) satisfaction in communities with low brand image might not be as effective as anticipated. Therefore, apparel companies with desirable brand image such as luxury designer goods firms need to create formal online brand communities (as opposed to informal communities with rudimentary online contents) to satisfy transaction and relationship needs systematically. It will create brand equity through consumers' increased emotional, continuous and normative commitments. Even though apparel brand is very famous, emotional commitment to apparel brand communities cannot be easily increased without transaction-needs satisfaction. Therefore famous fashion brand companies should focus on developing various marketing strategies to increase transaction-needs satisfaction.

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