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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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The Outcome of Anterior Cruciate Ligament Reconstruction in Patients with Meniscal Injury (반월판 연골 손상이 동반된 환자에서 전방 십자 인대 재건술의 임상적 결과)

  • Lee Kwang Won;Park Jae Guk;Jung Yu Hun;Kim Byung Sung;Kim Ha Yong;Choy Won Sik
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.2
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    • pp.160-168
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    • 2003
  • Purpose : To analyze the anterior stability and functional results after the arthroscopic ACL reconstruction and meniscectomy based on meniscus status at the time of surgery. Materials and Methods : From October 1997 to October 2002, 78 patients (male 64 female 14) were treated by arthroscopic ACL reconstruction and meniscectomy and followed more than 12 months (range, $12\~72$ months, average: 32 months). Average age was 32 years old (range, $18\~57$ years old). We divided the patients into 4 groups; Both menisci was intact (BMI, control group), lateral meniscus removed (LMR), medial meniscus removed (MMR) and both menisci removed (BMR). Anterior passive displacement (objective stability) was estimated using KT-2000 arthrometer under the loading of 15lb,20lb and 30lb and evaluated anterior drawer test, Lachman test, range of motion, thigh circumference. Functional evaluation system of IKDC, OAK and Lysholm knee score was used. Results : Average anterior displacement under the loading of 30lb were 2.47 mm, 2.96 mm, 2.96 mm and 3.57 mm in each group(BMI, LMR, MMR, BMR) and it was statistically significant difference (p<0.05). There is no statistically significant difference in average anterior displacement under the loading of 15lb and 20lb in each group but it has showed decreasing tendency in meniscal removed groups. The mean anterior displacement was within 3 mm in 21 cases, 15 cases, 24 cases and 12 cases (total 72 cases, $94\%$) under the loading of 15lb and 20 cases, 15 cases, 24 cases and 11 cases (total 70 cases, $91\%$) under the loading 20lb of in each group and postoperative knee joint stability has showed increasing tendency (p>0.05). The mean score was 94.5, 93.2, 92.2 and 90.4 points in each group and 71 cases $(91\%)$ were more than excellent or good with a OAK score and fair results were noted 4 cases in both meniscal removed group. There were 65 cases $(83\%)$ with a Lysholm knee score more than excellent or good, and IKDC grading were more than normal or nearly normal in 74 cases $(95\%)$ except 4 cases (2 cases in MMR group and 2 cases in BMR group). Conclusion : Long-term anterior stability and functional results of a successful ACL reconstruction affected by tile status of the menisci at the time of surgery and KT-2000 arthrometer was good for estimation of objective follow up.

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Effects of Joining Coalition Loyalty Program : How the Brand affects Brand Loyalty Based on Brand Preference (브랜드 선호에 따라 제휴 로열티 프로그램 가입이 가맹점 브랜드 충성도에 미치는 영향)

  • Rhee, Jin-Hwa
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.87-115
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    • 2012
  • Introduction: In these days, a loyalty program is one of the most common marketing mechanisms (Lacey & Sneath, 2006; Nues & Dreze, 2006; Uncles et al., 20003). In recent years, Coalition Loyalty Program is more noticeable as one of progressed forms. In the past, loyalty program was operating independently by single product brand or single retail channel brand. Now, companies using Coalition Loyalty Program share their programs as one single service and companies to participate to this program continue to have benefits from their existing program as well as positive spillover effect from the other participating network companies. Instead of consumers to earn or spend points from single retail channel or brand, consumers will have more opportunities to utilize their points and be able to purchase other participating companies products. Issues that are related to form of loyalty programs are essentially connected with consumers' perceived view on convenience of using its program. This can be a problem for distribution companies' strategic marketing plan. Although Coalition Loyalty Program is popular corporate marketing strategy to most companies, only few researches have been published. However, compared to independent loyalty program, coalition loyalty program operated by third parties of partnership has following conditions: Companies cannot autonomously modify structures of program for individual companies' benefits, and there is no guarantee to operate and to participate its program continuously by signing a contract. Thus, it is important to conduct the study on how coalition loyalty program affects companies' success and its process as much as conducting the study on effects of independent program. This study will complement the lack of coalition loyalty program study. The purpose of this study is to find out how consumer loyalty affects affiliated brands, its cause and mechanism. The past study about loyalty program only provided the variation of performance analysis, but this study will specifically focus on causes of results. In order to do these, this study is designed and to verify three primary objects as following; First, based on opinions of Switching Barriers (Fornell, 1992; Ping, 1993; Jones, et at., 2000) about causes of loyalty of coalition brand, 'brand attractiveness' and 'brand switching cost' are antecedents and causes of change in 'brand loyalty' will be investigated. Second, influence of consumers' perception and attitude prior to joining coalition loyalty program, influence of program in retail brands, brand attractiveness and spillover effect of switching cost after joining coalition program will be verified. Finally, the study will apply 'prior brand preference' as a variable and will provide a relationship between effects of coalition loyalty program and prior preference level. Hypothesis Hypothesis 1. After joining coalition loyalty program, more preferred brand (compared to less preferred brand) will increase influence on brand attractiveness to brand loyalty. Hypothesis 2. After joining coalition loyalty program, less preferred brand (compared to more preferred brand) will increase influence on brand switching cost to brand loyalty. Hypothesis 3. (1)Brand attractiveness and (2)brand switching cost of more preferred brand (before joining the coalition loyalty program) will influence more positive effects from (1)program attractiveness and (2)program switching cost of coalition loyalty program (after joining) than less preferred brand. Hypothesis 4. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive more positive impacts from (1)program attractiveness and (2)program switching cost of coalition loyalty program than less preferred brand. Hypothesis 5. After joining coalition loyalty program, (1)brand attractiveness and (2)brand switching cost of more preferred brand will receive less impacts from (1)brand attractiveness and (2)brand switching cost of different brands (having different preference level), which joined simultaneously, than less preferred brand. Method : In order to validate hypotheses, this study will apply experimental method throughout virtual scenario of coalition loyalty program if consumers have used or available for the actual brands. The experiment is conducted twice to participants. In a first experiment, the study will provide six coalition brands which are already selected based on prior research. The survey asked each brand attractiveness, switching cost, and loyalty after they choose high preference brand and low preference brand. One hour break was provided prior to the second experiment. In a second experiment, virtual coalition loyalty program "SaveBag" was introduced to participants. Participants were informed that "SaveBag" will be new alliance with six coalition brands from the first experiment. Brand attractiveness and switching cost about coalition program were measured and brand attractiveness and switching cost of high preference brand and low preference brand were measured as same method of first experiment. Limitation and future research This study shows limitations of effects of coalition loyalty program by using virtual scenario instead of actual research. Thus, future study should compare and analyze CLP panel data to provide more in-depth information. In addition, this study only proved the effectiveness of coalition loyalty program. However, there are two types of loyalty program, which are Single and Coalition, and success of coalition loyalty program will be dependent on market brand power and prior customer attitude. Therefore, it will be interesting to compare effects of two programs in the future.

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A New Exploratory Research on Franchisor's Provision of Exclusive Territories (가맹본부의 배타적 영업지역보호에 대한 탐색적 연구)

  • Lim, Young-Kyun;Lee, Su-Dong;Kim, Ju-Young
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.37-63
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    • 2012
  • In franchise business, exclusive sales territory (sometimes EST in table) protection is a very important issue from an economic, social and political point of view. It affects the growth and survival of both franchisor and franchisee and often raises issues of social and political conflicts. When franchisee is not familiar with related laws and regulations, franchisor has high chance to utilize it. Exclusive sales territory protection by the manufacturer and distributors (wholesalers or retailers) means sales area restriction by which only certain distributors have right to sell products or services. The distributor, who has been granted exclusive sales territories, can protect its own territory, whereas he may be prohibited from entering in other regions. Even though exclusive sales territory is a quite critical problem in franchise business, there is not much rigorous research about the reason, results, evaluation, and future direction based on empirical data. This paper tries to address this problem not only from logical and nomological validity, but from empirical validation. While we purse an empirical analysis, we take into account the difficulties of real data collection and statistical analysis techniques. We use a set of disclosure document data collected by Korea Fair Trade Commission, instead of conventional survey method which is usually criticized for its measurement error. Existing theories about exclusive sales territory can be summarized into two groups as shown in the table below. The first one is about the effectiveness of exclusive sales territory from both franchisor and franchisee point of view. In fact, output of exclusive sales territory can be positive for franchisors but negative for franchisees. Also, it can be positive in terms of sales but negative in terms of profit. Therefore, variables and viewpoints should be set properly. The other one is about the motive or reason why exclusive sales territory is protected. The reasons can be classified into four groups - industry characteristics, franchise systems characteristics, capability to maintain exclusive sales territory, and strategic decision. Within four groups of reasons, there are more specific variables and theories as below. Based on these theories, we develop nine hypotheses which are briefly shown in the last table below with the results. In order to validate the hypothesis, data is collected from government (FTC) homepage which is open source. The sample consists of 1,896 franchisors and it contains about three year operation data, from 2006 to 2008. Within the samples, 627 have exclusive sales territory protection policy and the one with exclusive sales territory policy is not evenly distributed over 19 representative industries. Additional data are also collected from another government agency homepage, like Statistics Korea. Also, we combine data from various secondary sources to create meaningful variables as shown in the table below. All variables are dichotomized by mean or median split if they are not inherently dichotomized by its definition, since each hypothesis is composed by multiple variables and there is no solid statistical technique to incorporate all these conditions to test the hypotheses. This paper uses a simple chi-square test because hypotheses and theories are built upon quite specific conditions such as industry type, economic condition, company history and various strategic purposes. It is almost impossible to find all those samples to satisfy them and it can't be manipulated in experimental settings. However, more advanced statistical techniques are very good on clean data without exogenous variables, but not good with real complex data. The chi-square test is applied in a way that samples are grouped into four with two criteria, whether they use exclusive sales territory protection or not, and whether they satisfy conditions of each hypothesis. So the proportion of sample franchisors which satisfy conditions and protect exclusive sales territory, does significantly exceed the proportion of samples that satisfy condition and do not protect. In fact, chi-square test is equivalent with the Poisson regression which allows more flexible application. As results, only three hypotheses are accepted. When attitude toward the risk is high so loyalty fee is determined according to sales performance, EST protection makes poor results as expected. And when franchisor protects EST in order to recruit franchisee easily, EST protection makes better results. Also, when EST protection is to improve the efficiency of franchise system as a whole, it shows better performances. High efficiency is achieved as EST prohibits the free riding of franchisee who exploits other's marketing efforts, and it encourages proper investments and distributes franchisee into multiple regions evenly. Other hypotheses are not supported in the results of significance testing. Exclusive sales territory should be protected from proper motives and administered for mutual benefits. Legal restrictions driven by the government agency like FTC could be misused and cause mis-understandings. So there need more careful monitoring on real practices and more rigorous studies by both academicians and practitioners.

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The Roles of Service Failure and Recovery Satisfaction in Customer-Firm Relationship Restoration : Focusing on Carry-over effect and Dynamics among Customer Affection, Customer Trust and Loyalty Intention Before and After the Events (서비스실패의 심각성과 복구만족이 고객-기업 관계회복에 미치는 영향 : 실패이전과 복구이후 고객애정, 고객신뢰, 충성의도의 이월효과 및 역학관계 비교를 중심으로)

  • La, Sun-A
    • Journal of Distribution Research
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    • v.17 no.1
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    • pp.1-36
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    • 2012
  • Service failure is one of the major reasons for customer defection. As the business environment gets tougher and more competitive, a single service failure might bring about fatal consequences to a service provider or a firm. Sometimes a failure won't end up with an unsatisfied customer's simple complaining but with a wide-spread animosity against the service provider or the firm, leading to a threat to the firm's survival itself in the society. Therefore, we are in need of comprehensive understandings of complainants' attitudes and behaviors toward service failures and firm's recovery efforts. Even though a failure itself couldn't be fixed completely, marketers should repair the mind and heart of unsatisfied customers, which can be regarded as an successful recovery strategy in the end. As the outcome of recovery efforts exerted by service providers or firms, recovery of the relationship between customer and service provider need to put on the top in the recovery goal list. With these motivations, the study investigates how service failure and recovery makes the changes in dynamics of fundamental elements of customer-firm relationship, such as customer affection, customer trust and loyalty intention by comparing two time points, before the service failure and after the recovery, focusing on the effects of recovery satisfaction and the failure severity. We adopted La & Choi (2012)'s framework for development of the research model that was based on the previous research stream like Yim et al. (2008) and Thomson et al. (2005). The pivotal background theories of the model are mainly from relationship marketing and social relationships of social psychology. For example, Love, Emotional attachment, Intimacy, and Equity theories regarding human relationships were reviewed. As the results, when recovery satisfaction is high, customer affection and customer trust that were established before the service failure are carried over to the future after the recovery. However, when recovery satisfaction is low, customer-firm relationship that had already established in the past are not carried over but broken up. Regardless of the degree of recovery satisfaction, once a failure occurs loyalty intention is not carried over to the future and the impact of customer trust on loyalty intention becomes stronger. Such changes imply that customers become more prudent and more risk-aversive than the time prior to service failure. The impact of severity of failure on customer affection and customer trust matters only when recovery satisfaction is low. When recovery satisfaction is high, customer affection and customer trust become severity-proof. Interestingly, regardless of the degree of recovery satisfaction, failure severity has a significant negative influence on loyalty intention. Loyalty intention is the most fragile target when a service failure occurs no matter how severe the failure criticality is. Consequently, the ultimate goal of service recovery should be the restoration of customer-firm relationship and recovery of customer trust should be the primary objective to accomplish for a successful recovery performance. Especially when failure severity is high, service recovery should be perceived highly satisfied by the complainants because failure severity matters more when recovery satisfaction is low. Marketers can implement recovery strategies to enhance emotional appeals as well as fair treatments since the both impacts of affection and trust on loyalty intention are significant. In the case of high severity of failure, recovery efforts should be exerted to overreach customer expectation, designed to directly repair customer trust and elaborately designed in the focus of customer-firm communications during the interactional recovery process to affect customer trust rebuilding indirectly. Because it is a longer and harder way to rebuild customer-firm relationship for high severity cases, low recovery satisfaction cannot guarantee customer retention. To prevent customer defection due to service failure of high severity, unexpected rewards as a recovery will be likely to be useful since those will lead to customer delight or customer gratitude toward the service firm. Based on the results of analyses, theoretical and managerial implications are presented. Limitations and future research ideas are also discussed.

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Categorizing Quality Features of Franchisees: In the case of Korean Food Service Industry (프랜차이즈 매장 품질요인의 속성분류: 국내 외식업을 중심으로)

  • Byun, Sook-Eun;Cho, Eun-Seong
    • Journal of Distribution Research
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    • v.16 no.1
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    • pp.95-115
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    • 2011
  • Food service is the major part of franchise business in Korea, accounting for 69.9% of the brands in the market. As the food service industry becomes mature, many franchisees have struggled to survive in the market. In general, consumers have higher levels of expectation toward service quality of franchised outlets compared that of (non-franchised) independent ones. They also tend to believe that franchisees deliver standardized service at the uniform food price, regardless of their locations. Such beliefs seem to be important reasons that consumers prefer franchised outlets to independent ones. Nevertheless, few studies examined the impact of qualify features of franchisees on customer satisfaction so far. To this end, this study examined the characteristics of various quality features of franchisees in the food service industry, regarding their relationship with customer satisfaction and dissatisfaction. The quality perception of heavy-users was also compared with that of light-users in order to find insights for developing differentiated marketing strategy for the two segments. Customer satisfaction has been understood as a one-dimensional construct while there are recent studies that insist two-dimensional nature of the construct. In this regard, Kano et al. (1984) suggested to categorize quality features of a product or service into five types, based on their relation to customer satisfaction and dissatisfaction: Must-be quality, Attractive quality, One-dimensional quality, Indifferent quality, and Reverse quality. According to the Kano model, customers are more dissatisfied when Must-be quality(M) are not fulfilled, but their satisfaction does not arise above neutral no matter how fully the quality fulfilled. In comparison, customers are more satisfied with a full provision of Attactive quality(A) but manage to accept its dysfunction. One-dimensional quality(O) results in satisfaction when fulfilled and dissatisfaction when not fulfilled. For Indifferent quality(I), its presence or absence influences neither customer satisfaction nor dissatisfaction. Lastly, Reverse quality(R) refers to the features whose high degree of achievement results in customer dissatisfaction rather than satisfaction. Meanwhile, the basic guidelines of the Kano model have a limitation in that the quality type of each feature is simply determined by calculating the mode statistics. In order to overcome such limitation, the relative importance of each feature on customer satisfaction (Better value; b) and dissatisfaction (Worse value; w) were calculated following the formulas below (Timko, 1993). The Better value indicates how much customer satisfaction is increased by providing the quality feature in question. In contrast, the Worse value indicates how much customer dissatisfaction is decreased by providing the quality feature. Better = (A + O)/(A+O+M+I) Worse = (O+M)/(A+O+M+I)(-1) An on-line survey was performed in order to understand the nature of quality features of franchisees in the food service industry by applying the Kano Model. A total of twenty quality features (refer to the Table 2) were identified as the result of literature review in franchise business and a pre-test with fifty college students in Seoul. The potential respondents of our main survey was limited to the customers who have visited more than two restaurants/stores of the same franchise brand. Survey invitation e-mails were sent out to the panels of a market research company and a total of 257 responses were used for analysis. Following the guidelines of Kano model, each of the twenty quality features was classified into one of the five types based on customers' responses to a set of questions: "(1) how do you feel if the following quality feature is fulfilled in the franchise restaurant that you visit," and "(2) how do you feel if the following quality feature is not fulfilled in the franchise restaurant that you visit." The analyses revealed that customers' dissatisfaction with franchisees is commonly associated with the poor level of cleanliness of the store (w=-0.872), kindness of the staffs(w=-0.890), conveniences such as parking lot and restroom(w=-0.669), and expertise of the staffs(w=-0.492). Such quality features were categorized as Must-be quality in this study. While standardization or uniformity across franchisees has been emphasized in franchise business, this study found that consumers are interested only in uniformity of price across franchisees(w=-0.608), but not interested in standardizations of menu items, interior designs, customer service procedures, and food tastes. Customers appeared to be more satisfied when the franchise brand has promotional events such as giveaways(b=0.767), good accessibility(b=0.699), customer loyalty programs(b=0.659), award winning history(b=0.641), and outlets in the overseas market(b=0.506). The results are summarized in a matrix form in Table 1. Better(b) and Worse(w) index indicate relative importance of each quality feature on customer satisfaction and dissatisfaction, respectively. Meanwhile, there were differences in perceiving the quality features between light users and heavy users of any specific franchise brand in the food service industry. Expertise of the staffs was labeled as Must-be quality for heavy users but Indifferent quality for light users. Light users seemed indifferent to overseas expansion of the brand and offering new menu items on a regular basis, while heavy users appeared to perceive them as Attractive quality. Such difference may come from their different levels of involvement when they eat out. The results are shown in Table 2. The findings of this study help practitioners understand the quality features they need to focus on to strengthen the competitive power in the food service market. Above all, removing the factors that cause customer dissatisfaction seems to be the most critical for franchisees. To retain loyal customers of the franchise brand, it is also recommended for franchisor to invest resources in the development of new menu items as well as training programs for the staffs. Lastly, if resources allow, promotional events, loyalty programs, overseas expansion, award-winning history can be considered as tools for attracting more customers to the business.

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Graves' Disease in Prepubertal Children Compared with Pubertal Children (소아 Graves병의 임상적 고찰 : 사춘기 이전군과 사춘기군의 비교)

  • Kim, Hyun Mi;Yoon, Ju Yun;Jung, Min Ho;Suh, Byung Kyu;Lee, Byung Churl
    • Clinical and Experimental Pediatrics
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    • v.46 no.1
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    • pp.76-82
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    • 2003
  • Purpose : The aim of this study was to determine whether differences exist in the presentation, clinical course, and outcome of Graves' disease between prepubertal children and adolescents. Methods : A retrospective chart review of 14 prepubertal(PREPUB, $7.2{\pm}0.9yr) and 38 pubertal (PUB, $12.4{\pm}1.5yr$) children with Graves' disease between January 1989 and November 1995 at St. Mary's Hospital and Kangnam St. Mary's Hospital was undertaken. Results : There were no significant differences in $T_3$, $T_4$, TSH between two the groups at diagnosis. The PUB group had significantly higher titers of antimicrosomal antibody(positive dilution factor $11,727.3{\pm}22,888.4$) than did the PREPUB group($2,111.5{\pm}2,285.0$, P<0.001). The PREPUB group had significantly higher titers of TSH-binding inhibitory immunoglobulin(TBII, $62.5{\pm}39.6$) than did the PUB group($44.9{\pm}10.4$, P<0.05) before treatment started. The duration(months) of medical therapy before thyroid function tests were normalized was longer in the PREPUB group than in the PUB group($T_3:6.8{\pm}5.0$ vs. $5.4{\pm}13.2$, $T_4:2.3{\pm}1.9$ vs. $2.1{\pm}2.2$, $TBII:26.7{\pm}24.0$ vs. $20.8{\pm}12.1$), especially that of TSH was significantly longer in the PREPUB group($14.6{\pm}11.0$ vs. $6.8{\pm}7.8$, P< 0.05). Total length of medical therapy was significantly longer in the PREPUB group than the PUB group($52.3{\pm}19.3$ vs. $37.9{\pm}16.3months$, P<0.01). During three years of antithyroid drug therapy, in the PREPUB group, the remission rate was lower and the relapse rate was higher than in the PUB group. Total length of treatment correlated negatively with chronological age(P=0.03). Conclusion : Prepubertal children require longer medical therapy to achieve a remission than do pubertal children. But there is an obvious need for more studies because of the small number of patients and the short duration of the follow-up.

An Exploratory Study of Hospice Care to Patients with Advanced Cancer (암환자를 위한 호스피스 케어에 관한 탐색적 연구)

  • Park, Hye-Ja
    • The Korean Nurse
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    • v.28 no.3
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    • pp.52-67
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    • 1989
  • True nursing care means total nursing care which includes physical, emotional and spiritual care. The modern nursing care has tendency to focus toward physical care and needs attention toward emotional and spiritual care. The total nursing care is mandatory for patients with terminal cancer and for this purpose, hospice care became emerged. Hospice case originated from the place or shelter for the travellers to Jerusalem in medieval stage. However, the meaning of modem hospice care became changed to total nursing care for dying patients. Modern hospice care has been developed in England, and spreaded to U.S.A. and Canada for the patients with terminal cancer. Nowaday, it became a part of nursing care and the concept of hospice care extended to the palliative care of the cancer patients. Recently, it was introduced to Korea and received attention as model of total nursing care. This study was attempted to assess the efficacy of hospice care. The purpose of this study was to prove a difference in terms of physical, emotional a d spiritual aspect between the group who received hospice care and who didn't receive hospice care. The subject for this study were 113 patients with advanced cancer who were hospitalized in the S different hospitals. 67 patients received hospice care in 4 different hospitals, and 46 patients didn't receive hospice care in another 4 different hospitals. The method of this study was the questionaire which was made through the descriptive study. The descriptive study was made by individual contact with 102 patients cf advanced cancer for 9 months period. The measurement tool for questionaire was made by author through the descriptive study, and included the personal religious orientation obtained from chung(originated R. Fleck) and 5 emotional stages before dying from Kubler Ross. The content ol questionaire consisted in 67 items which included 11 for general characteristics, 10 for related condition with cancer, 13 for wishes far physical therapy, 13 for emotional reactions and 20 for personal religious orientation. Data for this study was collected from Aug. 25 to Oct. 6 by author and 4 other nurse's who received education and training by author for the collection of data. The collected data were ana lysed using descriptive statistics, $X^2-test$, t-test and pearson correlation coefficient. Results of the study were as follows: "H.C Group" means the group of patient with cancer who received hospice care. "Non H.C Group" means the group of patient with cancer who did not receive hospice care. 1. There is a difference between H.C Group and Non H.C Group in term of the number of physical symptoms, subjective degree of pain sensation and pain control, subjective beliefs in physical cure, emotional reaction, help of present emotional and spiritual care from other personal, needs of emotional and spiritual care in future, selection of treatment method by patients and personal religious orientation. 2. The comparison of H.C Group and Non H.C Group 1) There is no difference in wishes for physical therapy between two groups(p=.522). Among Non H.C Group, a group, who didn't receive traditional therapy and herb medicine was higher than a group who received these in degree of belief that the traditional therapy and herb medicine can cure their disease, and this result was higher in comparison to H.C Group(p=.025, p=.050). 2) Non H.C Group was higher than H.C Group in degree of emotional reaction(p=.050). H.C Group was higher than Non H.C Group in denial and acceptant stage among 5 different emotional stages before dying described by Kubler Ross, especially among the patient who had disease more than 13 months(p=.0069, p=.0198). 3) Non H.C Group was higher than H. C Group in demanding more emotional and spiritual care to doctor, nurse, family and pastor(p=. 010). 4) Non H.C Group was higher than H.C Group in demanding more emotional and spiritual care to each individual of doctor, nurse and family (p=.0110, p=.0029, P=. 0053). 5) H.C Group was higher th2.n Non H.C Group in degree of intrinsic behavior orientation and intrinsic belief orientation of personal religious orientation(p=.034, p=.026). 6) In H.C Group and Non H.C Group, the degree of emotional demanding of christians was significantly higher than non christians to doctor, nurse, family and pastor(p=. 000, p=.035). 7) In H.C Group there were significant positive correlations as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and: the degree of intrinsic behavior orientation in personal religious orientation(r=. 5512, p=.000). (2) Between the degree of emotional demandings to doctor, nurse. family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.4795, p=.000). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic: belief orientation in personal religious orientation(r=.8986, p=.000). (4) Between the degree of extrinsic religious orientation and the degree of consensus religious orientation in personal religious orientation (r=. 2640, p=.015). In H.C. Group there were significant negative correlations as following; (1) Between the degree of intrinsic behavior orientation and extrinsic religious orientation in personal religious orientation (r=-.4218, p=.000). (2) Between the degree or intrinsic behavior orientation and consensus religious orientation in personal religious orientation(r=-. 4597, p=.000). (3) Between the degree of intrinsic belief orientations and the degree of extrinsic religious orientation in personal religious orientation(r=-.4388, p=.000). (4) Between the degree of intrinsic belief orientation and the degree of consensus religious orientation in personal religious orientation(r=-. 5424, p=.000). 8) In Non H.C Group there were significant positive correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic behavior orientation in personal religious orientation(r= .3566, p=.007). (2) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of intrinsic belief orientation in personal religious orientation(r=.3430, p=.010). (3) Between the degree of intrinsic behavior orientation and the degree of intrinsic belief orientation in personal religious orientation(r=.9723, p=.000). In Non H.C Group there were significant negative correlation as following; (1) Between the degree of emotional demandings to doctor, nurse, family & pastor and the degree of extrinsic religious orientation in personal religious orientation(r= -.2862, p=.027). (2) Between the degree of intrinsic behavior orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5083, p=.000). (3) Between the degree of intrinsic belief orientation and the degree of extrinsic religious orientation in personal religious orientation(r=-. 5013, p=.000). In conclusion above datas suggest that hospice care provide effective total nursing care for the patients with terminal cancer, and hospice care is mandatory in all medical institutions.

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Actual Status of Constipation and Life Factors Affecting Constipation by Diagnosis of Rome in Female University Students in Korea (일부 한국여대생의 로마진단기준에 의한 변비 실태조사 및 변비에 영향을 미치는 생활요인)

  • Jung, Su-Jin;Chae, Soo-Wan;Sohn, Hee-Sook;Kim, Sook-Bae;Rho, Jeong-Ok;Baik, Sang-Ho;Kang, Myung-Hee;Kim, Gun-Hee;Kim, Mi-Hyun;Kim, Hyun-Sook;Park, Eun-Ju;Heo, Young-Ran;Cha, Youn-Soo
    • Journal of Nutrition and Health
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    • v.44 no.5
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    • pp.428-442
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    • 2011
  • This study investigated the actual status of constipation. In total, 978 female students in Korea participated. We identified the relationship among constipation and life style, clothing patterns, housing patterns, dietary habits, and dietary intake in a constipation symptom group and a normal group. The actual constipation rate based on the Rome II criteria was 27.0% (n = 264). Body weight (p < 0.05) and body mass index (p < 0.05) in the constipation group were significantly higher than those in the normal group. The incidence of functional bowel disease and irritable bowel syndrome in the constipation group were significantly higher than those in the normal group. The discomfort of wearing underwear was significantly higher in the constipation group than that in the normal group. The constipation group revealed a significantly higher rate of irregular dietary habits than those in the normal group. The dietary diversity score of the normal group was 4.22 (p < 0.05), which was significantly higher than that of constipation group (4.12). No significant difference in life style factors was observed. It is necessary for university female students to correct their dietary habits, maintain food intake of three times per day, and select diverse foods. Furthermore, it is necessary for university female students to wear comfortable clothing to lessen symptoms and improve constipation rates.

Effects of the Seed Treatment on Field Germination and Seedling Growth in four useful species, Euonymus alatus, Nandina domestica, Thea sinensis and Zanthoxylum piperitum (화살, 남천, 차, 초피나무 4유용수종(有用樹種)의 종자(種子) 발아촉진처리(發芽促進處理)가 포지발아(圃地發芽)와 유묘(幼苗) 생장(生長)에 미치는 효과)

  • Goo, Gwan Hyo;Choi, Jai Sik;Youn, Ki Sik
    • Journal of Korean Society of Forest Science
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    • v.84 no.1
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    • pp.87-96
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    • 1995
  • We examined the effects of seed treatment on field germination rate and seedling growth for four woody species, Euonymus alatus, Thea sinensis, Zanthoxylum piperitum, Nandina domestia which are economically useful in Korea. The seeds of each species were purified carefully after collection during Oct. and Nov.. E. alatus, T. sinensis, and Z. piperitum were sowed in the experimental field after stored in open ground with treatment of Pon-Pon. $H_2O_2$, $GA_3$, scarification. and N. domestica was sowed in container within green house after treatment of three different periods(7, 15, 21days) in growth chamber(4, 25, $32^{\circ}C$). Germination rate and seedling growth were measured in mid-Oct.. In E. alatus germination rate was higher in storaging in open ground after soaking in $GA_3$(67.1%) than in only storaging in open ground(18.4%). But the rate in T. sinensis showed no differences between storage in open ground after treatment of $GA_3$, and scarification, and only storage in open ground, Germination rate of Z. piperitum was much higher in storaging in open ground after treatment of Pon-Pon(80.3%) than in only storaging in open ground(12.4%). In N. domestica. seeds stored for 7 days at $32^{\circ}C$ were germinated faster than those stored for 7 days at $4^{\circ}C$, and germination rate of the former was also higher than that of the latter. Peak Times of seed germination in field were order of E. alatus (32 days). Z. piperitum (49 days). T. sinensis (83 days), N. domestica (87 days). The growth of seedling germinated in field showed a good result because of early germination following the effect of seed treatment. The periods of highest growth performances of the seedlings were 72 days in late Jun.-mid Jul. in E. alatus. 59 days in late Jun.- mid Jul. in Z. Piperitum, and 45 days in mid Aug.- mid Sep. in T. sinensis.

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