• Research in Community and Public Health Nursing
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• v.6 no.1
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• pp.55-73
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• 1995

An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.34 no.1
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• pp.18-39
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• 2016

The study pertains to reviewing and discussing of the master plan of the main buildings in the palaces of Joseon Dynasty regarding on a Feng Shui concept that has been implemented on the palace axis that is originated from the main mountain. Gyeongbokgung (景福宮) Palace is located on the northwest coner of Hanyang (漢陽) and on the tip of the main mountain which is in contrast a quite distinguishable from the location of the Fobidden city in Beijing located in the middle of a vast basin. Changdeokgung (昌德宮) Palace as well is also located on the tip of Eungbong (鷹峯), a part of Samkaksan (三角山) mountain, of which the locations were designed for the palaces to receive the benevolent force from the main mountain. The same concept was also applied to appointing the ideal location of the maJor buildings such as Jungjeon (正殿: The throne hall), Pyunjeon (便殿: The king's office) and Chimjeon (寢殿: The king and queen's residence) in the palace that must receive the benevolent force from the qui stream also originated from the main mountain, as such that the buildings have in close relationship with the king. Amisa (蛾眉砂) had been considered as an important geographical milestone of the estate where the palace is located, especially as the guiding landmark for other buildings that must be on the land axis. The land axis with the Amisa as the starting point attributed the Feng Shui as an important measure that determines the location and the shape of other buildings. The buildings location was appeared as having the conceptual buildings location as 'front office-back bedroom building (前朝後寢)' and 'three gates-three sectors (三問三朝)' as per the Rites of Zhou (周禮). On both palaces, Amisa is located on the benevolent point of the land, and the king's bed room buildings are located near the Amisa. The main offices were located on the south of the king's bed room buildings. By practicing this type of concept, consequently the king can receive the pure benevolent force first. In the case of the clearly distinguished locations of the buildings in Gyeongbokgung Palace, Chimjeon, Pyunjeon and Jungjeon were located on the same main qui stream. However, in Changdeokgung Palace where scattered qui stream is observed, the buildings are located on the scattered qui stream. The study found that the type of location of Jungjeon receives least amount of benefit from the Feng Shui but reflects primarily the king's authority rather than order and formality of the space.

• Journal of the Korean Institute of Landscape Architecture
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• v.38 no.4
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• pp.25-34
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• 2010

This study was conducted to develop evaluation indicators to improve athletic performance and operational management of golf courses and the results of the research are as follows. Through theoretical research and a preliminary professional survey, 15 on-going evaluations of golf course composition and operational management and 55 sub-evaluation indices were rejected while 10 on-going evaluations and 52 sub-evaluation indicators were reconfigured as final for environmental-friendliness, level of member services, level of human service of game personnel, difficulties of course, management level of the course, fairness of operational management, accessibility and location characteristic, traditions and ambiance of the golf club, quality of course, and course layout. When analyzing the important decision factors in golf course user preference evaluation indicators, the following contributed in the order of higher to lower contributions: the management level of the course, excellence of the course, level of human services for personnel, course layout and environmental-friendliness. When identifying the path coefficient of golf course evaluation indicators, the curvature of a hole and the length of the course had a causal effect on the 'course layout' section. Tournament facilities and various shot values had a causal relationship with 'excellence of the course', in the order of higher to lower, and convenience of waiting and fair allocation of reservations for 'fairness of operational management'. The history of the golf course and its environmental characteristics, history and culture of the region have relatively higher causal effects on 'traditions of the golf club' and geographical conditions on 'accessibility and location characteristics', pesticide and fertilizer usage and water pollution on 'environmental-friendliness', and member benefit and kindness of employees on 'level of member services'. The kindness and expertise of the game personnel had a relatively higher causal effect on the 'level of human services of game personnel', the location of tenning area, and location of OB and hazards on 'difficulties of course', and rough conditions and obstacles management on 'management level of the course'. There is a need to complete a systematic evaluation index system for golf course user preferences through future studies for a more detailed assessment, as well as a process to verify these evaluation indicators by application to domestic and international golf courses.

• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Journal of dental hygiene science
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• v.18 no.4
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• pp.210-217
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• 2018

Periodontal disease is a chronic inflammatory disease that affects quality of life and nutrition. Several studies have demonstrated a link between periodontal disease and low bone density, and vitamin D is expected to have a beneficial effect on periodontal disease as well as on bone mineral density and anti-inflammatory effects. The purpose of this study was to identify the association between periodontal disease and vitamin D because the results are different in some studies and there is a lack of research in Korea. In this study, we conducted a multiple linear regression analysis of 8,783 subjects among 23,626 subjects who were older than 20 years of age, who had serum vitamin D levels and periodontal disease, who had three years of the National Health and Nutrition Survey that was conducted in Korea from 2012 to 2014. We examined the relationship between serum vitamin D levels and periodontal disease. Tooth loss and vitamin D levels were negatively correlated (${\beta}=-0.028$, p=0.008). In addition, the prevalence of periodontal disease was found to be higher in men younger than 50 years of age with lower vitamin D levels (Q1: 1.769 [1.125~2.782], Q2: 1.182 [0.743~1.881], Q3: 0.676 [0.400~1.881]; p=0.001). Low vitamin D levels and periodontal disease are common diseases in primary care. Vitamin D supplementation is expected to have favorable effect on periodontal disease and falls, osteoporosis, osteoarthritis, and cancer. Therefore, patients with periodontal disease may benefit from periodic vitamin D management to improve quality of life as well as to manage periodontal disease. In addition, as shown in this study, not only elderly individuals, but also men younger than 50 years of age are related to periodontal disease, so there should be interest in controlling the levels of vitamin D in adults.

• The Critical Review of Religion and Culture
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• no.31
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• pp.141-172
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• 2017

The objectives of this paper are to investigate hunting, stock raising, sacrifice recorded in the oracle bone inscriptions of Shang Dynasty. I want to raise two basic questions. First, what were the functions of hunting, stock raising, sacrifice, which constructed the world of life in Shang Dynasty? Second, what were the relationships of gods, men, animals derived from them? These questions are brought up to how the commoners of Shang Dynasty build the world and perceive it. I adopted positively prevalent theories for answering those questions. I am particularly provided with Michael J. Puett's insightful remarks in this presentation. He criticizes the previous viewpoint that the relationships of gods and men in ancient China were harmonious and mutually respondent. According to him, in the ancient way of thinking of China the world of gods was full of whimsical and unpredictable power and also contained the risks, which led to disaster to the human world. So it is needed to be controled in a certain way. The sacrifice and the divination must have been instruments for controlling it in ancient China. In the same vein his arguments can be applied to the special connotations of hunting and stock raising, by the benefit of which I developed my own ideas in this paper. The conclusions are as follows. First, Shang dynasty tried to suppress the latent danger of two worlds. The nature represented by animals and the world of gods were respectively considered as the unknown domains, which is to threatening human life. Hunting, stock raising, sacrifice were the ways and means of controlling these two domains of power, which cause chaos in life. Second, the relationships among gods, men, animals had various functions and changed their status role, depending on the circumstances. Hunting and stock raising were important methods to domesticate animals with violence. In this domestication process animals became "victims" but animals are also to be the messengers to gods through being slain in the sacrifice. In this way animals are both inferior and superior to men and hold a unique status between gods and men.

• Journal of Korea Water Resources Association
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• v.54 no.spc1
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• pp.1107-1118
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• 2021

Climate change brought on by global warming increased the frequency of flood and drought on the Korean Peninsula, along with the casualties and physical damage resulting therefrom. Preparation and response to these water disasters requires national-level planning for water resource management. In addition, watershed-level management of water resources requires flow duration curves (FDC) derived from continuous data based on long-term observations. Traditionally, in water resource studies, physical rainfall-runoff models are widely used to generate duration curves. However, a number of recent studies explored the use of data-based deep learning techniques for runoff prediction. Physical models produce hydraulically and hydrologically reliable results. However, these models require a high level of understanding and may also take longer to operate. On the other hand, data-based deep-learning techniques offer the benefit if less input data requirement and shorter operation time. However, the relationship between input and output data is processed in a black box, making it impossible to consider hydraulic and hydrological characteristics. This study chose one from each category. For the physical model, this study calculated long-term data without missing data using parameter calibration of the Soil Water Assessment Tool (SWAT), a physical model tested for its applicability in Korea and other countries. The data was used as training data for the Long Short-Term Memory (LSTM) data-based deep learning technique. An anlysis of the time-series data fond that, during the calibration period (2017-18), the Nash-Sutcliffe Efficiency (NSE) and the determinanation coefficient for fit comparison were high at 0.04 and 0.03, respectively, indicating that the SWAT results are superior to the LSTM results. In addition, the annual time-series data from the models were sorted in the descending order, and the resulting flow duration curves were compared with the duration curves based on the observed flow, and the NSE for the SWAT and the LSTM models were 0.95 and 0.91, respectively, and the determination coefficients were 0.96 and 0.92, respectively. The findings indicate that both models yield good performance. Even though the LSTM requires improved simulation accuracy in the low flow sections, the LSTM appears to be widely applicable to calculating flow duration curves for large basins that require longer time for model development and operation due to vast data input, and non-measured basins with insufficient input data.

• The Korean Society of Law and Medicine
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• v.21 no.2
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• pp.37-73
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• 2020

Medical practice with medical adaptability is not illegal. Consent to medical practice is also not intended to exclude causes of Illegality. The patient's consent to medical practice is the exercise of the right to self-determination, and the patient's right to self-determination is take shape through the doctor's information. If a doctor violates his duty to inform, failure to inform or lack of inform constitutes an act of illegality of omission in itself. As a result, the legal interest of self-determination is violated. The patient has the right to know and make decisions on his or her own, even when it is not connected to the benefit of life and body as the subject of the body. If that infringed and lost, the non-property damage shall be recognized and the immaterial damage must be compensated. On the other hand, the violation of the duty of information does not belong to deny the compensation for physical damage. Which the legal interest violated by violation of the obligation to inform is the self-determination, and loss of opportunity of choice is recognized as ordinary damage. However, if the opportunity of choice was lost because of the infringement of the right to self-determination and the patient could not choice the better way, that dose not occur plainly bad results, under the prove of these causal relationship, that bad results could be compensated. But the unexpectable damage could not be compensated, because the physical damage is considered as the special damage due to the violation of the right of the self-determination.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of Global Scholars of Marketing Science
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• v.18 no.4
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• pp.61-118
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• 2008

The purpose of this research is to construct research framework for international franchising based on existing literature and to identify research components in the framework. Franchise can be defined as management styles that allow franchisee use various management assets of franchisor in order to make or sell product or service. It can be divided into product distribution franchise that is designed to sell products and business format franchise that is designed for running it as business whatever its form is. International franchising can be defined as a way of internationalization of franchisor to foreign country by providing its business format or package to franchisee of host country. International franchising is growing fast for last four decades but academic research on this is quite limited. Especially in Korea, research about international franchising is carried out on by case study format with single case or empirical study format with survey based on domestic franchise theory. Therefore, this paper tries to review existing literature on international franchising research, providing research framework, and then stimulating new research on this field. International franchising research components include motives and environmental factors for decision of expanding to international franchising, entrance modes and development plan for international franchising, contracts and management strategy of international franchising, and various performance measures from different perspectives. First, motives of international franchising are fee collection from franchisee. Also it provides easier way to expanding to foreign country. The other motives including increase total sales volume, occupying better strategic position, getting quality resources, and improving efficiency. Environmental factors that facilitating international franchising encompasses economic condition, trend, and legal or political factors in host and/or home countries. In addition, control power and risk management capability of franchisor plays critical role in successful franchising contract. Final decision to enter foreign country via franchising is determined by numerous factors like history, size, growth, competitiveness, management system, bonding capability, industry characteristics of franchisor. After deciding to enter into foreign country, franchisor needs to set entrance modes of international franchising. Within contractual mode, there are master franchising and area developing franchising, licensing, direct franchising, and joint venture. Theories about entrance mode selection contain concepts of efficiency, knowledge-based approach, competence-based approach, agent theory, and governance cost. The next step after entrance decision is operation strategy. Operation strategy starts with selecting a target city and a target country for franchising. In order to finding, screening targets, franchisor needs to collect information about candidates. Critical information includes brand patent, commercial laws, regulations, market conditions, country risk, and industry analysis. After selecting a target city in target country, franchisor needs to select franchisee, in other word, partner. The first important criteria for selecting partners are financial credibility and capability, possession of real estate. And cultural similarity and knowledge about franchisor and/or home country are also recognized as critical criteria. The most important element in operating strategy is legal document between franchisor and franchisee with home and host countries. Terms and conditions in legal documents give objective information about characteristics of franchising agreement for academic research. Legal documents have definitions of terminology, territory and exclusivity, agreement of term, initial fee, continuing fees, clearing currency, and rights about sub-franchising. Also, legal documents could have terms about softer elements like training program and operation manual. And harder elements like law competent court and terms of expiration. Next element in operating strategy is about product and service. Especially for business format franchising, product/service deliverable, benefit communicators, system identifiers (architectural features), and format facilitators are listed for product/service strategic elements. Another important decision on product/service is standardization vs. customization. The rationale behind standardization is cost reduction, efficiency, consistency, image congruence, brand awareness, and competitiveness on price. Also standardization enables large scale R&D and innovative change in management style. Another element in operating strategy is control management. The simple way to control franchise contract is relying on legal terms, contractual control system. There are other control systems, administrative control system and ethical control system. Contractual control system is a coercive source of power, but franchisor usually doesn't want to use legal power since it doesn't help to build up positive relationship. Instead, self-regulation is widely used. Administrative control system uses control mechanism from ordinary work relationship. Its main component is supporting activities to franchisee and communication method. For example, franchisor provides advertising, training, manual, and delivery, then franchisee follows franchisor's direction. Another component is building franchisor's brand power. The last research element is performance factor of international franchising. Performance elements can be divided into franchisor's performance and franchisee's performance. The conceptual performance measures of franchisor are simple but not easy to obtain objectively. They are profit, sale, cost, experience, and brand power. The performance measures of franchisee are mostly about benefits of host country. They contain small business development, promotion of employment, introduction of new business model, and level up technology status. There are indirect benefits, like increase of tax, refinement of corporate citizenship, regional economic clustering, and improvement of international balance. In addition to those, host country gets socio-cultural change other than economic effects. It includes demographic change, social trend, customer value change, social communication, and social globalization. Sometimes it is called as westernization or McDonaldization of society. In addition, the paper reviews on theories that have been frequently applied to international franchising research, such as agent theory, resource-based view, transaction cost theory, organizational learning theory, and international expansion theories. Resource based theory is used in strategic decision based on resources, like decision about entrance and cooperation depending on resources of franchisee and franchisor. Transaction cost theory can be applied in determination of mutual trust or satisfaction of franchising players. Agent theory tries to explain strategic decision for reducing problem caused by utilizing agent, for example research on control system in franchising agreements. Organizational Learning theory is relatively new in franchising research. It assumes organization tries to maximize performance and learning of organization. In addition, Internalization theory advocates strategic decision of direct investment for removing inefficiency of market transaction and is applied in research on terms of contract. And oligopolistic competition theory is used to explain various entry modes for international expansion. Competency theory support strategic decision of utilizing key competitive advantage. Furthermore, research methodologies including qualitative and quantitative methodologies are suggested for more rigorous international franchising research. Quantitative research needs more real data other than survey data which is usually respondent's judgment. In order to verify theory more rigorously, research based on real data is essential. However, real quantitative data is quite hard to get. The qualitative research other than single case study is also highly recommended. Since international franchising has limited number of applications, scientific research based on grounded theory and ethnography study can be used. Scientific case study is differentiated with single case study on its data collection method and analysis method. The key concept is triangulation in measurement, logical coding and comparison. Finally, it provides overall research direction for international franchising after summarizing research trend in Korea. International franchising research in Korea has two different types, one is for studying Korean franchisor going overseas and the other is for Korean franchisee of foreign franchisor. Among research on Korean franchisor, two common patterns are observed. First of all, they usually deal with success story of one franchisor. The other common pattern is that they focus on same industry and country. Therefore, international franchise research needs to extend their focus to broader subjects with scientific research methodology as well as development of new theory.