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A Comparative Study on the Characteristics of Cultural Heritage in China and Vietnam (중국과 베트남의 문화유산 특성 비교 연구)

  • Shin, Hyun-Sil;Jun, Da-Seul
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.40 no.2
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    • pp.34-43
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    • 2022
  • This study compared the characteristics of cultural heritage in China and Vietnam, which have developed in the relationship of mutual geopolitical and cultural influence in history, and the following conclusions were made. First, the definition of cultural heritage in China and Vietnam has similar meanings in both countries. In the case of cultural heritage classification, both countries introduced the legal concept of intangible cultural heritage through UNESCO, and have similarities in terms of intangible cultural heritage. Second, while China has separate laws for managing tangible and intangible cultural heritages, Vietnam integrally manages the two types of cultural heritages under a single law. Vietnam has a slower introduction of the concept of cultural heritage than China, but it shows high integration in terms of system. Third, cultural heritages in both China and Vietnam are graded, which is applied differently depending on the type of heritage. The designation method has a similarity in which the two countries have a vertical structure and pass through steps. By restoring the value of heritage and complementing integrity through such a step-by-step review, balanced development across the country is being sought through tourism to enjoy heritage and create economic effects. Fourth, it was confirmed that the cultural heritage management organization has a central government management agency in both countries, but in China, the authority of local governments is higher than that of Vietnam. In addition, unlike Vietnam, where tangible and intangible cultural heritage are managed by an integrated institution, China had a separate institution in charge of intangible cultural heritage. Fifth, China is establishing a conservation management policy focusing on sustainability that harmonizes the protection and utilization of heritage. Vietnam is making efforts to integrate the contents and spirit of the agreement into laws, programs, and projects related to cultural heritage, especially intangible heritage and economic and social as a whole. However, it is still dependent on the influence of international organizations. Sixth, China and Vietnam are now paying attention to intangible heritage recently introduced, breaking away from the cultural heritage protection policy centered on tangible heritage. In addition, they aim to unite the people through cultural heritage and achieve the nation's unified policy goals. The two countries need to use intangible heritage as an efficient means of preserving local communities or regions. A cultural heritage preservation network should be established for each subject that can integrate the components of intangible heritage into one unit to lay the foundation for the enjoyment of the people. This study has limitations as a research stage comparing the cultural heritage system and preservation management status in China and Vietnam, and the characteristic comparison of cultural heritage policies by type remains a future research task.

The Effects of the Perceived Motivation Type toward Corporate Social Responsibility Activities on Customer Loyalty (기업사회책임활동적인지인지동기류형대고객충성도적영향(企业社会责任活动的认知认知动机类型对顾客忠诚度的影响))

  • Kim, Kyung-Jin;Park, Jong-Chul
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.5-16
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    • 2009
  • Corporate social responsibility (CSR) activities have been shown to be potential factors that can improve corporate image and increase the ability of corporations to compete. However, most previous studies related to CSR activities investigated how these activities influence product and corporate evaluation, as well as corporate image. In addition, some researchers treated consumers' perceptions of corporate motives as moderator variables in evaluating the relationship between corporate social responsibilities and consumer response. However, motive-based theories have some weaknesses. Corporate social responsibility activities cause two motives(egoistic vs. altruistic) for consumers, but recently, Vlachos et al. (2008) argued that these motives should be segmented. Thus, it is possible to transform the original theory into a modified theory model (persuasion knowledge model, PKM). Vlachos et al. (2008) segmented corporate social responsibility motives into four types and compared the effects of these motives on customer loyalty. Prior studies have proved that CSR activities with positive motives have positive influences on customer loyalty. However, the psychological reasons underlying this finding have not been determined empirically. Thus, the objectives of this research are twofold. First, we attempt to determine why most customers favor companies that they feel have positive motives for their corporate social responsibility activities. Second, we attempt to measure the effects of consumers' reciprocity when society benefits from corporate social responsibility activities. The following research hypotheses are constructed. H1: Values-driven motives for corporate social responsibility activities have a positive influence on the perceived reciprocity. H2: Stakeholder-driven motives for corporate social responsibility activities have a negative influence on the perceived reciprocity. H3: Egoistic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H4: Strategic-driven motives for corporate social responsibility activities have a negative influence on perceived reciprocity. H5: Perceived reciprocity for corporate social responsibility activities has a positive influence on consumer loyalty. A single company is selected as a research subject to understand how the motives behind corporate social responsibility influence consumers' perceived reciprocity and customer loyalty. A total sample of 200 respondents was selected for a pilot test. In addition, to ensure a consistent response, we ensured that the respondents were older than 20 years of age. The surveys of 172 respondents (males-82, females-90) were analyzed after 28 invalid questionnaires were excluded. Based on our cutoff criteria, the model fit the data reasonably well. Values-driven motives for corporate social responsibility activities had a positive effect on perceived reciprocity (t = 6.75, p < .001), supporting H1. Morales (2005) also found that consumers appreciate a company's social responsibility efforts and the benefits provided by these efforts to society. Stakeholder-driven motives for corporate social responsibility activities did not affect perceived reciprocity (t = -.049, p > .05). Thus, H2 was rejected. Egoistic-driven motives (t = .3.11, p < .05) and strategic-driven (t = -4.65, p < .05) motives had a negative influence on perceived reciprocity, supporting H3 and H4, respectively. Furthermore, perceived reciprocity had a positive influence on consumer loyalty (t = 4.24, p < .05), supporting H5. Thus, compared with the general public, undergraduate students appear to be more influenced by egoistic-driven motives. We draw the following conclusions from our research findings. First, value-driven attributions have a positive influence on perceived reciprocity. However, stakeholder-driven attributions have no significant effects on perceived reciprocity. Moreover, both egoistic-driven attributions and strategic-driven attributions have a negative influence on perceived reciprocity. Second, when corporate social responsibility activities align with consumers' reciprocity, the efforts directed towards social responsibility activities have a positive influence on customer loyalty. In this study, we examine whether the type of motivation affects consumer responses to CSR, and in particular, we evaluate how CSR motives can influence a key internal factor (perceived reciprocity) and behavioral consumer outcome (customer loyalty). We demonstrate that perceived reciprocity plays a mediating role in the relationship between CSR motivation and customer loyalty. Our study extends the research on consumer CSR-inferred motivations, positing them as a direct indicator of consumer responses. Furthermore, we convincingly identify perceived reciprocity as a sub-process mediating the effect of CSR attributions on customer loyalty. Future research investigating the ultimate behavior and financial impact of CSR should consider that the impacts of CSR also stem from perceived reciprocity. The results of this study also have important managerial implications. First, the central role that reciprocity plays indicates that managers should routinely measure how much their socially responsible actions create perceived reciprocity. Second, understanding how consumers' perceptions of CSR corporate motives relate to perceived reciprocity and customer loyalty can help managers to monitor and enhance these consumer outcomes through marketing initiatives and management of CSR-induced attribution processes. The results of this study will help corporations to understand the relative importance of the four different motivations types in influencing perceived reciprocity.

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Legal Issues in Protecting and Utilitizing Medical Data in United States - Focused on HIPAA/HITECH, 21st Century Cures Act, Common Law, Guidance - (미국의 보건의료데이터 보호 및 활용을 위한 주요 법적 쟁점 -미국 HIPAA/HITECH, 21세기 치료법, 공통규칙, 민간 가이드라인을 중심으로-)

  • Kim, Jae Sun
    • The Korean Society of Law and Medicine
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    • v.22 no.4
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    • pp.117-157
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    • 2021
  • This research reviewed the HIPAA/HITECH, 21st Century Cures Act, Common Law, and private Guidances from the perspectives in protecting and utilitizing the medical data, while implications were followed. First, the standards for protection and utilization are relatively clearly regulated through single law on personal medical information in the United States. The HIPAA has been introduced in 1996 as fundamental act on protection of medical data. Medical data was divided into personally identifiable information, non-identifying information, and limited dataset under HIPAA. Regulations on de-identification measures for medical information, objects for deletion of limited data sets, and agreement on prohibition of data re-identification were stipulated. Moreover, in the 21st Century Cures Act regulated mutual compatibility for data sharing, prohibition of data blocking, and strengthening of accessibility of data subjects. Common Law introduced comprehensive consent system and clearly stipulates procedures. Second, the regulatory system is relatively simplified and clearly stipulated in the United States. To be specific, the expert consensus and the safe harbor system were introduced as an anonymity measure for identifiable medical information, which clearly defines the process while increasing trust. Third, the protection of the rights of the data subject is specified, the duty of explanation is specified in detail, while the information right of the consumer (opt-out procedure) for identification information is specified. For instance, the HHS rule and FDA regulations recognize the comprehensive consent system for human research, but the consent procedure, method, and requirements are stipulated through the common rule. Fourth, in the case of the United States, a trust-based system is being used throughout the health and medical data legislation. To be specific, Limited Data Sets are allowed to use in condition to the researcher's agreement to prohibit re-identification, and de-identification or consent process is simplified under the system.

Factors Influencing Satisfaction on Home Visiting Health Care Service of the Elderly based on the degree of chronic diseases (만성질환 유병상태에 따른 노인 방문건강관리 서비스 만족도 영향요인 연구)

  • Seo, Daram;Shon, Changwoo
    • 한국노년학
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    • v.41 no.2
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    • pp.271-284
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    • 2021
  • This study was conducted to derive factors that affect the satisfaction of home visiting health care services and to develop effective community care models by using the results of Seoul's outreach service which is the basis for Korean community care. The population of the study was the elderly aged 65 and 70 who participated in the Seoul's outreach community services 3rd stage (July 2017 - June 2018) and 4th stage (July 2018 to June 2019). 2,200 people were extracted by the proportional allocation method and home visit interviews were conducted on them. Subjects were divided into sub-groups based on chronic disease prevalence, and logistic regression was conducted to derive factors that affect the satisfaction of home visiting health care services. The results demonstrated that the elderly without chronic diseases were more satisfied when they received health education and counseling services, the elderly with one chronic disease were more satisfied when they received Community resource-linked services. In the case of elderly people with two or more chronic diseases, the service satisfaction level is increased when health condition assessment and Community resource-linked services are provided. Regardless of whether or not they have chronic diseases, service delivery time was a factor that increased satisfaction in home visiting health care. And the degree of explanation understanding was a factor that increased satisfaction for both single and complex chronic patients. Home Visiting health care services based on the community is a key component of the ongoing community care. In order to increase the sustainability and effectiveness of community care in the future, Community-oriented health care services based on the degree of chronic diseases of the elderly should be provided. In order to provide more effective services, however, it is necessary (1) to establish a linkage system to share health information of the subject held by the National Health Insurance Service to local governments and (2) to provide capacity-building education for visiting nurses to improve the quality of home visiting health care services. It is hoped that this study will be us ed as bas ic data for the successful settlement of community care.

Analysis of Metadata Standards of Record Management for Metadata Interoperability From the viewpoint of the Task model and 5W1H (메타데이터 상호운용성을 위한 기록관리 메타데이터 표준 분석 5W1H와 태스크 모델의 관점에서)

  • Baek, Jae-Eun;Sugimoto, Shigeo
    • The Korean Journal of Archival Studies
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    • no.32
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    • pp.127-176
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    • 2012
  • Metadata is well recognized as one of the foundational factors in archiving and long-term preservation of digital resources. There are several metadata standards for records management, archives and preservation, e.g. ISAD(G), EAD, AGRkMs, PREMIS, and OAIS. Consideration is important in selecting appropriate metadata standards in order to design metadata schema that meet the requirements of a particular archival system. Interoperability of metadata with other systems should be considered in schema design. In our previous research, we have presented a feature analysis of metadata standards by identifying the primary resource lifecycle stages where each standard is applied. We have clarified that any single metadata standard cannot cover the whole records lifecycle for archiving and preservation. Through this feature analysis, we analyzed the features of metadata in the whole records lifecycle, and we clarified the relationships between the metadata standards and the stages of the lifecycle. In the previous study, more detailed analysis was left for future study. This paper proposes to analyze the metadata schemas from the viewpoint of tasks performed in the lifecycle. Metadata schemas are primarily defined to describe properties of a resource in accordance with the purposes of description, e.g. finding aids, records management, preservation and so forth. In other words, the metadata standards are resource- and purpose-centric, and the resource lifecycle is not explicitly reflected in the standards. There are no systematic methods for mapping between different metadata standards in accordance with the lifecycle. This paper proposes a method for mapping between metadata standards based on the tasks contained in the resource lifecycle. We first propose a Task Model to clarify tasks applied to resources in each stage of the lifecycle. This model is created as a task-centric model to identify features of metadata standards and to create mappings among elements of those standards. It is important to categorize the elements in order to limit the semantic scope of mapping among elements and decrease the number of combinations of elements for mapping. This paper proposes to use 5W1H (Who, What, Why, When, Where, How) model to categorize the elements. 5W1H categories are generally used for describing events, e.g. news articles. As performing a task on a resource causes an event and metadata elements are used in the event, we consider that the 5W1H categories are adequate to categorize the elements. By using these categories, we determine the features of every element of metadata standards which are AGLS, AGRkMS, PREMIS, EAD, OAIS and an attribute set extracted from DPC decision flow. Then, we perform the element mapping between the standards, and find the relationships between the standards. In this study, we defined a set of terms for each of 5W1H categories, which typically appear in the definition of an element, and used those terms to categorize the elements. For example, if the definition of an element includes the terms such as person and organization that mean a subject which contribute to create, modify a resource the element is categorized into the Who category. A single element can be categorized into one or more 5W1H categories. Thus, we categorized every element of the metadata standards using the 5W1H model, and then, we carried out mapping among the elements in each category. We conclude that the Task Model provides a new viewpoint for metadata schemas and is useful to help us understand the features of metadata standards for records management and archives. The 5W1H model, which is defined based on the Task Model, provides us a core set of categories to semantically classify metadata elements from the viewpoint of an event caused by a task.

Haptic Perception presented in Picturesque Gardens - With a Focus on Picturesque Garden in Eighteenth-Century England - (픽처레스크 정원에 나타난 촉지적 지각 - 18세기 영국 픽처레스크 정원을 중심으로 -)

  • Kim, Jin-Seob;Kim, Jin-Seon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.44 no.2
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    • pp.37-51
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    • 2016
  • Modern optical mechanisms slanted toward Ocular-centrism have neglected diverse functions of vision, judged objects in abstract and binary perspectives, and organized spaces accordingly, there by neglecting the function of eyes groping objects. Recently, various experiences have been induced through communication with other senses by the complex perception beyond the binary perception system of vision. Haptic perception is dynamic vision that induces accompanying bodily experiences through interaction among the various senses; it recognizes the characteristics of material properties and various sensitive stimulations of human beings. This study elaborates on the major features of haptic perception by examining the theoretical background of this concept, which stimulates the active experience of the subject and determines how characteristics of haptic perception are displayed in picturesque gardens. In order to identify the major features of haptic perception, this study examines how Adolf Hildebrand's theory of vision is developed, expanded, and reinterpreted by Alois Riegl, Wilhelm Worringer, Walter Benjamin, Maurice Merleau Ponty, and Gilles Deleuze in the histories of philosophy and aesthetics. Based thereon, the core differences in haptic perception models and visual perception models are analyzed, and the features of haptic perception are identified. Then, classical gardens are set for visual perception and picturesque gardens are set for haptic perception so that the features from haptic perception identified previously are projected onto the picturesque gardens. The research results drawn from this study regarding features of haptic perception presented in picturesque gardens are as follows. The core differences of haptic perception in contrast to visual perception can be summarized as ambiguity and obscureness of boundaries, generation of dynamic perspectives, induction of motility by indefinite circulation, and strangeness and sublime beauty by the impossibility of perception. In picturesque gardens, the ambiguity and obscureness of boundaries are presented in the irregularity and asymmetric elements of planes and the rejection of a single view, and the generation of dynamic perspectives results from the adoption of narrative structure and overlapping of spaces through the creation of complete views, medium range views, and distant views, which the existing gardens lack. Thus, the scene composition technique is reproduced. The induction of motility by indefinite circulation is created by branching circulation, and strangeness and sublime beauty are presented through the use of various elements and the adoption of 'roughness', 'irregularity', and 'ruins' in the gardens.

Assessment of Anion Generation on the Isolated Trees at Summer (여름철 단일수목의 음이온 발생에 관한 평가)

  • Kim, Jeong-Ho;Seo, Yu-Hwan;Joo, Chang-Hun;Yoon, Yong-Han
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.4
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    • pp.1-9
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    • 2014
  • This research aims to analyze changes in anion according to locations through changes in the measuring point centering on a single tree. The subject tree was the Zelkova serrata which is most widely used as a landscape tree, and the measurement was conducted for a total of 3 days with summer solstice as the basic date. In consideration of the solar altitude and the location of the Zelkova serrata, a total of 4 measurement points - $T_a$ at the opposite direction of the shadow, $T_b$ in the center of the tree $T_c$ in the center of the shadow, and $T_d$ at the end of the shadow - were established. The mean temperature of the measurement days was the highest at $T_a$ with $28.4^{\circ}C$ and was the lowest at $T_c$, in the center of the shadow with $27.9^{\circ}C$. The relative humidity was the lowest with 42.5% at $T_a$ where the temperature was the highest. The amount of insolation was the highest at $T_a$ with $1,024.6W/m^2$, followed by $T_d(701.48W/m^2$), $T_c$($215.63W/m^2$), and $T_b(227.75W/m^2)$, and the anion was the highest at $T_a$ with $654ea/cm^3$, followed by $T_d$, $T_c$, and $T_b$, with $639.4ea/cm^3$, $615.3ea/cm^3$, $612.3ea/cm^3$, respectively. The results of the correlation analysis proved that anion correlated with the temperature, the amount of insolation, and the relative humidity on the significant level. Of these, the temperature and the amount of insolation had the positive correlation with the correlation coefficients of .687 and .332, respectively, and the significance probability of .000, and .037, respectively. The relative humidity was found to have negative correlation. Its correlation coefficient and the significance probability were -.557, and .000, respectively.

Business Strategies for Korean Private Security-Guard Companies Utilizing Resource-based Theory and AHP Method (자원기반 이론과 AHP 방법을 활용한 민간 경호경비 기업의 전략 연구)

  • Kim, Heung-Ki;Lee, Jong-Won
    • Korean Security Journal
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    • no.36
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    • pp.177-200
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    • 2013
  • As we enter a high industrial society that widens the gap between the rich and poor, demand for the security services has grown explosively. With the growth in quantitative expansion of security services, people have also placed increased requirements on more sophisticated and diversified security services. Consequently, market outlook for private security services industry is positive. However, Korea's private security services companies are experiencing difficulties in finding a direction to capture this new market opportunity due to their small sizes and lack of management-strategic thinking skills. Therefore, we intend to offer a direction of development for our private security services industry using a management-strategy theory and the Analytic Hierarchy Process(AHP), a structured decision-making method. A resource-based theory is one of the important management strategy theories. It explains that a company's overall performance is primarily determined by its competitive resources. Using this theory, we could analyze a company's unique resources and core competencies and set a strategic direction for the company accordingly. The usefulness and validity of this theory has been demonstrated as it has often been subject to empirical verification since 1990s. Based on this theory, we outlined a set of basic procedures to establish a management strategy for the private security services companies. We also used the AHP method to identify competitive resources, core competencies, and strategies from private security services companies in contrast with public companies. The AHP method is a technique that can be used in the decision making process by quantifying experts' knowledge and unstructured problems. This is a verified method that has been used in the management decision making in the corporate environment as well as for the various academic studies. In order to perform this method, we gathered data from 11 experts from academic, industrial, and research sectors and drew distinctive resources, competencies, and strategic direction for private security services companies vis-a-vis public organizations. Through this process, we came to the conclusion that private security services companies generally have intangible resources as their distinctive resources compared with public organization. Among those intangible resources, relational resources, customer information, and technologies were analyzed as important. In contrast, tangible resources such as equipment, funds, distribution channels are found to be relatively scarce. We also found the competencies in sales and marketing and new product development as core competencies. We chose a concentration strategy focusing on a particular market segment as a strategic direction considering these resources and competencies of private security services companies. A concentration strategy is the right fit for smaller companies as a strategy to allow them to focus all of their efforts on target customers in a single segment. Thus, private security services companies would face the important tasks such as developing a new market and appropriate products for such market segment and continuing marketing activities to manage their customers. Additionally, continuous recruitment is required to facilitate the effective use of human resources in order to strengthen their marketing competency in a long term.

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Comparative Study on the Nurses' Job Satisfaction between the Oriental Medicine Ward and the General Ward (한방병동과 일반병동 간호사의 직무만족도의 비교연구)

  • Byun, Chang-Ja;Choi, Sang-Soon;Paik, Seung-Nam;Lee, Mi-Aie
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.97-111
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    • 1995
  • In our society today, a variety of medical caring system, along with a scientific development in the area of oriental medical science plus national demand, has increased the augmentation and the opening of oriental wards and hospitals (Han Bang), which has come to create an additional requirement of nursing activity at oriental medicine wards should be different from that of the general wards or the same as the other. In view of this, various studies need to be made in this connection. The purpose of this study is to comprehend the number of nurses who want to work at oriental medicine wards and measure job satisfaction in nursing as compared with those working at general wards so as to provide basic materials for future assignment and supplementary training for the nurses. An attempt was made to contribute toward nursing administration on the one hand improving nursing training course on the other hand. A total of 72 nurses currently working at two oriental medicine hospitals available in Seoul and 82 general nurses were selected for this study using the questionaire from December 1993 to January 1994. An instrument for the study was based on the measurement of work satisfaction developed by Paula L. Stamps including 37 questions complemented by Kim for revision (1993) and 14 questions regarding general characteristics and oriental medicine wards. The instrument to test dependability showed Cronbach's=0.7711. The collected data have been processed by computer package SPSS. General characteristics of the two groups and the matters involved in oriental medicine wards were calculated into real figure and percentage an similarities between the two groups were analyzed by t-test and F-test according to the characteristics of variables. The comparative test on work satisfaction among the two groups including general characteristics and work factors were conducted by t-test and F-test. The major findings as a result of the study are as follows : 1. As general characteristics, age group of $26{\sim}30$ years are more than any segment of age. As to marital status, the number of those in single status is slightly higher than the married. Approximately 80% of them are graduates of nursing schools and nursing colleges. They are mostly in service for one to three years. There is no significant difference between the two groups. 2. The number of those who want to work at oriental medicine wards represents 40.3% against 58.4%, being in favor of general wards. 3. The reason for service at oriental medicine wards is that "there is room for potential research" which happened to rank first, followed by "easy job," "good working atmosphere" and "growing interest in oriental medicine." 4. Work satisfactions among nurses who work at oriental medicine wards prove greater than that of nurses who work at general wards. 5. Work satisfaction between the two groups by work factors is reflected with significant difference statistically on task requirement, interaction and doctor-nurse relationships. 6. The general charcateristics and the work satisfaction by work factors prove that there are significant difference in age, marital status, education and the period of work. They tend to be more satisfied with the work as they grow in age. Significant differneces are found in the work factors such as autonomy, adiministration and professional job in the relationship with doctor-nurse. As to marital status, the married are more satisfied than the unmarried. There are significant differneces in the factors respecting administration and doctor-nurse college graduates are highly satisfied with task requirement. However, satisfaction with the professional level has proven the highest degree for those having master degree. The period of work and satisfaction : There are significant differneces in task requirement, administration, interactions, professional level and doctor-nurse relationships. As a general rule, the degree of satisfactions is in proportion to the lengrh of service. The following conclusions are drawn based on the fndings mentioned above. Even though the work satisfaction of the nurse who work at oriental medicine ward is relatively high, it is desired that personal consultation be given as to disposition of nurses when they are assigned to oriental medicine wards. It is also recommended that lectures on oriental medicine be conducted through supplementary training and/or basic nursing course in order that they may be motivated for ingenious activities with an increasing sense of self-esteem which will eventually enhance positive changes for the patients who are in need of oriental medicine nursing and for the medical teams. In addition, joint reseaches involvingclinical care and education should be in constant process for unique and scientific development for those who are subject to oriental medicine nursing care.

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The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.