• 제목/요약/키워드: Behavioral Management

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웹기반의 신장질환별 영양평가 밑 식사처방 프로그램 (A Web-based Internet Program for Nutritional Assessment and Diet Prescription by Renal Diseases)

  • 한지숙;김종경;전영수
    • 한국식품영양과학회지
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    • 제31권5호
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    • pp.847-885
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    • 2002
  • 본 연구는 임상영양 분야의 전문 웹사이트로서 신장질환 환자를 위한 식사관리 및 영양평가프로그램을 개발하기 위하여 수행되었다 프로그램은 신장질환을 신증후군, 신부전증, 혈액투석 및 복막투석으로 분류하고 식단 및 영양관리 프로그램과 식사섭취의 진단 및 평가 프로그램으로 구성하였다. 프로그램은 신장질환별 영양권장량 및 표준체중 파일, 식사섭취자료, 식품 및 영양소 데이터베이스 파일, 음식영양소 함량 파일, 영양소별 20순위 식품 파일, 신장질환별 식단 및 일일 식단표 파일, 식사력 조사 및 평가 파일, 식사요법 및 영양관리 파일 등을 데이터 베이스로 하여 사용자가 편리하게 이용할 수 있도록 웹 페이지 형식으로 만들어졌다. 사용자는 인터넷 사이트로 들어가 자신의 신장질환 및 일반사항 등을 입력함으로서 표준체중, 체격지수, 열량 및 단백질, 나트륨 등의 영양소 필요량과 함께 사용자의 BUN, Cr, na, K, Ca, P Ccr, Alb이 표준수치와 비교 제시된다. 사용자의 열량 및 영양소 필요양에 대한 정보를 이용하여 그 환자에게 알맞은 10일간의 식단이 제공되며 그 중 원하는 식단의 선택에 따라 식품명, 섭취량, 목측량이 표시된 구체적인 일일 식단표도 제공받을 수 있다. 사용자가 자신이 섭취한 음식에 대하여 영양섭취상태를 평가받으려면 식사섭취 진단 항목을 클릭한 후 섭취 음식 입력 항목을 선택하여 날짜별, 식사별로 자신이 하루동안 섭취한 음식 및 섭취량 등을 입력하고 영양섭취상태를 클릭하면 식사별, 식품군별로 다양하게 식사섭취상태의 진단과 영양평가를 받을 수 있다. 또한 각 신장질환에 따른 식사력 조사 및 상담\ulcorner평가를 이용함으로서 자신의 식습관 및 식사요법 등에 있어서 문제점을 파악할 수 있도록 하였다. 이밖에 신장 질환별로 식품선택방법, 외식, 조리법, 식품교환표 등 환자들이 자신의 영양관리를 하는데 필요한 모든 정보를 제공받을 수 있도록 하였다.

두부 외상 후 섬망의 자문 정신 의학적 고찰 (Delirium after Head Trauma at Psychiatric Consultation)

  • 김현철;이상철;김도훈;이상규;홍승관;손봉기
    • 정신신체의학
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    • 제12권1호
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    • pp.15-22
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    • 2004
  • 연구목적: 두부 외상은 신체적 후유 증상뿐 아니라 다양한 정신 증상을 야기한다. 본 연구에서는 두부 외상 후 섬망을 보이는 환자들을 대상으로 정신과 자문을 실시하고 과다행동 증상의 유무 등의 임상 양상과 회복 기간과의 관련성에 대해 평가하고자 하였다. 방 법: 1998년부터 2002년까지 두부 외상을 주소로 신경외과에 입원한 환자들 중 섬망이 발생하여 정신과에 자문 조정이 의뢰된 45명의 환자를 대상으로 하였다. 섬망 발생 4주 후 추적 자문에서 섬망의 회복 여부에 따라 완전 관해 된 군 및 잔류 증상이 남아 있는 군으로 나누고, 두 군간의 차이를 과다행동 유무와 사회 인구학적 변수, 두부 외상 부위의 빈도에 따라 살펴보았다. 결 과: 첫 자문 주소에서 과다 행동 유무에 따라 분류해 보았을 때 4주 후의 섬망의 관해와 유의미한 관계를 보였다(p<.01). 섬망의 잔류 증상이 남아 있는 군은 완전 관해 된 군에 비해 중환자실 입원 기간 및(p<.05), 전체 입원 기간이 길었다(p<.01). 섬망 발생 4주 후 잔류 증상이 남아 있는 군은 완전 관해된 군에 비해 사고보험과의 관련성이 많았으며(p<.05), 신경 영상학적 조사에서 피질 하 회백질의 손상의 여부와 유의미한 관계를 보였다(p<.05). 결 론: 본 연구를 통해 첫 자문 의뢰 시 과다행동 유무에 따라 섬망의 회복 기간에 유의한 차이가 있었다. 또한 섬망의 회복 기간이 지연될수록 재원기간이 길어짐을 알 수 있었다. 향후 두부 외상 후 섬망 환자의 정신과적 개입에 있어 과다행동의 유무를 비롯한 임상 변수들에 대한 다각적인 연구가 필요할 것으로 사료된다.

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환경의식에 따른 산림생태관광객의 심리적 반응에 관한 연구 (A Study of the Environmental Consciousness Influences on the Psychological Reaction of Forest Ecotourists)

  • 연광호;나승화
    • 유통과학연구
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    • 제10권1호
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    • pp.43-52
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    • 2012
  • 2011년은 유엔(UN)이 지정한 '세계 산림의 해'이다. 최근 들어 산림은 환경, 경제, 사회, 문화 등 우리 사회 제 분야에서 그 가치와 기능이 점차 확대되고 있다. 특히 기후변화에 따른 지구환경문제가 국제적인 아젠다로 부각되면서, 산림은 지구온난화의 주범인 이산화탄소에 대한 유일한 흡수 원으로서 그 가치가 새롭게 조명되고 있다. 또한 산림은 생태관광자원의 주요한 구성요소의 하나로서 현재 생태관광객이 널리 이용하는 자원이기도 하다. 게다가 한국의 경우 국토의 60%이상을 차지하는 산림은 국민들한테 아주 좋은 생태환경을 제공함과 동시에 국민들의 생태관광지에 대한 환경보전의식도 제고를 가져왔다. 따라서 환경에 대한 관심이 급증하면서 보전가치가 우수한 산림생태지역을 방문하는 관광객이 매년 큰 폭으로 증가함과 동시에 정부에서도 많은 관심을 보이고 있다. 반면에 생태환경은 관광지를 개발하는 과정과 결과에서 부적절한 개발로 오히려 손상을 받게 되는 경우가 더 많으며, 생태관광객의 높은 환경의식과 엇갈려 실패를 보는 경우도 존재한다. 그럼에도 불구하고 생태관광객의 환경에 대한 관점이나 의식 등에 관한 연구가 미흡하여 지속가능한 생태관광개발에서 생태관광지와 관광객사이에 초점을 맞추지 못하고 있는 실정이다. 따라서 본 연구는 산림생태관광의 지속가능한 발전을 위하여 산림자원을 이용한 생태관광객과 그들의 환경의식을 정의하여 관광지에 대한 매력성, 만족 및 관광 후 태도에 어떠한 영향관계가 있는지 실증적으로 규명함으로서, 관광객의 입장에서 어떠한 생태관광지를 선호하는지를 파악하는데 그 중점을 두었다. 연구결과 산림생태관광객의 높은 자연보호의식은 관광지 매력성, 만족 및 관광 후 태도에 모두 유의한 영향을 미치는 것으로 해석되었고 환경오염의식은 관광지 매력성 유의한 영향을 미치지 못하는 것으로 해석되었다. 이에 따라 우리는 지속적인 생태관광지 개발과 생태관광 프로그램을 작성함에 있어서 관광객의 자연보호의식 전환 및 생태관광객의 심리적 반응을 중심으로 진행되어야 한다는 점을 시사한다.

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한.미 간호 교육과정의 비교 연구 -간호대학과정을 중심으로- (A Comparative Study on the Curriculum of Nursing Education in America and Korea)

  • 김정자
    • 대한간호학회지
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    • 제7권2호
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    • pp.60-82
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    • 1977
  • The purpose of this study is first, to analyse the present nursing education and the curriculum in Korea in view of the changes and the new tendency of nursing education and second, to compare our curriculum with that of America, where nursing activities are actively earring on and, third, to try to find out what we should reconsider and improve in our nursing education. The object of this study is the educational program and the curriculum from 1973 to 1976 by selecting each five from colleges and department of nursing in Korea and America. The results of the study were as fellows : . 1. The aim of nursing education puts impassion the role of leader, knowledge and technology of nursing, welfare of society and service of community in both the America and Korea. In Korea nursing is mainly restricted to the treatment of diseases, while in the America the items of the aim of nursing are mainly extended to the capacity for Self- realization of nurse, in Korea they are restricted to the treatment of diseases. 2. In Korea the rate of credit of the curriculum of nursing education is the highest in professional education, next in general education, next in supporting science and educational subject, while in America the rate of the credit is the highest in general education, next professional education and then supporting Science and educational subject isn′t included in the curriculum. 3. In both Korea and America the role of the animal credit allotment in general education, is the highest in the first year and the rate in supporting science is the highest in the second year. In Korea professional subjects are concentrated in the third year while in America there is a tendency that they are increasing in number in the grade order. 4. There is a tendency that the rate of the credit allotment of the main professional subjects in curriculum is higher in Korea than in America : that is, in Korea the rate of the allotment of the credit is the highest in medical - surgical nursing, next maternal - child nursing, next community - health nursing and the psychiatric nursing and there in a great difference in the rate of the allotment of each credit. While in America the rate of the allotment of the credit is the highest in community - health nursing, next in medical- surgical nursing, next in maternal - child nursing, and then in psychiatric nursing and there is little difference in the rate of tile allotment of each credit. 5. From general education, supporting science and professional education, they have considered the continuity and sequence in the structure of nursing curriculum of Korea and America. While in Korea we have partly made integration in tile content of the subjects. Most of the school in America, they have made integration in the content of subjects especially in all subjects, but in Korea we haven't made it in all subjects. 6. In the system and form of nursing education Problem solving method, Dialectical method and operational method are introduced in some America schools and in others there is a tendency that the whole nursing education has the system based on Preventive frame - work or Health -illness frame work ; while only one college has an attempt for Health - Illness continue in Korea. 7. In Korea nursing education, as the importance of health- nursing and team nursing, the aim which is also comparatively emphasized is about health management and service of collective community. The subject pertaining to the aim is the studies of community health nursing, which are more in number in America. 8. When we consider the association between the social, general aims ?f the nursing education and the formation of the curriculum in Korean nursing school the courses of study concerning "the role of leadership and cooperative personal relation": "nursing care for the group": dynamic nursing care": and "the system of the public health nursing associated with the understanding of the regional community" are insufficient as compared with those of America. Especially, the lack of the behavioral science including the nursing care connected with the care for the group, the basic science on the clinical and developmental psychology, anthropology in known to be a prominent issue.

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해외진출 국내 프랜차이즈기업의 조직특성 (Organizational Factors Facilitating the Internationalization of Korean Franchising Companies)

  • 임영균;이동휘;김희정
    • 마케팅과학연구
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    • 제19권2호
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    • pp.40-52
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    • 2009
  • Franchising is one of the fastest growing types of business. It is already popular and well-known in the U.S., and has been growing in many other countries including Korea. Furthermore, many Korean franchising companies have expanded their business overseas actively. According to the data by the Ministry of Industry and Resource, 82 companies out of a sample of 500 franchising companies are already operating in many foreign countries and 48% of them have started their foreign business since 2006. This clearly indicates the fast growing current trend of foreign operation by Korean franchising companies. In spite of the fast growing trend of foreign expansion in the industry, academic research on internationalization of franchising companies is extremely difficult to find. Accordingly, academic research on the issue is necessary and urgent in Korea. Among the various research questions on internationalization of franchising business, this study intends to investigate the difference in organizational factors between the franchising companies doing foreign operation and those doing business only domestically. More specifically, this research has the following purposes. First, considering the lack of theoretical basis of previous studies, resource-based theory and agency theory are employed as the theoretical bases. Second, this study explains the difference in internationalization based on organizational factors such as company size, history and growth rate. Third, the five hypotheses regarding the difference in organizational factors are presented and tested empirically, which is the first attempt in the area of this topic. Finally, the study attempts to clarify the conflicting implications among theories regarding some organizational factos such as growth rate. As the theoretical background, resource-based theory and agency theory are discussed. According to resource-based theory, a firm can grow continuously when it has competence and resource, and also the ability to develop them. The competence and resource can include capital, human resource, management skill, market information, ability to manage risk, etc. Meanwhile, agency theory views the relationship between franchisor and franchisee as an agency relationship. In agency theory, bonding capability and monitoring capability are the two key factors which promote internationalization of franchising companies. Based on the two theories, a conceptual model is designed. The model consists of two groups of variables. One is organizational factors including size, history, growth rate, price bonding and geographic dispersion. The other is whether a franchising company is operating overseas or not. We developed the following five research hypotheses basically describing the relationship between organizational factors and internationalization of franchising companies. H1: The size of franchising companies operating overseas is larger than that of franchising companies operating domestically. H2: The history of franchising companies operating overseas is longer than that of franchising companies operating domestically. H3: The growth rate of franchising companies operating overseas is higher than that of franchising companies operating domestically. H4: The price bonding of franchising companies operating overseas is higher than that of franchising companies operating domestically. H5: The geographic dispersion of franchising companies operating overseas is wider than that of franchising companies operating domestically. Data for the analyses are obtained from 2005 Korea Franchise Survey data co-generated by Ministry of Industry and Resource, GS1 Korea, and Korea Franchise Association. Out of 2,804 population companies, 2,489 companies are excluded for various reasons and 315 companies are selected as the final sample. Prior to hypotheses tests, validity and reliability of the measures of size, history, growth rate and price bonding are examined for further analyses. Geographic dispersion is not validated since it is measured using nominal data. A series of independent sample T-tests is used to find out whether there exists any significant difference between the companies internationalized and those operating only domestically for each organizational factor. Among the five factors, size and geographic dispersion show significant difference, growth rate and price bonding do not reveal any difference and, finally, history factor shows conflicting results in the difference depending on how to measure it.

    shows the summary statistics for hypotheses testing. In conclusion, the results show that the size and history, which are the key variables in resource-based theory, have a significant relationship with internationalization and that geographic area, which belongs to agency theory, also has a strong relationship with internationalization. The results support the findings of extant research and, therefore, prove the usefulness of resource-based theory and agency theory in explaining internationalization of franchising companies. However, growth rate and price-bonding do not show a clear difference between the two types of companies. Accordingly, these two factors need further attention in the future research. Although this study shows meaningful findings theoretically and practically, it has several limitations. First, only organizational factors are considered even if there are various environmental factors influencing franchising firm's internationalization. Second, only being internationalized or not is considered. That is, modes of entry and the size of foreign operations are not included in the study. Third, internationalization strategy is often determined based on the desire for business expansion and higher profitability and egoistical reasons of the CEOs. However, this type of factors belonging to behavioral science is not discussed in the study. Finally, organizational ecology perspective is usefully applicable in explaining the survival and performance of internationally operating companies. Accordingly, research propositions based on this perspective need to be developed and tested.

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  • 간호교육 철학정립 및 교육과정 개발을 위한 기초조사 (A Preliminary Study on Setting Philosophy and Curriculum Development in Nursing Education)

    • 정연강;김윤회;양광희;한경자;한상임
      • 대한간호학회지
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      • 제18권2호
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      • pp.162-188
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      • 1988
    • The purpose of this study is to guide the direction of the Korean nursing education to analysize ⑴ the philosophy and objectives ⑵ curriculum, and ⑶ educational environment. This analysis is based on the data from 50 nursing schools (14 4-year colleges and 35 3-year colleges) The survey was conducted from Dec. 1986 through Jan. 1987 by mail. 1) Educational philosophy and objectives 10 4-year colleges and 8 3-year college program have curricular philosoph. Most popular curricular philosophies are human beings, health, nursing, nursology, nursing education, nurses role in the present and in the future. 10 nursing schools mentioned that human being is the subject to interact with : environment physically, mentally and socially. 2 schools mentioned that health is the state of functioning well physically, mentally and socially. 13 schools mentioned that the nursing is the dynamic act to maintain and to promote the highest possible level of health. 4 schools mentioned that the nursology is an applied science. 4 schools mentioned that nursing education is the process to induce the behavioural changes based on the individual ability. There is different opinion about the nurses' role between 4-year college and 3-year college. In the responses from 4-year colleges they focus on the leadership in effective changes, self-regulating and self-determining responsibilities, applying the new technology, continuing education, and participation in research to further nursing knowledge. In the responses from 3-year colleges, they focus on the education in college, primary health care nursing, direct care provider and public health education. Among 50 respondents 40 schools have educational goals which can be divided into two categories. One is to establish the moral and the other is to develop the professionalism. 2) Curriculm The analsis of curriculum is only based on the data from the 4-year colleges because the most of 3-year colleges follow the curriculum guideline set by the Ministry of Education. a) Comparison of the credits in cultural subject and in nursing major. The average required credit for graduation is 154.6 and the median credit is the range of 140-149. The average credit of cultural subjects is 43.4. In detail, the average number of credit of required course and elective courses are 24.1 and 19.3 respectively. The average credit for major subject is 111.2. In detail, the average credit for required courses and electives course are 100.9 and 10.4 respectively. In 5 colleges, students are offered even on elective course b) Comparison of the credit by class. The average earned credits are as follows : 41.1 in freshman, 400 in sophormore 38.3 in junior and 32.4 in senior. Cultural subjects are studied in early phases. c) Comparison of the compulsory and elective cultural subject by institute. The range of credit is 7-43 in compulsory cultural subjects and there are lot of differences among institutions. While all respondents require liberal arts as compulsary subjects, few respondents lists social science, natural science and behavioral science as required subjects. Social science-related subjects are frequently chosen as cultural subjects d) Distribution of creditsin cultural subjects by institute. The liberal art subjects are taught in 20 institute. English and physical education courses are taught in all instituions. The social science subjects are taught in 15 colleges and the basic Psycology and the Basic sociology are the most popular subjects. The natural science subjects are taught in 7 colleges and Biology and Chemistry are the most popular subjects among them. e) Distribution of credits in major basic courses by institute. Most of the institutes select Anatomy, Microbiology, Physiology, biochemistry and Pathology as basic major courses. f) Comparison of the required and elective courses for nursing major by institutions. Subjects and credit ranges in major are varing by institute. More than half of the respondents select the following subjects as required major subjects. (1) Adults Health Nursing and Practice (19.5 credits) (2) Mother and Child Care and Practice (8.9 credits) (3) Community Health Care and Practice (8.5 credits) (4) Psychiatric Nursing Care and Practice (8.1 credits) (5) Nursing Management and Practice (3.9 credits) (6) Fundamental of Nursing, Nursing Research and Health Assessment and Practice. Three institutions select Introduction to nursing, Rehabilitation Nursing, School Nursing, Public Health Nursing, Nursing English, Communication, Human Development as electives in nursing major. 3) Educational environment a) Nursing institution There are forty-three 3-year colleges and seventeen 4-year colleges and 81.4% of which are private b) Number of students and faculty 19.2% of the students are in 4-year colleges and 80.8% of the students are in 3-year colleges. In 4-year colleges, the number of nursing faculty members is in the other of assistant professor, instructor and professor. In 3-year colleges, the orderiis lecturer, associate professor, full time instructor and assistant professor. In 4-year colleges, 18.8 students are allocated per nursing faculty and in 3-year colleges, 33.1 students are allocated per nursing faculty. c) Clinical practices 66.7% of the 4-year colleges practice over 1201 hours in clinic and 28.5% of 3-year colleges practice over 1201 hours in clinic. In 4-year colleges, 11.5 students are allocated per nursing faculty and in 3-year colleges,17 students are allocated per nursing faculty The survey shows no difference in the procedure between 4-year colleges and 3-year colleges but 3-year colleges choose the more variety practicing site such as special hospital and community health clinic. d) Audiovisual facilities The survey shows a lot of difference in audiovisual facilities among institution and 3-year colleges are less equipped than 4-year colleges.

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    스마트폰 위치기반 어플리케이션의 이용의도에 영향을 미치는 요인: 프라이버시 계산 모형의 적용 (Factors Influencing the Adoption of Location-Based Smartphone Applications: An Application of the Privacy Calculus Model)

    • 차훈상
      • Asia pacific journal of information systems
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      • 제22권4호
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      • pp.7-29
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      • 2012
    • Smartphone and its applications (i.e. apps) are increasingly penetrating consumer markets. According to a recent report from Korea Communications Commission, nearly 50% of mobile subscribers in South Korea are smartphone users that accounts for over 25 million people. In particular, the importance of smartphone has risen as a geospatially-aware device that provides various location-based services (LBS) equipped with GPS capability. The popular LBS include map and navigation, traffic and transportation updates, shopping and coupon services, and location-sensitive social network services. Overall, the emerging location-based smartphone apps (LBA) offer significant value by providing greater connectivity, personalization, and information and entertainment in a location-specific context. Conversely, the rapid growth of LBA and their benefits have been accompanied by concerns over the collection and dissemination of individual users' personal information through ongoing tracking of their location, identity, preferences, and social behaviors. The majority of LBA users tend to agree and consent to the LBA provider's terms and privacy policy on use of location data to get the immediate services. This tendency further increases the potential risks of unprotected exposure of personal information and serious invasion and breaches of individual privacy. To address the complex issues surrounding LBA particularly from the user's behavioral perspective, this study applied the privacy calculus model (PCM) to explore the factors that influence the adoption of LBA. According to PCM, consumers are engaged in a dynamic adjustment process in which privacy risks are weighted against benefits of information disclosure. Consistent with the principal notion of PCM, we investigated how individual users make a risk-benefit assessment under which personalized service and locatability act as benefit-side factors and information privacy risks act as a risk-side factor accompanying LBA adoption. In addition, we consider the moderating role of trust on the service providers in the prohibiting effects of privacy risks on user intention to adopt LBA. Further we include perceived ease of use and usefulness as additional constructs to examine whether the technology acceptance model (TAM) can be applied in the context of LBA adoption. The research model with ten (10) hypotheses was tested using data gathered from 98 respondents through a quasi-experimental survey method. During the survey, each participant was asked to navigate the website where the experimental simulation of a LBA allows the participant to purchase time-and-location sensitive discounted tickets for nearby stores. Structural equations modeling using partial least square validated the instrument and the proposed model. The results showed that six (6) out of ten (10) hypotheses were supported. On the subject of the core PCM, H2 (locatability ${\rightarrow}$ intention to use LBA) and H3 (privacy risks ${\rightarrow}$ intention to use LBA) were supported, while H1 (personalization ${\rightarrow}$ intention to use LBA) was not supported. Further, we could not any interaction effects (personalization X privacy risks, H4 & locatability X privacy risks, H5) on the intention to use LBA. In terms of privacy risks and trust, as mentioned above we found the significant negative influence from privacy risks on intention to use (H3), but positive influence from trust, which supported H6 (trust ${\rightarrow}$ intention to use LBA). The moderating effect of trust on the negative relationship between privacy risks and intention to use LBA was tested and confirmed by supporting H7 (privacy risks X trust ${\rightarrow}$ intention to use LBA). The two hypotheses regarding to the TAM, including H8 (perceived ease of use ${\rightarrow}$ perceived usefulness) and H9 (perceived ease of use ${\rightarrow}$ intention to use LBA) were supported; however, H10 (perceived effectiveness ${\rightarrow}$ intention to use LBA) was not supported. Results of this study offer the following key findings and implications. First the application of PCM was found to be a good analysis framework in the context of LBA adoption. Many of the hypotheses in the model were confirmed and the high value of $R^2$ (i.,e., 51%) indicated a good fit of the model. In particular, locatability and privacy risks are found to be the appropriate PCM-based antecedent variables. Second, the existence of moderating effect of trust on service provider suggests that the same marginal change in the level of privacy risks may differentially influence the intention to use LBA. That is, while the privacy risks increasingly become important social issues and will negatively influence the intention to use LBA, it is critical for LBA providers to build consumer trust and confidence to successfully mitigate this negative impact. Lastly, we could not find sufficient evidence that the intention to use LBA is influenced by perceived usefulness, which has been very well supported in most previous TAM research. This may suggest that more future research should examine the validity of applying TAM and further extend or modify it in the context of LBA or other similar smartphone apps.

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    인지된 위험의 유형이 소비자 신뢰 및 온라인 구매의도에 미치는 영향 (The Impact of Perceived Risks Upon Consumer Trust and Purchase Intentions)

    • 홍일유;김우성;임병하
      • Asia pacific journal of information systems
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      • 제21권4호
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      • pp.1-25
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      • 2011
    • Internet-based commerce has undergone an explosive growth over the past decade as consumers today find it more economical as well as more convenient to shop online. Nevertheless, the shift in the common mode of shopping from offline to online commerce has caused consumers to have worries over such issues as private information leakage, online fraud, discrepancy in product quality and grade, unsuccessful delivery, and so forth, Numerous studies have been undertaken to examine the role of perceived risk as a chief barrier to online purchases and to understand the theoretical relationships among perceived risk, trust and purchase intentions, However, most studies focus on empirically investigating the effects of trust on perceived risk, with little attention devoted to the effects of perceived risk on trust, While the influence trust has on perceived risk is worth studying, the influence in the opposite direction is equally important, enabling insights into the potential of perceived risk as a prohibitor of trust, According to Pavlou (2003), the primary source of the perceived risk is either the technological uncertainty of the Internet environment or the behavioral uncertainty of the transaction partner. Due to such types of uncertainty, an increase in the worries over the perceived risk may negatively affect trust, For example, if a consumer who sends sensitive transaction data over Internet is concerned that his or her private information may leak out because of the lack of security, trust may decrease (Olivero and Lunt, 2004), By the same token, if the consumer feels that the online merchant has the potential to profit by behaving in an opportunistic manner taking advantage of the remote, impersonal nature of online commerce, then it is unlikely that the merchant will be trusted, That is, the more the probable danger is likely to occur, the less trust and the greater need to control the transaction (Olivero and Lunt, 2004), In summary, a review of the related studies indicates that while some researchers looked at the influence of overall perceived risk on trust level, not much attention has been given to the effects of different types of perceived risk, In this context the present research aims at addressing the need to study how trust is affected by different types of perceived risk, We classified perceived risk into six different types based on the literature, and empirically analyzed the impact of each type of perceived risk upon consumer trust in an online merchant and further its impact upon purchase intentions. To meet our research objectives, we developed a conceptual model depicting the nomological structure of the relationships among our research variables, and also formulated a total of seven hypotheses. The model and hypotheses were tested using an empirical analysis based on a questionnaire survey of 206 college students. The reliability was evaluated via Cronbach's alphas, the minimum of which was found to be 0.73, and therefore the questionnaire items are all deemed reliable. In addition, the results of confirmatory factor analysis (CFA) designed to check the validity of the measurement model indicate that the convergent, discriminate, and nomological validities of the model are all acceptable. The structural equation modeling analysis to test the hypotheses yielded the following results. Of the first six hypotheses (H1-1 through H1-6) designed to examine the relationships between each risk type and trust, three hypotheses including H1-1 (performance risk ${\rightarrow}$ trust), H1-2 (psychological risk ${\rightarrow}$ trust) and H1-5 (online payment risk ${\rightarrow}$ trust) were supported with path coefficients of -0.30, -0.27 and -0.16 respectively. Finally, H2 (trust ${\rightarrow}$ purchase intentions) was supported with relatively high path coefficients of 0.73. Results of the empirical study offer the following findings and implications. First. it was found that it was performance risk, psychological risk and online payment risk that have a statistically significant influence upon consumer trust in an online merchant. It implies that a consumer may find an online merchant untrustworthy if either the product quality or the product grade does not match his or her expectations. For that reason, online merchants including digital storefronts and e-marketplaces are suggested to pursue a strategy focusing on identifying the target customers and offering products that they feel best meet performance and psychological needs of those customers. Thus, they should do their best to make it widely known that their products are of as good quality and grade as those purchased from offline department stores. In addition, it may be inferred that today's online consumers remain concerned about the security of the online commerce environment due to the repeated occurrences of hacking or private information leakage. Online merchants should take steps to remove potential vulnerabilities and provide online notices to emphasize that their website is secure. Second, consumer's overall trust was found to have a statistically significant influence on purchase intentions. This finding, which is consistent with the results of numerous prior studies, suggests that increased sales will become a reality only with enhanced consumer trust.

    지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例) (A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment)

    • 손창호;신민섭;홍강의;정오언
      • 수면정신생리
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      • 제3권1호
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      • pp.85-95
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      • 1996
    • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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    양치시설 설치여부에 따른 중학생의 구강환경관리능력 및 구강건강관리 행태 변화 (Effect of Toothbrushing Facilities on PHP Index and Oral Health-Related Behaviors in Middle Schools)

    • 김수화;황윤숙;김광수;정재연;유영재;임미희
      • 치위생과학회지
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      • 제13권3호
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      • pp.271-280
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      • 2013
    • 본 연구는 서울특별시 성동구에서 치아건강사업의 일환으로 관내 모든 초 중 고등학교에 양치시설을 확대 설치하기 결정 한 후 2012년 양치교실을 설치한 중학교의 양치시설 효과를 분석하기 위하여 기존에 양치시설이 설치되어있는 A중학교와 2012년 양치시설이 설치된 B중학교 1학년을 대상으로 구강환경관리능력 및 치아건강관리 행태의 변화를 조사하여 다음과 같은 결과를 얻었다. 1. DMFT와 DMFS는 기존에 양치시설이 설치 운영되어 온 A중학교가 B중학교보다 더 낮게 나타났으나 유의한 차이는 보이지 않았다(p>0.05). CPI는 치아우식경험지수와 다른 결과를 보였는데 학교별로는 유의한 차이를 보이지 않았으나 여학생이 남학생에 비하여 code (0)은 높게 나타났고 code (2)는 낮게 나타났다(p<0.05). 2. 양치시설이 설치되기 전, 양치시설 유무에 따른 PHP index 검사에서는 양치시설이 있는 학교의 학생들이 구강환경관리능력이 더 좋은 것으로 나타났다(p<0.01). 양치시설 전 후에 따른 조사에서는 양치시설 설치 전보다 양치시설 설치 후에 구강환경관리능력 개선 정도가 유의하게 크게 나타났다(p<0.01). 3. 양치시설 유무에 따른 치아건강관리 행태 비교에서는 지난 1주간 점심 후 칫솔질 하지 않았다고 응답한 경우는 양치시설이 없었던 B중학교에서 더 높게 나타났고, 1주간 점심 후 칫솔질 평균횟수는 양치시설이 있는 A중학교에서 더 높게 나타났다(p<0.01). 점심 후 칫솔질을 하지 않는 이유에 대해서는 학교간의 유의한 차이를 보이지 않았으나 '장소가 부족해서' 항목은 A중학교보다 양치시설이 없는 B중학교에서 높게 나타나 차이를 보였다(p<0.01). 4. 양치시설 설치 전후 치아건강관리 행태 변화에서는 1주간 점심 후 칫솔질을 하지 않았다고 응답한 경우가 설치 전보다 설치 후에 증가하였고, 1주간 점심 후 칫솔질 평균 횟수도 양치시설 설치 후에 더 감소하였으나 유의한 차이는 보이지 않았다(p>0.05). 칫솔질을 하지 않는 이유 중 '장소가 부족해서'는 설치 전보다 설치 후에 유의하게 감소하였으나(p<0.01), '친구들이 하지 않아서'는 설치 전보다 설치 후에 크게 증가하였다(p<0.05). 구강보건지식의 개선만으로는 임상적, 행동적 의의를 가지지 않는다. 청소년들의 행동변화를 유도하여 직접 참여하기 위해서는 학교나 가정 한 단체만으로는 불가능하다. 학교뿐만 아니라 정부기관의 정책과 재정적 지원, 지역사회관련 교육기관들과 관련 단체들의 프로그램 개발과 평가에 대한 협조 등이 청소년들의 올바른 구강건강관리를 습관화 시키는 데 기여할 것이다.