Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.
1991년부터 1997년월까지 7년간 한림대학교 이비인후과학교실에서 국소침범한 갑상선암으로 치료를 받은 10명의 환자들을 후향적으로 검토하여 다음과 같은 결과를 얻었다. 1) 성별 분포는 남녀비는 1:2.3이었으며 연령별 분포는 60대 이상이 7명으로 노인에 호발함을 알 수 있었다. 2) 임상승상은 애성이 5례(50%)로 가장 많았으며 무증상이면서 경부종괴로 온 경우가 3례 그외에 연하곤란, 호흡곤란 객혈 등이었다. 3) 침범된 구조는 기관 7례, 반회후두신경과 종격동임파절이 각각 5례, 경부식도 3례, 경동맥 3례, 기관주위임파절 3례, 하인두 1례, 미주신경 1례 순이었다. 4) 침범된 구조물들에 대한 수술로는 기관 수상절제술 및 단단문합술이 1례. 기관 수상절제와 윤상기관성형술 1례, 기관 창절제술 및 일차봉합술 1례. 기관 창절제술 및 흉쇄유돌근-근막피판재건술 1례, 기관 면도식절제술 1례, 식도 부분절제술 2례, 식도 면도식절제술 1례, 편측 윤상후두절제술 1례, 윤상연골 부분절제술 및 흉쇄유돌근-근골막피판재건술 1례, 갑상연골 면도식절제술 1례, 반회후두신경절제술이 2례, 미주신경절제술 1례, 경동맥절제술 및
The release of administrative information has been the challenge of our age following the maturation of democratic ideology in our society. However, differences of opinion and conflict still exist between the government and private sectors regarding the issue, and it seems that the technical and policy-related insufficiencies of information and record management that actually operate the release of information are the main causes. From the perspective of records management, records or information are variable in their nature, value, and influence during their life span. The most controversial issue is the records and information in the current stage of carrying out business activities. This is because the records and information pertaining to finished business are but evidence to ascertain the past, and have only a limited relationship to the ideal of the 'democratic participation' by citizens in activities of the public sector. The current information release policies are helpless against the 'absence of information,' or incomplete records, but such weakness can be supplemented by enforcing record management policies that make obligatory the recording of all details of business activities. In addition, it is understood that the installation of 'document offices("Jaryogwan")' that can manage each organization's information and records will be an important starting point to integrate the release, management, and preservation of information and records. Nevertheless, it seems that the concept of 'release' in information release policies refers not to free use by all citizens but is limited to the 'provision' of records according to public requests, and the concept of 'confidential' refers not to treating documents with total secrecy but varies according to the particulars of each situation, making the actual practice of information release difficult. To solve such problems, it is absolutely necessary to collect the opinions of various constituents associated with the recorded information in question, and to effectively mediate the collective opinions and the information release requests coming from applicants, to carry out the business more practically. Especially crucial is the management of the process by which the nature and influence of recorded information changes, so that information which has to be confidential at first may become available for inquiry and use over time through appropriate procedures. Such processes are also part of the duties that record management, which is in charge of the entire life span of documents, must perform. All created records will be captured within a record management system, and the record creation data thus collected will be used as a guide for inquiry and usage. With 'document offices(Jaryogwan)' and 'archives' controlling the entire life span of records, the release of information will become simpler and more widespread. It is undesirable to try to control only through information release policies those records the nature of which has changed because, unlike the ones still in the early stages of their life span and can directly influence business activities, their work has finished, and they have become historical records or evidences pointing to the truth of past events. Even in the past, when there existed no formal policy regarding the release of administrative information, the access and use of archival records were permitted. A more active and expanded approach must be taken regarding the 'usage' of archival records. If the key factor regarding 'release' lies in the provision of information, the key factor regarding 'usage' lies in the quality and level of the service provided. The full-scale usage of archival records must be preceded by the release of such records, and accordingly, a thorough analysis of the nature, content, and value of the records and their changes must be implemented to guarantee the release of information before their use is requested. That must become a central task of document offices and "Today's information" will soon become "yesterday's records," and the "reality" of today will become "history" of the past. The policies of information release and record management share information records as their common objective. As they have a mutual relationship that is supplementary and leads toward perfection, the two policies must both be differentiated and integrated with each another. It is hoped that the policies and business activities of record management will soon become normalized and reformed for effective and fair release of information.
전자기록관리는 수많은 사회적 기술적 요소가 상호작용하는 하나의 시스템이다. 신뢰받는 상태를 계속 유지하기 위해 전자기록관리기관은 감사와 인증의 정규적인 수행이 필요할 것이다. 이에 따라 개별 전자기록관리기관에서는 스스로의 신뢰도를 지속적으로 평가해보는 도구로 사용할 수 있고 스스로의 환경과 시스템을 자체 평가하여 부족한 부분도 파악할 수 있게 하는 도구의 필요성이 생겼다. 본 연구의 목적은 OAIS 참조모형(ISO 14721)과 영국 UKDA와 TNA의 자가진단보고서, TRAC 및 DRAMBORA 등 4개 표준과 국제모범사례를 분석하고, MoReq2와 현행 국내 법령 및 표준 등을 종합, 분석하여 자체인증도구를 개발하고자 하는 것이었다. 본 연구에서는 이 인증도구의 개발과정과 전체적인 틀을 기술함으로써, 타 기관에서도 기관의 특성에 따라 이러한 도구를 개발하고 자체적으로 활용할 수 있는 개발방법론을 제시하고자 하였다. 본 연구의 진행 결과, (기관) 운영관리, 분류체계 및 기준정보 관리, 입수, 등록 기술, 저장 보존, 처분, 서비스, 검색도구 제공, 시스템 관리, 접근통제 보안, 모니터링 감사증적 통계, 위험관리 등 총 12개 영역으로 진단영역이 확정되었다. 설정된 12개 영역 각각에 대해 각 영역별로 프로세스 맵 또는 기능차트 등을 만들고 업무기능을 분석한 후, 영역별 주요 업무기능 단위를 중심으로 구성된 54개의 '평가지표'가 도출되었다. 각 평가지표 별로 실제 자가진단을 시행할 수 있는 측정 가능하고 증빙이 가능하도록 작성한 208개의 '평가세부지표'를 도출하였다. 본 연구의 결과물로 생성된 이 지표는 전자기록관리기관의 감사인증도구로 사용될 수 있어, 기관 스스로 정기적으로 자가진단을 실행하는 데에 활용함으로써, 발견된 미비점을 보완하고 향후 기관의 발전 전략에 반영할 수 있다.
현재 육상에서는 유무선 통신의 발전으로 다양한 IT 서비스를 제공받고 있다. 이러한 변화는 육상을 넘어서서 해상에서 항해 중인 선박에서도 다양한 IT 서비스가 제공되어야 하며 육상에서 이용하는 것과 마찬가지로 양방향 디지털 데이터 전송, Web, App 등과 같은 다양한 IT 서비스들의 제공에 대한 요구가 증가될 것으로 예상하고 있다. 하지만 이러한 초고속 정보통신망은 AP(Access Point)와 기지국과 같은 고정된 기반 구조를 바탕으로 네트워크를 구성하는 지상에서는 쉽게 사용할 수 있는 반면 해상에서는 고정된 기반 구조를 이용하여 네트워크를 구성할 수 없다. 그래서 전송 거리가 긴 라디오 통신망 기반의 음성 위주의 통신 서비스를 사용하고 있다. 이러한 라디오 통신망은 낮은 전송 속도로 인해 매우 기본적인 정보만을 제공할 수 있었으며, 효율적인 서비스 제공에 어려움이 있다. 이를 해결하기 위해서 디지털 데이터 상호교환을 위한 추가적인 주파수가 할당되었으며 이 주파수를 사용하여 활용할 수 있는 선박 애드 혹 네트워크인 SANET(ship ad-hoc network)이 제안되었다. SANET은 높은 설치비용과 사용료의 위성 통신을 대신하여 해상에서 IP 기반으로 선박에 다양한 IT 서비스를 제공할 수 있도록 개발되었다. SANET에서는 육상 기지국과 선박의 연결성이 중요하다. 이러한 연결성을 갖기 위해서는 선박은 자신의 IP 주소를 할당 받아 네트워크의 구성원이 되어야 한다. 본 논문에서는 선박 스스로 자신의 IP 주소를 할당 받을 수 있는 SANET-CC(Ship Ad-hoc Network-Cell Connection) 프로토콜을 제안한다. SANET-CC는 중복되지 않는 다수의 IP 주소들을 육상기지국에서 선박들에 이어지는 트리 형태로 네트워크 전반에 전파한다. 선박은 IP 주소를 할당할 수 있는 육상 기지국 또는 나누어진 구역의 M-Ship(Mother Ship)들과 간단한 요청(Request) 및 응답(Response) 메시지 교환을 통해 자신의 IP 주소를 할당한다. 따라서 SANET-CC는 IP 충돌 방지(Duplicate Address Detection) 과정과 선박의 이동에 의해 발생하는 네트워크의 분리나 통합에 따른 처리 과정을 완전히 배제할 수 있다. 본 논문에서는 SANET-CC의 SANET 적용가능성을 검증하기 위해서 다양한 조건의 시뮬레이션을 수행하였으며 기존 연구와 비교 분석을 진행하였다.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70