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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • 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.

Development of a Method to Measure the Radiation Isocenter Size of Linear Accelerators and Quantitative Analysis of the Radiation Isocenter Size for Clinac 21EX Linear Accelerator (선형가속기 방사선 중심점의 크기 측정 방법 개발과 Clinac 21EX 선형가속기의 방사선 중심점 크기 분석)

  • Jeon, Ho-Sang;Nam, Ji-Ho;Park, Dahl;Kim, Yong-Ho;Kim, Won-Taek;Kim, Dong-Won;Ki, Yong-Kan;Kim, Dong-Hyun
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.131-139
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    • 2011
  • A method to get a size of the radiation isocenter of linear accelerators using star-shot images was presented and a computer program was developed to automate the method. Accuracy of the method was verified. The developed program was used to measure sizes of the radiation isocenters for a Clinac 21EX (Varian, USA) using data of quality assurance (QA) performed from June 2008 to December 2010. To calculated the size of radiation isocenter, positions of two points on each central ray of the star-shot image were found and the equation of the central ray was determined using the positions of two points. Using the equations of central rays the radius of the minimum circle intersecting all the central rays, which is one half of the size of radiation isocenter, was calculated. The program measured x-intercepts and y-intercepts of the central rays within errors of 0.084 mm and sizes of radiation isocenters within 0.053 mm. All the errors were less than the spatial resolution of star-shot images 0.085 mm. The radiation isocenter sizes of Clinac 21EX were $0.33{\pm}0.27mm$, $0.71{\pm}0.36mm$, $0.50{\pm}0.16mm$ for collimator, gantry and couch respectively. During the measurement period all the measured sizes were less than 2.0 mm and within tolerance. The developed program could calculate the size of radiation isocenters and it would be helpful to routine QA.

Results of Treatment for Children with Primary Brain Tumors : Long-Term Follow Up Results of a Single Institute (소아 원발성 뇌종양의 치료 결과 : 단일 기관에서의 장기간 추적 관찰)

  • Choi, Sung-Yeon;Won, Sung-Chul;Lyu, Chuhl-Joo;Oh, Seung-Hwan;Yang, Chang-Hyun;Suh, Chang-Ok;Choi, Joong-Uhn;Kim, Byung-Soo
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.1016-1023
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    • 2002
  • Purpose : Brain tumors are the most common solid tumor in children. We retrospectively investigated the clinical characteristics of pediatric brain tumors, such as age, sex, tumor site and survival, as seen in a single institution over the last 15 years. We tried to evaluate the role of chemotherapy on the survival of some brain tumors. Methods : Three hundred fifty four children with primary brain tumor who were treated at Severance Hospital from Jan. 1985 to Sep. 2001 were enrolled. Results : Pediatric brain tumors were found most frequently in 10-15 years of age group(35.3%) and the ratio of male to female was 1.3 : 1. Supratentorial tumors(52%) were more frequent than infratentorial tumors(48%). Medulloblastoma/primitive neuroectodermal tumor(PNET) was the most common type(24.6%), followed by cerebellar astrocytoma(14.1%). Ten year survival rate of medulloblastoma, cerebellar astrocytoma and cerebral astrocytoma were 59.4%, 79.3% and 71%, respectively. The prognosis for brain stem glioma and glioblastoma multiforme were still grim with a 10 year survival rate of 12.7% and 13.3%, respectively. The addition of chemotherapy for high grade medulloblastoma led to an improved 10 year survival rate of 54.5%, compared with 40% without chemotherapy. Conclusion : The combined use of chemotherapy and radiation and surgery improved survival rate of pediatric brain tumors in our study. Chemotherapy for high grade medulloblastoma improved the 10 year survival rate. Further data analysis of the treatment modalities will lead to better comparisons.

Calculation of Crop Loads for Structural Design of Greenhouse (온실의 구조설계용 작물하중 산정)

  • Na, Wook-Ho;Lee, Jong-Won;Rasheed, Adnan;Kwak, Cheul-Soon;Lee, Si-Young;Yoon, Yong-Cheol;Lee, Hyun-Woo
    • Journal of Bio-Environment Control
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    • v.26 no.4
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    • pp.301-309
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    • 2017
  • This study was conducted to provide basic data needed to calculate the crop loads for the greenhouse design. Four countries' crop loads for greenhouse structures were compared and the crop loads were measured directly and analyzed for various greenhouse crops, including tomato, strawberry, cucumber, and eggplant. According to the analysis results of four country's standards for the design crop loads, it was judged that the new design crop loads suit for greenhouse crops in our country should be suggested because our standards just used the design crop loads of other countries. The maximum crop loads per plant of tomato, cucumber, eggplant, and strawberry were 3.9, 0.75, 1.9 and $2.1kgf{\cdot}plant^{-1}$, respectively. The crop load per unit area of tomato was $8.5kgf{\cdot}m^{-2}$, which was much greater than the cucumber and eggplant's crop load of 2.1 and $2.4kgf{\cdot}m^{-2}$ respectively. The crop loads of tomato and cucumber, suggested by the greenhouse structure design standard of Korea, is $15kgf{\cdot}m^{-2}$, which is far greater than the values suggested by this research. It was judged that this was because our standard just used the Dutch standard, our crop load standard should be reviewed considering this difference. The crop load of strawberry, including the growing bed, was $21.0kgf{\cdot}m^{-2}$, which was much greater than the crop load in the Dutch standard.

A Study on the Relationship Between Entrepreneur Characteristics and the Performance of Small Firms (창업자 특성과 소기업 사업성과 간 관계에 관한 연구)

  • Kim, Wan-Jae;Chung, Hwa-Young
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.2 no.3
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    • pp.33-60
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    • 2007
  • This study alms to analyze the entrepreneur characteristics of founder on enterprise performance from the strategic viewpoint as well as features of founder of small firms such as background feature of founder, psychological features and management skill. As considered by Background features of founder include educational background of founder, his experience in business creation, consultation or course related to business creation. This study verified the effects of factor which business performance (financial, non financial) on small firms. Also, this study considered psychological features of founder include achievement desire, risk-free propensity, level of patience on vagueness and control position. And it analyzed that between such factors and performance of small firms were examined in related. In the mean time, management ability of founder, entrepreneur ability, technical and function ability were considered for management skill of founder and alalyzed effect of the factors on performance of small firm were examined. Effects of strategic intention of founder of small firm were analyzed by the strategic viewpoint. At this time, strategy of small firm was divided into product-service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy. This study distributed questionnaire on CEO of small firms in Daejeon and Chungnam area for accomplish the study objective and it collected a total of 145 copies of questionnaires. As a result of analyzing collected questionnaire, this study deduced the following study results and suggestions. First, results different from those of existing studies were found Since sales, net income and profit rate of small firm were not high cause economic depression on the whole. Second, entrepreneur ability was found to be required for success of business creation. Entrepreneur ability of founder was the factor that affects both financial and non - financial performance of small firm. As such, entrepreneur ability can be regarded as the most important factor for success in business creation of small firm. Accordingly, entrepreneur ability is the most important source for success in business creation of small firm. Third, strategy of small firm was found to be the important factor that affects the non-financial performance even if it could not give significant effects on financial performance. Thus, product service reform differentiation strategy, marketing differentiation strategy and cost leadership strategy have significant effects on non - financial performance of small firm. Accordingly, it is required to operate small firm with strategic mind - set for small firm to achieve success. This study analyzed the effects of feature of founder and strategy of small firm on business performance of small firm through practical analysis on small firms in Daejeon and Chungnam area, and deduced meaningful results. However, Since this study collected data on small firms in Daejeon and Chungnam only, there is a limit in generalizing the results of this study to all small firms in Korea. Companies answering to this questionnaire process were mainly wholesale and retail service companies. In addition, there is a limit in that it failed to analyze feature of representative type of industry due to limit in number of sample, it is required to divide representative type of industry and to compare and analyze types of industry in future studies.

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An Empirical Study on Successful Factor of Local Mobile App One-Person Creating Company : The Moderating Effects of Social Capital (지역 모바일 앱 1인 창조기업의 성공요인에 관한 실증분석 : 사회적 자본의 조절효과를 중심으로)

  • Cheon, Phyeong Uk;Chung, Dong Seop;Ock, Young Seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.9 no.2
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    • pp.201-219
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    • 2014
  • The Republic of Korea in the real economy to a knowledge economy, and a center of creativity and imagination in the creative economy is changing the paradigm. As the core of creating economic, creative industries with the technology and information play an important role in the industry individuals. In order to solve the problem of the polarization of the economy and high youth unemployment rate of Korea, to recognize the role of the creative industries, as objection part, dimensions pan-national and one creative companies in industries of Mobile Apps various policies that support has been promoted. Support these policies to be able to contribute to the establishment of the success of mobile apps one-person creating company, we performed this study targeting one-person company that creates mobile apps area, we conducted a demonstration study of success factors, and thus more effective and efficient in an attempt to seek out support measures. In this study, we derive a research 4 hypothesis about the success factors of one creative enterprise through literature discussion, a study was made on the basis of empirical data of one-person company that creates mobile apps. The results of the analysis, first, if the development rate of the mobile application technology is fast and a new competition associated product is appeared, it was possible to find a tendency to be higher at the performance quantitative companies. Second, if the founder is a founding for the benefit and rewarding work and come to terms with the risk, it was possible to discover tends to be higher achievement quantitative. Third, if one-person company select a target market with capture intensively, it was possible to find a tendency for higher qualitative results. Fourth, it could be found that the reliability of the contact frequency of the network related performance business environment these characteristics enterprise management strategy and act as a significant modulatory effect. Provision of information relating to management and entrepreneurship education to be one creative enterprise is required, these results suggest that there is a provision continuing need for the opportunity to be able to meet and network and reliable variety have. In this study, to take advantage to promote the elimination measures that can increase the likelihood of success of the company of institutions to support one company that creates knowledge-based, such as in the field of mobile application.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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A Study on Serum Leptin Values by Elisa Method in Children (ELISA법으로 측정한 소아 혈중 LEPTIN 치에 관한 연구)

  • Song, Soo-Ho;Chung, Young-Hun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.2
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    • pp.175-180
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    • 2000
  • Purpose: Leptin is an adipocyte-derived blood-borne satiety factor that acts on its cognate leptin receptor in the hypothalamus, thereby regulating food intake and energy expenditure. We measured the leptin concentrations in serum of normal and obese children with human leptin ELISA kit, unlike previous study with leptin RIA kit and investigated the relationship between leptin concentrations and body mass index, gender, and age. Methods: We measured serum concentrations of leptin in 67 children who were visited to the Department of Pediatrics, Chungnam National University Hospital during the period of 5 months from February, 1999 to June, 1999. Height, weight, obesity index, and body mass index were measured in 67 subjects. Leptin values in serum were measured by sandwich ELISA method. Data analysis was done according to the obesity, body mass index, gender and age. Results: The mean concentration of leptin was $7.69{\pm}8.83\;ng/ml$ in normal children group and $36.34{\pm}18.57\;ng/ml$ in obese group. Serum leptin concentrations were significant correlation with the body mass index (p<0.01). Serum leptin concentration was significant higher in the group of over 10 years of age (p<0.01). Leptin levels showed no significant difference by gender. Conclusion: Serum leptin levels were significantly higher in obesity group than in control one, and they were correlated with body mass index and age. Measurements of leptin value by sandwich ELISA method are very useful and easily applicable to determine obesity.

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Korean Children and Adolescents with Crohn's Disease Are More Likely to Present with Perianal Fistulizing Disease at Diagnosis Compared to Their European Counterparts

  • Kang, Ben;Kim, Jung Eun;Jung, Jae Hun;Choe, Jae Young;Kim, Mi Jin;Choe, Yon Ho;Kim, Seung;Koh, Hong;Lee, Yoo Min;Lee, Jee Hyun;Lee, Yoon;Lee, Ji-Hyuk;Lee, Hae Jeong;Jang, Hyo-Jeong;Choi, Youjin;Choi, So Yoon;Kim, Ju Young;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.49-62
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    • 2020
  • Purpose: We aimed to investigate the disease phenotype of Korean pediatric Crohn's disease (CD) patients at diagnosis according to the Paris classification by comparison with patients from the European multicenter 5-years recruitment of children with newly developed IBD (EUROKIDS registry). Methods: Korean children and adolescents who had been newly diagnosed with CD at the age of <18 years during 2013-2016 were included in this multicenter retrospective study. Disease phenotype at diagnosis was classified according to the Paris classification, and compared with the published data from the EUROKIDS study. Results: A total of 255 patients were included. The median diagnosis age was 14.7 years (range, 0.8-17.9 years). No significant difference was observed in male-to-female ratio with EUROKIDS (1.9:1 vs. 1.45:1, p=0.062). The proportion of children aged <10 years was significantly lower in Koreans (7.1% vs. 19.6%, p<0.001). Colonic disease was less prominent (10.0% vs. 27.3%, p<0.001), while upper GI involvement was more prominent in Korean children (59.3% vs. 46.2%, p<0.001). The proportion with perianal fistulizing disease at diagnosis was significantly higher in Korean patients (44.8% vs. 8.2%, p<0.001). A separate analysis of Korean patients revealed that perianal fistulizing disease at diagnosis was positively associated with male sex and body mass index z-score (odds ratio [OR]=2.12, 95% confidence interval [CI]=1.20-3.76, p=0.010; and OR=1.29, 95% CI=1.05-1.58, p=0.015, respectively). Conclusion: Approximately half of pediatric CD patients in Korea present with perianal fistulas and/or abscesses at diagnosis, which is a distinct feature of CD in Korean children and adolescents compared to their European counterparts. An underlying genetic difference between ethnicities may play a role in this expression of different phenotypes in pediatric CD.

A Study on Health Status of the 1,559 Korean Applicants Applying for the Coal Miners in West Germany during the Year of 1972 and 1973 (우리나라 독일광부(獨逸鑛夫) 지원자(志願者)에 대(對)한 건강상태(健康狀態)에 관(關)한 조사연구(調査硏究))

  • Jun, Hyun-Sook;Choi, Sam-Sup
    • Journal of Preventive Medicine and Public Health
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    • v.7 no.2
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    • pp.383-393
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    • 1974
  • The importance of the health care for the miners not only concerns the productivity of the enterprises but also as a fundamental human right, it has to be secured and protected by the society and the government. The Korean coal miners began to find their works at overseas since 1963 when the Korean government selected and dispatched its miners to West Germany. As years go by, the demand and the supply of the coal miners, the program of the coal miners health care became the important tasks to be solved and the further studies and research were necessary to support these tasks achievement. The writers made a statistical analysis on health status of the 1,559 Korean applicants applying for the coal miners in West Germany during the year of 1972 and 1973 by the using of the data of physical examination which were directed by the Korea Overseas Development Cooperation. The standard of physical examination which was applied for coal miners applying the jobs in West Germany was authorized by the Government Office of Labor in 1967. The results are as following; 1. The applicants were from the various provinces throughout Korea; Gang Weon 50.2%, Jeon-Nam 16.8%, Chung-Nam 13.7%, Gyeong-Nam 10.5%, City of Seoul 5.4%, and others 3.7%. 2. The ages of the applicants were from 20 to 44. The age group of 25-29(36.3%) and of 30-34(55.2%) together occupied the 91.5 per cent of the total applicants. 3. Among the 1,559 applicants 52.1 per cent passed the physical examinations. The tendency were shown that as the age increased, the passing rate decreased, and the married applicnts had lower passing rates compared to the unmarried applicants. 4. The height of the applicants averaged $168.4{\pm}4.74(cm)$ and the weight averaged $61.3{\pm}5.65(kg)$. 5. The average vision of the left eye of the applicants was $0.92{\pm}0.23$ and the right eye was $0.91{\pm}0.30$. 6. The mean value of the systolic blood pressure of the applicants was $145{\pm}13(mmHg)$ and the diastolic blood pressure was $85{\pm}8(mmHg)$. 7. Fifteen hundred and fifty-nine applicants were taken chest X-ray and 17.2 per cent were found abonrmal. For each 1,000 applicants, 46 Pulmonary calcification and fibrosis, 45 chronic bronchitis, 27 pleural thickening and adhesion, 20 pulmonary tuburculosis, 11 anomalies of the rib, 10 pulmonary infiltration and 21 others diseases were found. 8. Lumber X-ray examination showed that 23.9 per cent (372 applicants) were found abnormal. For each 1,000 applicants, 77 osteoarthritis, 56 lumbarization, 15 fracture of vertebrae, 15 spondyloarthritis, 14 deformity of vertebrae, 13 spina bifida, 12 sacralization, 12 spondylolysis, and 5 others diseases were found. 9. In total, 47.9 per cent of 1,559 applicants failed the physical examinations, and the main causes for the failure were shown to be 7.1% of anomalies of spine, 6.3% of osteoarthritis, 4.7% of pulmonary calcification and fibrosis, 4.6% of chronic brochitis, 3.6% of hypertension (only), 3.4% of fracture of vertebrae. 3.1% of underweight(under 57.0kg), 2.0% of spondyloarthritis, 2.0% oe pulmonary tuberculosis, 1.7% of pleurisy, 1.0% of spina bifida, 1.5% of syphilis, 1.5% of color blindess, and 1.0% of underheight(under 160.0cm).

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