• Title/Summary/Keyword: Internal stress model

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Effect of Attenuation Correction, Scatter Correction and Resolution Recovery on Diagnostic Performance of Quantitative Myocardial SPECT for Coronary Artery Disease (감쇠보정, 산란보정 및 해상도복원이 정량적 심근 SPECT의 관상동맥질환 진단성능에 미치는 효과)

  • Hwang, Kyung-Hoon;Lee, Dong-Soo;Paeng, Jin-Chul;Lee, Myoung-Mook;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.5
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    • pp.288-297
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    • 2002
  • Purpose: Soft tissue attenuation and scattering are major methodological limitations of myocardial perfusion SPECT. To overcome these limitations, algorithms for attenuation, scatter correction and resolution recovery (ASCRR) is being developed, while quantitative myocardial SPECT has also become available. In this study, we investigated the efficacy of an ASCRR-corrected quantitative myocardial SPECT method for the diagnosis of coronary artery disease (CAD). Materials and Methods: Seventy-five patients (M:F=51:24, $61.0{\pm}8.9$ years old) suspected of CAD who underwent coronary angiography (CAG) within $7{\pm}12$ days of SPECT(Group-I) and 20 subjects (M:F=10:10, age $40.6{\pm}9.4$) with a low likelihood of coronary artery disease (Group-II) were enrolled. Tl-201 rest/ dipyridamole-stress Tc-99m-MIBI gated myocardial SPECT was performed. ASCRR correction was peformed using a Gd-153 line source and automatic software (Vantage-Pro; ADAC Labs, USA). Using a 20-segment model, segmental perfusion was automatically quantified on both the ASCRR-corrected and uncorrected images using an automatic quantifying software (AutoQUANT; ADAC Labs.). Using these quantified values, CAD was diagnosed in each of the 3 coronary arterial territories. The diagnostic performance of ASCRR-corrected SPECT was compared with that of non-corrected SPECT. Results: Among the 75 patients of Group-I, 9 patients had normal CAG while the remaining 66 patients had 155 arterial lesions; 61 left anterior descending (LAD), 48 left circumflex (LCX) and 46 right coronary (RCA) arterial lesions. For the LAD and LCX lesions, there was no significant difference in diagnostic performance. In Group-II patients, the overall normalcy rate improved but this improvement was not statistically significant (p=0.07). However, for RCA lesions, specificity improved significantly but sensitivity worsened significantly with ASCRR correction (both p<0.05). Overall accuracy was the same. Conclusion: The ASCRR correction did not improve diagnostic performance significantly although the diagnostic specificity for RCA lesions improved on quantitative myocardial SPECT. The clinical application of the ASC-RR correction requires more discretion regarding cost and efficacy.

A Study on the Relationship between the Experience of Sanhujori, the Traditional Postpartal Care in Korea and Present Health Status of Chronic Arthritis Female Patient (만성관절염 여성 환자의 산후조리 경험과 건강상태와의 관계)

  • Yoo, Eun-Kwang;Lee, Sun-Hyae;Kim, Myoung-Hee
    • Women's Health Nursing
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    • v.4 no.2
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    • pp.217-230
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    • 1998
  • The purpose of this descriptive correlational study was to define the relationship between the experience of Sanhuujori, Korean traditional non-professional postpartal care after delivery and abortion and present health status of chronic arthritis female patient who visited to outpatient clinic of rheumatic internal medicine at a hospital located in Seoul, Korea. A convenience sample of 64 women who orally agreed to be a participant and data were collected form October 1996 to May, 1997 for sis months by way of interview with semistructured questionnaire. The data were analyzed by the SPSS pc program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; Mean age of participants was 53.2 years and mean number of children was 3.1. Mean frequency of abortion was 2.1 times per woman. Seventy four percentage of respondents did not have Sanhujori after abortion. The mean period of Sanhujori after delivery was 17.7, 15.2, 13.8 days from the first child to third child and shorter than that of general woman such as 20.0, 19.0, 17.3 days in the previous study. On the subjective evaluation of whether the women did Sanhujori well or not, the rate of 'did Sanhujori wrongly' was the highest rank in each child where as general woman 'did Sanhujori well' at the first child, 'moderate' at the second and third child and 'did Sanhujori wrongly' at the 4th and fifth child. The health status implies both subjective health status women perceived and the rate of complaints of physical symptom distress women are experiencing presently. The respondents of 82.5% perceived them as unhealthy or sick and 68.9% of women complained more than two symptoms. Mean number of physical symptom distress women complained was 2.33. The main sites of physical symptom distress were upper & lower extremities 69.1% including knee and hand, whole body 19.1%, neck 3.7%, waist & shoulders 2.7% respectively. The characteristics of the symptoms were mostly pain 60%, swelling 19.8%, rigidity & deformity 7.9% respectively, sensation of heat 6.8% and weakness 1.7%. Women perceived the etiology of the chronic arthritis as stress 25.8%, 'did Sanhujori wrongly' & overwork 23.4% respectively, genetic 12.9%, malnutrition, 4.8%, and aging process 3.2%. There were significant positive correlation between subjective health status and the period of Sanhujori after delivery of the second child(r=-0.22) and negative correlation with the number of child at the level of 5% of significance statistically(r=0.27). There were significant negative correlation between the rate of complaints of physical symptom distress and the subjective evaluation whether she did Sanhujori well or not at the level of 5% of significance statistically(r=-0.23). And the rate of complaints of physical symptom distress in the group of women who experienced abortion was significantly higher than that of women who did not experience it at the level of 5% significance statistically(t=2.00) In conclusion, this finding reconfirmed the possible relationship between health status of chronic arthritis female patient and the experience of Sanhujori after delivery & abortion. It provides a challenge to the professional care givers to research further on the effects of Sanhujori on the health status, health recovery after abortion or delivery from the various aspects through the crosssectional and longitudinal research for the refinement of the reality of not only as cultural phenomenon but as conceptual model for the appropriateness of intervention and quality of care for desirable health outcomes.

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Factors influencing health and quality of life among allergy and asthma patients: With specific focus on self-efficacy, social support and health management (건강과 삶의 질에 영향을 주는 요인에 대한 분석: 자기효능감, 사회적 지원 및 질병관리를 중심으로)

  • Uichol Kim ;Chun-soo Hong ;Jeung-Gweon Lee ;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.11 no.2
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    • pp.143-181
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    • 2005
  • This article examines factors that influence health and quality of life. In addition to the symptomatology and physiological functioning, the influence of the psychological functioning and interpersonal relationship on the overall health and quality of life are also investigated. Using a case-study approach, a total of 70 patients suffering from allergy or asthma were interviewed using a semi-structured questionnaire developed by the present authors. It assessed the following six areas: Cause and onset of illness, psychological functioning, health management, trust, social support received and overall health and quality of life. Based on the transactional model (Bandura, 1997; Kim & Park, 2005), the results of the case studies have been integrated and divided into three aspects: (1) Cause and onset of illness that includes physiological and environment factors; (2) mediating influences that includes psychological functioning, health management, interpersonal relationship and social support received; and (3) outcome factor that includes symptomatology, health and quality of life. The psychological functioning includes self-efficacy (self-regulated efficacy, efficacy for enlisting social support, efficacy for managing the environment, and efficacy for overcoming difficulties), positive outlook, life goals, experience of stress, and proxy control. Interpersonal relationship includes trust of family members and the physician. Health management includes receiving proper health assessment, following the advice and prescription given by the physicians, control of the environment and maintaining a healthy lifestyle. The results indicate that physiological, psychological, relational and environment factors interact with each other and affect individual's overall health and quality of life. Self-efficacy, social support received from family members, trust of physicians, and the health care system are key factors promoting healthy lifestyle and quality of life. The results indicate the need for further interdisciplinary, indigenous and cultural psychological research.

The Effect of Corporate Association on the Perceived Risk of the Product (소비자의 제품 지각 위험에 대한 기업연상과 효과: 지식과 관여의 조절적 역활을 중심으로)

  • Cho, Hyun-Chul;Kang, Suk-Hou;Kim, Jin-Yong
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.4
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    • pp.1-32
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    • 2008
  • Brown and Dacin (1997) have investigated the relationship between corporate associations and product evaluations. Their study focused on the effects of associations with a company's corporate ability (CA) and its corporate social responsibility (CSR) on consumers' product evaluations. Their study has found that both of CA and CSR influenced product evaluation but CA association has a stronger effect than CSR associations. Brown and Dacin (1997) have, however, claimed that there are few researches on how corporate association impacts product responses. Accordingly, some of researchers have found the variables to moderate or to mediate the relationship between the corporate association and the product responses. In particular, there has been existed a few of studies that tested the influence of the reputation on the product-relevant perceived risk, but the effects of two types of the corporate association on the product-relevant perceived risk were not identified so far. The primary goal of this article is to identify and empirically examine some variables to moderate the effects of CA association and CSR association on the perceived risk of the product. In this articles, we take the concept of the corporate associations that Brown and Dacin (1997) had proposed. CA association is those association related to the company's expertise in producing and delivering its outputs and CSR association reflected the organization's status and activities with respect to its perceived societal obligations. Also, this study defines the risk, which is the uncertainty or loss of the product and corporate that consumers have taken in a particular purchase decision or after having purchased. The risk is classified into product-relevant performance risk and financial risk. Performance risk is the possibility or the consequence of a product not functioning at some expected level and financial risk is the monetary loss one perceives to be incurring if a product does not function at some expected level. In relation to consumer's knowledge, expert consumers have much of the experiences or knowledge of the product in consumer position and novice consumers does not. The model tested in this article are shown in Figure 1. The model indicates that both of CA association and CSR association influence on performance risk and financial risk. In addition, the effects of CA and CSR are moderated by product category knowledge (product knowledge) and product category involvement (product involvement). In this study, the relationships between the corporate association and product-relevant perceived risk are hypothesized as the following form. For example, Hypothesis 1a($H_{1a}$) is represented that CA association has a positive influence on the performance risk of consumer. Also, the hypotheses that identified some variables to moderate the effects of two types of corporate association on the perceived risk of the product are laid down. One of the hypotheses of the interaction effect is Hypothesis 3a($H_{3a}$), it is described that consumer's knowledges of the product moderates the negative relationship between CA association and product-relevant performance risk. A field experiment was conducted in order to examine our model. The company tested was not real but imagined to meet the internal validity. Water purifiers were used for our study. Four scenarios have been developed and described as the imaginary company: Type A with both of superior CA and CSR, Type B with superior CSR and inferior CA, Type C with superior CA and inferior CSR, and Type D with both inferior of CA and CSR. The respondents of this study were classified into four groups. One type of four scenarios (Type A, B, C, or D) in its questionnaire was given to the respondent who filled out questions. Data were collected by means of a self-administered questionnaire to the respondents, chosen in convenience. A total of 300 respondents filled out the questionnaire but 207 were used for further analysis. Table 1 indicates that the scales in this study are reliable because the range of coefficients of Cronbach's $\alpha$ are from 0.85 to 0.92. The composite reliability is in the range of 0,85 to 0,92 and average variance extracted is in 0.72-0.98 range that is higher than the base level of 0.6. As shown in Table 2, the values for CFI, NNFI, root-mean-square error approximation (RMSEA), and standardized root-mean-square residual (SRMR) are acceptably close to the standards suggested by Hu and Bentler (1999):.95 for CFI and NNFI,.06 for RMSEA, and.08 for SRMR. We also tested discriminant validity provided by Fornell and Larcker (1981). As shown in Table 2, we found strong evidence for discriminant validity between each possible pair of latent constructs in all samples. Given that these batteries of overall goodness-of-fit indices were accurate and that the model was developed on theoretical bases, and given the high level of consistency across samples, this enables us to proceed the previously defined scales. We used the moderated hierarchical regression analysis to test the influence of the corporate association(CA and CSR associations) on product-relevant perceived risk(performance and financial risks) and to identify the variables moderating the relationship between the corporate association and product-relevant performance risk. In this study, dependent variables are performance and financial risk. CA and CSR associations are described the independent variables. The moderating variables are product category knowledge and product category involvement. The results are, as expected, found that CA association has statistically a significant influence on the perceived risk of the product, but CSR association does not. Product category knowledge and involvement moderate the relationship between the CA association and the perceived risk of the product. However, the effect of CSR association on the perceived risk of the product is not moderated by the consumers' knowledge and involvement. For this result, it is necessary for a corporate to inform its customers CA association more than CSR association so that they could be felt to be the reduction of the perceived risk. The important theoretical contribution of this research is the meanings that two types of corporate association that Brown and Dacin(1997), and Brown(1998) have proposed replicated the difference of the effects on product evaluation. According to Hunter(2001), it was an important affair to accomplish the validity of a particular study and we had to take about ten studies to deduce a strict study. Next, there is the contribution of the this study to find that the effects of corporate association on the perceived risk of the product are varied by the moderator variables. In particular, the moderating effect of knowledge on the relationship between corporate association and product-relevant perceived risk has not been tested in Korea. In the managerial implications of this research, we suggest the necessity to stress the ability that corporate manufactures the product well(CA association) than the accomplishment of corporate's social obligation(CSR association). This study suffers from various limitations that imply future research directions. The moderating effects of product category knowledge and involvement on the relationship between corporate association and perceived risk need to be replicated. Next, future research could explore whether the mediated effects of the perceived risk has the relationship between corporate association and consumer's product purchase. In addition, to ensure the external validity of the study will be needed to use realistic company, not artificial.

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Perceptional Change of a New Product, DMB Phone

  • Kim, Ju-Young;Ko, Deok-Im
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.3
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    • pp.59-88
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    • 2008
  • Digital Convergence means integration between industry, technology, and contents, and in marketing, it usually comes with creation of new types of product and service under the base of digital technology as digitalization progress in electro-communication industries including telecommunication, home appliance, and computer industries. One can see digital convergence not only in instruments such as PC, AV appliances, cellular phone, but also in contents, network, service that are required in production, modification, distribution, re-production of information. Convergence in contents started around 1990. Convergence in network and service begins as broadcasting and telecommunication integrates and DMB(digital multimedia broadcasting), born in May, 2005 is the symbolic icon in this trend. There are some positive and negative expectations about DMB. The reason why two opposite expectations exist is that DMB does not come out from customer's need but from technology development. Therefore, customers might have hard time to interpret the real meaning of DMB. Time is quite critical to a high tech product, like DMB because another product with same function from different technology can replace the existing product within short period of time. If DMB does not positioning well to customer's mind quickly, another products like Wibro, IPTV, or HSPDA could replace it before it even spreads out. Therefore, positioning strategy is critical for success of DMB product. To make correct positioning strategy, one needs to understand how consumer interprets DMB and how consumer's interpretation can be changed via communication strategy. In this study, we try to investigate how consumer perceives a new product, like DMB and how AD strategy change consumer's perception. More specifically, the paper segment consumers into sub-groups based on their DMB perceptions and compare their characteristics in order to understand how they perceive DMB. And, expose them different printed ADs that have messages guiding consumer think DMB in specific ways, either cellular phone or personal TV. Research Question 1: Segment consumers according to perceptions about DMB and compare characteristics of segmentations. Research Question 2: Compare perceptions about DMB after AD that induces categorization of DMB in direction for each segment. If one understand and predict a direction in which consumer perceive a new product, firm can select target customers easily. We segment consumers according to their perception and analyze characteristics in order to find some variables that can influence perceptions, like prior experience, usage, or habit. And then, marketing people can use this variables to identify target customers and predict their perceptions. If one knows how customer's perception is changed via AD message, communication strategy could be constructed properly. Specially, information from segmented customers helps to develop efficient AD strategy for segment who has prior perception. Research framework consists of two measurements and one treatment, O1 X O2. First observation is for collecting information about consumer's perception and their characteristics. Based on first observation, the paper segment consumers into two groups, one group perceives DMB similar to Cellular phone and the other group perceives DMB similar to TV. And compare characteristics of two segments in order to find reason why they perceive DMB differently. Next, we expose two kinds of AD to subjects. One AD describes DMB as Cellular phone and the other Ad describes DMB as personal TV. When two ADs are exposed to subjects, consumers don't know their prior perception of DMB, in other words, which subject belongs 'similar-to-Cellular phone' segment or 'similar-to-TV' segment? However, we analyze the AD's effect differently for each segment. In research design, final observation is for investigating AD effect. Perception before AD is compared with perception after AD. Comparisons are made for each segment and for each AD. For the segment who perceives DMB similar to TV, AD that describes DMB as cellular phone could change the prior perception. And AD that describes DMB as personal TV, could enforce the prior perception. For data collection, subjects are selected from undergraduate students because they have basic knowledge about most digital equipments and have open attitude about a new product and media. Total number of subjects is 240. In order to measure perception about DMB, we use indirect measurement, comparison with other similar digital products. To select similar digital products, we pre-survey students and then finally select PDA, Car-TV, Cellular Phone, MP3 player, TV, and PSP. Quasi experiment is done at several classes under instructor's allowance. After brief introduction, prior knowledge, awareness, and usage about DMB as well as other digital instruments is asked and their similarities and perceived characteristics are measured. And then, two kinds of manipulated color-printed AD are distributed and similarities and perceived characteristics for DMB are re-measured. Finally purchase intension, AD attitude, manipulation check, and demographic variables are asked. Subjects are given small gift for participation. Stimuli are color-printed advertising. Their actual size is A4 and made after several pre-test from AD professionals and students. As results, consumers are segmented into two subgroups based on their perceptions of DMB. Similarity measure between DMB and cellular phone and similarity measure between DMB and TV are used to classify consumers. If subject whose first measure is less than the second measure, she is classified into segment A and segment A is characterized as they perceive DMB like TV. Otherwise, they are classified as segment B, who perceives DMB like cellular phone. Discriminant analysis on these groups with their characteristics of usage and attitude shows that Segment A knows much about DMB and uses a lot of digital instrument. Segment B, who thinks DMB as cellular phone doesn't know well about DMB and not familiar with other digital instruments. So, consumers with higher knowledge perceive DMB similar to TV because launching DMB advertising lead consumer think DMB as TV. Consumers with less interest on digital products don't know well about DMB AD and then think DMB as cellular phone. In order to investigate perceptions of DMB as well as other digital instruments, we apply Proxscal analysis, Multidimensional Scaling technique at SPSS statistical package. At first step, subjects are presented 21 pairs of 7 digital instruments and evaluate similarity judgments on 7 point scale. And for each segment, their similarity judgments are averaged and similarity matrix is made. Secondly, Proxscal analysis of segment A and B are done. At third stage, get similarity judgment between DMB and other digital instruments after AD exposure. Lastly, similarity judgments of group A-1, A-2, B-1, and B-2 are named as 'after DMB' and put them into matrix made at the first stage. Then apply Proxscal analysis on these matrixes and check the positional difference of DMB and after DMB. The results show that map of segment A, who perceives DMB similar as TV, shows that DMB position closer to TV than to Cellular phone as expected. Map of segment B, who perceive DMB similar as cellular phone shows that DMB position closer to Cellular phone than to TV as expected. Stress value and R-square is acceptable. And, change results after stimuli, manipulated Advertising show that AD makes DMB perception bent toward Cellular phone when Cellular phone-like AD is exposed, and that DMB positioning move towards Car-TV which is more personalized one when TV-like AD is exposed. It is true for both segment, A and B, consistently. Furthermore, the paper apply correspondence analysis to the same data and find almost the same results. The paper answers two main research questions. The first one is that perception about a new product is made mainly from prior experience. And the second one is that AD is effective in changing and enforcing perception. In addition to above, we extend perception change to purchase intention. Purchase intention is high when AD enforces original perception. AD that shows DMB like TV makes worst intention. This paper has limitations and issues to be pursed in near future. Methodologically, current methodology can't provide statistical test on the perceptual change, since classical MDS models, like Proxscal and correspondence analysis are not probability models. So, a new probability MDS model for testing hypothesis about configuration needs to be developed. Next, advertising message needs to be developed more rigorously from theoretical and managerial perspective. Also experimental procedure could be improved for more realistic data collection. For example, web-based experiment and real product stimuli and multimedia presentation could be employed. Or, one can display products together in simulated shop. In addition, demand and social desirability threats of internal validity could influence on the results. In order to handle the threats, results of the model-intended advertising and other "pseudo" advertising could be compared. Furthermore, one can try various level of innovativeness in order to check whether it make any different results (cf. Moon 2006). In addition, if one can create hypothetical product that is really innovative and new for research, it helps to make a vacant impression status and then to study how to form impression in more rigorous way.

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