• Title/Summary/Keyword: Risk management factors

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Predictors of Participation Restriction in Community-dwelling Persons With Spinal Cord Injury (지역사회 거주 척수장애인의 참여 제약에 영향을 미치는 예측요인)

  • Kim, Yeon-Ju;Park, Ji-Hyuk;Kim, Jung-Ran;Park, Hae Yean
    • Therapeutic Science for Rehabilitation
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    • v.7 no.4
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    • pp.19-30
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    • 2018
  • Objective: The purpose of this study was to suggest predictors of participation restriction in community-dwelling Spinal Cord Injury (SCI) based on environmental, functional, injury-related, psychosocial, and sociodemographic factors. Methods: The participants were 82 community-dwelling SCI adults over the age of 18. They were all included in the American Spinal Injury Association's (ASIA) Levels A, B, and C. This study surveyed participants' participation using the CHART-K-SF, environmental factors using the CHIEF-25 Korean version, and functional factors using the SCIM III. Further, pain and distress were surveyed using Zung's Self-rating Pain and the PAD, self-esteem was assessed using the RSES, and self-efficacy using the GSS. Finally, information concerning injury levels, post-injury period, causes of injury-related factors, and sociodemographic factors such as gender, age, marriage, education level, and residence information were collected. The collected data were analyzed using SPSS Version 21.0 Results: Participants' risk factors were environmental and functional. The Nagelkerke's $R^2$ was.737. The OddsRatio(OR) of environmental factors(referent,0-1) was 40.346. Moreover, the OR of the $1^{st}$ quartile functional factor(referent,4thquartile) was 236. 621, and that of the$2^{nd}$ quartile was 21.174. In addition, the occupational predictors included the "policies" subscales in the CHART-K-SF, "physical/structural" in the CHIEF-25, and "mobility" in the SCIM III. Further, the predictors of "physical independence" were "services/assistance" in CHIEF-25, and "respiration and sphincter management' on the SCIM III. Additionally, "mobility" was predicted by "physical/structural" on the CHIEF-25 and "mobility" on the SCIM III. Conclusions: This study multidimensionally confirmed predictors of participation restriction. Through these facts, we investigated occupational therapists' roles in community setting. Therefore, this study's results will provide useful information for occupational therapy services, for which the goal is SCI participation improvement within the community.

Delayed Treatment of Pulmonary Tuberculosis in a University Hospital (대학병원에서 발생하는 폐결핵 치료지연)

  • Kang, Shin Myung;Lee, Jun Gu;Chung, Jae Ho;Han, Chang Hoon;Byun, Min Kwang;Chung, Wou Youn;Park, Moo Suk;Kim, Young Sam;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.277-284
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    • 2006
  • Background : Delayed treatment of pulmonary tuberculosis is an important problem because it results in greater mortality and the nosocomial transmission of tuberculosis. This study was conducted to analyze the factors that contribute to the delayed treatment of pulmonary tuberculosis in a university hospital and we wanted to provide basic data for instituting an effective management program for tuberculosis. Methods : we retrospectively reviewed the medical records of 155 patients with smear-positive or culture-positive pulmonary tuberculosis and who were treated between May 1999 and October 1999. A case-control study was performed to analyze the factors. We then tried to follow up the patients in delayed treatment group via telephone for the purpose of assessing the therapeutic interventions. Results : Among 150 patients, 55 (37%) were included in the delayed treatment group. The factors associated with delayed treatment on the univariate analysis included age (61 vs 40 years old; p <0.001), a smear-negative sputum test for acid-fast bacilli (AFB) (85% vs 55%; p <0.001) and no visits to a private clinic before the patient presented to the university hospital (56% vs 36%; p = 0.014). Multivariate analysis revealed that old age (p = 0.001), a smear-negative sputum for AFB (p = 0.001), and lower lobe infiltrate on chest X-ray (p = 0.041) were the independent predictors of delayed treatment. Of the 22 patients who did not receive any treatment, 20 of them 91%) consented to our suggestion of revisiting the hospital. Conclusion : Delayed treatment of patients with pulmonary tuberculosis is not uncommon in a university hospital. Old age, smear-negative for AFB, and lower lobe infiltrate on chest X-ray are the risk factors for delayed treatment. A more systematic management system is required for achieving better control of tuberculosis.

Surgical Result of the Modified Blalock-Taussig Shunt in Early Infancy (조기 영아기에서의 변형 블라록-타우시히 단락술의 수술 결과)

  • 이정렬;곽재건;최재성
    • Journal of Chest Surgery
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    • v.35 no.8
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    • pp.573-579
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    • 2002
  • Background: In this study, the role and the surgical outcome of the modified Blalock-Taussig shunt in the treatment of the infants with cyanotic complex congenital heart diseases were investigated. Material and Method: Over the last 12 years, 105 modified BT shunts were performed in 100 infants. Postoperative course, shunt patency rate, complications, mortality and its risk factors were reviewed restrospectively. Result: The mean age at operation was 43.0$\pm$36.6 days. Sex ratio was 60:40(M:F). The postoperative oxygen saturations were lowest after mean duration of 11 hours after the shunt procedure. The operative mortality was 8%(8) with 3 late deaths. Causes of operative death included failure of maintenance of minimum oxygenation during the procedure(2), immediate postoperative shunt occlusion(2), respiratory failure(2), low cardiac output due to heart failure and pericardial effusion(2) and sepsis(2). Late deaths resulted from acute cardiac arrest during the follow up cardiac catheterization, hypoxic myocardial failure, and arrhythmia. Year of surgery, shunt size, age at operation, and complexity of the anomalies were not the risk factors for mortality. Six month shunt patency rate was 97% and overall patency rate was 96%. Postoperative complications comprised of shunt occlusion(6), phrenic nerve palsy(3), and wound infection(2). Conclusion: We demonstrated that modified Blalock-Taussig shunt was a useful tool to palliate the infants with complex cyanotic heart disease in whom early complete repair was not feasible with acceptable mortality and patency rate. An adequate postoperative management and a meticulous surgical technique may be key factors for the better results.

Analysis of Risk Factors and Effect of Vancomycin for Sternal Infection after Coronary Artery Bypass Graft (관상동맥우회술 후 흉골감염의 위험인자분석 및 반코마이신의 효과)

  • Baek, Jong-Hyun;Jung, Tae-Eun;Lee, Dong-Hyup;Lee, Jang-Hoon;Kim, Jung-Hee
    • Journal of Chest Surgery
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    • v.43 no.4
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    • pp.381-386
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    • 2010
  • Background: Sternal wound infection (SWI) is an important complication after cardiac surgery. The aim of this study was to investigate the predictors affecting sternal wound infection and preventive factors including short term Vancomycin therapy in patients who underwent coronary artery bypass grafting (CABG). Material and Method: A retrospective study was done using data collected from January 2001 through December 2007. This included 219 patients who had isolated CABG. The definition of SWI was documentation from a microbiological study and a requirement for simple closure or other surgical revision. Result: The overall incidence of SWI was 7.8% (n=17). The causative organisms were methicillin resistant Staphylococcus aureus (MRSA, n=13), methicillin resistant Staphylococcus epidermidis (n=2), Pseudomonas aeruginosa (n=1), and Candida albicans (n=1). Ten cases had deep sternal wound infection with mediastinitis; 7 cases had a superficial wound infection. Infection-related mortality was low (1/17; 6%). Diabetes mellitus (p=0.006) and smoking history (p=0.020) were factors that predicted high risk. Short term use of vancomycin decreased the incidence of MRSA-associated SWI (p=0.009). For treatment, curettage and rewiring or flap were needed in most cases (88%, n=14). Conclusion: Patients who had diabetes mellitus and a smoking history need careful management. Short term use of vancomycin is effective for prevention of SWI with MRSA.

A Study on EC Acceptance of Virtual Community Users (가상 공동체 사용자의 전자상거래 수용에 대한 연구)

  • Lee, Hyoung-Yong;Ahn, Hyun-Chul
    • Asia pacific journal of information systems
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    • v.19 no.1
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    • pp.147-165
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    • 2009
  • Virtual community(VC) will increasingly be organized as commercial enterprises, with the objective of earning an attractive financial return by providing members with valuable resources and environment. For example, Cyworld.com in Korea uses several community services to enable customers of Cyworld to take control of their own value as potential purchasers of products and services. Although initial adoption is important for online network service success, it does not necessarily result in the desired managerial performance unless the initial usage is continuously related to the continuous usage and purchase. Particularly, the customer who receives relevant online services and is well equipped with online network services, will trust the online service provider and perceive less risk and experience more activities such as continuous usage and purchase. Thus, how to promote continued online service usage or, alternatively, how to prevent discontinuance is a critical issue for VC service providers to consider. By aggregating a wide range of information and online environments for customers and providing trust to its members, the service providers of virtual communities help to reduce the perceived risk of continuous usage and purchase. Drill down, online service managers realize that achieving strong and sustained customers who continuously use online service and purchase on it is crucial. Therefore, the research into this online service continuance will identify the relationship between the initial usage and the continuous usage and purchase. The research of continuous usage or post adoption has recently emerged as an important issue in the IS literature. Individuals' information systems(IS) continuous usage decisions are congruent with consumers' repeat purchase decisions. The TAM(Technology Acceptance Model) paradigm has been strongly confirmed across a wide range from product purchase on EC to online service usage contexts. The analysis of IS usage based on TAM has proven to be successful across almost online service contexts. However, most of previous studies have focused on only an area (i.e., VC or EC). Just little research has tried to analyze the relationship between VC and EC. The effect of some factors on user intention, captured through several theories such as TAM, has been demonstrated. Yet, few studies have explored the salient relationships of VC users' EC acceptance. To fill this gap between VC and EC research, this paper attempts to develop a research model that extends the TAM perspective in view of the additional contributions of trust in the service provider and trust in members on some factors that affect EC and VC adoption. In this extension, we applied the TAM-to-TAM(T2T) model, and analyzed the transfer effect of trust between these two TAMs. The research model was empirically tested on the context of a social network service. The model was to extend TAM with the trust concept for the virtual community environment from the perspective of tasks. By building an extended model of TAM and examining the relationships between trust and the existing variables of TAM, it is aimed to explain a user's continuous intention to use VC and purchase on EC. The unit of analysis in this paper is an individual user of a virtual community. The population of interest is the individual with the experiences in virtual community. The data for this paper was made available via a Web survey of VC users. In total, 281 cases were gathered for about one week, but there were some missing values in the sample and there were some inappropriate cases. Thus, only 248 cases were finally analyzed. We chose the structural equation analysis to test the hypotheses and it is better suited for explaining complex relationships than the other methods. In this test, AMOS was used to test the Structural Equation Model (SEM). Noticeable results have been found in the T2T model regarding the factors affecting the intention to use of virtual community and loyalty. Our result showed that trust transfer plays a key role in forming the two adoption beliefs. Overall, this study preliminarily confirms the salience of trust transfer in online service.

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

  • Cha, Hoon S.
    • Asia pacific journal of information systems
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    • v.22 no.4
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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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The Factors Influencing Intention to Use Bit Coin of Domestic Consumers (국내 소비자들의 비트코인 사용 의도에 영향을 미치는 요인 연구)

  • Shin, Dong-Hee;Kim, Yong-Moon
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.24-41
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    • 2016
  • Study is about Bit Coin that is electronic cash that is received attention globally in recent. It is increasing domestically that uses bit coin for convenience of micro payment, and also bit coin is possible to exchange each countries' currency. In this point, we searched understanding degree and acceptance of bit coin. Also we applied transformed TAM(Technology Acceptance Model) to search factors that have an effect on consumers' intention to use it. In advance, we analyze features of bit coin, and extract factors through preceding researches for existing electronic cash, because studies for intention to use bit coin are weak in internal and external. First of results is that 'economic efficiency' which is a characteristic variable of bit coin influences 'intention to use,' a dependent variable through 'perceived usefulness,' a parameter. It was investigated that monetary and mental costs that was costed when we use bit coin were less than using other cash. Secondly, 'payment convenience' that is a characteristic variable affects 'intention to use', a dependent variable through 'perceived usefulness,' a parameter. It was measured that problems of inconvenience that include transaction process, cash management time shortage and exchange changes will be solved by using bit coin. Thirdly, 'reliability' that is a perceived risk variable of bit coin has a direct effect on 'intention to use,' a dependent variable. It was investigated that we could achieve purpose of payment because we weren't influenced by breakdown on system by processing distributed database in some computers. Fourthly, 'perceived usefulness,' a parameter of bit coin directly affects 'intention to use,' a dependent variable. Then consumers who want to use bit coin are fascinated bit coin for various usability. Moreover, we want to provide implications to all of finance corporations, companies related electronic cash and bit coin users based on these results.

Risk Factors for the Progression of Pediatric Chronic Kidney Disease-A Single Center Study (소아 만성 신질환 진행의 위험인자 분석-단일기관 연구)

  • Han, Kyoung-Hee;Lee, Sung-Ha;Lee, Hyun-Kyung;Choi, Hyun-Jin;Lee, Bum-Hee;Cho, Hee-Yeon;Cheong, Hae-Il;Choi, Yong;Ha, Il-Soo
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.239-246
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    • 2007
  • Purpose : The progressive deterioration of renal function in children can impose a serious and lifelong impact on their lives. The ultimate goal in the management of children with chronic kidney disease(CKD) is to prolong survival, to prevent complications, and to promote growth and neurodevelopment. The aim of this study is to investigate the risk factors for the decline of renal function in pediatric CKD patients. Methods : Data from patients who met the criteria for the Kidney Disease Outcomes Quality Initiative(K/DOQI) CKD stage 2 to 4 between August 1999 and March 2007 were retrospectively analyzed. The estimated glomerular filtration rate(eGFR) was calculated by the Schwartz formula, using serum creatinine levels and height. We calculated the annual eGFR change from the difference between the baseline eGFR and the last eGFR divided by the duration(years) of the follow-up period. We analyzed the association between the annual eGFR change and factors such as age, gender, K/DOQI stage, underlying renal disease, serum calcium, and inorganic phosphorous during the follow-up period. Results : Sixty one children(44 boys & 17 girls) were enrolled. The age at entry was $7.1{\pm}4.7$ years. The annual eGFR change was $-1.2{\pm}11.9 mL/min/1.73m^2/year$. Our study showed that older age(P=0.005). hypocalcemia(P=0.012), and hypenhosphatemia(P=0.002) were significantly related to more rapid decline in renal function. Conclusion : In pediatric CKD, older age, hypocalcemia and hyperphosphatemia are related to more rapid deterioration of renal function.

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Postoperative Radiation Therapy in the Management of Early Cervical Cancer (초기 자궁경부암의 수술 후 방사선치료의 효과)

  • Kim, Jae-Chul
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.164-170
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    • 2006
  • [ $\underline{Purpose}$ ]: This study identified the result of postoperative radiation therapy and the prognostic factors to affect survival rates in cancer patients. $\underline{Materials\;and\;Methods}$: One hundred and thirty three patients with cervical cancer who were treated with postoperative radiation therapy following surgery at our institution between June 1985 and November 2002 were retrospectively analyzed. One hundred and thirteen patients had stage IB disease, and 20 patients had stage IIA disease. Histological examination revealed 118 squamous cell carcinoma patients and 15 adenocarcinoma patients. Sixty seven patients were noted to have stromal invasion greater than 10 mm, and 45 patients were noted to have stromal Invasion 10 mm or less. Positive lymphovascular invasion was found in 24 patients, and positive pelvic lymph nodes were noted in 39 patients. Positive vaginal resection margin was documented in 8 patients. All of the patients were treated with external beam radiation therapy to encompass whole pelvis and primary surgical tumor bed. Intracavitary radiation therapy was added to 19 patients who had positive or close surgical margins. $\underline{Results}$: Actuarial overall and disease-free survival rates for entire group of the patients were 88% and 84% at 5 years, respectively. Five-year disease-free survival rates for patients with stromal invasion greater than 10 mm and 10 mm or less were 76% and 97%, respectively (p<0.05). Also there was a significantly lower survival in patients with positive pelvic lymph nodes compared with patients with negative pelvic lymph nodes (p<0.05). However, lymphovascular invasion, positive vaginal resection margins were not statistically significant prognostic factors. Addition of neoadjuvant chemotherapy or type of surgery did not affect disease-free survival. $\underline{Conclusion}$: Postoperative radiation therapy appears to achieve satisfactory local control with limited morbidity in cervical cancer patients with high pathologic risk factors. Distant metastasis was a dominant failure pattern to affect survival in cervical cancer patients after radical surgery and radiation and more effective systemic treatment should be investigated in these high-risk patients.

The Effects of Economic Conditions on Capital Structure : Evidence from Korean Shipping Firms (경기변화를 고려한 해운기업의 자본구조에 관한 실증연구)

  • Lee, Sung-Yhun
    • Journal of Navigation and Port Research
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    • v.40 no.6
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    • pp.451-458
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    • 2016
  • Since Modigliani and Miller developed their theory of capital structure in 1958, it has become one of the most debated issues in corporate management. This is because the capital structure decision necessarily affects financial risk and the firm's value. Throughout the research, one of the most concerning problems is determining what factors influence the firm's capital structure. Since Korean shipping firms have been suffering from a long term economic recession, an optimal capital structure has become increasingly critical to survive in the shipping industry. This paper studies panel data on 46 Korean shipping companies since 2000 to find the factors that affect capital structure. The results suggest that a negative relationship arises between firm size, tangible assets, profitability and non-debt tax shields against leverage. Otherwise, it proved that growth opportunity has a positive relationship with the firm's leverage. In the research model during a booming shipping economy, growth opportunity and non-debt tax shield are not associated with firm's capital structure.