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Levels of Barriers to Pain Management of Cancer Patients and their Nurses (암 환자와 간호사의 통증관리 장애정도)

  • Yoo, Yang-Sook;Lee, Won-Hee;Cho, Ok-Hee;Lee, So-Woo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.224-233
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    • 2005
  • Purpose: This study was conducted to provide basic data for developing an effective strategy for cancer pain management by comparing the levels of barriers to pain management of metastatic or advanced cancer patient and their nurses. Methods: The subject of this study were 155 patients who were treated for metastatic or advanced cancer at one of three hospitals in Seoul from January 2004 to January 2005, and 153 nurses who take care of those patients. The levels of barriers to pain management were measured using a tool developed by Gunnarsdottir et al. (2002), 27 questions on a six point scale. The levels of stresses were measured using a tool modified from a stress response measurement reported by Goh Gyung-bong et al. (2000), 27 questions on a five point scale. The levels of barriers in cancer patients were analyzed using t-test and ANOVA, while the data obtained from patients and nurses were compared by t-test. Results: Higher levels of barriers to pain management were found in three groups: 'less than middle school,' 'not treated with anti-cancer chemotherapy,' and 'ECOG of 2.' The level (2.55) of barriers to pain management in the patient group was higher than that (1.76) of the nurse group. Both of the two groups had high levels of barriers in two variables: 'There is a danger of becoming addicted to pain medicine.' and 'Using pain medicine blocks your ability to know if you have any new pain.' There was not a significant difference in the levels of stresses between the two groups. Conclusion: It was found that, for effective cancer pain management practices, it would be necessary to provide cancer patients and their nurses with education and training about pain management and related barriers.

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Does Home Oxygen Therapy Slow Down the Progression of Chronic Obstructive Pulmonary Diseases?

  • Han, Kyu-Tae;Kim, Sun Jung;Park, Eun-Cheol;Yoo, Ki-Bong;Kwon, Jeoung A;Kim, Tae Hyun
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.128-135
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    • 2015
  • Purpose: As the National Health Insurance Service (NHIS) began to cover home oxygen therapy (HOT) services from 2006, it is expected that the new services have contributed to overall positive outcome of patients with chronic obstructive pulmonary disease (COPD). We examined whether the usage of HOT has helped slow down the progression of COPD. Methods: We examined hospital claim data (N=10,798) of COPD inpatients who were treated in 2007~2012. We performed ${\chi}^2$ tests to analyze the differences in the changes to respiratory impairment grades. Multiple logistic regression analysis was used to identify factors that are associated with the use of HOT. Finally, a generalized linear mixed model was used to examine association between the HOT treatment and changes to respiratory impairment grades. Results: A total of 2,490 patients had grade 1 respiratory impairment, and patients with grades 2 or 3 totaled 8,308. The OR for use of HOT was lower in grade 3 patients than others (OR: 0.33, 95% CI: 0.30~0.37). The maintenance/mitigation in all grades, those who used HOT had a higher OR than non-users (OR: 1.41, 95% CI: 1.23~1.61). Conclusion: HOT was effective in maintaining or mitigating the respiratory impairment in COPD patients.

Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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Risk Analysis of Household Debt in Korea: Using Micro CB Data (개인CB 자료를 이용한 우리나라 가계의 부채상환위험 분석)

  • Hahm, Joon-Ho;Kim, Jung In;Lee, Young Sook
    • KDI Journal of Economic Policy
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    • v.32 no.4
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    • pp.1-34
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    • 2010
  • We conduct a comprehensive risk analysis of household debt in Korea for the first time using the whole sample credit bureau (CB) data of 2.2 million individual debtors. After analysing debt service capacity profiles of debtor groups classified by the borrower characteristics such as income, age, occupation, credit scoring, and the type of creditor business companies, we investigate the impact of interest rate and income changes on debt service-to-income ratios (DTIs) and default rates of respective debtor groups. Empirical results indicate that debt service burdens are relatively high for low income wage earners, high income self-employed, low income capital and card loan holders, and high income mutual savings loan holders. We also find that debtors from multiple financial companies are particularly weak in their debt service capacity. The scenario analysis indicates that financial companies, with the current level of capital buffers, may be able to absorb negative consequences arising from the increase in DTIs and loan default rates if the interest rate and income changes remain modest. However, the negative consequences may fall disproportionately on non-bank financial companies such as capital, credit card, and mutual savings banks, whose debtors' DTIs are already high. We also find that the refinancing risk of household debt is relatively high in Korea as more than half of household mortgage debts are bullet loans. As the DTIs of mortgage loan holders are already high, under the current DTI regulation, mortgage loans may not be readily refinanced especially when the interest rate rises. Disruptions in mortgage loan refinancing may put downward pressure on housing prices, which may in turn magnify refinancing risk under the current loan-to-value (LTV) regulation. Overall our analysis suggests that, for more effective monitoring of household debt risk, it is necessary to combine existing surveillance schemes based on macro aggregate indicators with more comprehensive and detailed risk analyses based on micro individual data.

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Oral health status and treatment need of institutionalized elderly patients (노인요양시설에 있는 노인환자의 구강실태 및 치료수요도)

  • Yang, Soon-Bong;Moon, Hong-Suk;Han, Dong-Hoo;Lee, Ho-Yong;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.5
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    • pp.455-469
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    • 2008
  • Statement of problems: In the area of dental care, the institutionalized elderly have placed the most vulnerable state, and we cannot find their subjective need of dental treatment because of the physical and mental disabilities, But we have no basic investigation of their oral health conditions. Purpose: The aims of the current study were to investigate the oral health status of institutionalized elderly patients who are in the least benefited side of dental service, and to analyze their dental treatment needs. Material and methods: The survey of the oral status was carried out on 758 institutionalized elderly, and 212 elderly who was more than 65 years old from D dental office, and it was based on the Guidelines of Oral Health Research of year 2000 in Republic of Korea. Results and conclusion: The DMFT index of the institutionalized elderly appeared higher than that of the same ages in control group, and it increased with age. The number of residual teeth of the institutionalized elderly appeared lower than that of the same ages in control group, and it decreased with age (P < .05). The number of fixed partial denture in institutionalized elderly was lower than that of the same ages in control group (P < .05). The percentage wearing removable partial denture was not significant between the elderly in institutions and the control group, and was not different according to age between the two groups. The percentage of institutionalized elderly wearing complete denture appeared lower than that of the same ages in control group, and it increased with age. The percentage of institutionalized elderly needing complete denture was higher than that of control group, and the percentage of elderly needing complete denture on the maxilla was higher than that of the mandible. 16.35% of the institutionalized elderly was living without denture in spite of their fully edentulous state. The need for complete denture increased rapidly with age. The number of valued teeth and dental prostheses in shortened dental arch concept and number of occluding pairs of teeth of institutionalized elderly were lower than that of the control group (P < .05). In institutionalized elderly, the number of residual teeth, the number of fixed partial dentures, and the percentage wearing removable partial dentures were higher in the mandible, and the percentage wearing complete dentures was higher in the maxilla (P < .05). The rate of institutionalized elderly needing prosthodontic treatment appeared to be 67.82%, where the number of occluding pairs of teeth was less than 10. When it is difficult to evaluate the subjective need of dental treatment as with the institutionalized elderly, estimation using the number of occluding pairs of teeth can be a useful indicator that can project treatment needs. For the oral health care of institutionalized elderly, it is essential to increase the awareness of nurses and caregivers who take care of them, about the importance of the oral health. Since the average life span and number of residual teeth are increasing gradually, the welfare policy should be changed to implementing regular dental examinations, preservative treatment forms and oral health control of dentulous patients where the traveling-treatment system and visit system are supplemented. And principles should be set that the present denture project of edentulous patients should be done by specialists who'll also be responsible for postmanagement. Through this research of institutionalized elderly, the oral health status which is worsened by aging could be confirmed. And the interest and positive participation of dental society on the elderly should come first in order to solve the rising treatment needs of the elderly patients.

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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A Qualitative Study on Facilitating Factors of User-Created Contents: Based on Theories of Folklore (사용자 제작 콘텐츠의 활성화 요인에 대한 정성적 연구: 구비문학 이론을 중심으로)

  • Jung, Seung-Ki;Lee, Ki-Ho;Lee, In-Seong;Kim, Jin-Woo
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.43-72
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    • 2009
  • Recently, user-created content (UCC) have emerged as popular medium of on-line participation among users. The Internet environment has been constantly evolving, attracting active participation and information sharing among common users. This tendency is a significant deviation from the earlier Internet use as an one-way information channel through which users passively received information or contents from contents providers. Thanks to UCCs online users can now more freely generate and exchange contents; therefore, identifying the critical factors that affect content-generating activities has increasingly become an important issue. This paper proposes a set of critical factors for stimulating contents generation and sharing activities by Internet users. These factors were derived from the theories of folklores such as tales and songs. Based on some shared traits of folklores and UCC content, we found four critical elements which should be heeded in constructing UCC contents, which are: context of culture, context of situation, skill of generator, and response of audience. In addition, we selected three major UCC websites: a specialized contents portal, a general internet portal, and an official contents service site, They have different use environments, user interfaces, and service policies, To identify critical factors for generating, sharing and transferring UCC, we traced user activities, interactions and flows of content in the three UCC websites. Moreover, we conducted extensive interviews with users and operators as well as policy makers in each site. Based on qualitative and quantitative analyses of the data, this research identifies nine critical factors that facilitate contents generation and sharing activities among users. In the context of culture, we suggest voluntary community norms, proactive use of copyrights, strong user relationships, and a fair monetary reward system as critical elements in facilitating the process of contents generation and sharing activities. Norms which were established by users themselves regulate user behavior and influence content format. Strong relationships of users stimulate content generation activities by enhancing collaborative content generation. Particularly, users generate contents through collaboration with others, based on their enhanced relationship and specialized skills. They send and receive contents by leaving messages on website or blogs, using instant messenger or SMS. It is an interesting and important phenomenon, because the quality of contents can be constantly improved and revised, depending on the specialized abilities of those engaged in a particular content. In this process, the reward system is an essential driving factor. Yet, monetary reward should be considered only after some fair criterion is established. In terms of the context of the situation, the quality of contents uploading system was proposed to have strong influence on the content generating activities. Among other influential factors on contents generation activities are generators' specialized skills and involvement of the users were proposed. In addition, the audience response, especially effective development of shared interests as well as feedback, was suggested to have significant influence on contents generation activities. Content generators usually reflect the shared interest of others. Shared interest is a distinct characteristic of UCC and observed in all the three websites, in which common interest is formed by the "threads" embedded with content. Through such threads of information and contents users discuss and share ideas while continuously extending and updating shared contents in the process. Evidently, UCC is a new paradigm representing the next generation of the Internet. In order to fully utilize this innovative paradigm, we need to understand how users take advantage of this medium in generating contents, and what affects their content generation activities. Based on these findings, UCC service providers should design their websites as common playground where users freely interact and share their common interests. As such this paper makes an important first step to gaining better understand about this new communication paradigm created by UCC.

Designing female-oriented computer games: Emotional expression

  • Shui, Lin-Lin;Lee, Won-Jung
    • Cartoon and Animation Studies
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    • s.20
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    • pp.75-86
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    • 2010
  • Recently, as the number of female players has increased rapidly, the electronic gaming industry has begun to look at ways to appeal to the largely untapped female market. According to the latest game market investigative report by China Internet Network Information Center (CNNIC), the total number of game players in China increased by 24.8% in 2009, reached 69,130,000 people, and 38.9% of them are female players. This growth in the number of female player is corroborated by a series of investigative reports from IResearch Company in Shanghai, China: from 2003 to 2009, the number of female players grew from 8% to more than 49%. Therefore, no matter how much attention the game production companies have given to male players or how they have ignored the female players before, the companies would be sensible to face up this reality and adjust their marketing policy a bit more. This article analyzes gender preferences in video games which shows that male players are more likely to be attracted to elements of aggression, violence, competition and fast action in electronic game-playing, while female players are drawn to emotional and social aspects of the games such as an understanding of character relationships. The literatures cited indicates that female players also show apparent preference for games with familiar environments, games that allow players to work together, games that have more than one way to win, and games in which characters do not die. It also discusses the characteristics of female-friendly games from the aspect of emotion, pointing out that the simulation games involving pet, dressing-up, and social simulation games are very popular with female players. Because these are the most suitable game types to fill with emotions of love, share, jealousy, superiority, mystery, these are absolutely attractive to female players. Finally, in accord with the above, I propose some principles of designing female-oriented games, including presenting a good-looking leading character, making the story interesting with "live" NPCs(Non-Playing Characters), and finding ways to satisfy female nature instincts such as taking care of others and the inborn interest of classifying and selecting.

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Adoption and Efficacy of ISO 15189 in Medical Laboratories for Diagnostic and Research (메디컬시험기관에서 ISO 15189 도입의 필요성과 시행의 효용성)

  • Yang, Man-Gil;Lee, Won Ho;Jun, Jin Hyun
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.2
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    • pp.158-167
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    • 2016
  • The requirements for medical laboratories ISO 15189 is examined in organization and a quality management system, stressing the importance of evidence, document control, and control of records and clinical material. Medical services are provided from the areas of resource management, and pre-examination, examination and post-examination processes. The main goal of ISO 15189 accreditation is to improve the quality of laboratory services provided for patients and clinical users not only through compliance with consensually developed and harmonized requirements but also by adopting the philosophy of continual improvement using the Plan-Do-Check-Act cycle. Laboratory quality should be evaluated and improved in all steps of the testing process as the state-of-the art indicates that the pre- and post-analytical phases are more vulnerable to errors than the intra-analytical phase. The Korea Laboratory Accreditation Scheme (KOLAS), a national accreditation body, provides medical laboratory accreditations for appropriate approaches to evaluating the competence of a medical laboratory in providing effective services to its customers and clinical users. Adoption of ISO 15189 in 2010s as a government policy has been delayed, and only 5 laboratories have been accredited to date in Korea. The medical laboratories should seek the adoption of ISO 15189 with a positive attitude for quality improvement and strengthening of international competitiveness.

An Empirical Study on Technological Innovation Management Factors of SMEs (중소기업의 기술혁신 관리요소에 관한 실증연구)

  • Im, Chae-Hyon;Shin, Jin-Kyo
    • Journal of Technology Innovation
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    • v.20 no.2
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    • pp.75-107
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    • 2012
  • Previous researches on technological innovation have several limitations such as lack of general mechanism for technological innovation(inputs, throughputs and outputs of technological innovation), large company oriented studies, and ignoring importance of technology management capabilities. So, this study suggested a new model using resource-based theory and system theory, and empirically applied that to SMEs. Structural equation model analysis by using 223 SMEs in Daegu region provided a support for most of hypotheses. Research results showed that all of factors on technological innovation were significantly and positively related with each other: inputs(R&D leadership, innovation strategy, R&D investment, R&D human resource management, external network), throughputs(portfolio management, project management, technology commercialization) and output(technological innovation). In case of technological innovation inputs, R&D leadership influenced on innovation strategy positively and significantly. And R&D leadership and innovation strategy had positive and significant effects on R&D investment, R&D human resource management and external network. R&D human resource management and external network exerted positive and significant influences on technological innovation throughputs such as portfolio management and project management. But R&D investment did not significant impacts on technological innovation throughputs. Among technological innovation throughputs, both portfolio management and project management had positive and significant effect on technology commercialization. In addition, technology commercialization acted positively and significantly technological innovation output. This study suggests necessary of efforts to implement innovation strategy and manage R&D human resource effectively based on CEO's innovativeness and entrepreneurship. Also, if SMEs want to develop technology and commercialize it, they have to cooperate with external technology resources and informations. Research results revealed that proper level of R&D investment, internal and external communication, information sharing, and learning and cooperative culture were very important for improvement of technological innovation performance in SMEs. Especially, this research suggested that if SMEs manage technological innovation process effectively based on resource-based and system approaches, then they can overcome their resource limitations and gain high technological innovation performance. Also, useful policy support for technological innovation of central or regional government by this research model is important factor for SMEs' technological innovation performance.

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