• Journal of Trauma and Injury
• /
• 제18권2호
• /
• pp.141-147
• /
• 2005

Purpose: Recently, The new Injury Severity Score (NISS) has become a more accurate predictor of mortality than the traditional Injury Severity Score (ISS) in the trauma population. Trauma Score Injury Severity Score (TRISS) method, regarded as the gold standard for mortality prediction in trauma patients, still contains the ISS as an essential factor within its formula. The purpose of this study was to determine whether a simple modification of the TRISS by replacing the ISS with the NISS would improve the prediction of in-hospital mortality in a trauma population with blunt head and neck trauma. Objects and Methods: The study population consisted of 641 patients from a regional emergency medical center in Kyoungsangnam-do. Demographic data, clinical information, the final diagnosis, and the outcome for each patient were collected in a retrospective manner. the ISS, NISS, TRISS, and modified TRISS were calculated for each patients. The discrimination and the calibration of the ISS, NISS, modified TRISS and conventional TRISS models were compared using receiver operator characteristic (ROC) curves, areas under the ROC curve (AUC) and Hosmer-Lemeshow statistics. Results: The AUC of the ISS, NISS, modified TRISS, and conventional TRISS were 0.885, 0.941, 0.971, and 0.918 respectively. Statistical differences were found between the ISS and the NISS (p=0.008) and between the modified TRISS and the conventional TRISS (p=0.009). Hosmer-Lemeshow chi square values were 13.2, 2.3, 50.1, and 13.8, respectively; only the conventional TRISS failed to achieve the level of and an excellent calibration model (p<0.001). Conclusion: The modified TRISS is a more accurate predictor of in-hospital mortality than the conventional TRISS in a trauma population of blunt head and neck trauma.

• Korean Journal of Acupuncture
• /
• 제29권4호
• /
• pp.623-633
• /
• 2012

Objectives : Fatigue is a common and distressing symptom that is a concern for cancer patients. It has a decisive effect on quality of life. The purpose of this study was to examine the feasibility of clinical trial to evaluate of efficacy and safety of acupuncture on cancer related fatigue of lung cancer patients. Methods : Total lung cancer 9 patients complained of fatigue were treated by acupuncture twice a week for four weeks(8 times in total). Evaluation of the severity of fatigue was measured by FSS(Fatigue Severity Score). In visit 1, 10, we checked FSS. For check safety of acupuncture treatment, we did blood test. Results : After 4 weeks of acupuncture treatment, the FSS was significantly decreased from $4.92{\pm}1.06$ to $3.74{\pm}1.37$(p=0.008). And the level of hemoglobin was significantly increased from 10.87 g/dl to 12.01 g/dl(p=0.014). No other lab measures indicated any significant differences between before and after acupuncture treatment. Conclusions : This study suggests that acupuncture treatment will be beneficial for lung cancer patients to improve the fatigue severity. And acupuncture treatment is safe method for lung cancer patients. A large-scale study to confirm efficacy and safety of acupuncture is needed.

• 기본간호학회지
• /
• 제14권4호
• /
• pp.483-492
• /
• 2007

Purpose: The purpose of this study was to compare anxiety, depression and quality of life according to the severity of urinary incontinence in married women. Method: The participants were 168 married women aged 30-65 years who experienced urinary incontinence. The data were collected from May to July, 2006 using a structured questionnaire. Frequencies, percent, means and standard deviation, t-test, ANOVA, $X^2-test$ and Scheffe test with SPSS win 14.0 program were used to analyze the data. Results: The distribution of urinary incontinence severity was mild 87.5%, or moderate 12.5%. Significant differences in the severity of urinary incontinence were found for the general characteristics of age, education level, having a job and having a spouse and for the obstetric characteristics of type of delivery, and menopause. Differences in the score for anxiety(t=-2.41, p=0.001) and quality of life(t=5.50, p<0.001) according to the severity of urinary incontinence were statistically significant. Conclusion: Women with moderate to severe urinary incontinence should be screened for psychosocial factors. Severity of urinary incontinence in married women negatively affects their quality of life. Further research is needed to determine factors predicting the quality of life for incontinent women.

• 한국안전학회지
• /
• 제30권1호
• /
• pp.94-103
• /
• 2015

This study analyzes the influence factors on elderly pedestrian accident. Elderly people are easy to be badly injured by car accidents compared to younger people. Therefore, various plans and measures are required to protect elderly pedestrian from accidents. However, pedestrian accidents studies only focused on microscopic factors such as attribute of driver, pedestrian, road design. In order to prevent pedestrian accident and reduce the severity of the accident, not only microscopic factors but macroscopic variables such as urban planning and facility should be considered. In this regard, this study develops an ordered probit model introduced the characteristics of urban facility which were not considered in the previous studies. The result shows that there is higher level of accident severity in such areas as large commercial area, well-developed area with transportation infrastructure service and non-pedestrian safety zone. Thus, various and appropriate countermeasures should be prepared in order that pedestrian accident can be prevented in the areas mentioned above. In addition to the aforementioned variables, it is revealed that other variables including vehicle speed, gender and age of pedestrian, weather condition, type of vehicle, etc. partly affect the severity of pedestrian accident.

• 근관절건강학회지
• /
• 제5권1호
• /
• pp.7-25
• /
• 1998

Rheumatoid arthritis, unlike other chronic diseases, causes the patients to experience uncertainty in their daily lives and thus to feel threat on their emotional comfort because of inconsistent and unpredictable symptoms such as pain. Therefore, a theoretical framework is needed for explanation of uncertainty in patients having rheumatoid arthritis. A hypothetical model was constructed on the basis of Mishel's Uncertainty Theory and other literature review. The model included 9 theoretical concepts and 19 paths. Subjects of the study constituted 330 partients who visited outpatient clinics of two university hospitals and one general hospital in Seoul. Self report questionnaires were used to measure the variables affecting uncertainty. Reliability coefficients of these instruments were found Cronbach's Alpha=$.70{\sim}.94$. In data analysis, SAS program and PC-LISREL 8.03 computer program were utilized for descriptive statistics and covariance structure analysis. The results of covariance structure analysis for model fitness were as follows : 1) Hypothetical model showed a good fit to the empirical data : Chi-square($X^2$)=41.81 (df=11, P=.000), Goodness of Fit Index=.974, Root Mean Square Residual=.049, Normed Fit Index=.928, Non Normed Fit Index=.814. 2) For the validity and the parcimony of model, a modified model was constructed by appending 2 paths and deleting 5 paths according to the criteria of statistical significance and meaningfulness. 3) The results of hypothesis testing were as follows : (1) Educational level, event familiarity and severity of illness had a direct effect on uncertainty : Event congruency had both direct and indirect effect on uncertainty : Credible authority and symptom consistency had a nonsignificant direct effect on uncertainty, (2) Illness duration, symptom consistency, and event congruency had a direct effect on severity of illness ; Credible authority had a both direct and indirect effect on severity of illness ; Event congruency had the greatest effect on severity of illness, and event familiarity had a nonsignificant direct effect on severity of illness.

• Journal of Trauma and Injury
• /
• 제22권2호
• /
• pp.134-141
• /
• 2009

Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

• 응용통계연구
• /
• 제26권6호
• /
• pp.857-871
• /
• 2013

한국을 비롯한 많은 국가에서 수출보험은 수출증진을 위한 수단으로 이용되어 왔다. 무역자유화를 위한 세계무역기구의 출범 이후에도 수출보험은 여전히 수출증진을 위한 주요 수단으로 인식된다. 본 논문은 국내 기업의 해외법인이 체결한 단기수출보험의 자료를 이용하여 수출보험과 관련한 위험요소(수입자의 신용등급, 결제기간, 모기업의 크기)의 각 등급에 따른 보험가입금액 대비 보험금 지급비율을 산출한다. 이를 위해 일반화 선형모형을 활용, 모델 선택과정을 거쳐 사고빈도(frequency)와 사고심도(severity)를 각각 음이항분포와 로그노말분포로 적합한다. 그리고 일반화 선형모형의 분석결과를 바탕으로 사고빈도와 사고심도에 미치는 각 위험요소의 등급에 따른 계약건수 대비 평균 사고발생 비율과 보험가입금액 대비 평균 지급비율을 제시한다. 이후 이를 통합함으로써 각 위험요소의 등급별 지급비율의 기댓값을 추정한다. 그리고 이 결과를 이용하여 요율산정에 대한 시사점을 논의한다.

• 한국전자통신학회논문지
• /
• 제15권6호
• /
• pp.1123-1130
• /
• 2020

본 연구는 고속도로 교통사고 심각도 예측모델을 구축하기 위해 다섯가지 머신러닝 기반의 분류모형 적용하였다. 2015년~2017년 동안 전국 고속도로에서 발생한 사고 데이터 21,013건을 5가지의 분류 모형을 적용한 결과 LightGBM(Light Gradient Boosting Model)이 가장 좋은 성능을 나타내는 것으로 나타났다. LightGBM에서는 교통사고심각도 추정에 있어 우선순위 요인으로 사고차량 수, 사고유형, 사고지점, 사고차로유형, 사고차량 유형 순으로 나타났다. 이러한 모형의 결과를 기반으로 일관적인 사고심각도 예측 과정을 통하여 교통사고대응관리 전략 수립에 활용할 수 있다. 본 연구는 국내 기계학습을 활용한 사례가 적은 여건에서 향후 빅데이터 기반의 다양한 기계학습 기법을 활용이 가능함을 제시하고 있다.

• 말소리와 음성과학
• /
• 제2권4호
• /
• pp.193-212
• /
• 2010

The purpose of our study was to provide effective speech evaluation items examining the variables of speech that successfully predict the speech intelligibility in CP children. The subjects were 55 children with spastic type cerebral palsy. As for the speech evaluation, we performed a speech subsystem evaluation and a speech intelligibility test. The results of the study are as follows. The evaluation task for the speech subsystems consisted of 48 task items within an observational evaluation stage and three levels of severity. The levels showed correlations with gross motor functions, fine motor functions, and age. Second, the evaluation items for the speech subsystems were rearranged into seven factors. Third, 34 out of 48 task items that positively correlated with the syllable intelligibility rating were as follows. There were four items in the observational evaluation stage. Among the nonverbal articulatory function evaluation items, there were 11 items in level one. There were 12 items in level two. In level three there were eight items. Fourth, there were 23 items among the 48 evaluation tasks that correlated with the sentence intelligibility rating. There was one item in the observational evaluation stage which was in the articulatory structure evaluation task. In level one there were six items. In level two, there were eight items. In level three, there was a total number of eight items. Fifth, there was a total number of 14 items that influenced the syllable intelligibility rating. Sixth, there was a total number of 13 items that influenced the syllable intelligibility rating. According to the results above, the variables that influenced the speech intelligibility of CP children among the articulatory function tasks were in the respiratory function task, phonatory function task, and lip and chin related tasks. We did not find any correlation for the tongue function. The results of our study could be applied to speech evaluation, setting therapy goals, and evaluating the degree of progression in children with CP. We only studied children with the spastic type of cerebral palsy, and there were a small number of severe degree CP children compared to those with a moderate degree of CP. Therefore, when evaluating children with other degrees of severity, we may have to take their characteristics more into account. Further study on speech evaluation variables in relation to the severity of the speech intelligibility and different types of cerebral palsy may be necessary.

• 서비스연구
• /
• 제6권2호
• /
• pp.215-232
• /
• 2016

본 연구에서는 서비스 실패 상황에서 서비스 자체의 요인, 소비자의 내적 요인, 주위 상황 등의 외적 요인으로 나누어 소비자가 지각하는 서비스 실패의 정도에 영향을 미치는 요인들을 밝히고 그에 따른 소비자의 서비스 실패 상황에 대한 불평 행동과 이탈 행동에 관한 연구를 진행하였다. 가설 검증 결과, 과거 경험의 만족도, 기입이미지, 서비스 중요도는 서비스 실패에 대한 허용 영역에 부(-)의 영향을 미쳤다. 서비스 중요도는 지각된 서비스 실패의 심각성에는 정(+)의 영향을 미쳤다. 서비스 실패에 대한 허용 영역은 지각된 서비스 실패의 심각성에 부(-)의 영향을 미쳤다. 따라서 가설 1, 가설 2, 가설 3, 가설 4, 가설 5는 지지되었다. 반면, 사회비교에 대한 의식 수준은 지각된 서비스 실패의 심각성에 영향을 미치지 않는 것으로 나타났다. 부정적 감정 성향 또한 지각된 서비스 실패의 심각성에 영향을 미치지 않는 것으로 나타났다. 따라서 가설 6, 가설7은 기각되었다. 본 연구는 서비스산업의 연구자 및 제공자들에게 다음과 같은 시사점을 제공할 수 있다. 연구결과를 통해서 서비스 실패 및 회복 프레임워크를 개발에 도움을 줄 수 있으며, 특히 서비스 제공자에게 서비스 실패를 회복하기 위한 특정 가이드라인 제공을 통해서 서비스 회복 전략에 효과적인 심각성 포인트를 제시하였다.