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The Effect of Assertiveness Training on the Stress Response and Assertive Behavior of Nurses (주장훈련이 간호사의 스트레스 반응과 주장행동에 미치는 효과)

  • Ha, Na-Sun
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.1
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    • pp.149-167
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    • 1999
  • This study was designed and carried out to investigate the effect of Assertiveness Training on the stress response and assertive behavior of emergency room nurses from September 22, to December 21. 1997. The subjects were 45 emergency room nurses of three general hospitals of Korea University Medical Center; 25 assigned for the experimental and 20 for the control group. The Assertive Training Program was composed of cognitive training, behavioral training and progressive muscle relaxation. The subjects of the experimental group carried out the 15-minute progressive muscle relaxation according to recorded-tape once a day for 6 weeks. The cognitive and the behavioural training were conducted by the investigator for 5-8 subjects at a time for 9 series, at an interval of 4-5 days. Post-measurement were administered to all sujects in two groups three weeks after the last session. The level of general stress (Cline, 1992), job stress (Kim & Koo, 1984), physiological response to stress (cortisol, epinephrine, norepinephrine), symptoms of stress (Lee, 1984) and assertive behavior (Kim, 1982) were measured before the first and after the last experiments. Data were analysed by x2, t, paired t, Wilcoxon signed rank tests Wilcoxon rank sums tests. The results are as follows : 1. The level of general stress of the experimental group was lower than that of the control group, however, no significant difference between the two groups (P=0.234) was revealed. 2. A significant reduction of job stress was revealed in the experimental group (P=0.017). 1) A significant reduction of interpersonal conflicts in the experimental group was revealed (P=0.018). 3. The physiological stress-response were analyzed as follows : 1) A decrease of Cortisol in both the experimental and the control groups was noticed, however, the difference between the two groups was not statistically significant (P=0.991). Pre-and post-measurement of the level of Corti sol revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.765), a significant decrease was noted on the level of Cortisol of the experimental group in the night-night nurses (P=0.036). 2) An increase of Epinephrine in both groups was noticed, however, a difference was not statistically significant between the two groups (P=0.082). Pre-and post-measurement of the level of Epinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.136). increases were noted on the level of Epinephrinel of both groups in the night-night nurses (P=0.136), 3) The level of Norepinephrine of the experimental group was significantly decreased (P=0.020). Pre-and post-measurement of the level of Norepinephrine revealed that a notable decrease in the experimental group and an increase in the control group with no significant difference in the day-day subjects (P=0.073). a significant decrease was noted on the level of Norepinephrine of the experimental group in the night-night nurses (P=0.036), 4. Symptoms of stress were reduced in both groups, with no significant differences between the groups (P=0.127). 1) The physical stress symptoms were reduced in both groups, with no significant difference (P=0.386), 2) The cognitive-behavioral stress symptoms were significantly reduced in the experimental group (P=0.037). 3) The emotional stress symptoms were reduced in both groups with no significant difference between the groups (P=0.110). 5. The assertive behavior was significantly increased in the experimental group (P=0.000). This study signified the Assertiveness Training as an effective mean of self intervention for the reduction of stress of nurses assigned to emergency rooms.

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A Study on Prediction of Asian Dusts Using the WRF-Chem Model in 2010 in the Korean Peninsula (WRF-Chem 모델을 이용한 2010년 한반도의 황사 예측에 관한 연구)

  • Jung, Ok Jin;Moon, Yun Seob
    • Journal of the Korean earth science society
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    • v.36 no.1
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    • pp.90-108
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    • 2015
  • The WRF-Chem model was applied to simulate the Asian dust event affecting the Korean Peninsula from 11 to 13 November 2010. GOCART dust emission schemes, RADM2 chemical mechanism, and MADE/SORGAM aerosol scheme were adopted within the WRF-Chem model to predict dust aerosol concentrations. The results in the model simulations were identified by comparing with the weather maps, satellite images, monitoring data of $PM_{10}$ concentration, and LIDAR images. The model results showed a good agreement with the long-range transport from the dust source area such as Northeastern China and Mongolia to the Korean Peninsula. Comparison of the time series of $PM_{10}$ concentration measured at Backnungdo showed that the correlation coefficient was 0.736, and the root mean square error was $192.73{\mu}g/m^3$. The spatial distribution of $PM_{10}$ concentration using the WRF-Chem model was similar to that of the $PM_{2.5}$ which were about a half of $PM_{10}$. Also, they were much alike in those of the UM-ADAM model simulated by the Korean Meteorological Administration. Meanwhile, the spatial distributions of $PM_{10}$ concentrations during the Asian dust events had relevance to those of both the wind speed of u component ($ms^{-1}$) and the PBL height (m). We performed a regressive analysis between $PM_{10}$ concentrations and two meteorological variables (u component and PBL) in the strong dust event in autumn (CASE 1, on 11 to 23 March 2010) and the weak dust event in spring (CASE 2, on 19 to 20 March 2011), respectively.

Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Stability Analysis of Open Pit Slopes in the Pasir Coal Field, Indonesia (인도네시아 Pasir 탄전에서의 노천채탄장 사면의 안전성해석)

  • 정소걸;선우춘;한공창;신희순;박연준
    • Proceedings of the Korean Society for Rock Mechanics Conference
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    • 2000.09a
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    • pp.183-193
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    • 2000
  • A series of studies such as geological logging data analysis, detailed geological survey, rock mass evaluation, in-situ and laboratory tests, rock strength and mechanical properties of the rock were concerned. The stability of the slope were carried out inorder to design the pit slope and individual benches using the stereographic projection analysis and numerical methods in Roto Pit of Pasir coal fetid. The bedding plane was one of the major discontinuities in the Roto Pit and the dip of which is about $60^{\circ}$in the northern part and $83^{\circ}$in the southern part. The dip of bedding becomes steeper from north to south. The plane and toppling failures are presented in many slopes. In laboratory test the average uniaxial compressive strength of mudstone was 9 MPa and that of weak sandstone was 10 MPa. In-situ test showed that the rocks of Roto north mining area are mostly weak enough to be classified in grade from R2(weak) to R3(medium strong weak) and the coal is classified in grades from R1(Very weak) to R2(Weak). The detailed stability analysis were carried out on 4 areas of Roto north(east, west, south and north), and 2 areas of Roto south(east and west). In this paper, the minimum factor of safety was set to 1.2 which is a general criterion for open pit mines. Using the stereographic projection analysis and the limit equilibrium method, slope angles were calculated as 30~$36^{\circ}$for a factor of safety greater than 1.2. Then these results were re-evaluated by numerical analysis using FLAC. The final slope angles were determined by rational described abode. A final slope of 34 degrees can guarantee the stability for the eastern part of the Roto north area, 33 degrees for the western part, 35 degrees for the northern part and 35 degrees for the southern part. For the Roto south area, 36 degrees was suggested for both sides of the pit. Once the pit slope is designed based on the stability analysis and the safety measures. the stability of 니ope should be checked periodically during the mining operations. Because the slope face will be exposed long time to the rain fall, a study such aspreventive measures against weathering and erosion is highly recommended to be implemented.

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Stability Analysis of Open Pit Slopes in the Pasir Coal Field, Indonesia (인도네시아 Pasir 탄전에서의 노천채탄장 사면의 안정성 해석)

  • 정소걸;선우춘;한공창;신희순;박연준
    • Tunnel and Underground Space
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    • v.10 no.3
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    • pp.430-440
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    • 2000
  • A series of studies such as geological logging data analysis, detailed geological survey, rock mass evaluation, in-situ and laboratory tests, rock strength and mechanical properties of the rock were concerned. The stability of the slope were carried out inorder to design the pit slope and individual benches using the stereographic projection analysis and numerical methods in Roto Pit of Pasir coal field. The bedding plane was one of the major discontinuities in the Roto Pit and the dip of which is about 60$^{\circ}$ in the northern part and 83$^{\circ}$ in the southern part. The dip of bedding becomes steeper from north to south. The plane and toppling failures are presented in many slopes. In laboratory test the average uniaxial compressive strength of mudstone was 9MPa and that of weak sandstone was 10MPa. In-situ test showed that the rocks of Roto north mining area are mostly weak enough to be classified in grade from R2(weak) to R3(medium strong weak) and the coal is classified in grades from R1(Very weak) to R2(Weak). The detailed stability analysis were carried out on 4 areas of Roto north (east, west, south and north), and 2 areas of Roto south(east and west). In this paper, the minimum factor of safety was set to 1.2 which is a general criterion for open pit mines. Using the stereographic projection analysis and the limit equilibrium method, slope angles were calculated as 30∼36$^{\circ}$ for a factor of safety greater than 1.2. Then these results were re-evaluated by numerical analysis using FLAC. The final slope angles were determined by rational described above. A final slope of 34 degrees can guarantee the stability for the eastern part of the Roto north area, 33 degrees for the western part, 35 degrees for the northern part and 35 degrees for the southern part. For the Roto south area, 36 degrees was suggested for both sides of the pit. Once the pit slope is designed based on the stability analysis and the safety measures, the stability of slope should be checked periodically during the mining operations. Because the slope face will be exposed long time to the rain fall, a study such aspreventive measures against weathering and erosion is highly recommended to be implemented.

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A Study On Design of ZigBee Chip Communication Module for Remote Radiation Measurement (원격 방사선 측정을 위한 ZigBee 원칩형 통신 모듈 설계에 대한 연구)

  • Lee, Joo-Hyun;Lee, Seung-Ho
    • Journal of IKEEE
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    • v.18 no.4
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    • pp.552-558
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    • 2014
  • This paper suggests how to design a ZigBee-chip-based communication module to remotely measure radiation level. The suggested communication module consists of two control processors for the chip as generally required to configure a ZigBee system, and one chip module to configure a ZigBee RF device. The ZigBee-chip-based communication module for remote radiation measurement consists of a wireless communication controller; sensor and high-voltage generator; charger and power supply circuit; wired communication part; and RF circuit and antenna. The wireless communication controller is to control wireless communication for ZigBee and to measure radiation level remotely. The sensor and high-voltage generator generates 500 V in two consecutive series to amplify and filter pulses of radiation detected by G-M Tube. The charger and power supply circuit part is to charge lithium-ion battery and supply power to one-chip processors. The wired communication part serves as a RS-485/422 interface to enable USB interface and wired remote communication for interfacing with PC and debugging. RF circuit and antenna applies an RLC passive component for chip antenna to configure BALUN and antenna impedance matching circuit, allowing wireless communication. After configuring the ZigBee-chip-based communication module, tests were conducted to measure radiation level remotely: data were successfully transmitted in 10-meter and 100-meter distances, measuring radiation level in a remote condition. The communication module allows an environment where radiation level can be remotely measured in an economically beneficial way as it not only consumes less electricity but also costs less. By securing linearity of a radiation measuring device and by minimizing the device itself, it is possible to set up an environment where radiation can be measured in a reliable manner, and radiation level is monitored real-time.

Forecasting of Demand for Papers in Korea (한국(韓國)의 지류(紙類) 수요예측(需要豫測)에 관한 연구(硏究))

  • Chung, Il Yong;Chung, Young Gwan
    • Journal of Korean Society of Forest Science
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    • v.65 no.1
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    • pp.80-91
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    • 1984
  • The purposes of this study are to analyze and forecast the domestic demand for papers by regression models with time-series data (1965-81). For the period of 1965-81, the real GNP of Korea grew at annual average increase rate of 8.8 percent. On the other hand, the domestic demand of papers grew at annual average increase rate of 17.9 percent in this period. Especially, the annual average increase rate for board-papers accounted to 25.8 percent. To analyze domestic demand for papers, GNP, per capita GNP, price findex of papers, production activity index of the major papers consuming industries and price index of substitutive goods were selected as independent variables. The expected values of domestic demand for papers were computed by forecasting equations as follows. T-values are in parentheses. ${\ell}nDDP=2.452+1.986{\ell}nPG-0.844{\ell}nPWI$ $(33.397)^*\;(-6.149)^*\;R^2=0.997$ ${\ell}nDDP=6.468+0.827{\ell}nPDA$ $(17.403)^*\;R^2=0.950$ DDP : Domestic demand for papers PG : Real GNP per capita (1,000 won) PWI : Real price index of papers (1980 = 100) PDAV : Production activity index of the major papers consuming industries The results analyzed and forecasted by these models are summarized as follows: The domestic demand for papers had positive correlation toward per capita GNP and production activity index of the major papers consuming industries. Per capita GNP elasticity of the domestic demand for papers was the most elastic among independent variables. The price elasticity of domestic demand for papers had negative sign and inelastic. These were not only statistically significant but theoretically compatible. The domestic demand for papers was projected to be 3,152-4,470 thousand mit in 1991, representing at annual increase rate of 5.0-12.4 percent during the period of 1982-91. Domestic demand for papers per capita was projected to be 69.1-98.0 kg in 1991.

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An Analysis of the Roles of Experience in Information System Continuance (정보시스템의 지속적 사용에서 경험의 역할에 대한 분석)

  • Lee, Woong-Kyu
    • Asia pacific journal of information systems
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    • v.21 no.4
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    • pp.45-62
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    • 2011
  • The notion of information systems (IS) continuance has recently emerged as one of the most important research issues in the field of IS. A great deal of research has been conducted thus far on the basis of theories adapted from various disciplines including consumer behaviors and social psychology, in addition to theories regarding information technology (IT) acceptance. This previous body of knowledge provides a robust research framework that can already account for the determination of IS continuance; however, this research points to other, thus-far-unelucidated determinant factors such as habit, which were not included in traditional IT acceptance frameworks, and also re-emphasizes the importance of emotion-related constructs such as satisfaction in addition to conscious intention with rational beliefs such as usefulness. Experiences should also be considered one of the most important factors determining the characteristics of information system (IS) continuance and the features distinct from those determining IS acceptance, because more experienced users may have more opportunities for IS use, which would allow them more frequent use than would be available to less experienced or non-experienced users. Interestingly, experience has dual features that may contradictorily influence IS use. On one hand, attitudes predicated on direct experience have been shown to predict behavior better than attitudes from indirect experience or without experience; as more information is available, direct experience may render IS use a more salient behavior, and may also make IS use more accessible via memory. Therefore, experience may serve to intensify the relationship between IS use and conscious intention with evaluations, On the other hand, experience may culminate in the formation of habits: greater experience may also imply more frequent performance of the behavior, which may lead to the formation of habits, Hence, like experience, users' activation of an IS may be more dependent on habit-that is, unconscious automatic use without deliberation regarding the IS-and less dependent on conscious intentions, Furthermore, experiences can provide basic information necessary for satisfaction with the use of a specific IS, thus spurring the formation of both conscious intentions and unconscious habits, Whereas IT adoption Is a one-time decision, IS continuance may be a series of users' decisions and evaluations based on satisfaction with IS use. Moreover. habits also cannot be formed without satisfaction, even when a behavior is carried out repeatedly. Thus, experiences also play a critical role in satisfaction, as satisfaction is the consequence of direct experiences of actual behaviors. In particular, emotional experiences such as enjoyment can become as influential on IS use as are utilitarian experiences such as usefulness; this is especially true in light of the modern increase in membership-based hedonic systems - including online games, web-based social network services (SNS), blogs, and portals-all of which attempt to provide users with self-fulfilling value. Therefore, in order to understand more clearly the role of experiences in IS continuance, analysis must be conducted under a research framework that includes intentions, habits, and satisfaction, as experience may not only have duration-based moderating effects on the relationship between both intention and habit and the activation of IS use, but may also have content-based positive effects on satisfaction. This is consistent with the basic assumptions regarding the determining factors in IS continuance as suggested by Oritz de Guinea and Markus: consciousness, emotion, and habit. The principal objective of this study was to explore and assess the effects of experiences in IS continuance, with special consideration given to conscious intentions and unconscious habits, as well as satisfaction. IN service of this goal, along with a review of the relevant literature regarding the effects of experiences and habit on continuous IS use, this study suggested a research model that represents the roles of experience: its moderating role in the relationships of IS continuance with both conscious intention and unconscious habit, and its antecedent role in the development of satisfaction. For the validation of this research model. Korean university student users of 'Cyworld', one of the most influential social network services in South Korea, were surveyed, and the data were analyzed via partial least square (PLS) analysis to assess the implications of this study. In result most hypotheses in our research model were statistically supported with the exception of one. Although one hypothesis was not supported, the study's findings provide us with some important implications. First the role of experience in IS continuance differs from its role in IS acceptance. Second, the use of IS was explained by the dynamic balance between habit and intention. Third, the importance of satisfaction was confirmed from the perspective of IS continuance with experience.

Life-Sustaining Procedures, Palliative Care, and Cost Trends in Dying COPD Patients in U.S. Hospitals: 2005~2014

  • Kim, Sun Jung;Shen, Jay;Ko, Eunjeong;Kim, Pearl;Lee, Yong-Jae;Lee, Jae Hoon;Liu, Xibei;Ukken, Johnson;Kioka, Mutsumi;Yoo, Ji Won
    • Journal of Hospice and Palliative Care
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    • v.21 no.1
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    • pp.23-32
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    • 2018
  • Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

The Effects of Female Wage on Fertility in Korea (여성의 임금수준이 출산율에 미치는 영향 분석)

  • Kim, Jungho
    • KDI Journal of Economic Policy
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    • v.31 no.1
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    • pp.105-138
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    • 2009
  • Although the decline in fertility rate is generally observed along the history of economic development throughout the world, the continuing decline hitting below the replacement level in Korea over the recent years gathered serious social concerns on the ground that it accelerates the process of population aging. The total fertility rate in Koreareached 2.08 in 1983, and gradually fell to the levels of 1.08 in 2005 and 1.26 in 2007. The policy debate over the role of the government has been focused mainly on the level of theoretical discussion without substantial basis on firm empirical evidence and the determinants of fertility. The objective of the paper is to empirically investigate the fertility effect of the female wage, which is understood as one of the most important determinants of fertility in Koreasince 1980 focusing on one aspect of fertility, namely birth spacing. Using the Korean National Fertility Survey conducted in 2006, I estimate a duration model of first and second births taking into account individual heterogeneity, which turned out to be an important factor to control for. Compared with previous studies in the literature on the Korean fertility, the study has an advantage of using the complete pregnancy history of women in a more representative sample. Unlike the previous studies, the analysis also deals with the endogeneity of marriage by treating a certain age, rather than age at marriage, as the time in which a woman becomes exposed to the risk of pregnancy. The study shares the common problem in the literature on birth spacing of lacking relevant wage information for respondents in a retrospective survey. I estimate the wage series as a function of the basic characteristics using the annual Wage Structure Survey from 1980 to 2005, which is considered as a nationally representative sample for wage information of employees. The results suggest that the increase in female wage by 10 percent leads to a decrease in second birth hazard by 0.56~0.92 percentage points and that the increase in spouse's wage by the equal amount is accompanied by the increase in second birth hazard by 0.36~1.13 percentage points. These estimates are more precisely estimated and of smaller magnitude than those presented by the previous studies. The results are robust to the different specifications of the wage equation. The simulation analysis based on the predicted values shows that about 17% of the change in the second birth hazard over the period 1980 to 2005 was due to the change in the female wage. Although there is some limitation in data, the results can be viewed as one estimate of the role of female wage on the recent fertility decline in Korea. The question raised by the paper is not a normative one of whether a government should promote childbearing but a positive one thatexplains fertility decline. Therefore, if there is a wide consensus on promoting childbearing, the finding suggests that the policies designed to reduce the opportunity cost of women in the labor market would be effective. The recent movement of implementing a wide range of family-friendly policies including child care support, maternity leave, parental leave and tax benefit in developed countries should be understood in this context.

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