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Pediatric Urolithiasis: Our 22-year Experience at a Single Center (소아에서의 요로결석: 단일기관에서 22년간의 경험)

  • Kim, Su-Yon;Kim, Min-Jee;Lee, Joo Hoon;Kim, Kun Suk;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.17 no.2
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    • pp.101-109
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    • 2013
  • Purpose: Pediatric urolithiasis is uncommon in children but is a cause of significant morbidity and damage to the kidney. Although much information on adult urolithiasis is available in the literature, large studies on the pediatric population are still scarce. In this report, we review our experience with pediatric urolithiasis over 22 years at a tertiary referral center. Method: We retrospectively reviewed the records of children with newly diagnosed urolithiasis between January 1991 and May 2013. We assessed the age, sex, family history, initial symptoms, location of stones, underlying cause, stone analysis, treatment, and recurrence among the patients. Results: In total, 137 patients (96 male, 41 female) were assessed. The age range was 0-17 years (mean age, 6.0 years). Forty-three (31%) children were aged <1 year, and 37% (16/43) had a history of intensive care unit (ICU) admission. Thirteen patients (9.5%) had a family history of stones. The most common symptoms at presentation among the patients were gross hematuria (56/137, 41%) and flank or abdominal pain (46/137, 34%). The stones were located in the kidney (85/137, 62%), ureter (29/137, 21%), bladder (2/137, 1.4%), and multiple locations (20/137, 15 %). Congenital abnormalities of the genitourinary (G-U) tract, with or without metabolic abnormality, or urinary tract infection (UTI) was detected in 26 children (19%). Ninety-one patients (66%) underwent metabolic examination, and 38% of these patients exhibited an abnormality. UTI, with or without abnormalities of the G-U tract, or metabolic abnormality was detected in 26 children (19%). Of the 35 stones analyzed, the majority were calcium stones (20/35, 57%), followed by infected stones (5/35, 14%), uric acid stones (4/35, 11%), carbonate apatite stones (3/35, 7%), cystine stones (2/35, 6%), and phosphate stones (1/35, 3%). Five patients (4%) required open procedures, with or without non-open procedures, whereas 77 patients (56%) were managed conservatively; the remaining 55 patients (40%) received some other form of intervention. Eighteen patients (13%) had stone recurrence during the follow-up period. Conclusions: Pediatric urolithiasis is commonly associated with abnormalities of the G-U tract and/or metabolic disorders and/or UTI. Half of the patients will pass their stones spontaneously, and all the techniques of minimally invasive surgery are applicable in the treatment of children with stones. As the recurrence rates are high among this population, long-term follow-up is recommended and the complete clearance of stones is important.

Analysis of Application of Massive Transfusion Protocol for Trauma Patients at a Single Tertiary Referral Hospital (단일 3차 의료기관에서 외상환자에 대한 대량수혈 프로토콜 적용 분석)

  • Kim, Hyerin;Yoo, Dong-Won;Kim, Hyerim;Shin, Kyung-Hwa;Lee, Hyun-Ji;Chang, Chulhun L.;Kim, Hyung-Hoi
    • The Korean Journal of Blood Transfusion
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    • v.29 no.3
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    • pp.262-272
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    • 2018
  • Background: Massive hemorrhage due to trauma is one of the major causes of death in trauma patients, and the quick supply of appropriate blood products is critical in order to reduce the mortality rate. We introduced a massive transfusion protocol (MTP) for safe and rapid transfusion of trauma patients. Using records collected since its adoption, we compared the characteristics of MTP applied group (MTP group) and MTP not applied group (non-MTP group) to determine whether there is an indicator for predicting patients to be treated with MTP. Methods: We retrospectively reviewed the electronic medical records and laboratory findings of patients who received massive transfusions in the trauma emergency room of a single tertiary hospital from February to August 2018. We analyzed various laboratory test results, the amount and ratio of the transfused blood products, and the time required for blood products to be released for the MTP group and the non-MTP group. Results: Of the 54 trauma patients who received massive transfusions, 31 were in the MTP group and 22 in the non-MTP group. There was no significant difference in initial vital signs (except blood pressure) and laboratory test results. Also there was no difference in the amount and ratio of blood products, but the time required for blood product release was shorter in the MTP group. Conclusion: There was no significant difference in clinical findings such as initial vital signs and laboratory test results between the MTP and non-MTP groups, but required blood products were prepared and released more quickly for the MTP group.

Survival in clinical stage I endometrial cancer with single vs. multiple positive pelvic nodes: results of a multi-institutional Italian study

  • Uccella, Stefano;Falcone, Francesca;Greggi, Stefano;Fanfani, Francesco;De Iaco, Pierandrea;Corrado, Giacomo;Ceccaroni, Marcello;Mandato, Vincenzo Dario;Bogliolo, Stefano;Casarin, Jvan;Monterossi, Giorgia;Pinelli, Ciro;Mangili, Giorgia;Cormio, Gennaro;Roviglione, Giovanni;Bergamini, Alice;Pesci, Anna;Frigerio, Luigi;Uccella, Silvia;Vizza, Enrico;Scambia, Giovanni;Ghezzi, Fabio
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.100.1-100.13
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    • 2018
  • Objective: To investigate survival outcomes in endometrioid endometrial cancer (EEC) patients with single vs. multiple positive pelvic lymph nodes. Methods: We performed a retrospective evaluation of all consecutive patients with histologically proven International Federation of Gynecology and Obstetrics (FIGO) stage IIIC1 EEC who underwent primary surgical treatment between 2004 and 2014 at seven Italian gynecologic oncology referral centers. Patients with pre- or intra-operative evidence of extra-uterine disease (including the presence of bulky nodes) and patients with stage IIIC2 disease were excluded, in order to obtain a homogeneous population. Results: Overall 140 patients met the inclusion criteria. The presence of >1 metastatic pelvic node was significantly associated with an increased risk of recurrence and mortality, compared to only 1 metastatic node, at both univariate (recurrence: hazard ratio [HR]=2.19; 95% confidence interval [CI]=1.2-3.99; p=0.01; mortality: HR=2.8; 95% CI=1.24-6.29; p=0.01) and multivariable analysis (recurrence: HR=1.91; 95% CI=1.02-3.56; p=0.04; mortality: HR=2.62; 95% CI=1.13-6.05; p=0.02) and it was the only independent predictor of prognosis in this subset of patients. Disease-free survival (DFS) and disease-specific survival (DSS) were significantly longer in patients with only 1 metastatic node compared to those with more than 1 metastatic node (p=0.008 and 0.009, respectively). Conclusion: The presence of multiple metastatic nodes in stage IIIC1 EEC represents an independent predictor of worse survival, compared to only one positive node. Our data suggest that EEC patients may be categorized according to the number of positive nodes.

Recommender system using BERT sentiment analysis (BERT 기반 감성분석을 이용한 추천시스템)

  • Park, Ho-yeon;Kim, Kyoung-jae
    • Journal of Intelligence and Information Systems
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    • v.27 no.2
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    • pp.1-15
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    • 2021
  • If it is difficult for us to make decisions, we ask for advice from friends or people around us. When we decide to buy products online, we read anonymous reviews and buy them. With the advent of the Data-driven era, IT technology's development is spilling out many data from individuals to objects. Companies or individuals have accumulated, processed, and analyzed such a large amount of data that they can now make decisions or execute directly using data that used to depend on experts. Nowadays, the recommender system plays a vital role in determining the user's preferences to purchase goods and uses a recommender system to induce clicks on web services (Facebook, Amazon, Netflix, Youtube). For example, Youtube's recommender system, which is used by 1 billion people worldwide every month, includes videos that users like, "like" and videos they watched. Recommended system research is deeply linked to practical business. Therefore, many researchers are interested in building better solutions. Recommender systems use the information obtained from their users to generate recommendations because the development of the provided recommender systems requires information on items that are likely to be preferred by the user. We began to trust patterns and rules derived from data rather than empirical intuition through the recommender systems. The capacity and development of data have led machine learning to develop deep learning. However, such recommender systems are not all solutions. Proceeding with the recommender systems, there should be no scarcity in all data and a sufficient amount. Also, it requires detailed information about the individual. The recommender systems work correctly when these conditions operate. The recommender systems become a complex problem for both consumers and sellers when the interaction log is insufficient. Because the seller's perspective needs to make recommendations at a personal level to the consumer and receive appropriate recommendations with reliable data from the consumer's perspective. In this paper, to improve the accuracy problem for "appropriate recommendation" to consumers, the recommender systems are proposed in combination with context-based deep learning. This research is to combine user-based data to create hybrid Recommender Systems. The hybrid approach developed is not a collaborative type of Recommender Systems, but a collaborative extension that integrates user data with deep learning. Customer review data were used for the data set. Consumers buy products in online shopping malls and then evaluate product reviews. Rating reviews are based on reviews from buyers who have already purchased, giving users confidence before purchasing the product. However, the recommendation system mainly uses scores or ratings rather than reviews to suggest items purchased by many users. In fact, consumer reviews include product opinions and user sentiment that will be spent on evaluation. By incorporating these parts into the study, this paper aims to improve the recommendation system. This study is an algorithm used when individuals have difficulty in selecting an item. Consumer reviews and record patterns made it possible to rely on recommendations appropriately. The algorithm implements a recommendation system through collaborative filtering. This study's predictive accuracy is measured by Root Mean Squared Error (RMSE) and Mean Absolute Error (MAE). Netflix is strategically using the referral system in its programs through competitions that reduce RMSE every year, making fair use of predictive accuracy. Research on hybrid recommender systems combining the NLP approach for personalization recommender systems, deep learning base, etc. has been increasing. Among NLP studies, sentiment analysis began to take shape in the mid-2000s as user review data increased. Sentiment analysis is a text classification task based on machine learning. The machine learning-based sentiment analysis has a disadvantage in that it is difficult to identify the review's information expression because it is challenging to consider the text's characteristics. In this study, we propose a deep learning recommender system that utilizes BERT's sentiment analysis by minimizing the disadvantages of machine learning. This study offers a deep learning recommender system that uses BERT's sentiment analysis by reducing the disadvantages of machine learning. The comparison model was performed through a recommender system based on Naive-CF(collaborative filtering), SVD(singular value decomposition)-CF, MF(matrix factorization)-CF, BPR-MF(Bayesian personalized ranking matrix factorization)-CF, LSTM, CNN-LSTM, GRU(Gated Recurrent Units). As a result of the experiment, the recommender system based on BERT was the best.

Effects of Telephone Hotline Counseling Program on Stroke Care (뇌졸중 환자에 적용한 핫라인 전화상담 프로그램의 효과)

  • Baik Kyun Kim;Dong-Wan Kang;Do Yeon Kim;Jung Hyun Park;Ji-Seok Woo;Young-Hee Kim;Hyun-Sook Kim;Min-Joo Moon;Jeong-Yoon Lee;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Hakyeu Ahn;Bosco Seong Kyu Yang;Jun Yup Kim;Jihoon Kang;Moon-Ku Han;Hee-Joon Bae;Beom Joon Kim
    • Health Policy and Management
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    • v.33 no.2
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    • pp.185-193
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    • 2023
  • Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

Development and Validation of Classroom Problem Behavior Scale - Elementary School Version(CPBS-E) (초등학생 문제행동선별척도: 교사용(CPBS-E)의 개발과 타당화)

  • Song, Wonyoung;Chang, Eun Jin;Choi, Gayoung;Choi, Jae Gwang;ChoBlair, Kwang-Sun;Won, Sung-Doo;Han, Miryeung
    • Korean Journal of School Psychology
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    • v.16 no.3
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    • pp.433-451
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    • 2019
  • This study aimed to develop and validate the Classroom Problem Behavior Scale - Elementary School Version (CPBS-E) measure which is unique to classroom problem behavior exhibited by Korean elementary school students. The focus was on developing a universal screening instrument designed to identify and provide intervention to students who are at-risk for severe social-emotional and behavioral problems. Items were initially drawn from the literature, interviews with elementary school teachers, common office discipline referral measures used in U.S. elementary schools, penalty point systems used in Korean schools, 'Green Mileage', and the Inventory of Emotional and Behavioral Traits. The content validity of the initially developed items was assessed by six classroom and subject teachers, which resulted in the development of a preliminary scale consisting of 63 two-dimensional items (i.e., Within Classroom Problem Behavior and Outside of Classroom Problem Behavior), each of which consisted of 3 to 4 factors. The Within Classroom Problem Behavior dimension consisted of 4 subscales (not being prepared for class, class disruption, aggression, and withdrawn) and the Outside of Classroom Problem Behavior dimension consisted of 3 subscales (rule-violation, aggression, and withdrawn). The CPBS-E was pilot tested on a sample of 154 elementary school students, which resulted in reducing the scale to 23 items. Following the scale revision, the CPBS-E was validated on a sample population of 209 elementary school students. The validation results indicated that the two-dimensional CPBS-E scale of classroom problem behavior was a reliable and valid measure. The test-retest reliability was stable at above .80 in most of the subscales. The CPBS-E measure demonstrated high internal consistency of .76-.94. In examining the criterion validity, the scale's correlation with the Teacher Observation of Classroom Adaptation-Checklist (TOCA-C) was high and the aggression and withdrawn subscales of the CPBS-E demonstrated high correlations with externalization and internalization, respectively, of the Child Behavior Checklist - Teacher Report Form CBCL-TRF). In addition, the factor structure of the CPBS-E scale was examined using the structural equation model and found to be acceptable. The results are discussed in relation to implications, contributions to the field, and limitations.

National Survey of Mycobacterial Diseases Other Than Tuberculosis in Korea (비결핵항산균증 전국 실태조사)

  • 대한결핵 및 호흡기학회 학술위원회
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.3
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    • pp.277-294
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    • 1995
  • Background: The prevalence of tuberculosis in Korea decreased remarkably for the past 30 years, while the incidence of disease caused by mycobacteria other than tuberculosis is unknown. Korean Academy of Tuberculosis and Respiratory Diseases performed national survey to estimate the incidence of mycobacterial diseases other than tuberculosis in Korea. We analyzed the clinical data of confirmed cases for the practice of primary care physicians and pulmonary specialists. Methods: The period of study was from January 1981 to October 1994. We collected the data retrospectively by correspondence with physicians in the hospitals that referred the specimens to Korean Institute of Tuberculosis, The Korean National Tuberculosis Association for the detection of mycobacteria other than tuberculosis. In confirmed cases, we obtained the records for clinical, laboratory and radiological findings in detail using protocols. Results: 1) Mycobacterial diseases other than tuberculosis were confirmed that 1 case was in 1981, 2 cases in 1982, 4 cases in 1983, 2 cases in 1984, 5 cases in 1985, 1 case in 1986, 3 cases in 1987, 1 case in 1988, 6 cases in 1989, 9 cases in 1990, 14 cases in 1990, 10 cases in 1992, 4 cases in 1993, and 96 cases in 1994. Cases since 1990 were 133 cases(84.2%) of a total. 2) Fifty seven percent of patients were in the age group of over 60 years. The ratio of male to female patients was 2.6:1. 3) The distribution of hospitals in Korea showed that 61 cases(38.6%) were referred from Double Cross Clinic, 42 cases(26.6%) from health centers, 21 cases(13.3%) from tertiary referral hospitals, 15 cases(9.5%) from secondary referral hospitals, and 10 cases(6.3%) from primary care hospitals. The area distribution in Korea revealed that 98 cases(62%) were in Seoul, 17 cases(10.8%) in Gyeongsangbuk-do, 12 cases(7.6%) in Kyongki-do, 8 cases(5.1%) in Chungchongnam-do, each 5 cases(3.2%) in Gyeongsangnam-do and Chungchongbuk-do, 6 cases(3.8%) in other areas. 4) In the species of isolated mycobacteria other than tuberculosis, M. avium-intracellulare was found in 104 cases(65.2%), M. fortuitum in 20 cases(12.7%), M. chelonae in 15 cases(9.5%), M. gordonae in 7 cases(4.4%), M. terrae in 5 cases(3.2%), M. scrofulaceum in 3 cases(1.9%), M. kansasii and M. szulgai in each 2 cases(1.3%), and M. avium-intracellulare coexisting with M. terrae in 1 case(0.6%). 5) In pre-existing pulmonary diseases, pulmonary tuberculosis was 113 cases(71.5%), bronchiectasis 6 cases(3.8%), chronic bronchitis 10 cases(6.3%), and pulmonary fibrosis 6 cases(3.8%). The timing of diagnosis as having pulmonary tuberculosis was within 1 year in 7 cases(6.2%), 2~5 years ago in 32 cases(28.3%), 6~10 years ago in 29 cases(25.7%), 11~15 years ago in 16 cases(14.2%), 16~20 years ago in 15 cases (13.3%), and 20 years ago in 14 cases(12.4%). Duration of anti-tuberculous treatment was within 3 months in 6 cases(5.3%), 4~6 months in 17 cases(15%), 7~9 months in 16 cases(14.2%), 10~12 months in 11 cases(9.7%), 1~2 years in 21 cases(18.6%), and over 2 years in 8 cases(7.1%). The results of treatment were cure in 44 cases(27.9%) and failure in 25 cases(15.8%). 6) Associated extra-pulmonary diseases were chronic liver disease coexisting with chronic renal failure in 1 case(0.6%), diabetes mellitus in 9 cases(5.7%), cardiovascular diseases in 2 cases(1.3%), long-term therapy with steroid in 2 cases(1.3%) and chronic liver disease, chronic renal failure, colitis and pneumoconiosis in each 1 case(0.6%). 7) The clinical presentations of mycobacterial diseases other than tuberculosis were 86 cases (54.4%) of chronic pulmonary infections, 1 case(0.6%) of cervical or other site lymphadenitis, 3 cases(1.9%) of endobronchial tuberculosis, and 1 case(0.6%) of intestinal tuberculosis. 8) The symptoms of patients were cough(62%), sputum(61.4%), dyspnea(30.4%), hemoptysis or blood-tinged sputum(20.9%), weight loss(13.3%), fever(6.3%), and others(4.4%). 9) Smear negative with culture negative cases were 24 cases(15.2%) in first examination, 27 cases(17.1%) in second one, 22 cases(13.9%) in third one, and 17 cases(10.8%) in fourth one. Smear negative with culture positive cases were 59 cases(37.3%) in first examination, 36 cases (22.8%) in second one, 24 cases(15.2%) in third one, and 23 cases(14.6%) in fourth one. Smear positive with culture negative cases were 1 case(0.6%) in first examination, 4 cases(2.5%) in second one, 1 case (0.6%) in third one, and 2 cases(1.3%) in fourth one. Smear positive with culture positive cases were 48 cases(30.4%) in first examination, 34 cases(21.5%) in second one, 34 cases(21.5%) in third one, and 22 cases(13.9%) in fourth one. 10) The specimens isolated mycobacteria other than tuberculosis were sputum in 143 cases (90.5%), sputum and bronchial washing in 4 cases(2.5%), bronchial washing in 1 case(0.6%). 11) Drug resistance against all species of mycobacteria other than tuberculosis were that INH was 62%, EMB 55.7%, RMP 52.5%, PZA 34.8%, OFX 29.1%, SM 36.7%, KM 27.2%, TUM 24.1%, CS 23.4%, TH 34.2%, and PAS 44.9%. Drug resistance against M. avium-intracellulare were that INH was 62.5%, EMB 59.6%, RMP 51.9%, PZA 29.8%, OFX 33.7%, SM 30.8%, KM 20.2%, TUM 17.3%, CS 14.4%, TH 31.7%, and PAS 38.5%. Drug resistance against M. chelonae were that INH was 66.7%, EMB 66.7%, RMP 66.7%, PZA 40%, OFX 26.7%, SM 66.7%, KM 53.3%, TUM 53.3%, CS 60%, TH 53.3%, and PAS 66.7%. Drug resistance against M. fortuitum were that INH was 65%, EMB 55%, RMP 65%, PZA 50%, OFX 25%, SM 55%, KM 45%, TUM 55%, CS 65%, TH 45%, and PAS 60%. 12) The activities of disease on chest roentgenogram showed that no active disease was 7 cases(4.4%), mild 20 cases(12.7%), moderate 67 cases(42.4%), and severe 47 cases(29.8%). Cavities were found in 43 cases(27.2%) and pleurisy in 18 cases(11.4%). 13) Treatment of mycobacterial diseases other than tuberculosis was done in 129 cases(81.7%). In cases treated with the first line anti-tuberculous drugs, combination chemotherapy including INH and RMP was done in 86 cases(66.7%), INH or RMP in 30 cases(23.3%), and not including INH and RMP in 9 cases(7%). In 65 cases treated with the second line anti-tuberculous drugs, combination chemotherapy including below 2 drugs were in 2 cases(3.1%), 3 drugs in 15 cases(23.1%), 4 drugs in 20 cases(30.8%), 5 drugs in 9 cases(13.8%), and over 6 drugs in 19 cases (29.2%). The results of treatment were improvement in 36 cases(27.9%), no interval changes in 65 cases(50.4%), aggravation in 4 cases(3.1%), and death in 4 cases(3.1%). In improved 36 cases, 34 cases(94.4%) attained negative conversion of mycobacteria other than tuberculosis on cultures. The timing in attaining negative conversion on cultures was within 1 month in 2 cases(1.3%), within 3 months in 11 cases(7%), within 6 months in 14 eases(8.9%), within 1 year in 2 cases(1.3%) and over 1 year in 1 case(0.6%). Conclusion: Clinical, laboratory and radiological findings of mycobacterial diseases other than tuberculosis were summarized. This collected datas will assist in the more detection of mycobacterial diseases other than tuberculosis in Korea in near future.

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Media Habits of Sensation Seekers (감지추구자적매체습관(感知追求者的媒体习惯))

  • Blakeney, Alisha;Findley, Casey;Self, Donald R.;Ingram, Rhea;Garrett, Tony
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.2
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    • pp.179-187
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    • 2010
  • Understanding consumers' preferences and use of media types is imperative for marketing and advertising managers, especially in today's fragmented market. A clear understanding assists managers in making more effective selections of appropriate media outlets, yet individuals' choices of type and use of media are based on a variety of characteristics. This paper examines one personality trait, sensation seeking, which has not appeared in the literature examining "new" media preferences and use. Sensation seeking is a personality trait defined as "the need for varied, novel, and complex sensations and experiences and the willingness to take physical and social risks for the sake of such experiences" (Zuckerman 1979). Six hypotheses were developed from a review of the literature. Particular attention was given to the Uses and Gratification theory (Katz 1959), which explains various reasons why people choose media types and their motivations for using the different types of media. Current theory suggests that High Sensation Seekers (HSS), due to their needs for novelty, arousal and unconventional content and imagery, would exhibit higher frequency of use of new media. Specifically, we hypothesize that HSS will use the internet more than broadcast (H1a) or print media (H1b) and more than low (LSS) (H2a) or medium sensation seekers (MSS) (H2b). In addition, HSS have been found to be more social and have higher numbers of friends therefore are expected to use social networking websites such as Facebook/MySpace (H3) and chat rooms (H4) more than LSS (a) and MSS (b). Sensation seekers can manifest into a range of behaviors including disinhibition,. It is expected that alternative social networks such as Facebook/MySpace (H5) and chat rooms (H6) will be used more often for those who have higher levels of disinhibition than low (a) or medium (b) levels. Data were collected using an online survey of participants in extreme sports. In order to reach this group, an improved version of a snowball sampling technique, chain-referral method, was used to select respondents for this study. This method was chosen as it is regarded as being effective to reach otherwise hidden population groups (Heckathorn, 1997). A final usable sample of 1108 respondents, which was mainly young (56.36% under 34), male (86.1%) and middle class (58.7% with household incomes over USD 50,000) was consistent with previous studies on sensation seeking. Sensation seeking was captured using an existing measure, the Brief Sensation Seeking Scale (Hoyle et al., 2002). Media usage was captured by measuring the self reported usage of various media types. Results did not support H1a and b. HSS did not show higher levels of usage of alternative media such as the internet showing in fact lower mean levels of usage than all the other types of media. The highest media type used by HSS was print media, suggesting that there is a revolt against the mainstream. Results support H2a and b that HSS are more frequent users of the internet than LSS or MSS. Further analysis revealed that there are significant differences in the use of print media between HSS and LSS, suggesting that HSS may seek out more specialized print publications in their respective extreme sport activity. Hypothesis 3a and b showed that HSS use Facebook/MySpace more frequently than either LSS or MSS. There were no significant differences in the use of chat rooms between LSS and HSS, so as a consequence no support for H4a, although significant for MSS H4b. Respondents with varying levels of disinhibition were expected to have different levels of use of Facebook/MySpace and chat-rooms. There was support for the higher levels of use of Facebook/MySpace for those with high levels of disinhibition than low or medium levels, supporting H5a and b. Similarly there was support for H6b, Those with high levels of disinhibition use chat-rooms significantly more than those with medium levels but not for low levels (H6a). The findings are counterintuitive and give some interesting insights for managers. First, although HSS use online media more frequently than LSS or MSS, this groups use of online media is less than either print or broadcast media. The advertising executive should not place too much emphasis on online media for this important market segment. Second, social media, such as facebook/Myspace and chatrooms should be examined by managers as potential ways to reach this group. Finally, there is some implication for public policy by the higher levels of use of social media by those who are disinhibited. These individuals are more inclined to engage in more socially risky behavior which may have some dire implications, e.g. by internet predators or future employers. There is a limitation in the study in that only those who engage in extreme sports are included. This is by nature a HSS activity. A broader population is therefore needed to test if these results hold.

Comparision of Medical Care Utilization Patterns between Beneficiaries of Medical Aid and Medical Insurance (의료보호대상자의 의료이용양상)

  • Kim, Bok-Youn;Kim, Seok-Beom;Kim, Chang-Yoon;Kang, Pock-Soo;Chung, Jong-Hak
    • Journal of Yeungnam Medical Science
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    • v.8 no.2
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    • pp.185-201
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    • 1991
  • A household survey was conducted to compare the patterns of morbidity and medical care utilization between medical aid beneficiaries and medical insurance beneficiaries. The study population included 285 medical aid beneficiaries that were completely surveyed and 386 medical insurance benficiaries selected by simple random sampling from a Dong(Township) in Taegu. Well-trained surveyers mainly interviewed housewives with a structured questionnaire. The morbidity rates of acute illness during the 15-day period, were 63 per 1,000 medical aid beneficiaries and 62 per 1,000 medical insurance beneficiaries. The rates for chronic illness were 123 per 1,000 medical aid beneficiaries and 73 per 1,000 medical insurance beneficiaries. The most common type of acute illness in medical aid and medical insurance beneficiaries was respiratory disease. In medical aid beneficiaries, musculoskeletal disease was most common, but in medical insurance beneficiaries, gastrointestinal disease was most common. The mean duration of acute illness of medical aid beneficiaries was 3.8 days and that of medical insurance beneficiaries was 6.8 days. During the one year period, mean duration of medical aid beneficiaries chronic illnesses was 11.5 months which was almost twice as long compared to medical insurance beneficiaries. Pharmacy was most preferrable facility among the acute illness patient in medical aid beneficiaries, but acute cases of medical insurance beneficiaries visited the clinic most commonly. Chronic cases of both groups visited the clinic most frequently. There were some findings suggesting that much unmet need existed among the medical aid beneficiaries. In acute cases, the average number of days of medical aid users utilized medical facilities was less than medical insurance users. On the other hand, the length of medical care utilization of chronic cases was reversed. Geographical accessibility was the most important factors in utilization of medical facilities. Almost half of the study population answered the questions about source of funds on medical security correctly. Most respondents considered that the objective of medical security was afford ability. The chief complaint on hospital utilization was the complicated administrative procedures. These findings suggest that there were some problems in the medical aid system, especially in the referral system.

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A Review of Personal Radiation Dose per Radiological Technologists Working at General Hospitals (전국 종합병원 방사선사의 개인피폭선량에 대한 고찰)

  • Jung, Hong-Ryang;Lim, Cheong-Hwan;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.28 no.2
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    • pp.137-144
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    • 2005
  • To find the personal radiation dose of radiological technologists, a survey was conducted to 623 radiological technologists who had been working at 44 general hospitals in Korea's 16 cities and provinces from 1998 to 2002. A total of 2,624 cases about personal radiological dose that were collected were analyzed by region, year and hospital, the results of which look as follows : 1. The average radiation dose per capita by region and year for the 5 years was 1.61 mSv. By region, Daegu showed the highest amount 4.74 mSv, followed by Gangwon 4.65 mSv and Gyeonggi 2.15 mSv. The lowest amount was recorded in Chungbuk 0.91 mSv, Jeju 0.94 mSv and Busan 0.97 mSv in order. By year, 2000 appeared to be the year showing the highest amount of radiation dose 1.80 mSv, followed by 2002 1.77 mSv, 1999 1.55 mSv, 2001 1.50 mSv and 1998 1.36 mSv. 2. In 1998, Gangwon featured the highest amount of radiological dose per capita 3.28 mSv, followed by Gwangju 2.51 mSv and Daejeon 2.25 mSv, while Jeju 0.86mSv and Chungbuk 0.85 mSv belonged to the area where the radiation dose remained less than 1.0 mSv In 1999, Gangwon also topped the list with 5.67 mSv, followed by Daegu with 4.35 mSv and Gyeonggi with 2.48 mSv. In the same year, the radiation dose was kept below 1.0 mSv. in Ulsan 0.98 mSv, Gyeongbuk 0.95 mSv and Jeju 0.91 mSv. 3. In 2000, Gangwon was again at the top of the list with 5.73 mSv. Ulsan turned out to have less than 1.0 mSv of radiation dose in the years 1998 and 1999 consecutively, whereas the amount increased relatively high to 5.20 mSv. Chungbuk remained below the level of 1.0 mSv with 0.79 mSv. 4. In 2001, Daegu recorded the highest amount of radiation dose among those ever analyzed for 5 years with 9.05 mSv, followed by Gangwon with 4.01 mSv. The area with less than 1.0 mSv included Gyeongbuk 0.99 mSv and Jeonbuk 0.92 mSv. In 2002, Gangwon also led the list with 4.65 mSv while Incheon 0.88 mSv, Jeonbuk 0.96 mSv and Jeju 0.68 mSv belonged to the regions with less than 1.0 mSv of radiation dose. 5. By hospital, KMH in Daegu showed the record high amount of average radiation dose during the period of 5 years 6.82 mSv, followed by GAH 5.88 mSv in Gangwon and CAH 3.66 mSv in Seoul. YSH in Jeonnam 0.36 mSv comes first in the order of the hospitals with least amount of radiation dose, followed by GNH in Gyeongnam 0.39 mSv and DKH in Chungnam 0.51 mSv. There is a limit to the present study in that a focus is laid on the radiological technologists who are working at the 3rd referral hospitals which are regarded to be stable in terms of working conditions while radiological technologists who are working at small-sized hospitals are excluded from the survey. Besides, there are also cases in which hospitals with less than 5 years since establishment are included in the survey and the radiological technologists who have worked for less than 5 years at a hospital are also put to survey. We can't exclude the possibility, either, of assumption that the difference of personal average radiological dose by region, hospital and year might be ascribed to the different working conditions and facilities by medical institutions. It seems therefore desirable to develop standardized instruments to measure working environment objectively and to invent device to compare and analyze them by region and hospital more accurately in the future.

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