• KDI Journal of Economic Policy
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• v.30 no.2
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• pp.129-155
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• 2008

The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

• Journal of dental hygiene science
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• v.10 no.6
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• pp.431-438
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• 2010

This study was designed to identify the relationship between emotional labor and reaction factor(job satisfaction, fatigue), buffer factor(social support) among dental hygienist. The number of respondents was 50 who work in dental clinic and period of investigation was march 2010 through April 2010. A structured questionnaire was employed to evaluate the level of participants' sociodemographics, job-related factors, health-related behaviors, emotional labor and self-perceived fatigue, job satisfaction, social support. While the mean values of emotional labor were higher than thosewho work in hospital and lower than those who work in service employees. These results suggest that emotional labor was related to an increase in fatigue and strong correlation between involuntary emotional expression, self-perceived fatigue, job satisfaction, social support in dental hygienist. Multiple regression analysis has found that social support and no. of personnel were main factors that influence to the level of emotional labor in dental hygienist. The results of this study suggest that emotional labor was a determinant predictor of self perceived fatigue. Thus, a management program for emotional labor is strongly recommended for promotion of quality of life in dental hygienist and to improve dental service and competitiveness.

• Korean Journal of Environment and Ecology
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• v.28 no.6
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• pp.779-788
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• 2014

This study, as a case where the environmental conflict and dispute arose between the use and the conservation as in the other protected areas in Korea, took the first step to build ecological citizenship to solve various and complicated issues in a fundamental level by providing a basic information on differentiated environmental perceptions of the locality and the visitors of Seoraksan National Park. The questionnaire survey was employed on September 6th and 7th with 150 residents of the park area and 200 visitors of Osaek-Daechungbong trail. Total number of 13 survey questions was introduced using Dunlap and Liere's NEP index. The result shows that the perception of 'balance of nature' was more dominant to the perception of 'humans over nature' and the perception to the 'limits to growth' was also somewhat positive in both groups. The differences in environmental perceptions between the groups exist; the visitor group tended to have more positive level of acceptance of NEP views. Such differences in perceptions suggest that a different normative approach should be taken to the residents of the national park with less pro-environment in their perceptions when policy making. It thus seemed possible that ecological citizenship could be realized since the younger and the higher education level are, the more pro-environment. The findings of the research may cause some concerns however, because the study has been confined as a case study with basic understanding of environmental perceptions and its differences between the interest groups. More extensive research is required to confirm if this is generalized.

• Journal of Bio-Environment Control
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• v.12 no.1
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• pp.45-53
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• 2003

The object of this study was to develop the control technology of daily integral photosynthetic photon flux (PPF) by the artificial lighting and shading screen in greenhouse. The shading time needed to get the target PPF by using two types of shading screens having shading ratio of 55% and 85% was analyzed. The results showed the shading ratio of screen to be installed in greenhouse should be different depending on the amount of target PPF to be controlled. The PPF control experiment by using the 55% shading screen in July and August showed that the maximum difference between measured and calculated value was about 5 mol$.$ $m^{-2}$ $.$ $d^{-1}$ in no shading condition. This difference is satisfactory result because the daily integral PPF is quite different depending on the weather condition. The simulation result about PPF distribution pattern shortened the time needed to find the proper arrangement of artificial lightings in greenhouse. But the further study was required to find the supplemental lighting arrangement to be able to provide the exactly uniform distribution of target light intensity. The supplemental irradiation time needed to acquire the target daily integral PPF for different supplemental light intensities, weather conditions, and months was analyzed. The result showed that the supplemental light intensity should be decided depending on the amount of target PPF to be controlled. The result of PPF control experiment conducted by using 55% shading screen and 300 $\mu$mol$.$ $m^{-2}$ $.$ $s^{-1}$ supplemental light intensity from the end of May to the beginning of June showed that the maximum difference between target and measured value was about 3 mol$.$ $d^{-1}$ $.$ $m^{-2}$ . If we consider that the difference of the daily integral PPF depending on weather condition was the maximum 30 mol$.$ $m^{-2}$ $.$ $d^{-l}$, the control effect was acceptable. Although the result of this study was the PPF control technology to grow lettuce, the data and control method obtained could be employed for other crop production.n.

• Journal of Bio-Environment Control
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• v.29 no.2
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• pp.141-152
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• 2020

The rapid on-site measurement of hydroponic nutrients allows for the more efficient use of crop fertilizers. This paper reports on the development of an embedded on-site system consisting of multiple ion-selective electrodes (ISEs) for the real-time measurement of the concentrations of macronutrients in hydroponic solutions. The system included a combination of PVC ISEs for the detection of NO₃, K, and Ca ions, a cobalt-electrode for the detection of H₂PO₄, a double-junction reference electrode, a solution container, and a sampling system consisting of pumps and valves. An Arduino Due board was used to collect data and to control the volume of the sample. Prior to the measurement of each sample, a two-point normalization method was employed to adjust the sensitivity followed by an offset to minimize potential drift that might occur during continuous measurement. The predictive capabilities of the NO₃ and K ISEs based on PVC membranes were satisfactory, producing results that were in close agreement with the results of standard analyzers (R² = 0.99). Though the Ca ISE fabricated with Ca ionophore II underestimated the Ca concentration by an average of 55%, the strong linear relationship (R² > 0.84) makes it possible for the embedded system to be used in hydroponic NO₃, K, and Ca sensing. The cobalt-rod-based phosphate electrodes exhibited a relatively high error of 24.7±9.26% in the phosphate concentration range of 45 to 155 mg/L compared to standard methods due to inconsistent signal readings between replicates, illustrating the need for further research on the signal conditioning of cobalt electrodes to improve their predictive ability in hydroponic P sensing.

• Progress in Medical Physics
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• v.13 no.3
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• pp.120-128
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• 2002

To investigate differences between the metabolic ratios of normal controls and brain tumors such as astrocytomas and glioblastoma multiforme (GM) by proton MR spectroscopy (MRS) at 37 high field system. Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67$\pm$018 and 1.16$\pm$0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (P=0.005). Cho/Cr ratio of glioblastoma multiforme was significantly higher than that of astrocytomas (P=0.001). Lactate was observed in all tumor cases. The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. This results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy.

• Progress in Medical Physics
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• v.24 no.4
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• pp.315-322
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• 2013

The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

• Investigative Magnetic Resonance Imaging
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• v.7 no.2
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• pp.124-131
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• 2003

Purpose : To reveal clinical usefulness of functional MRI (fMRI) using sensorymotor and language stimuli for demonstrating anatomic relationship between sensorimotor or language cortices and lesions in the planning of brain tumor surgery. Materials and Methods : This study included 12 right-handed patients with brain tumors in or around sensorimotor or language cortices. Eleven patients were evaluated with primary motor and sensory stimuli. Of these patients, six patients were also evaluated with language stimuli. One patient was evaluated with language stimuli only. For fMR imaging, a 1.5T scanner was used and the EPI BOLD technique was employed. For postprocessing image, the SPM99 program and a program made by our department was utilized. We evaluated whether sensorimotor and language stimuli activate sensorimotor and language cortices. And also, clinical efficacy of revealing anatomic relationship between cerebral cortices and lesions for planning neurosurgical operation were evaluated. Finally, we compared post-operative neurologic function with pre-operative neurologic function in same patients. Results : The fMRI examination was successful in identifying the functional cortices and depicting anatomic relationship between functional cortices and lesions in all patients. In nine patients of 11 patients with identified sensorimotor cortices, postoperative grade of manual motor test was not changed, compared with preoperative grade. Whereas postoperative improved than preoperative grade in one patient of remaining two patients, postoperative aggravated than preoperative grade in the other. This result was due to atherosclerotic lacunar infarction, regardless of tumor resection. Postoperative deficit of language function was not found in seven patients with identified language cortices. Conclusion : fMRI could be a helpful method for determining the best approach to neurosurgical treatment in patients with brain tumors in or around sensorimotor or language cortices.

• Clinical and Experimental Reproductive Medicine
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• v.26 no.1
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• pp.55-65
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• 1999

There have been many reports to date regarding the role of GnRH as a local regulatory factor of ovarian function as studies of human and rat ovaries revealed GnRH and its receptor. In recent studies it has been shown that GnRH directly causes apoptosis in the granulosa cells of the rat ovary, and such results leads to the suggestion that the use of GnRH agonist for more stable long term ovarian hyperstimulation in human IVF-ET programs causes granulosa cell apoptosis which may lead to follicular atresia. Therefore this study attempts to determine if granulosa-luteal cell apoptosis occurs in patients during IVF-ET programs in which GnRH agonist is employed for ovarian hyperstimulation. The quality of oocyte-cumulus complexes obtained during ovum pickup procedures were assessed morphologically and then the fertilization rate and developmental rate was determined. Apoptotic cells among the granulosa-luteal cells obtained during the same procedure were observed after staining with Hematoxylin-eosin. The fragmentation degree of DNA extracted from granulosa-luteal cells was determined and comparatively analyzed. There was no difference in the average age of the patients, the number of oocytes retrieved, and fertilization and developmental rates between the FSH/hMG group and GnRH-long group. There was also no difference in the apoptosis rate and pyknosis rate in the granulosa-luteal cells between the two groups. However, when the oocyte-cumulus complexes were morphoogically divided into the healthy group and atretic group without regard for the method of hyperstimulation, the results showed that the number of oocytes obtained averaged $11.09{\pm}8.75\;and\;10.33{\pm}4.53$ per cycle, respectively, showing no significant difference, but the fertilization rate (77.05%, 56.99%, respectively, p<0.01) and developmental rate (65.96%, 41.51%, respectively, p<0.01) was significantly increased in the healthy group when compared to the atretic group. The degree of apoptosis in the granulosa-luteal cells showed that in the healthy group it was 2.25% which was not significantly different from the atretic group (2.77%), but the pyknosis rate in the atretic group (27.81%) was significantly higher compared to the healthy group (11.35%, p<0.01). The quantity of DNA fragmentation in the FSH/hMG group was 32.22%, while in the GnRH-long group it was 34.27%, showing no significant difference. On the other hand the degree of DNA fragmentation was 39.05% and 11.83% in the healthy group and atretic group, respectively, showing significantly higher increase in the atretic group (p<0.01). The above results suggest that death of granulosa-luteal cells according to the state of the oocyte-cumulus complex is more related to pyknosis rather than apoptosis. Also, the GnRH agonist used in ovarian hyperstimulation does not seem to directly affect the apoptosis of retrieved oocytes and granulosa-luteal cells, and which is thought to be due to the suppression of the apoptogenic effect of GnRH agonist as a result of the high doses of FSH administered.

• The Journal of Information Systems
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• v.25 no.1
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• pp.1-23
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• 2016

Purpose Self-congruity deals with the effect of symbolic value-expressive attributes on consumer decision and behavior, which is the theoretical foundation of the "non-utilitarian destination positioning". Functional congruity refers to utilitarian evaluation of a product or service by consumers. In addition, recent years, social network services, especially mobile social network services have created many opportunities for e-WOM communication that enables consumers to share personal consumption related information anywhere at any time. Moreover, self-construal is a hot and popular topic that has been discussed in the field of modem psychology as well as in marketing area. This study aims to examine the moderating effect of self-construal on the relationship between self-congruity, functional congruity and tourists' positive electronic word of mouth (e-WOM). Design/methodology/approach In order to verify the hypotheses, we developed a questionnaire with 32 survey items. We measured all the items on a five-point Likert-type scale. We used Sojump.com to collect questionnaire and gathered 218 responses from whom have visited Korea before. After a pilot test, we analyzed the main survey data by using SPSS 20.0 and AMOS 18.0, and employed structural equation modeling to test the hypotheses. We first estimated the measurement model for its overall fit, reliability and validity through a confirmatory factor analysis and used common method bias test to make sure that whether measures are affected by common-method variance. Then we tested the hypotheses through the structural model and used regression analysis to measure moderating effect of self-construal. Findings The results reveal that the effect of self-congruity on tourists' positive e-WOM is stronger for tourists with an independent self-construal compared with those with interdependent self-construal. Moreover, it shows that the effect of functional congruity on tourists' positive e-WOM becomes salient when tourists' self-construal is primed to be interdependent rather than independent. We expect that the results of this study can provide important implications for academic and practical perspective.