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Prioritisation of Medical Procedure for Health Technology Assessment (전문의 대상 설문조사를 이용한 보건의료 기술평가 대상 시술의 우선 순위 선정 - 이비인후과와 흉부외과를 중심으로 -)

  • 안형식;김선민;신영수;김차엽;김선미;이순형
    • Health Policy and Management
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    • v.7 no.2
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    • pp.46-64
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    • 1997
  • Background & Objectives : Korea is face with the social need for health care technology assessment so that it is urgently needed to found principles and methodology in technology assessment in health care. As a groundwork for health care technology assessment, we tried to prioritize medical technology for assessment. Among medical technologies, procedure is somewhat difficult to assess, compared to drug or equipment. In this study, we aimed at the prioritisation of medical procedure to be assessed, in terms of efficay, safety, and adequacy. Method : For the standardized classification of medical procedure, ICD-9-CM(International Classification of Diseases 9th edition - Clinical Modification) was used. Among the list the procedures coming under otorhinolaringjology and thoracic surgery were selected by three family physicians. The list of procedure was mailed to the board certified surgeons of both disciplines, with the question asking about the necessity for assessment in terms of efficay, safety, and adequacy. Replied questionnaires were analyzed in each procedure. Results : Of 560 otorhinolaryngologist and 480 thoracic surgeon, 114 surgeons replied. Of otorhinolaryngological procedure, incision, excision, and destruction of inner ear : fenestration of inner ear : stapedectomy and its revision were the most urgent technology to assess in the aspect of safety. For adequacy, operations on Eustachian tube: fenestration of inner ear: incision, excision, and destruction of inner ear were highly ranked in necessity, and for efficary, operations on Eustachian tube; external maxillary antrotomy; fenestration of inner ear. Thoracic surgeons replied thoracic procedures, lung transplantation; heart transplantation; implantation of heart assist system [pump] are most important for evaluation in terms of safety; and heart transplantation; Lung transplantation; Implantation of heart assist system [pump] in terms of adequacy, and surgical collapse of lung [Artificia니 pnemothorax or pnuexoperitoeum]; lung transplantation; periarterial sympathectomy in terms of efficacy. As a whole, surgeons regard safety evaluation is more urgent than adequacy or efficary. In addition, otorhinolaryngological surgeons regard evaluation of their procedures more urgent than thoracic surgeons regard theirs. Conclusion : By the questionnaire to board certified physicians, we get some preliminary data for prioritisation of technologies to assess. Through the questionnaire like this, much information would be gathered for technology assessment, especially for medical procedure, if not enough. In the near future, well structured expert opinion gathering research, such as modified Delphi or nominal group technique, should be done succeedingly.

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A Study on the Experimental Animation and Movement Expression of Norman McLaren (노먼 맥라렌의 실험적 애니메이션과 움직임 표현 연구)

  • Hong, Il-Yang
    • The Journal of the Korea Contents Association
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    • v.19 no.4
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    • pp.458-465
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    • 2019
  • Experimental animation is an independent art animation and a visual art that is integrated with the spirit of experimentation. Norman McLaren pursues original beauty in each piece through scientific exploration of visual expression technology and experiment that transcends common sense with great creativity and sensitivity, and the aesthetic value of animation is very high as the master of experimental animation that has brought innovation of real image media today. Therefore, it is meaningful to analyze the experimental expressions of Norman McLaren, who expanded the field of experimental animation by challenging various techniques and carried out a ceaseless search for motion creation between each frame, and to study the expressions of movement he focused on. The most significant feature of his movement expression was analyzed as repetition of motion and repetition of metamorphosis. I hope that this derivation will be understood as experimental animation of experimental method which requires more specific type of inquiry than simple question about experimental method. Also, I hope that it will be meaningful as a preliminary study to deeply explore the possibility and direction of animation creation in university education.

Association Between Vertebrobasilar Insufficiency and Cervicogenic Headache: Hypothetical Approach Towards Etiopathogenesis of Headache

  • Kaur, Aninditya;Rakesh, N.;Reddy, Sujatha S.;Thomas, Nithin;Nagi, Ravleen;Patil, Deepa Jatti
    • Journal of Oral Medicine and Pain
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    • v.45 no.4
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    • pp.97-109
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    • 2020
  • Purpose: Cervicogenic headache (CGH) is pain referred to the head/ face from the structures in vicinity of upper cervical spinal nerves via trigeminocervical pathway. Ponticulus Posticus (PP) and Elongated Styloid Process (ESP) are anatomical structures that cause compression of vasculature present around upper cervical nerve plexus. Recently, computational fluid dynamics (CFD) has shown to play an essential role in identification of these high-pressure zones in the brain. The aim of this research is to study the association of ESP and PP in patients with CGH and to develop a hypothesis by CFD to analyse vertebrobasilar insufficiency as a contributing factor in occurrence of CGH. Methods: Retrospective analysis of 4500 full skull CBCT scans was done for the presence of partial or complete PP and length of Styloid Process (SP). Research was divided into two phases; In first Preliminary Phase, 150 scans that showed the presence of PP and ESP were analysed, and only 134 patients gave consent to fill the questionnaire containing 96 question items pertaining to symptoms associated with CGH. In the second phase, simulation of Vertebral and Carotid Artery was done using Fluent 14.5 Software and by CFD, pressure distribution on arteries was obtained that helped to identify high pressure regions. Results: Both PP and ESP showed a statistically significant association with CGH (p<0.001). By CFD analysis, both steady and transient phases of simulation showed drop in pressure due to constriction of internal carotid and vertebral artery by ESP and PP respectively and were found to decrease the volume of blood reaching the brain, 0.12 /0.13 mL and 0.06 mL respectively. Conclusions: Our analysis proves ESP and PP as contributing factors towards CGH. Hence for proper diagnosis and management of headache disorders, clinicians should have adequate knowledge about these anatomical structures and their resulting clinical symptoms.

A Qualitative Analysis of Psychiatric Patients' Experiences and Perceptions of Korean Medicine Utilization - Preliminary Study (정신과 환자의 한의의료 이용경험 및 인식에 대한 질적 분석 - 예비연구)

  • Moon, Seung-Hwan;Jang, Bo-Hyoung;Suh, Hyo-Weon;Kim, Jong Woo;Chung, Sun-Yong
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.2
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    • pp.123-131
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    • 2022
  • Objectives: The purpose of this study was to investigate the experience and perception of using Korean medicine treatments for patients with mental disorders. Methods: The method of a qualitative analysis was used, and semi-structured interviews were conducted. The researchers developed the survey questionnaires with consultation from psychiatrists from various university hospitals. Before conducting interviews, an IRB was approved KHSIRB-21-131 (RA), and the Hankook Research Company managed the interviews. The question composition comprised 11 questions based on symptoms and treatment situations accompanying treatment due to mental distress, perception of Korean medicine, awareness of treatment costs, and awareness of treatment costs. Results: A total of six patients were interviewed. Each interviewee took 90 minutes to answer questions. Through the analysis of the data, the patients comprised four categories: characteristics, awareness of Korean medicine, awareness of Western treatment, and daily life due to mental disorder. The experience and perception of patients using Korean medicine showed positive attitudes. There was an opinion among patients that Korean medicine treatment was less dependent on drugs, and had fewer side effects, than Western medicine. Some patients said that Korean medical treatment is expensive and burdensome medical expenses. Some patients were not aware of the application of insurance to mitigate medical expenses. Conclusions: Based on the findings of the study, it is urgent to expand the application of insurance benefits to Korean medicine.

Preliminary Research for Developing a Pattern Identification Tool for Idiopathic Pulmonary Fibrosis (특발성 폐섬유화증 변증 도구 개발을 위한 기초연구)

  • Hong, Sung-eun;Park, Ji-won;Shin, Jeong-won;Kil, Jung-eun;Kim, Kwan-il;Bu, Yung-min;Jung, Hee-jae;Lee, Beom-joon
    • The Journal of Internal Korean Medicine
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    • v.43 no.3
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    • pp.327-343
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    • 2022
  • Objective: The purpose of this study was to develop a standard tool for identifying idiopathic pulmonary fibrosis patterns. Methods: Textbooks, published literature, and references with comments on patterns were reviewed. Using the Delphi method, we determined pattern identification based on the advice of a committee consisting of 11 Korean respiratory internal medicine professors. Results: Four pattern identifications were selected by the Delphi method: qi difficiency (氣虛), yin difficiency (陰虛), phlegm dampness (痰飮), blood stasis (瘀血). The tool was developed in a question-and-answer format containing 38 questions. Conclusions: An IPF pattern identification tool that can analyze IPF patterns for standardized diagnostics was developed with the consent of experts. Further research is needed on its reliability.

A Study on the Development of the Measuring Scale of Safety Consciousness (안전의식 측정 척도 개발 연구 : 서울시 일부 중학생을 중심으로)

  • 김혜원;이명선
    • Korean Journal of Health Education and Promotion
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    • v.19 no.1
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    • pp.87-107
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    • 2002
  • Recently, the industrialized world is suffering from accidents referring from the lack of safety consciousness. According to Korean Safety Regulation Department(1996), students at junior high schools are mostly involved in safety accidents, and this is due to lack of safety consciousness. To prevent these accidents, we need to have safety consciousness and attitude. To make junior high school students who are mostly affected in these accidents act safely, they need to know their level of safety consciousness. The purpose of this study is to develop a guideline of measuring the scale of safety consciousness and analyze the relationship between safety education, accident experiences and safety consciousness. This study is based on a survey of 708 junior high students in Seoul, which was carried out from 12 November, 2001 to 21 November, 2001. 1. The main fields of safety consciousness are home safety, school safety, fire safety, emergency management based on documents. Home safety is again divided into facility safety and livelihood safety, school safety is divided into facility safety, livelihood safety and laboratory safety, traffic safety is divided into pedestrian safety, bicycling safety and public transportation safety, fire safety divided into prevention and escaping during fire breakouts, emergency management safety is divided into general principles and escaping during emergency situations. 2. The primary safety consciousness scale was made according to every field of safety consciousness. A preliminary examination based on the scale and a study of reliance and the factors was held. Based on these results, 27 questions which were concerned to be impairing reliability or lacking in factor were deleted on the secondary safety consciousness scale development The secondary safety consciousness scale which constituted of 73 questions was put into another preliminary study and after analyzing reliability and the factors, 12 questions of low reliabilities were deleted and with these results, the third scale were made consisting of 61 questions. 3. A study based on the third safety scale which is made of 61 questions, were held and with a analysis of the reliability and factors made, the relationship between safety education, accident experience and safety mind were examined. (1) The study of reliability and factors show that Cronbach's coefficient in home safety fields is .7598, in school safety .7924, in traffic safety .8306, in emergency treatment .7775, in fire safety .7247. The questions indicating low reliability were deleted. The factor analysis revealed that home safety is converged on facility safety and livelihood safety. But one question was deleted because it showed incongruence of validity. School safety was converged on facility safety, livelihood safety and laboratory safety. But 2 questions showed incongruence of validity and these were deleted. Traffic safety fields were converged on pedestrian safety, bicycle safety and public transportation safety. One question showing incongruence of validity was deleted. Emergency treatment fields converged on general principles and acting in emergency situations and three questions showing incongruence of validity were deleted. Fire safety was converged on prevention and acting in fire breakouts. Totally, eight questions were removed and the final scale were consisted of 53 questions (2) The 3/sup rd/ grade students scored higher average safety mind scales than 1st graders(p〈.05). And students who had high scores at school tend to have a higher scale than those who do not(p〈.001). (3) Average scale of students who had experience in safety education were higher(p〈.001). Students who had previously been involved in home safety accidents had a low score(p〈.001). This was same to students with experience in school safety accidents(p〈.001). Students with traffic safety accidents and fire safety accidents tend to have a lower scale too(p〈.05, p〈.001).

Development and Validation of a Career Decision-Making Scale for Scientifically Gifted Undergraduates (과학영재 대학생을 위한 진로결정 요인 척도개발 및 타탕화)

  • Yang, Tae-Youn;Han, Ki-Soon;Park, In-Ho
    • Journal of Gifted/Talented Education
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    • v.21 no.4
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    • pp.927-943
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    • 2011
  • What are the critical factors in deciding future career to the gifted and talented students? The present study started with this question, and was to develop a career decision-making scale for scientifically gifted undergraduates. For this, literatures related to the scientifically gifted/talent and scientists' career decision-making were reviewed and examined in depth. Based on the review of the related literature, the developed scale of career decision-making was comprised of 26 items in 6 factors, such as individual aptitude & self-realization, economic aspect, work & leisure, familial influence, parents/teachers' recommendation, and experience of science activity during the school days. For the preliminary exploratory factor analysis, 153 undergraduate students who were majoring in natural sciences and engineer participated in the study. For the confirmatory factor analysis, 264 undergraduates who were awarded the presidential scholarships and 93 undergraduates who completed a university-affiliated gifted education center participated. The results of the study are as follows. The fit of measurement model was found to be $x^{2}$=645.157 (df=279, p=.00), TLI=.924, CFI= .935, RMSEA=.061, indicating most of fit indexes were acceptable. Cronbach's ${\alpha}$ in each sub-factor was quite high, .82 for individual aptitude & self-realization, .94 for economic aspect, .84 for work and leisure, .88 for familial influence, .79 for patents/ teachers' recommendation, and .79 for experience of science activity during the school days. The results of the study were discussed whether the developed scale could be used as a valid and reliable tool for measuring career decision-making factors of the scientifically gifted undergraduates in our country.

A Study on The Effects of Business Plan upon Firm Performance (사업계획이 경영성과에 미치는 영향에 관한 연구: 구성요소 및 기업가유형, 발전단계 측면에서)

  • Koh, In-Kon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.6 no.4
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    • pp.111-135
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    • 2011
  • While previous studies and publications all assert a strong correlation between company's business plan and performance, very few have actually conducted practical analyses to support that. This study takes a practical approach in its analysis of Korean small and mid-sized enterprises(SME) with the view to finding an answer to the question. In addition, with the considerations of entrepreneur type and company's development stage, I analyzed the differences of business plan components' effects on performances. I selected business plan's components, which have been suggested only in theory and in concept, through the literature review and preliminary examination. Corporate performances were the recent improvements of ROS, ROA, market share and the number of employees to measure how greatly each is impacted by the components of a business plan. Results show that business plan components have influenced upon the number of employees. The business plan components discriminated superior company group and inferior company group properly. Especially, finance & related system and advertising & distribution factors showed statistically significant classification forecasting power. Technical/Craftsman evaluated the effects of producing & sales and profit & quality factors high and General/Opportunistic evaluated the effects of finance & related system, advertising & distribution, corporate mission factors high. The effect of corporate mission was highest among company development stages. Finance & related system and advertising & distribution factors showed the statistically significant difference in entrepreneur type and company development stages.

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A Study on the How the Handicapped Use Orthosis and Their Satisfaction (장애인의 보조기 사용에 대한 현황과 만족도에 관한 연구)

  • Kim, Dong-Gil
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.129-140
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    • 2002
  • This study intended to find out how the handicapped use medical aid, their satisfaction at using it and so on. First a preliminary survey(Apr. 20$\sim$24, 2002) was made for the handicapped who had been cured for rehabilitation by wearing medical aid at hospitals and welfare center in Jeonbuk region. Then total 120 subjects were asked to fill out a standardized questionnaire from May 15$\sim$22, 2002. Out of total 95 questionnaires collected, 84 questionnaires were analyzed except for 11 cases unsuitable for the intention of this study. The results can be outlined as follows: 1. In general characteristic, it was found that the causes of disability included disease(35 respondents; 41.7%), traffic accident(23 respondents, 27.4%) and so on. In addition, 1st handicap comprised the majority(32 respondents; 58.2%) in handicap grade and ankle foot orthosis(or b-k orthosis) was most often used as medical aid(28 respondents: 33.3%) 2. In particular, it was also shown that the 1st handicap mainly resulted from traffic accident(15 respondents, 27.3%) and post-disease disability (11 respondents, 20.0%). They wore medical aid for 1 year or less on the average, because they were hospitalized for cure, which showed statistically significant level(P<0.05). 3. It was found that total 69 respondents(82.1%) were more or less satisfied with their medical aids depending on the causes of disability, and total 46 respondents(83.6%) were satisfied with their aids according to their handicap grade, but there were no statistical significance. 4. Total 56(66.7%) respondents answered that they would purchase medical aid on their own expenses, when they became handicapped. And the price of medical aid ranged from $\300,000{\sim}400,000$(25 respondents: 29.8%) to \ 500,000 or more(24 respondents: 28.6%). It means that they purchased more or less expensive medical aid on their own expenses, which showed statistical significance(P<0.05). 5. If there was any failure of medical aid, 9 respondents(37.5%) answered that they would be serviced from medical companies, and 7 respondents(29.2%) would be serviced from medical aid manufacturers. Most respondents were serviced for their medical aids from related companies. For the question about the causes of dissatisfaction upon repair service, 11 respondents(45.8%) answered that existing service company provided unskilled repair services and other respondents answered that there was no spare part or higher service expenses than they thought. These answers had the statistical significance(P<0.05). However, 20 respondents(79.2%) answered that they were satisfied with the repair service, which means that most respondents are satisfied with the service. In view of the results as described above, it can be concluded that their handicap or disability results from disease or sequelae after traffic accident and most of the affected wear their own medical aid. In the future, it is required that the medical insurance should cover those medical aids, and the service for failed medical aids should be commissioned by technical serviceman to realize customized manufacture and repair service according to different causes so that the handicapped can enjoy more or less comfort and convenience in their daily lives without any extreme difficulty.

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A Study on the Implied Terms of Safe Berth under Voyage Charterparty (항해용선계약상 안전선석의 묵시조건에 관한 연구)

  • Han, Nak-Hyun;Kim, Eun-Joo
    • Journal of Korea Port Economic Association
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    • v.26 no.3
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    • pp.92-113
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    • 2010
  • The purpose of this study aims to analyse the implied terms of safe berth under Voyage charterparty with the Rebon case. Where the safety of the berth is warranted, but not the safety of the port, then the charterer's obligation is to nominate a berth which can be approached safely from within the port and which was itself, save insofar as affected by hazards or risks which affect the port as a whole or all of the berths within it. This case is an appeal from an order made by the judge dismissing an appeal from a final declaratory award on preliminary issues made by arbitrators. The judge expressed the question for decision somewhat differently as follows: if a specific load port is named in a voyage charterparty and there are several possible berths within that port to which a vessel could be directed to load by the charterers and there is no express warranty in the charterparty of the safety of either the port or the berth to which the vessel is to be directed by the charterers, is the charterparty subject to an implied term that the charterers must nominate a safe berth at that load port?