• Journal of Korean Society for Quality Management
• /
• v.51 no.4
• /
• pp.531-550
• /
• 2023

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

• Korean Journal of Remote Sensing
• /
• v.40 no.4
• /
• pp.397-418
• /
• 2024

The Land Surface Temperature (LST) is a crucial parameter in identifying drought. It is essential to identify how LST can increase its accuracy, particularly in mountainous and hill areas. Increasing the LST accuracy can be achieved by applying early data processing in the correction phase, specifically in the context of topographic correction on the Lambertian model. Empirical evidence has demonstrated that this particular stage effectively enhances the process of identifying objects, especially within areas that lack direct illumination. Therefore, this research aims to examine the application of the Lambertian model in estimating LST using the Multi-Channel Method (MCM) across various physiographic regions. Lambertian model is a method that utilizes Lambertian reflectance and specifically addresses the radiance value obtained from Sun-Canopy-Sensor(SCS) and Cosine Correction measurements. Applying topographical adjustment to the LST outcome results in a notable augmentation in the dispersion of LST values. Nevertheless, the area physiography is also significant as the plains terrain tends to have an extreme LST value of ≥ 350 K. In mountainous and hilly terrains, the LST value often falls within the range of 310-325 K. The absence of topographic correction in LST results in varying values: 22 K for the plains area, 12-21 K for hilly and mountainous terrain, and 7-9 K for both plains and mountainous terrains. Furthermore, validation results indicate that employing the Lambertian model with SCS and Cosine Correction methods yields superior outcomes compared to processing without the Lambertian model, particularly in hilly and mountainous terrain. Conversely, in plain areas, the Lambertian model's application proves suboptimal. Additionally, the relationship between physiography and LST derived using the Lambertian model shows a high average R² value of 0.99. The lowest errors(K) and root mean square error values, approximately ±2 K and 0.54, respectively, were achieved using the Lambertian model with the SCS method. Based on the findings, this research concluded that the Lambertian model could increase LST values. These corrected values are often higher than the LST values obtained without the Lambertian model.

• Annals of Occupational and Environmental Medicine
• /
• v.34
• /
• pp.40.1-40.9
• /
• 2022

Background: According to the occupational accident status analysis in 2020, of 1,180 occupational deaths, 463 were caused by cardiovascular disease (CVD). Workers should be assessed for CVD risk at regular intervals to prevent work-related CVD in accordance with the rules on occupational safety and health standards. However, no previous study has addressed risk and mortality. Therefore, this longitudinal study was conducted to evaluate the relationship between 10-year cardiovascular risk of the general health checkup and mortality. Methods: The study included 545,859 participants who visited Kangbuk Samsung Total Healthcare Centers from January 1, 2002, to December 31, 2017. We performed 10-year cardiovascular risk assessment for the participants and the risk was divided into 4 groups (low, moderate, high, and very high). The study used death data from the Korea National Statistical Office for survival status as an outcome variable by December 31, 2019, and the cause of death based on the International Classification of Diseases, 10^th Revision (ICD-10) was identified. Statistical analysis was performed using Cox proportional hazards regression analysis, and the sum of the periods from the first visit to the date of death or December 31, 2019, was used as a time scale. We also performed a stratified analysis for age at baseline and sex. Results: During 5,253,627.9 person-years, 4,738 overall deaths and 654 cardiovascular deaths occurred. When the low-risk group was set as a reference, in the multivariable-adjusted model, the hazard ratios (HRs) (95% confidence interval [CI]) for overall mortality were 3.36 (2.87-3.95) in the moderate-risk group, 11.08 (9.27-13.25) in the high-risk group, and 21.20 (17.42-25.79) in the very-high-risk group, all of which were statistically significant. In cardiovascular deaths, the difference according to the risk classification was more pronounced. The HRs (95% CI) were 8.57 (4.95-14.83), 38.95 (21.77-69.69), and 78.81 (42.62-145.71) in each group. As a result of a subgroup analysis by age and sex, the HRs of all-cause mortality and cardiovascular mortality tended to be higher in the high-risk group. Conclusions: This large-scale longitudinal study confirmed that the risk of death increases with the 10-year cardiovascular risk of general health checkup.

• Asia pacific journal of information systems
• /
• v.18 no.3
• /
• pp.21-43
• /
• 2008

The task network which is formed of different individuals can be recognized as a social network. Therefore, the way to communicate with people inside or outside the network has considerable influence on their outcome. Moreover, the position on which a member stands in a network shows the different effects of the information systems supporting communication with others. In this paper, it is to be studied how personal CMC (computer-mediated communication) tools affect the mission that those who work for a network perform through diverse task networks. Especially, we focused on synchronicity of CMC. On this score, the perspective of Media Synchronicity Theory was taken that had been suggested by criticizing Media Richness Theory. It is the objective, from this perspective, to find which characteristics of networks make the value of IT supporting synchronicity high. In the research trends of social networks, there have been two traditional perspectives to explain the effect of network: embeddedness and diversity ones. These differ from the aspect which type of social network can provide much more economic benefits. As similar studies have been reported by various researchers, these are also divided into the bonding and bridging views which are based on internal and external tie, respectively, Size, density, and centrality were measured as the characteristics of personal task networks. Size means the level of relationship between members. It is the total number of other colleagues who work with a specific member for a certain project. It means, the larger the size of task network, the more the number of coworkers who interact each other through the job. Density is the ratio of the number of relationships arranged actually to the total number of available ones. In an ego-centered network, it is defined as the ratio of the number of relationship made really to the total number of possible ones between members who are actually involved each other. The higher the level of density, the larger the number of projects on which the members collaborate. Centrality means that his/her position is on the exact center of whole network. There are several methods to measure it. In this research, betweenness centrality was adopted among them. It is measured by the position on which one member stands between others in a network. The determinant to raise its level is the shortest geodesic that represents the shortest distance between members. Centrality also indicates the level of role as a broker among others. To verify the hypotheses, we interviewed and surveyed a group of employees of a nationwide financial organization in which a groupware system is used. They were questioned about two CMC applications: MSN with a higher level of synchronicity and email with a lower one. As a result, the larger the size of his/her own task network, the smaller its density and the higher the level of his/her centrality, the higher the level of the effect using the task network with CMC tools. Above all, this positive effect is verified to be much more produced while using CMC applications with higher-level synchronicity. Among the a variety of situations under which the use of CMC gives more benefits, this research is considered as one of rare cases regarding the characteristics of task network as moderators by focusing ITs for the operation of his/her own task network. It is another contribution of this research to prove empirically that the values of information system depend on the social, or comparative, characteristic of time. Though the same amount of time is shared, the social characteristics of users change its value. In addition, it is significant to examine empirically that the ITs with higher-level synchronicity have the positive effect on productivity. Many businesses are worried about the negative effect of synchronous ITs, for their employees are likely to use them for personal social activities. However. this research can help to dismiss the concern against CMC tools.

• Journal of Intelligence and Information Systems
• /
• v.22 no.1
• /
• pp.43-61
• /
• 2016

Customer reviews help potential customers make purchasing decisions. However, the prevalence of reviews on websites push the customer to sift through them and change the focus from a mere search to identifying which of the available reviews are valuable and useful for the purchasing decision at hand. To identify useful reviews, websites have developed different mechanisms to give customers options when evaluating existing reviews. Websites allow users to rate the usefulness of a customer review as helpful or not. Amazon.com uses a ratio-type helpfulness, while Yelp.com uses a count-type usefulness index. This usefulness index provides helpful reviews to future potential purchasers. This study investigated the effects of sentiment and readability on useful votes for customer reviews. Similar studies on the relationship between sentiment and readability have focused on the ratio-type usefulness index utilized by websites such as Amazon.com. In this study, Yelp.com's count-type usefulness index for restaurant reviews was used to investigate the relationship between sentiment/readability and usefulness votes. Yelp.com's online customer reviews for stores in the beverage and food categories were used for the analysis. In total, 170,294 reviews containing information on a store's reputation and popularity were used. The control variables were the review length, store reputation, and popularity; the independent variables were the sentiment and readability, while the dependent variable was the number of helpful votes. The review rating is the moderating variable for the review sentiment and readability. The length is the number of characters in a review. The popularity is the number of reviews for a store, and the reputation is the general average rating of all reviews for a store. The readability of a review was calculated with the Coleman-Liau index. The sentiment is a positivity score for the review as calculated by SentiWordNet. The review rating is a preference score selected from 1 to 5 (stars) by the review author. The dependent variable (i.e., usefulness votes) used in this study is a count variable. Therefore, the Poisson regression model, which is commonly used to account for the discrete and nonnegative nature of count data, was applied in the analyses. The increase in helpful votes was assumed to follow a Poisson distribution. Because the Poisson model assumes an equal mean and variance and the data were over-dispersed, a negative binomial distribution model that allows for over-dispersion of the count variable was used for the estimation. Zero-inflated negative binomial regression was used to model count variables with excessive zeros and over-dispersed count outcome variables. With this model, the excess zeros were assumed to be generated through a separate process from the count values and therefore should be modeled as independently as possible. The results showed that positive sentiment had a negative effect on gaining useful votes for positive reviews but no significant effect on negative reviews. Poor readability had a negative effect on gaining useful votes and was not moderated by the review star ratings. These findings yield considerable managerial implications. The results are helpful for online websites when analyzing their review guidelines and identifying useful reviews for their business. Based on this study, positive reviews are not necessarily helpful; therefore, restaurants should consider which type of positive review is helpful for their business. Second, this study is beneficial for businesses and website designers in creating review mechanisms to know which type of reviews to highlight on their websites and which type of reviews can be beneficial to the business. Moreover, this study highlights the review systems employed by websites to allow their customers to post rating reviews.

• The korean journal of orthodontics
• /
• v.34 no.1 s.102
• /
• pp.1-11
• /
• 2004

Predicting the arch length discrepancy by simply comparing the available arch perimeter with tooth materials is merely a 2-dimensional analysis of the teeth movement. However, the real teeth movement takes place 3-dimensionally and is affected by various factors such as, the arch fen the curve of Spee and the axis of the incisors. The purpose of this study is to clarify the relationship between the decrease in the arch perimeter and the horizontal positional change of the incisors after extraction of the 1st bicuspids, for more analytic evaluation of the arch length discrepancy at pre-treatment model analysis stage. In addition to that to evaluate the effect of the curve of Spee, teeth axis to the basal plane, and the incisional crowding to the treatment outcome. All patients were treated at the department of orthodontics, dental hospital, Yonsei university. Inclusion criteria for patients selection were as follows. $\cdot$ Angle classification I malocclusion with bialveolar protrusion $\cdot$ Extraction of 4 1st bicuspids $\cdot$ No tooth anomaly or prosthesis $\cdot$ No abnormal attrition $\cdot$ No ectopically erupted teeth $\cdot$ Angle classification I canine and molar relationship $\cdot$ Less than 3mm of crowding Model analysis of the above patients was performed and the following conclusions were obtained. 1. When the intercanine distance was maintained, the available space for the distal movement of the mandibular incisors after the extraction of the 4 1st bicuspids was larger than the space provided by the extraction of the 4 1st bicuspids. However the difference was less than 1mm. The more tapered the anterior arch form, the larger the difference. 2. Compared to the situation in which the intercanine distance was maintained, when the intercanine distance was expanded to meet the width of the Posterior teeth, the incisors could move about 3mm more distally. 3. The positional difference of the incisal tip was insignificant whether the central incisors were moved by tipping or bodily movement. 4. When the anterior crowding was solved without changing the intercanine distance, the larger the anterior arch length was, the more the anterior movement of the incisors. 5. When the curve of Spee was levelled, the increase in the arch perimeter was less than half of the deepest curve of Spee.

• Journal of Chest Surgery
• /
• v.38 no.1 s.246
• /
• pp.56-62
• /
• 2005

Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

• Clinics in Shoulder and Elbow
• /
• v.14 no.1
• /
• pp.59-66
• /
• 2011

Purpose: We wanted to evaluate the clinical and radiological outcomes and the prognosis of various surgical treatments for the distal clavicle fracture with an acromioclavicular joint injury. Materials and Methods: A retrospective study of 21 patients with a minimum of 12 months follow up was done. We classified acromioclavicular (AC) injury into type I (only intra-articular fracture (IAF), 5 cases), type II (IAF with widening of the AC joint > 7 mm, 9 cases) and type III (IAF with AC joint superior subluxation > 50%, 7 cases). The distal clavicle fractures were fixed using plate (9 cases), mini screws (1 case), K wire and tension band wiring (10 cases) and transarticular pinning (1 case). Acromioclavicular or coracoacromial ligament reconstruction was not done in all the cases. Results: In 20 of 21 cases, bone union was achieved at an average of 8.4 weeks. Traumatic arthritis (5 cases), AC joint widening (4 cases) and AC joint subluxation (2 cases) were noted at the last follow up. The average UCLA score was 32.6 in the type I AC joint injuries, 34 in type II and 34.1 in type III. There was no relationship between the clinical outcomes and the preoperative AC joint injury pattern, postoperative traumatic arthritis, AC joint widening or AC joint subluxation (p>0.05). Conclusion: Satisfactory results were achieved by acute reduction and firm fixation of the distal clavicle fracture with AC joint injury. There was no relationship between the pattern of AC joint injury, the residual radiologic findings and the functional outcome.

• Journal of Chest Surgery
• /
• v.30 no.8
• /
• pp.760-769
• /
• 1997

This study aimed to determine factors that influence blood flow through coronary bypass grafts and to analyze relationship between the graft flow and postoperative outcome. Blood flow through 146 bypass grafts(GBF) was measured with transit-time ultrasound flowmeter during coronary artery bypass grafting operations in 50 patients. Single and multiple regression analyses were done for relationships between the GBF and four variables: internal diameter of recipient coronary artery, myocardial value of bypassed branch(es), type of graft, and finding of preoperative myocardial perfusion scan. The relationship between GBF and postoperative scan finding was also analyzed. 1. The mean GBF was significantly higher in sequential grafts than in single vein grafts or in internal thoracic artery grafts(61.5 vs. 46.9 and 42.5 ml/min). 2. Myocardial value and recipient artery diameter were found to be the factors determining GBF. There was no correlation between GHF and presence of perfusion defect in the preoperative scan. 3. Myocardial value was found to be more important than recipient artery diameter in determinintg GBF. 4. Reversible perfusion defects were more frequently found in the areas upplied by grafts with low GBP. But this fact had only mild statistical significance. These results suggest that blood flow through a bypass graft is more determined by the size of its supplyinf: myocardium than by the size of recipient artery. So, we can expect effective improvement in myocardial flow reserve after grafting of small(1~1.5mm) coronary arteries, if they supply substantial area of myocardium.

• Tuberculosis and Respiratory Diseases
• /
• v.45 no.1
• /
• pp.116-127
• /
• 1998

Background: The natural course of sarcoidosis is variable from spontaneous remission to significant morbidity or death. So the assessment of disease activity is important but no single parameter was generally accepted as a good marker. Recently several studies suggested that adhesion molecules, especially ICAM-1 can be a marker, but there are some controversies. And only few data are available about the relationship of ICAM-1 with clinical follow-up course. Methods: We measured the expression of adhesion molecules on BAL cells by flow cytometry and the level of soluble ICAM-1(sICAM-1) in serum and BALF at the time of diagnosis in 12 patients with active disease and 7 inactive sarcoidosis(5 male, 14 female, mean age: $39.4{\pm}10.7$ years, mean follow-up : $20{\pm}15$ months). Follow-up clinical course were compared with the changes in serum sICAMA-1 level and the adhesion molecule on BAL cells. Results: In the patients with active disease, the ICAM-1 on AM(RMFI: $3.68{\pm}1.71$) and sICAM-1 level in serum($582{\pm}193$ng/ml) and BAL fluid($47.8{\pm}16.5$ng/ml) were all higher than those of 7 inactive disease(RMFI: $1.89{\pm}0.75$, p=0.0298, serum: $294{\pm}117$ ng/ml, p=0.0049, BALF: $20.9{\pm}8.3$ ng/ml). In the active sarcoidosis, ICAM-1 on AM(RMFI : $1.51{\pm}0.84$) and serum sICAM-1 were decreased after the therapy($250{\pm}147$ ng/ml) but no significant change was noted in inactive disease. Also we found the initial ICAM-1 on AM and serum sICAM-1 had a significant correlation with the degree of improvement in PFT after the therapy. During the follow-up, the disease relapsed in 4 patients after the discontinuation of steroid and the serum sICAM-1 level went-up again at the time of relapse. Conclusion: Our data suggest that the serum sICAM-1 level and the ICAM-1 expression on AM can be a good marker of disease activity and also a predictor of outcome in sarcoidosis.