Cafeteria Users' Preference of Indoor green-wall in a University \dining Hall

학위논문 (석사)-- 서울대학교 대학원 : 생태조경·지역시스템공학부, 2014. 8. 안동만.벽면녹화는 도시 내 수직공간을 활용하여 부족한 녹지공간을 확보하기 위해 점차 많은 곳에 설치되고 있다. 수직 녹색공간이 주는 경관은 쾌적하고 건강한 생활환경을 제공하고 도시민에게 심리적 안정감을 주기 때문에, 실내외 벽면녹화가 이용행태에 미 치는 영향에 대해 아는 것은 더욱 중요하다. 본 연구의 목적은 실내벽면녹화가 이용자에게 어떠한 측면에서 긍정적으로 인식될 수 있는지 이용행태에 어떠한 영향을 미치는가에 대해 알아보는 것이다. 공용공간 이용객이 벽면녹화 조성 공간을 선호한다는 실 험 가설 하에 벽면녹화가 이용객의 행태에 어떠한 영향을 미치는 지에 대한 관찰실험을 진행하였다. 실내벽면녹화를 설치한 후 행 태관찰과 설문조사를 토대로 실내벽면녹화 선호도를 분석하였다. 관찰실험은 실내벽면녹화 선호가 이용행태에 어떠한 영향을 미 치는가에 관해 2014년 3월 24일부터 31일까지 총 8일간 진행 하였다. 실험대상지는 서울대학교 학생회관식당으로 선정하였고, 식당 내부의 배식구와 퇴식구 위치 등을 고려하여 가장 유사한 환경조건을 갖춘 두 영역을 관찰범위로 설정하였다. 한 영역은 기존칸막이를 그대로 두고, 바로 옆 영역은 기존칸막이(높이 1.2m)에 높이 0.7m~1.2m 범위로 벽면녹화를 조성하여 비교 관 찰을 진행하였다. 벽면녹화방법은 식재판에 화분을 끼워 고정하 는 방식으로 격자형 모듈 디자인이 가능하고 교체관리가 간편한 분리형 탈부착식 벽면녹화 방식으로 하였다. 일반칸막이 공간과 벽면녹화 칸막이 공간 이용행태를 관찰카메라로 녹화하여 영상을 보면서 분석하였으며, 좌석 선택의 여지가 없이 붐비는 시간대는 관찰시간에서 제외하였다. 동영상 분석을 통해 얻어진 이용시간 을 엑셀 프로그램으로 데이터화 하였으며, SPSS 통계프로그램을 사용하여 좌석별 평균이용시간을 독립표본 T-검정을 실행하였 다. 유의확률 0.05를 기준으로 총 사용시간 평균을 비교하여 실 내벽면녹화 선호를 분석하였다. 좌석별 이용자수 데이터는 4단계 로 나누어 선호좌석 분포를 살펴보았으며, 일반칸막이 공간과 벽 면녹화 칸막이 공간에서 선호좌석 분포가 가장 큰 차이를 보이는 여성이용자를 중심으로 칸막이와 식물이 좌석 선택에 어떠한 영 향을 미쳤는지를 알아보았다. 설문조사는 행태관찰 후 2013년 4월 1일부터 2일까지 총 2일 간 일반칸막이 공간과 벽면녹화 칸막이 이용객 224명에게 설문 조사를 진행하였다. 설문조사로 실내벽면녹화 선호도와 그 이유 에 대해 알아보고 관찰실험, 좌석분석 결과를 종합하여 분석하였 다. 위 과정을 통해 도출한 본 연구 결과는 다음과 같다. 첫째, 벽면녹화 칸막이 공간과 일반칸막이 공간의 칸막이 인접 좌석의 총 이용시간 비교결과, 실내벽면녹화 선호도가 없는 것으 로 나타났다. 3월 25일부터 31일까지 총 7일간 총 45시간 11분 중 좌석 당 평균이용시간은 벽면녹화 칸막이 공간은 7시간 17분 41초, 일반칸막이 공간은 7시간 39분 37초로 일반칸막이 공간 이 21분 57초 더 많게 나타났으나, 유의수준 5%에서 통계적으 로 의미 있는 차이가 나지 않아 일반칸막이 공간과 벽면녹화 칸 막이 공간 선호도에 차이가 없었다. 둘째, 벽면녹화 칸막이 공간의 여성이용자 비율이 일반칸막이 공간에 비해 더 높은 것으로 나타났다. 총 이용자 2,074명 중 여 성의 비율은 29.3%(607명)이다. 일반칸막이 공간을 이용한 1,034명 중 여성이용자의 비율은 26.5%(274명), 벽면녹화 칸막 이 공간을 이용한 1,040명 중 여성이용자의 비율이 32.0%(333 명)로 여성이용자 비율이 벽면녹화 칸막이 공간에서 5.5% 더 높 은 것으로 나타났다. 일반칸막이 공간보다 벽면녹화 칸막이 공간 평균이용시간 차이가 가장 큰 3월 30일 오후 4시 50분부터 오 후 5시 10분까지 20분 동안 이용자수 26명 중 38.5%(10명)이 여성이용자였으며, 일반칸막이 공간 이용자 14명 중 21.4%(3 명), 벽면녹화 칸막이 공간 이용자 12명 중 58.3%(7명)로 여성 이용자 비율이 36.9% 더 높은 것으로 나타났다. 벽면녹화가 여 성이용자들에게 더 큰 선호도가 있는 것으로 생각된다. 셋째, 칸막이와 식물은 좌석선택에 영향을 주지 않는 것으로 나타났다. 여성이용자를 중심으로 일반칸막이 공간의 칸막이 인 접좌석과 벽면녹화 칸막이의 칸막이 인접좌석의 평균이용시간을 비교한 결과 통계적으로 유의한 차이가 나지 않았다. 칸막이 인 접좌석과 통로인접좌석의 여성이용자수는 통계적으로 유의한 차 이가 있었는데, 빨리 먹고 가야 하는 구내식당의 장소적 특성상 이용객은 배식구와 퇴식구에 가까운 통로 인접좌석을 선호한 것 으로 보인다. 넷째, 설문조사에서는 실내벽면녹화에 대한 선호도가 있는 것 으로 나타났다. 행태관찰에서 나타나지 않는 이용자의 심리적 측 면을 파악하기 위해 설문조사를 진행하였다. 일반칸막이 공간 이 용객 94명 중 11.7%(11명)가 벽면녹화 칸막이 공간에 앉기를 원하였으나벽면녹화 칸막이 공간에 자리가 없어서일반칸막이 공간에 앉았다고 응답하였다. 또한 벽면녹화 칸막이 공간 이용객 130명 중 24.6%(33명)가실내벽면녹화를 선호해서라고 응답하였다. 일반칸막이 공간과 벽면녹화 칸막이 이용객의 64.3%(144명)가 동일조건이라면 벽면녹화 칸막이 공간을 선택 하겠다고 응답하여 선호의사가 있는 것으로 나타났으나, 행태관 찰에서 선호에 차이가 없는 것으로 보아 이용행태는 선호의사 외 에 다른 요인에 따라 더 큰 영향을 받았을 것으로 생각된다. 본 연구의 한계점은 실험대상지에 대한 장소적 특성에 그 원인 이 있다. 대학 구내식당의 경우 주 이용객이 20대 대학생으로 빠 른 시간 안에 배식과 퇴식이 이루어져 실내 경관을 시각적으로 즐기며 이용행태에 영향을 받기에 한계가 있을 것으로 생각된다. 실내벽면녹화 공간에 대한 선호가 있다 하더라도 이러한 상황에 서는 벽면녹화 선호가 이용행태에 반영되지 않았을 것이다. 또한 본 연구 결과에서 여성이 벽면녹화 설치 여부에 따라 이용에 가 장 큰 영향을 받은 것으로 나타났으나, 행태관찰 대상지 이용자 의 70.7%가 남성이었다는 점을 감안한다면 실험가설을 증명하기 에 적합한 장소가 아니었다고 생각된다. 향후 여성을 대상으로 하는 공간에서 벽면녹화가 어떠한 행태 변화를 주는가에 대한 연구, 주변 경관을 즐기며 여유있게 식음 행위가 가능한 카페, 휴게 공간 등 벽면녹화 설치에 적합한 장소 를 찾는 연구를 할 필요가 있다I. 서론 ···········································································1 1. 연구배경 및 목적 ···························································1 2. 연구목적 ···········································································2 3. 연구흐름 ···········································································3 Ⅱ. 이론적 고찰 ··························································4 1. 벽면녹화 ···········································································4 1.1. 벽면녹화의 개념 ·······································································4 1.2. 벽면녹화의 유형 ·······································································4 1.3. 벽면녹화 선행연구 ···································································5 2. 실내벽면녹화 ···································································7 2.1. 실내벽면녹화의 개념 ·······························································7 2.2. 실내벽면녹화 선행연구 ···························································7 3. 환경심리행태 ···································································8 3.1. 행태 ····························································································8 3.2. 환경심리학의 개념 ···································································9 3.3. 이용행태 선행연구 ···································································9 4. 공간 ·················································································11 4.1. 공용공간 ··················································································12 4.2. 식음공간 ··················································································12 Ⅲ. 연구범위 및 방법 ··············································13 1. 연구범위 ·········································································13 1.1. 공간적 범위 ············································································13 1.2. 내용적 범위 ············································································14 2. 연구방법 ·········································································15 2.1. 연구 진행 과정 ······································································15 2.2. 행태관찰 ··················································································17 2.2.1. 관찰방법 ············································································17 2.2.2. 분석방법 ············································································18 2.2.3. 실험설치방법 ····································································19 2.3. 설문조사 ··················································································30 Ⅳ. 결과 ······································································32 1. 행태관찰 ·········································································32 1.1. 총 이용자수 ············································································36 1.2. 총 이용시간 ············································································37 2. 선호도 분석 ··································································39 2.1. 공간선호 분석 ········································································39 2.2. 선호좌석 분석 ········································································43 2.3. 칸막이와 식물이 미치는 영향 분석 ··································47 2.4. 소결 ··························································································50 3. 설문조사 분석 ······························································51 3.1. 공간선택 이유 ········································································52 3.2. 동일조건 선호 공간 선택 ····················································54 3.3. 소결 ··························································································55 V. 결론 ·······································································56 Ⅵ. 인용문헌 ······························································60 ❚ 부록 1 ··································································65 ❚ 부록 2 ··································································67 ❚ 부록 3 ··································································77 ❚ Abstract ······························································83Maste

Impact of a Wearable Device-Based Walking Programs in Rural Older Adults on Physical Activity and Health Outcomes: Cohort Study

BACKGROUND: Community-dwelling older adults living in rural areas are in a less favorable environment for health care compared with urban older adults. We believe that intermittent coaching through wearable devices can help optimize health care for older adults in medically limited environments. OBJECTIVE: We aimed to evaluate whether a wearable device and mobile-based intermittent coaching or self-management could increase physical activity and health outcomes of small groups of older adults in rural areas. METHODS: To address the above evaluation goal, we carried out the "Smart Walk" program, a health care model wherein a wearable device is used to promote self-exercise particularly among community-dwelling older adults managed by a community health center. We randomly selected older adults who had enrolled in a population-based, prospective cohort study of aging, the Aging Study of Pyeongchang Rural Area. The "Smart Walk" program was a 13-month program conducted from March 2017 to March 2018 and included 6 months of coaching, 1 month of rest, and 6 months of self-management. We evaluated differences in physical activity and health outcomes according to frailty status and conducted pre- and postanalyses of the Smart Walk program. We also performed intergroup analysis according to adherence of wearable devices. RESULTS: We recruited 22 participants (11 robust and 11 prefrail older adults). The two groups were similar in most of the variables, except for age, frailty index, and Short Physical Performance Battery score associated with frailty criteria. After a 6-month coaching program, the prefrail group showed significant improvement in usual gait speed (mean 0.73 [SD 0.11] vs mean 0.96 [SD 0.27], P=.02), International Physical Activity Questionnaire scores in kcal (mean 2790.36 [SD 2224.62] vs mean 7589.72 [SD 4452.52], P=.01), and European Quality of Life-5 Dimensions score (mean 0.84 [SD 0.07] vs mean 0.90 [SD 0.07], P=.02), although no significant improvement was found in the robust group. The average total step count was significantly different and was approximately four times higher in the coaching period than in the self-management period (5,584,295.83 vs 1,289,084.66, P<.001). We found that participants in the "long-self" group who used the wearable device for the longest time showed increased body weight and body mass index by mean 0.65 (SD 1.317) and mean 0.097 (SD 0.513), respectively, compared with the other groups. CONCLUSIONS: Our "Smart Walk" program improved physical fitness, anthropometric measurements, and geriatric assessment categories in a small group of older adults in rural areas with limited resources for monitoring. Further validation through various rural public health centers and in a large number of rural older adults is required.ope

Expedited Safety Reporting Through an Alert System for Clinical Trial Management at an Academic Medical Center: Retrospective Design Study

Background: Early detection or notification of adverse event (AE) occurrences during clinical trials is essential to ensure patient safety. Clinical trials take advantage of innovative strategies, clinical designs, and state-of-the-art technologies to evaluate efficacy and safety, however, early awareness of AE occurrences by investigators still needs to be systematically improved. Objective: This study aimed to build a system to promptly inform investigators when clinical trial participants make unscheduled visits to the emergency room or other departments within the hospital. Methods: We developed the Adverse Event Awareness System (AEAS), which promptly informs investigators and study coordinators of AE occurrences by automatically sending text messages when study participants make unscheduled visits to the emergency department or other clinics at our center. We established the AEAS in July 2015 in the clinical trial management system. We compared the AE reporting timeline data of 305 AE occurrences from 74 clinical trials between the preinitiative period (December 2014-June 2015) and the postinitiative period (July 2015-June 2016) in terms of three AE awareness performance indicators: onset to awareness, awareness to reporting, and onset to reporting. Results: A total of 305 initial AE reports from 74 clinical trials were included. All three AE awareness performance indicators were significantly lower in the postinitiative period. Specifically, the onset-to-reporting times were significantly shorter in the postinitiative period (median 1 day [IQR 0-1], mean rank 140.04 [SD 75.35]) than in the preinitiative period (median 1 day [IQR 0-4], mean rank 173.82 [SD 91.07], P≤.001). In the phase subgroup analysis, the awareness-to-reporting and onset-to-reporting indicators of phase 1 studies were significantly lower in the postinitiative than in the preinitiative period (preinitiative: median 1 day, mean rank of awareness to reporting 47.94, vs postinitiative: median 0 days, mean rank of awareness to reporting 35.75, P=.01; and preinitiative: median 1 day, mean rank of onset to reporting 47.4, vs postinitiative: median 1 day, mean rank of onset to reporting 35.99, P=.03). The risk-level subgroup analysis found that the onset-to-reporting time for low- and high-risk studies significantly decreased postinitiative (preinitiative: median 4 days, mean rank of low-risk studies 18.73, vs postinitiative: median 1 day, mean rank of low-risk studies 11.76, P=.02; and preinitiative: median 1 day, mean rank of high-risk studies 117.36, vs postinitiative: median 1 day, mean rank of high-risk studies 97.27, P=.01). In particular, onset to reporting was reduced more in the low-risk trial than in the high-risk trial (low-risk: median 4-0 days, vs high-risk: median 1-1 day). Conclusions: We demonstrated that a real-time automatic alert system can effectively improve safety reporting timelines. The improvements were prominent in phase 1 and in low- and high-risk clinical trials. These findings suggest that an information technology-driven automatic alert system effectively improves safety reporting timelines, which may enhance patient safety.ope

Discrepancies in Demand of Internet of Things Services Among Older People and People With Disabilities, Their Caregivers, and Health Care Providers: Face-to-Face Survey Study

Background: Home Internet of Things (IoT) services and devices have the potential to aid older adults and people with disabilities in their living environments. IoT services and devices can also aid caregivers and health care providers in conveniently providing care to those in need. However, real-world data on the IoT needs of vulnerable people are lacking. Objective: The objective of this study is to conduct a face-to-face survey on the demand for IoT services among older people and people with disabilities, their caregivers, and health care providers in a real-world setting and to see if there are any differences in the aspects of need. Methods: We conducted a face-to-face survey with 500 participants between January 2019 and March 2019. A total of 300 vulnerable people (200 older adults aged ≥65 years and 100 physically disabled people aged 30-64 years) were randomly sampled from either a population-based, prospective cohort study of aging-the Aging Study of Pyeongchang Rural Area (ASPRA)-or from the outpatient clinics at the Asan Medical Center, Seoul, South Korea. Simultaneously, their caregivers (n=150) and health care providers (n=50) participated in the survey. Detailed socioeconomic status, digital literacy, health and physical function, and home IoT service needs were determined. Among all commercially available IoT services, 27 services were classified into five categories: emergency and security, safety, health care, convenience (information), and convenience (operation). The weighted-ranking method was used to rank the IoT needs in different groups. Results: There were discrepancies in the demand of IoT services among the vulnerable groups, their caregivers, and health care providers. The home IoT service category that was required the most by the vulnerable groups and their caregivers was emergency and security. However, health care providers indicated that the safety category was most needed by the older adults and disabled people. Home IoT service requirements differed according to the different types of disabilities among the vulnerable groups. Participants with fewer disabilities were more willing to use IoT services than those with more disabilities. Conclusions: Our survey study shows that there were discrepancies in the demand of IoT services among the vulnerable groups, their caregivers, and health care providers. IoT service requirements differed according to the various types of disabilities. Home IoT technology should be established by combining patients' priorities and individualized functional assessments among vulnerable people. Trial registration: Clinical Research Information Service (CRIS; KCT0004157);ope

Event-free survival following early endometrial events in breast cancer patients treated with anti-hormonal therapy: A nationwide claims data study

Tamoxifen, an anti-estrogen agent that can suppress breast cancer, has been reported to increase endometrium-related adverse events. There are no guidelines for screening tamoxifen-treated patients for endometrial disease. We analyzed nationwide claims data related to endometrial diseases to investigate patterns of endometrial disease in breast cancer patients who underwent hormonal treatment.We sourced claims data from the Health Insurance Review and Assessment Service in South Korea. Patients who made their first claim for an anti-hormonal agent between January 1, 2010 and December 31, 2012 were enrolled retrospectively. We analyzed patient characteristics and all claims related to endometrial disease, stratified by prescribed hormonal agents.Among a total of 32,496 enrolled patients, 19,603 used tamoxifen only and 10,101 were treated with an aromatase inhibitor (AI) alone. Endometrial events occurred in 15.4% (3028/19603) of the tamoxifen-only patients and 2.0% (201/10101) of the AI-only group. In patients diagnosed with breast cancer at the age of 50 or older, the hazard ratio (HR) of endometrial malignancy in the tamoxifen-only group compared to the AI-only group was 4.13 (95% CI 1.404-12.159, P = .010). The HR of curettage in the tamoxifen-only group was 31.0 (95% CI 19.668-48.831, P <.001).The occurrence of endometrial events among tamoxifen-treated breast cancer patients was higher than in patients treated with only AI, similar to previous studies. However, the HR of curettage was uniquely high, despite its invasiveness. Guidelines for screening endometrial disease and improvements of healthcare policy are required to appropriately manage high-risk patients.ope

Apical Lung Cancer Associated with Neurofibromatosis Type 1

ope

Designing Electronic Medical Record using Health Level 7 Development Framework

Objective: This is designing the part of Electronic Medical Record using HL7 Development Framework and Reference Information Model to realize the building medical standard data model for sharing medical record between heterogeneous hospital systems. Methods: The process used development of HL7 specifications consists of the following seven activities: 1.Project initiation. 2.Requirements Documentation. 3.Specification Modeling. 4.Specification Documentation. 5.Specification Approval. 6. Specification Publication. 7.Implementation Profiling. Each activity is briefly described in the subsections that follow and described in detailed in the methodology chapters that follow this introduction.3. Result. The steps, after 4 step, needs to standardized the results. So we didn’t followed that steps1). Results: We got the diagrams at each steps of the HDF methodology: 1.A dynamic description. 2.A static description of the concepts involved in the business process. 3.A Use Case model which identifies the system involved in the actual HL7 data/information exchange1). Conclusion: It was confirmed that HL7 RIM could take in the domestic demands of medical records, and concrete methodology was applied in practice. It can be a good reference for the hospitals constructing new information system and for the enterprises developing medical information systems to apply the HL7 version 3 to their works.ope

A Case of Endoscopic Mucosal Resection for Esophageal Adenocarcinoma Arising from Barrett´s Esophagus

Barrett's esophagus is defined as the replacement of normal squamous epithelium of distal esophagus with metaplastic columnar epithelium. It is a well known risk factor of esophageal adenocarcinoma. If high grade dysplasia or early stage esophageal cancer develops in a patient with Barrett's esophagus, esophagectomy shoud be performed. However, operative procedures have various complications and the patients may suffer resulting in poor quality of life. Therefore, if the cancer is detected at an early stage such as superficial mucosal lesion, it is possible to resect the tumor with the use of endoscopic technique. Furthermore, endoscopic mucosal resection (EMR) also can be performed for the patients with mucosal or submucosal cancer who can not receive esophagectomy due to old age or poor general condition. We experienced a case of esophageal adenocarcinoma from Barrett's esophagus which had been successfully resected endoscopically.ope

A Feasibility Study of Adenosine Triphosphate-based Chemotherapy Response Assay (ATP-CRA) as a Chemosensitivity Test for Lung Cancer

PURPOSE: A chemosensitivity test can reflect the differences in responses of individual cancer patients to chemotherapeutic agents. The adenosine triphosphate-based chemotherapy response assay (ATP-CRA) is an accurate method, which does not require a large amount of tissue specimen. So far, no studies have evaluated the utility of the ATP-CRA in Korea. Therefore, we investigated the clinical usefulness of the ATP-CRA in 53 patients with lung cancer. MATERIALS AND METHODS: Tumor tissues were obtained from bronchoscopic biopsies or surgical resections. The validity of ATP-CRA was assessed focusing on the success rate, experimental error level (intraassay mean coefficient of variation [CV]) and reproducibility. RESULTS: The overall success rate of ATP-CRA was 90.6% (48/53). Normal cells were effectively eliminated from the tumor tissues with the use of ficoll gradient centrifugation and immunomagnetic separation, which was confirmed using loss of heterozygosity analysis of the 3p deletion. The mean CV of ATP assays was 10.5+/-4.6%. The reproducibility of ATP assays was 94+/-3.8%. The results of the ATP assays were reported to physicians within 7 days of specimen collection. More than 6 anticancer drugs were tested on the tumor specimens obtained from bronchoscopic biopsies. CONCLUSION: The ATP-CRA is a stable, accurate and potentially practical chemosensitivity test in patients with lung cancer.ope

A Case of Budd-Chiari Syndrome and Superior Mesenteric Vein Thrombosis in Ulcerative Colitis

Patients with inflammatory bowel disease are at increased risk for thromboembolic complications. Its prevalenceVrate ranges from 1% to 7% in clinical studies and reaches 39% in autopsy series. The cause of thrombotic complications in inflammatory bowel disease is generally considered to be associated with hypercoagulability. We experienced a case of ulcerative colitis associated with Budd-Chiari syndrome and superior mesenteric vein thrombosis. This rare complication of ulcerative colitis was successfully managed by conventional treatment for ulcerative colitis and anticoagulation therapy.ope