• Title/Summary/Keyword: Cost Score

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Development and Evaluation of a Nutritional Risk Screening Tool (NRST) for Hospitalized Patients (입원환자의 영양불량위험 검색도구의 개발 및 평가)

  • Han, Jin-Soon;Lee, Song-Mi;Chung, Hye-Kyung;Ahn, Hong-Seok;Lee, Seung-Min
    • Journal of Nutrition and Health
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    • v.42 no.2
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    • pp.119-127
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    • 2009
  • Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

A study on Hospital based Home Health Care Service and the Level of Client Satisfaction (일 대학 병원의 가정간호시범사업 서비스 내용 및 만족도에 대한 조사연구)

  • Kim Chung Nam;Kwan Young Sook;Koh Hyo Jung;Kim Myung Ae;Park Chung Ja;Shin Yeong Hee;Lee Byung Sook;Lee Kyung Hee;Seo Hanng Suk
    • Journal of Korean Public Health Nursing
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    • v.14 no.2
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    • pp.246-259
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    • 2000
  • The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebral­cardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.

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Development of a Home-based Nursing Intervention, Mothering Program for Low-Birth-Weight Infants (저체중출생아를 위한 가정간호형 모성역할중재 프로그램 개발과 그 효과에 대한 연구)

  • Han, Kyung-Ja
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.8 no.1
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    • pp.5-24
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    • 2001
  • The purpose of this study was to develop a parenting intervention program and determine the efficacy of the program with low-birth weight infants and their mothers. Nine dyads for the experimental group and twelve dyads for the control group discharged from the Neonatal Intensive Care Unit of a University Hospital in Seoul were recruited for the study. For the intervention group, programmed education and support which focused on the maternal sensitivity of the infant's behavior. rearing environment. motherinfant interaction and infant care were given to each subject. Individual counseling and home visits were provided at discharge, one week after discharge. and one and three months of corrected age in every infant. Structured questionaires were administered and feeding interactions were videotaped and coded by a blinded certified observer. A Quasi-experimental design was conducted for this study. Postpartum depression, maternal self esteem. infant care burden, HOME. mother-infant interaction, and infant development were measured. Results were in favor of the intervention versus the control group. On the Beck depression inventory, intervention mothers showed decreasing trends in depressive symptom vs control mothers although, there were statistically no significant differences between the two groups at each time. The mean score of experimental group was 11.55(mild depression state) at discharge and became 8,6(normal state) at 1 month of corrected age. On the other hand, the mean score of the control group was 13.92(mild depression state) at discharge and became 14.0. Maternal self esteem in both groups improved over time. Infant care burden in both groups was also shown to increase over time. There was a significant difference between the two groups in HOME(p=.0340) at 3 months of corrected age. HOME scores of the experimental group and the control's were 31.10 and 25.58, respectively. Mothers' emotional and language responses were significantly high in the intervention group compared with the control group(p=.0155). Intervention group (53.33) showed a significantly high quality of motherinfant interaction compared with the in control group (42.80)(p =.0340). Intervention group mothers appeared have a better quality of mother-infant interaction behaviors. On the other hand, there was no statistical difference in the infant part between groups. Intervention group infants had higher trends in a general developmental quotient: although, there was no statistical difference between groups. The general developmental quotient of intervention infants was 102.56 and control's was 91.28. However, the developmental quotient of the domain of 'individuality-sociality' was higher in the intervention group infants compared with the control's(p=.0155). The concerns identified by parents revealed two domains of an infants' health management -knowledge and skills in caregiving of lowbirthweight-infants, characteristics of lowbirthweight infants, identifying a developmental milestone, coping with emergency situations and relaxation strategies of mothers from the infant care burden. Interview data with the mothers of low-birth weight infants can be used to develop intervention program contents. Limited intervention time and frequency due to time and cost limitations of this study should be modified. The intervention should be continuously implemented when low-birth weight infants become three years old. An NNNS demonstration appeared to be a very effective intervention for the mothers to improve the quality of mother-infant interactions. Therefore intervening in the mothers of low-birth weight infants as early after delivery as possible is desirable. This study has shown that home visit interventions are worthwhile for mothers only beyond the approach as an essential factor in ability of facilitating a growth fostering environment. In conclusion. the intervention program of this study was very effective in enhancing the parenting for the mothers of low-birth weight infants, resulting in health promotion of low-birth weight infants. The home-visit outreach intervention program of this study will contribute to the health delivery system in this country where there is a lack of continuous follow-up programs for low-birth weight infants after discharge from NICU, if it is activated as part of the home visit programs in community health systems.

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Selective Word Embedding for Sentence Classification by Considering Information Gain and Word Similarity (문장 분류를 위한 정보 이득 및 유사도에 따른 단어 제거와 선택적 단어 임베딩 방안)

  • Lee, Min Seok;Yang, Seok Woo;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.25 no.4
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    • pp.105-122
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    • 2019
  • Dimensionality reduction is one of the methods to handle big data in text mining. For dimensionality reduction, we should consider the density of data, which has a significant influence on the performance of sentence classification. It requires lots of computations for data of higher dimensions. Eventually, it can cause lots of computational cost and overfitting in the model. Thus, the dimension reduction process is necessary to improve the performance of the model. Diverse methods have been proposed from only lessening the noise of data like misspelling or informal text to including semantic and syntactic information. On top of it, the expression and selection of the text features have impacts on the performance of the classifier for sentence classification, which is one of the fields of Natural Language Processing. The common goal of dimension reduction is to find latent space that is representative of raw data from observation space. Existing methods utilize various algorithms for dimensionality reduction, such as feature extraction and feature selection. In addition to these algorithms, word embeddings, learning low-dimensional vector space representations of words, that can capture semantic and syntactic information from data are also utilized. For improving performance, recent studies have suggested methods that the word dictionary is modified according to the positive and negative score of pre-defined words. The basic idea of this study is that similar words have similar vector representations. Once the feature selection algorithm selects the words that are not important, we thought the words that are similar to the selected words also have no impacts on sentence classification. This study proposes two ways to achieve more accurate classification that conduct selective word elimination under specific regulations and construct word embedding based on Word2Vec embedding. To select words having low importance from the text, we use information gain algorithm to measure the importance and cosine similarity to search for similar words. First, we eliminate words that have comparatively low information gain values from the raw text and form word embedding. Second, we select words additionally that are similar to the words that have a low level of information gain values and make word embedding. In the end, these filtered text and word embedding apply to the deep learning models; Convolutional Neural Network and Attention-Based Bidirectional LSTM. This study uses customer reviews on Kindle in Amazon.com, IMDB, and Yelp as datasets, and classify each data using the deep learning models. The reviews got more than five helpful votes, and the ratio of helpful votes was over 70% classified as helpful reviews. Also, Yelp only shows the number of helpful votes. We extracted 100,000 reviews which got more than five helpful votes using a random sampling method among 750,000 reviews. The minimal preprocessing was executed to each dataset, such as removing numbers and special characters from text data. To evaluate the proposed methods, we compared the performances of Word2Vec and GloVe word embeddings, which used all the words. We showed that one of the proposed methods is better than the embeddings with all the words. By removing unimportant words, we can get better performance. However, if we removed too many words, it showed that the performance was lowered. For future research, it is required to consider diverse ways of preprocessing and the in-depth analysis for the co-occurrence of words to measure similarity values among words. Also, we only applied the proposed method with Word2Vec. Other embedding methods such as GloVe, fastText, ELMo can be applied with the proposed methods, and it is possible to identify the possible combinations between word embedding methods and elimination methods.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

A Study on Enhancing Personalization Recommendation Service Performance with CNN-based Review Helpfulness Score Prediction (CNN 기반 리뷰 유용성 점수 예측을 통한 개인화 추천 서비스 성능 향상에 관한 연구)

  • Li, Qinglong;Lee, Byunghyun;Li, Xinzhe;Kim, Jae Kyeong
    • Journal of Intelligence and Information Systems
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    • v.27 no.3
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    • pp.29-56
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    • 2021
  • Recently, various types of products have been launched with the rapid growth of the e-commerce market. As a result, many users face information overload problems, which is time-consuming in the purchasing decision-making process. Therefore, the importance of a personalized recommendation service that can provide customized products and services to users is emerging. For example, global companies such as Netflix, Amazon, and Google have introduced personalized recommendation services to support users' purchasing decisions. Accordingly, the user's information search cost can reduce which can positively affect the company's sales increase. The existing personalized recommendation service research applied Collaborative Filtering (CF) technique predicts user preference mainly use quantified information. However, the recommendation performance may have decreased if only use quantitative information. To improve the problems of such existing studies, many studies using reviews to enhance recommendation performance. However, reviews contain factors that hinder purchasing decisions, such as advertising content, false comments, meaningless or irrelevant content. When providing recommendation service uses a review that includes these factors can lead to decrease recommendation performance. Therefore, we proposed a novel recommendation methodology through CNN-based review usefulness score prediction to improve these problems. The results show that the proposed methodology has better prediction performance than the recommendation method considering all existing preference ratings. In addition, the results suggest that can enhance the performance of traditional CF when the information on review usefulness reflects in the personalized recommendation service.

Evaluation of Dental Hygienist Job Validity according to Judgment Standard of Medical Practice in Medical Law (의료행위 기준에 따른 치과위생사 직무 타당도 평가)

  • Bae, Soo-Myoung;Shin, Sun-Jung;Lee, Hyo-Jin;Shin, Bo-Mi
    • Journal of dental hygiene science
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    • v.18 no.6
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    • pp.357-366
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    • 2018
  • The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.

Preliminary Inspection Prediction Model to select the on-Site Inspected Foreign Food Facility using Multiple Correspondence Analysis (차원축소를 활용한 해외제조업체 대상 사전점검 예측 모형에 관한 연구)

  • Hae Jin Park;Jae Suk Choi;Sang Goo Cho
    • Journal of Intelligence and Information Systems
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    • v.29 no.1
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    • pp.121-142
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    • 2023
  • As the number and weight of imported food are steadily increasing, safety management of imported food to prevent food safety accidents is becoming more important. The Ministry of Food and Drug Safety conducts on-site inspections of foreign food facilities before customs clearance as well as import inspection at the customs clearance stage. However, a data-based safety management plan for imported food is needed due to time, cost, and limited resources. In this study, we tried to increase the efficiency of the on-site inspection by preparing a machine learning prediction model that pre-selects the companies that are expected to fail before the on-site inspection. Basic information of 303,272 foreign food facilities and processing businesses collected in the Integrated Food Safety Information Network and 1,689 cases of on-site inspection information data collected from 2019 to April 2022 were collected. After preprocessing the data of foreign food facilities, only the data subject to on-site inspection were extracted using the foreign food facility_code. As a result, it consisted of a total of 1,689 data and 103 variables. For 103 variables, variables that were '0' were removed based on the Theil-U index, and after reducing by applying Multiple Correspondence Analysis, 49 characteristic variables were finally derived. We build eight different models and perform hyperparameter tuning through 5-fold cross validation. Then, the performance of the generated models are evaluated. The research purpose of selecting companies subject to on-site inspection is to maximize the recall, which is the probability of judging nonconforming companies as nonconforming. As a result of applying various algorithms of machine learning, the Random Forest model with the highest Recall_macro, AUROC, Average PR, F1-score, and Balanced Accuracy was evaluated as the best model. Finally, we apply Kernal SHAP (SHapley Additive exPlanations) to present the selection reason for nonconforming facilities of individual instances, and discuss applicability to the on-site inspection facility selection system. Based on the results of this study, it is expected that it will contribute to the efficient operation of limited resources such as manpower and budget by establishing an imported food management system through a data-based scientific risk management model.

Research on ITB Contract Terms Classification Model for Risk Management in EPC Projects: Deep Learning-Based PLM Ensemble Techniques (EPC 프로젝트의 위험 관리를 위한 ITB 문서 조항 분류 모델 연구: 딥러닝 기반 PLM 앙상블 기법 활용)

  • Hyunsang Lee;Wonseok Lee;Bogeun Jo;Heejun Lee;Sangjin Oh;Sangwoo You;Maru Nam;Hyunsik Lee
    • KIPS Transactions on Software and Data Engineering
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    • v.12 no.11
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    • pp.471-480
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    • 2023
  • The Korean construction order volume in South Korea grew significantly from 91.3 trillion won in public orders in 2013 to a total of 212 trillion won in 2021, particularly in the private sector. As the size of the domestic and overseas markets grew, the scale and complexity of EPC (Engineering, Procurement, Construction) projects increased, and risk management of project management and ITB (Invitation to Bid) documents became a critical issue. The time granted to actual construction companies in the bidding process following the EPC project award is not only limited, but also extremely challenging to review all the risk terms in the ITB document due to manpower and cost issues. Previous research attempted to categorize the risk terms in EPC contract documents and detect them based on AI, but there were limitations to practical use due to problems related to data, such as the limit of labeled data utilization and class imbalance. Therefore, this study aims to develop an AI model that can categorize the contract terms based on the FIDIC Yellow 2017(Federation Internationale Des Ingenieurs-Conseils Contract terms) standard in detail, rather than defining and classifying risk terms like previous research. A multi-text classification function is necessary because the contract terms that need to be reviewed in detail may vary depending on the scale and type of the project. To enhance the performance of the multi-text classification model, we developed the ELECTRA PLM (Pre-trained Language Model) capable of efficiently learning the context of text data from the pre-training stage, and conducted a four-step experiment to validate the performance of the model. As a result, the ensemble version of the self-developed ITB-ELECTRA model and Legal-BERT achieved the best performance with a weighted average F1-Score of 76% in the classification of 57 contract terms.

Menu Development and Application for Rural Elderly of Gangwon and Chungnam Areas at Agricultural Off-season (강원, 충남지역의 농한기 농촌 노인의 급식식단 개발과 적용)

  • Kim, Hae-Young;Kim, Gil-Hoon;Kim, Haeng-Ran;Kim, Yang-Sook
    • The Korean Journal of Community Living Science
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    • v.20 no.3
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    • pp.423-435
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    • 2009
  • Meal menus were developed and applied for rural elderly of Gangwon and Chungnam areas at agricultural off-season. Amounts of the major nutrients of carbohydrate, protein, lipid, and calorie considered in the menu based on the dietary reference intakes(DRI) of the elderly aged over 65 years were 97.5g, 22.5g, 13.3g, and 600kcal, respectively. In Chungnam, softness and overall acceptance of rice in menu 4, consisted of cereals and rice, kimchi stew with tuna, pan-fried bulgogi mushroom, seasoned dropwort carrot, kimchi, and banana, scored the highest values of 8.5 out of 9.0point hedonic scale (p<0.05). In Gangwon, soup and side dish of menu 3 (rice, frozen pollack pot stew, meatball fried in egg, seasoned sea lettuce, and banana) scored significantly the highest of all (p<0.05). Overall acceptance of all the menus were high over 7.8 without significance in Chungnam. Overall acceptance of the menu 3 scored significantly the highest with value of 8.5 and menu 4 (rice, spicy chicken soup, seasoned bean sprouts, broiled brown seaweed trunk, kimchi, tomato) had significantly the lowest value with value of 7.8 in Gangwon(p<0.05). The total leftover volume of menu 4 was significantly the highest with score of 56g and the menu 4 showed the highest unit cost of 2,900won in Chungnam. However, the total leftover volume of all menus did not show significance ranging from 9g to 19g in Gangwon.

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