• 제목/요약/키워드: Delivery Service

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Using Implementation Science to Advance Cancer Prevention in India

  • Krishnan, Suneeta;Sivaram, Sudha;Anderson, Benjamin O.;Basu, Partha;Belinson, Jerome L;Bhatla, Neerja;D' Cruz, Anil;Dhillon, Preet K.;Gupta, Prakash C.;Joshi, Niranjan;Jhulka, PK;Kailash, Uma;Kapambwe, Sharon;Katoch, Vishwa Mohan;Kaur, Prabhdeep;Kaur, Tanvir;Mathur, Prashant;Prakash, Anshu;Sankaranarayanan, R;Selvam, Jerard M;Seth, Tulika;Shah, Keerti V;Shastri, Surendra;Siddiqi, Maqsood;Srivastava, Anurag;Trimble, Edward;Rajaraman, Preetha;Mehrotra, Ravi
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권9호
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    • pp.3639-3644
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    • 2015
  • Oral, cervical and breast cancers, which are either preventable and/or amenable to early detection and treatment, are the leading causes of cancer-related morbidity and mortality in India. In this paper, we describe implementation science research priorities to catalyze the prevention and control of these cancers in India. Research priorities were organized using a framework based on the implementation science literature and the World Health Organization's definition of health systems. They addressed both community-level as well as health systems-level issues. Community-level or "pull" priorities included the need to identify effective strategies to raise public awareness and understanding of cancer prevention, monitor knowledge levels, and address fear and stigma. Health systems-level or "push" and "infrastructure" priorities included dissemination of evidence-based practices, testing of point-of-care technologies for screening and diagnosis, identification of appropriate service delivery and financing models, and assessment of strategies to enhance the health workforce. Given the extent of available evidence, it is critical that cancer prevention and treatment efforts in India are accelerated. Implementation science research can generate critical insights and evidence to inform this acceleration.

시간활동 접근법에 의한 면 보건요원의 업무량 분석 (Measuring Myun Health Worker's Performance by Time-Activity Approach)

  • 김한중;김문식
    • Journal of Preventive Medicine and Public Health
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    • 제10권1호
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    • pp.34-43
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    • 1977
  • This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.

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청소년 임신과 스트레스 (Adolescents Pregnancy and Stress)

  • 김만지
    • 한국사회복지학회:학술대회논문집
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    • 한국사회복지학회 2000년도 춘계학술대회 자료집
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    • pp.615-628
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    • 2000
  • 스트레스란, 개인과 환경간의 특별한 관계가 개인의 안녕을 위협하고 개인이 가진 자원을 초과하는 것을 말한다. 븐 연구는 청소년 임신과 스트레스에 관한 문헌연구를 통하여 청소년 임신과스트레스와의 관계에 대해서 살펴봄으로써 임신력 있는 청소년들을 위한 스트레스 관련 임상사회 사업 서비스 개입 방안을 제시하고자 하는데 목적이 있다. 임신으로 인한 부모됨의 변화가 청소년기 자체의 인생 주기 상에서의 스트레스와 중복될 때, 누적된 스트레스는 보다 커진다. 변화의 중첩은 개인 역할의 애매함을 초래하여 스트레스를 가중시키고 발달 과업의 우선순위에 혼란을 가져온다. 청소년기의 임신은 성인기로 이동하는 청소년 당사자, 그 자녀, 사회이 부정적인 영향을 미친다. 이러한 부정적인 영향은 단기간에 끝나지 않으므로 임신한 청소년들의 대처 기술과 적응력을 향상시키기 위한 개입의 노력이 필요하다. 임신한 청소년들의 경우에는 개인 상담 접근만으로는 불충분하며 효과적인 예방 프로그램은 보다 나은 대안이자 동시에 목적이 될 수 있다. 이러한 개입은 임신한 청소년들을 출산 이후에 노출되기 쉬운 디스트레스로부터 보호해주고 성인으로 성장하게 될 청소년들의 건강한 정신건강 도모이 기여하는 것으로 나파났다. 이는 결국, 임신한 청소년들을 대상으로 한 스트레스 대처 능력을 향상시키고 긍정적인 인지를 발달시킬 수 있는 스트레스 관리 프로그램의 필요성을 암시하고 있다. 이러한 연구 결과가 갖는 결론과 함께 앞으로 실천적 개입방안에 대한 더욱 정교한 연구가 요구된다.

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지역아동센터 종사자의 아동 대상 실천역량 향상 프로그램 평가 연구 (A Study on the Evaluation of the Enhancement Program of the Social Work Practice Competency for children of Community Child Center Workers)

  • 배은경
    • 한국사회복지학
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    • 제67권4호
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    • pp.127-152
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    • 2015
  • 본 연구의 목적은 지역아동센터 종사자의 아동 대상 실천역량 향상 프로그램을 실행하고 그 영향을 평가하는 것이다. 이를 위하여 프로그램은 지역아동센터 종사자 10명을 대상으로 매 120분간 주1회로 5주간 실행되었다. 양적 평가를 위하여 유사실험설계의 비동일 비교집단 설계가 사용되었으며, 질적 평가를 위하여 프로그램관련 기록물 등을 통해 자료를 수집하고 분석하였다. 그 결과, 양적 평가에서는 본 프로그램에 참여한 지역아동센터 종사자의 사회복지실천기술 숙련도와 클라이언트관계변화 임파워먼트가 유의미하게 향상된 것으로 나타났다. 질적 평가에서는 종사자의 실천역량 향상, 아동의 변화에 대한 인식, 프로그램의 강점 및 보완점 인식이라는 주관적 경험이 나타났다. 본 연구결과는 아동을 대상으로 하는 대표적인 서비스전달체계인 지역아동센터의 종사자 실천역량을 향상시킴으로써, 지역아동센터 종사자의 실천에 있어 전문성과 효과성을 제고하고 궁극적으로 아동의 건강한 발달 및 정신건강 증진에 기여할 수 있을 것으로 기대된다.

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농촌보건의료서비스 향상을 위한 제도 개선방안 (Policy Measures for Improving Health Care Services in Rural Areas)

  • 문옥륜;이규식;박재용;고대하;이기효
    • 농촌의학ㆍ지역보건
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    • 제16권2호
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    • pp.97-119
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    • 1991
  • 본 연구는 농촌지역의 보건의료수준이 의료자원의 양적, 질적 격차와 의료이용과 의료접근도 및 건강수준의 면 등에서 도시지역보다 낙후되어 있다는 사실을 각종 통계지표를 이용하여 논증하였다. 다음으로 이러한 격차를 빚은 농촌보건사업의 문제점을 파악하여 이에 대한 대처방안을 농촌보건사업의 조직, 인력, 시설 및 장비, 재원 및 그리고 관리라는 5가지 부문으로 나누어서 모색해 보았는데 구체적으로는 첫째, 농촌보건 인력의 자질향상과 적정배치방안의 수립, 둘째, 농촌보건인력의 생산성 증대, 셋째, 보건소 및 지소의 운영개선, 넷째, 취약지 민간병원의 운영 개선, 다섯째, 사회, 경제여건의 변화에 따른 새로운 보건사업의 개발, 여섯째, 통합적인 보건의료인력관리 전담기관의 설립 등의 정책대안을 제시하고 있다.

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뇌성마비 취학아동 어머니의 양육체험 (The Lived Experience of Mothers about Rearing of School Children With Cerebral palsy)

  • 백경선
    • Child Health Nursing Research
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    • 제7권4호
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    • pp.434-450
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    • 2001
  • This study is designed to understand the meaning and nature of raising children with cerebral palsy. It researches the experience of mothers of schoolchildren with cerebral palsy by the research method of hermeneutic phenomenology. The study was conducted from November 10, 1999 to December 20, 2000. When children with cerebral palsy usually show symptoms in the early stage of cerebral palsy, mothers do not take children to a doctor for diagnosis. And, most of mothers have a difficult time to accept the reality; they usually respond to the initial diagnosis with shock, reproach, and deny. When mothers start recognizing the reality, they consider that their children have cerebral palsy due to the their mismanagement during pregnancy, delivery, nursing, and initial treatment. They shelter their children from view and feel guilty that they cannot afford to try folk remedies for their children. As time passes, mothers face conflicts between families in diverse ways. Families put the blame on genetic effects. Mothers-in-law give their daughters-in-law a hard time, husbands shift the responsibility of raising children onto their wives, and trouble arises between families-in-law and mothers native families. When children grow up, it is physically difficult for mothers to take care their children. In addition, they suffer from all the troubles in family due to childrens handicap. Mothers try the diverse methods of bringing up children. However, they start getting tired of raising children as they experience failures and financial difficulties. Mothers feel collapsed recalling the ways of raising children. They feel anxiety, miserable, lonely, and worrying when they think how children would attend school, make friends, and live in the future. In this stage, mothers do their best to raise their children with hope. They tend to compare their children with others without handicap and spend money and time in attempting all the treatments. When mothers and children join the society at school, they find that the society does not understand disabled people, teachers show inconsiderate attitude, friends avoid them, and children hardly follow classes. Such experiences make mothers feel angry and frustrated. However, when children adapt to school, mothers see the possibility that children could accomplish schoolwork. They appreciate teachers help and others consideration. Mothers place appropriate expectations on their children and help them to prepare for the future. I would make following suggestions based on the results. 1. As a primary basic course of rehabilitation nursing intervention, solution-centered nursing intervention system should be developed. The intervention needs to be based on the understanding of mothers, who raise children with cerebral palsy, through in-depth interview. 2. Advance researches on the development of individual nursing intervention should be conducted. Individual nursing intervention needs to prevent and release actual pain focusing on mothers raising children with cerebral palsy. 3. Integrated curriculum that help children with cerebral palsy lead a normal school life with ordinary children should be developed. 4. Basic research on using of facilities and effective application of service volunteer to help children with cerebral palsy in school needs to be conducted.

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무인로봇체계에서 QoS 보장을 위한 트래픽 방향 기반 중앙집중식 TDMA 슬롯 할당 기법 (Centralized TDMA Slot Assignment Scheme Based on Traffic Direction for QoS Guarantee in Unmanned Robot Systems)

  • 한지나;김다빈;고영배;권대훈
    • 한국통신학회논문지
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    • 제41권5호
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    • pp.555-564
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    • 2016
  • 본 논문은 무인로봇을 활용하는 군 정찰 환경에서 발생하는 트래픽 속성을 고려한 슬롯 할당 기법을 제안한다. 전장 지역을 탐지하고 적으로부터의 위협을 사전에 확인하기 위해 사람을 투입하는 것 대신 점차 무인로봇이 그 역할을 대신할 것으로 예상된다. 관제센터가 무인로봇을 조종하기 위해 전송하는 제어메시지의 경우, 한 번의 오작동이 큰 비극을 낳을 수 있기 때문에 고 신뢰성이 요구된다. 또한 각 무인로봇들이 감시정찰을 위해 관제센터로 전송하는 정찰용 멀티미디어 데이터의 경우, 실시간으로 끊김없는 영상을 제공하는 것이 중요하다. 본 논문에서는 이러한 무인로봇 환경의 요구사항을 고려하여 효과적인 데이터 전송을 보장하기 위해 per-path 기반의 중앙집중식 TDMA 슬롯 할당 기법을 제안하였다. 관제센터가 트래픽 방향을 기반으로 중앙집중식으로 슬롯을 할당함으로써 무인로봇들 간의 슬롯 할당 충돌을 감소시키고 전송 지연을 감소시킨다. 본 제안 기법은 ns-3 시뮬레이터를 활용하여 성능을 검증하였고 TDMA기반의 비교 알고리즘보다 높은 패킷 전송 성공률을 보였으며 다운링크 트래픽 전송 시나리오에서 비교 알고리즘에 비해 짧은 지연 시간을 보였다.

통신회사의 SI(Store Identity)가 소비자의 브랜드 이미지 정보전달에 관한 연구(한국통신회사 SI와 해외의 유명 통신회사SI 비교를 통하여) (A Study on the delivery of brand image information to consumers by telecom companies' SI(Store Identity) (through comparing SI between Korea telecom companies and foreign famous telecom companies))

  • 김종성
    • 한국산학기술학회논문지
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    • 제14권6호
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    • pp.2639-2644
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    • 2013
  • 휴대폰 사용자의 폭발적인 증가와 제품의 빠른 교체주기로 인하여 이동통신사 간의 마케팅 경쟁이 매장으로 확산되면서 매장을 새롭게 단장하는 리뉴얼 주기가 짧아지고 있다, 주요 이동통신사가 간판을 포함한 매장 리뉴얼은 소비자에게 자사의 브랜드 아이덴티티를 강하게 심기 위한 목적으로 추진되고 있다. 소비자들은 매장이 단순히 값싸고 질 좋은 제품을 판매만 하는 것이 아니라, 매장, 제품, 서비스에 대해 느끼고 수용할 수 있도록 고객 체험을 제공할 것을 바라고 있다. 특히 이동통신사 대리점의 경쟁이 치열해 매장수가 많이 늘어나는 추세를 보이고 최근에는 리뉴얼 시 단순 CI(Corporate Identity) 교체에 의미를 두기보다 매장의 인테리어에서 익스테리어까지 통합된 이미지로 바꾸는 SI(Store Identity) 개념을 적용해 매장들을 바꾸고 있다. 인테리어,Sign 등의 비주얼 요소를 일관성 있게 설계 및 디자인하여 매장 내, 외부에 적용하여 소비자에게 호의적인 매장 이미지를 심어주고 궁극적으로 매출액 증대에 큰 영향을 미치게 하는 요소라 할 수 있다. 이러한 활동은 기업이 Identity관리를 통해 이미지를 컨트롤 할 수 있으며 마케팅 측면에 매우 중요한 요소라 할 수 있다. 본 논문에서는 국내 이동통신사와 해외 이동통신사의 SI를 비교분석하고 효과적인 SI의 방향을 제언하는데 목적을 둔다.

State-Aware Re-configuration Model for Multi-Radio Wireless Mesh Networks

  • Zakaria, Omar M.;Hashim, Aisha-Hassan Abdalla;Hassan, Wan Haslina;Khalifa, Othman Omran;Azram, Mohammad;Goudarzi, Shidrokh;Jivanadham, Lalitha Bhavani;Zareei, Mahdi
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제11권1호
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    • pp.146-170
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    • 2017
  • Joint channel assignment and routing is a well-known problem in multi-radio wireless mesh networks for which optimal configurations is required to optimize the overall throughput and fairness. However, other objectives need to be considered in order to provide a high quality service to network users when it deployed with high traffic dynamic. In this paper, we propose a re-configuration optimization model that optimizes the network throughput in addition to reducing the disruption to the mesh clients' traffic due to the re-configuration process. In this multi-objective optimization model, four objective functions are proposed to be minimized namely maximum link-channel utilization, network average contention, channel re-assignment cost, and re-routing cost. The latter two objectives focus on reducing the re-configuration overhead. This is to reduce the amount of disrupted traffic due to the channel switching and path re-routing resulted from applying the new configuration. In order to adapt to traffic dynamics in the network which might be caused by many factors i.e. users' mobility, a centralized heuristic re-configuration algorithm called State-Aware Joint Routing and Channel Assignment (SA-JRCA) is proposed in this research based on our re-configuration model. The proposed algorithm re-assigns channels to radios and re-configures flows' routes with aim of achieving a tradeoff between maximizing the network throughput and minimizing the re-configuration overhead. The ns-2 simulator is used as simulation tool and various metrics are evaluated. These metrics include channel-link utilization, channel re-assignment cost, re-routing cost, throughput, and delay. Simulation results show the good performance of SA-JRCA in term of packet delivery ratio, aggregated throughput and re-configuration overhead. It also shows higher stability to the traffic variation in comparison with other compared algorithms which suffer from performance degradation when high traffic dynamics is applied.

푸드뱅크 기탁 조리식품의 미생물학적 위해분석(I) (Microbial Risk Analysis of Cooked Foods Donated to Foodbank(I))

  • 박형수;류경
    • 대한지역사회영양학회지
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    • 제12권5호
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    • pp.617-629
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    • 2007
  • To ensure the microbiological safety of food items prepared after cooking process, this study was aimed to identify the hazards related with cooked foods donated to foodbanks through quantitative microbial analysis. Five foodbanks located in Incheon and Gyeonggi area among government-dominant foodbanks were surveyed from February to June, 2007. Manager, recipient, donator, type and quantity of donated foot and facility and equipment were examined for the general characteristics of foodbank. The time and temperature of food md environment were measured at steps from after-production to before-distribution, and the microbial analysis was performed mainly with indicator organism and major pathogens. The amount of cooked foods donated to each foodbank was about 20 to 30 servings and consisted of 80% of total donated foods. Only three foodbanks had separate offices for foodbank operation and four institutions had at least one temperature-controlled vehicle. The flow of donated foods was gone through the steps; production, meal service and holding at donator, collection by foodbank, transport (or holding after transport) and distribution to recipients. It took about 3.8 to 6.5 hours at room temperature from after-production to before-distribution. Only aerobic plate counts (APC) and coliforms were found in microbial analysis. The APC after production were relatively high in $8.2{\times}10^5,\;7.4{\times}10^5,\;6.9{\times}10^5$ and $4.2{\times}10^5 CFU/g$ while $2.8{\times}10^6, \;9.4{\times}10^5,\;1.0{\times}10^6$ and $5.4{\times}10^5CFU/g$ before distribution in mixed Pimpinella brachycarpa, mixed chard mixed amaranth and mixed spinach, respectively. The levels of coliforms in mixed chard and mixed spinach were complied with the standards of the Ministry of Education and Human Resources Management The level of APC in boiled pork was increased from $< 1.0{\times}10 CFU/g$ to $4.0{\times}10^2 CFU/g$. One of delivery vessels was shown $6.2{\times}10^3 CFU/100 cm^2$ in APC, which was over the standards for environment. One of serving tables also showed the high level of $1.2{\times}10^3 CFU/100 cm^2$ in APC and $6.6{\times}10^2 CFU/100 cm^2$ in coliforms. These results suggest the sanitary management of holding at donator and the time-temperature control are key factors to ensure the safety of cooked foods donated to foodbank.