Journal of the Korea Society of Computer and Information
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v.16
no.12
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pp.71-81
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2011
The EMR management services can monitoring the patients' record with any doctors in any hospital by using the internet and smartphones online. To handle the real time, multidimensional, continuous data, database management systems (DBMS) must cope with high insert rates for updates, however the traditional DBMS suffers from processing these kinds of data due to its serious design bottlenecks. So the researchers put forward to Data Stream Management System (DSMS). In this paper we describe the real-time Data Stream Server for Continuity of Care Record (CCR) that including continuos query processor. This system is compiled with DSMS and DBMS in EMR system for processing and monitoring the coming CCR data stream, and also storing the processed result with high-efficiency. The system enables users not only to query stored CCR information from DBMS, but also to execute continue query on real-time CCR Data Stream, and health information can be transferred between different healthcare providers that would reduce medical error. At last, we develop a IPhone mobile application to test the proposed real-time data stream server.
Journal of the Korea Academia-Industrial cooperation Society
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v.17
no.8
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pp.17-22
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2016
For the self-adaptive equalization of higher-order QAM systems, this paper proposes a new soft decision-directed (SDD) algorithm that opens the eye patterns quickly as well as significantly reducing the error level in the steady-state when it is applied to the initial equalization stage with completely closed eye patterns. The proposed method for M-QAM application minimized the computational complexity of the existing SDD by the symbol estimated based on the two symbols closest to the observation, and greatly simplified the soft decision independently of the QAM order. Furthermore, in the symbol estimating it increased the reliability of the estimates by applying the superior properties of the sigmoid function and avoiding the erroneous estimation of the threshold function. In addition, the initialization performance was improved when an error is generated to update the equalizer, weighting the symbol decision by the threshold function to the error, resulting in an extension of the range of error fluctuations. As a result, the proposed method improves remarkably the computational complexity and the properties of initialization and convergence of the traditional SDD. Through simulations for 64-QAM and 256-QAM under multipath channel conditions with additive noise, the usefulness of the proposed methods was confirmed by comparing the performance of the proposed 2-SDD and two forms of weighted 2-SDD with CMA.
Goetze, Stefan;Schroder, Jens;Gerlach, Stephan;Hollosi, Danilo;Appell, Jens-E.;Wallhoff, Frank
Journal of Computing Science and Engineering
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v.6
no.1
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pp.40-50
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2012
Increase in the number of older people due to demographic changes poses great challenges to the social healthcare systems both in the Western and as well as in the Eastern countries. Support for older people by formal care givers leads to enormous temporal and personal efforts. Therefore, one of the most important goals is to increase the efficiency and effectiveness of today's care. This can be achieved by the use of assistive technologies. These technologies are able to increase the safety of patients or to reduce the time needed for tasks that do not relate to direct interaction between the care giver and the patient. Motivated by this goal, this contribution focuses on applications of acoustic technologies to support users and care givers in ambient assisted living (AAL) scenarios. Acoustic sensors are small, unobtrusive and can be added to already existing care or living environments easily. The information gathered by the acoustic sensors can be analyzed to calculate the position of the user by localization and the context by detection and classification of acoustic events in the captured acoustic signal. By doing this, possibly dangerous situations like falls, screams or an increased amount of coughs can be detected and appropriate actions can be initialized by an intelligent autonomous system for the acoustic monitoring of older persons. The proposed system is able to reduce the false alarm rate compared to other existing and commercially available approaches that basically rely only on the acoustic level. This is due to the fact that it explicitly distinguishes between the various acoustic events and provides information on the type of emergency that has taken place. Furthermore, the position of the acoustic event can be determined as contextual information by the system that uses only the acoustic signal. By this, the position of the user is known even if she or he does not wear a localization device such as a radio-frequency identification (RFID) tag.
Globally, efforts are being made to develop and strengthen a palliative care policy to support a comprehensive healthcare system. Korea has implemented a hospice and palliative care (HPC) policy as part of a cancer policy under the 10 year plan to conquer cancer and a comprehensive measure for national cancer management. A legal ground for the HPC policy was laid by the Cancer Control Act passed in 2003. Currently in the process is legislation of a law on the decision for life-sustaining treatment for HPC and terminally-ill patients. The relevant law has expanded the policy-affected disease group from terminal cancer to cancer, human immunodeficiency virus/acquired immune deficiency syndrome, chronic obstructive pulmonary disease and chronic liver disease/liver cirrhosis. Since 2015, the National Health Insurance (NHI) scheme reimburses for HPC with a combination of the daily fixed sum and the fee for service systems. By the provision type, the HPC is classified into hospitalization, consultation, and home-based treatment. Also in place is the system that designates, evaluates and supports facilities specializing in HPC, and such facilities are funded by the NHI fund and government subsidy. Also needed along with the legal system are consensus reached by people affected by the policy and more realistic fee levels for HPC. The public and private domains should also cooperate to set HPC standards, train professional caregivers, control quality and establish an evaluation system. A stable funding system should be prepared by utilizing the long-term care insurance fund and hospice care fund.
Methicillin-resistant Staphylococcus (MRS) can be colonized in various body sites and is more frequently isolated in healthcare associated persons. This study aimed to evaluate the contamination rate of MRS in a high school environment, those living with closed life style. Staphylococcus aureus was isolated from only the hands of 2 students among a sample of 28 students, and S. aureus were susceptible to methicillin antibiotics. Coagulase negative Staphylococci (CoNS) were isolated from the hands of 26 students (26/28, 92.9%), and among them, 14 (53.8%) isolates were methicillin-resistant CoNS (MRCoNS). Among the 14 MRCoNS, S. warneri was the most common (8/14, 57%) and susceptible to most $non-{\beta}-lactam$ antibiotics, such as clindamycin, erythromycin, ciprofloxacin, tetracycline, gentamicin, and vancomycin. In a culture of 31 desks, S. aureus was not isolated but CoNS were isolated from 26 desks (26/31, 83.6%), which did not harbor the mecA gene. The other bacteria isolated from the hands and desks were Micrococcus and Bacillus spp. In conclusion, methicillin-resistant S. aureus was not isolated from the hands and desks of high school students. However, the frequency of MRCoNS harboring mecA gene were high in the hands of high school students. Therefore, to prevent and to control the transfer of infection, intensifying preventive education, such as hand washing, and active surveillance systems, such as an investigation of contamination or carrier rate of resistant bacteria are necessary.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.24
no.3
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pp.310-320
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2014
Backgrounds: Endotoxin, which found in the outer membrane of the gram-negative bacteria cell wall, makes up almost all of the lipopolysaccharide(LPS). When people are exposed to endotoxin,it can result in diverse health effects such as an airway irritation and inflammation, fever, malaise, bronchitis, allergic asthma, toxic pneumonitis, hypersensitivity lung disease. Cases among the elderly, children or pregnant can occur more frequently than a healthy adult if they are repeatedly exposed to the existing endotoxin. Therefore, we investigated and assessed the environmental characteristics associated with the airborne endotoxin concentration level in six hospital lobbies. Method: Endotoxin from indoor air in six hospital lobbies was measured by an area sampling method and analyzed according to American Society for Testing and Materials International(ASTM international) E2144-01. Total suspended particulate(TSP), carbon dioxide($CO_2$), temperature and humidity were also measured by using direct reading measurements or airborne sampling equipment at the same time. Environmental characteristics were appropriately divided into two or three groups for a statistics analysis. One-way analysis variable(one-way ANOVA) was used to examine a difference of the endotoxin concentration, depending on the environmental characteristics. In addition, only variables with p-value(p<0.25) were eventually designed to the best model by using multiple regression analysis. Results: The correlation analysis result indicated that TSP(p=0.003) and $CO_2$(p<0.0001) levels were significantly associated with endotoxin concentration levels. In contrast, temperature(p<0.068) and humidity(p<0.365) were not associated with endotoxin concentration. Levels of endotoxin concentration were statistically different among the environmental characteristics of Service time(p=0.01), Establishment of hospital(p<0.001), Scale of hospital(p=0.01), Day average people using hospital(p=0.03), Cleaning time of lobby(p=0.05), Season(p<0.001), and Cleaning of ventilation system(p<0.001) according to ANOVA. Finally, the best model(Adjusted R-square=72%) that we designed through a multiple regression test included environmental characteristics related to Service time, Area of lobby, Season, Cleaning of ventilation system, and Temperature. Conclusions: According to this study, our result showed a normal level of endotoxin concentration in the hospital lobbies and found environmental management methods to reduce the level of endotoxin concentration to a minimum. Consequently, this study recognized to be requirement for the management of ventilation systems and an indoor temperature in order to reduce the level of endotoxin concentration in the hospital lobbies.
Parish nursing is a community health nursing role developed in 1983 by Lutheran chaplain Granger Westberg. An increasing emphasis on holistic care, personal reseponsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment and nurturance of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The autors conducted a study on pastor's expectations from parish nurses. Results of this study will be useful to those instrumental in planning, initiating, supporting, and evaluating a parish nurses program The research was done on 130 pastors in Taegue and Kyong Sang Buck Do, of various ages ranging from their 20's to 60's: and pastoring churches of various sizes, ranging from under 100 to over 300 members. 94.6% agreed that they needed a parish nurse on their staff; and 86.2% said they wanted to start a parish nurse program in their churches if certain basic conditions were met. The pastors responded that some would hire the nurses on a full-time basis(22.3%), a part -time basis (37.7%) or use volunteer nurses (40%). The pastors said they would expect the following from a parish nurse: health counselling (80.0%) regular health check-ups (78.5%) health care for the elderly (78.5%) health information and education (72.3%) hospice care (72.3%) visiting sick church members at home (69.2%) arranging and training volunteers to help the seek (59.2%) health care for expectant mothers (50.0%) introducing and taking people to health care facilities (46.2%) The pastors were surveyed about specific areas of health education they would want the parish nurse to teach(for example, high blood pressure and heart disease prevention and management(76.2%) ; stress management(74.6%); and diabetes prevention and management(73.8%). The pastors were surveyed about specific areas of health counselling they would expect the parish nurse to do (for example, drug abuse, (73.1), alcohol abuse(64.6%), marriage conflict(60.0%), recovery after the loss of a loved one(56.9%), and women's conflict with parents-in-law(53.8%). The pastors were surveyed about types of things they would want included in regular health check-ups, what they would want a parish nurse to do on home visits, and what they would want included in home care for the elderly. They were also surveyed on what kind of spiritual care they would like parish nurses to give. Most (90.7%) wanted their parish, parishioners to be involved in the parish nurses program as volunteers, and in a variety of ways(such as visiting sick in their homes(68.5%) and helping with housework(63.1%) and taking sick people to health facilities(60%). Parish nurses role, activities, and boundaries of practice should be continuously monitored and refined and a 'case manager' should be conceptualized as an additional or all-encompassing role. An initial parish / community needs and readiness assessment should be done prior to establishing a program to detemine if the congregation is ready, willing, and able to support such a position for at least a 2 to 3 year period.
Purpose: Gestational weight gain and prepregnancy body weight are important factors of childbirth outcomes, which further cause obesity, metabolic diseases, or psychological problems later in women's lives. Changes in diet, westernized lifestyle, traditional postpartum care, and childbirth at older age are thought to be threats to proper weight management in Korean women of reproductive age. Public health and antenatal care need to focus on the proper body weight management of women by carefully planning pregnancy to postpartum periods. Purpose: This study explored the body weight changes from pregnancy to postpartum and the related characteristics in women within 12 months after childbirth. Methods: A cross-sectional, retrospective study was conducted with 102 Korean women within 12 months after childbirth. Data were collected using an online survey system, and a structured questionnaire available for electronic self-administration was modified to include demographics, obstetrical history, and body weight at 6 time points. The International Physical Activity Questionnaire and Eating Habit Measurement instruments were also used in data collection. A professional survey agency recruited the participants, and data were automatically saved and then analyzed. Results: The average age of the participants was 33.8 years, 48% were housewives and were well-educated. Seventy-two percent of the participants were primiparas and 82% had breastfed their babies. The body mass index (BMI) ranged from 17.3 to 27.8, indicating that 21.5% of the participants were overweight or obese. The mean gestational weight gain was 11.8 kg, and weight loss was apparent during the first 3 months postpartum. The mean decline in weight was 3.4 kg at one year after childbirth. Women wanted to lose 5.6 kg (range: 3~20 kg), however 44% of them reported that they had not engaged in any weight control efforts. Further, 72% of them reported having engaged in a low level of physical activity. Body weight was not associated with women's characteristics, physical activity score, and diet. Conclusion: Women's awareness of gestational weight gain, lifestyle modification, and the risk of prolonged weight retention should be promoted through the antenatal and women's healthcare systems. As pregnancy and childbirth are critical events that affect women's health, integrative education to ensure healthy transition to life after delivery is required.
Interoperability has been deemphasized from the hospital information system in general, because it is operated independently of other hospital information systems. This study proposes a future-oriented hospital information system through the design and actualization of the HL7 clinical document architecture. A clinical document is generated using the hospital information system by analysis and designing the clinical document architecture, after we defined the item regulations and the templates for the release form and radiation interpretation form. The schema is analyzed based on the HL7 reference information model, and HL7 interface engine ver.2.4 was used as the transmission protocol. This study has the following significance. First, an expansion and redefining process conducted, founded on the HL7 clinical document architecture and reference information model, to apply international standards to Korean contexts. Second, we propose a next-generation web based hospital information system that is based on the clinical document architecture. In conclusion, the study of the clinical document architecture will include an electronic health record (EHR) and a clinical data repository (CDR), and also make possible medical information-sharing among various healthcare institutions.
This paper describes a remote system to monitor the circadian behavioral patterns of elders who live alone. The proposed system was designed and implemented to provide more conveniently and reliably the required functionalities of a remote monitoring system for elders based on the development of first phase prototype[2]. The developed system is composed of an in-house sensing system and a server system. The in-house sensing system is a set of wireless sensor nodes which have pyroelectric infrared (PIR) sensor to detect a motion of elder. Each sensing node sends its detection signal to a home gateway via wireless link. The home gateway stores the received signals into a remote database. The server system is composed of a database server and a web server, which provides web-based monitoring system to caregivers (friends, family and social workers) for more cost effective intelligent care service. The improved second phase system can provide 'automatic diagnosis', 'going out detection', and enhanced user interface functionalities. We have evaluated the first and second phase monitoring systems from real field experiments of 3/4 months continuous operation with installation of 9/15 elders' houses, respectively. The experimental results show the promising possibilities to estimate the behavioral patterns and the current status of elder even though the simplicity of sensing capability.
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