Journal of the Korean Data and Information Science Society
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제8권1호
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pp.1-7
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1997
전문가 시스템에서의 추론은 주로 IF-THEN 형태의 규칙을 기반으로 하는 지식베이스에 기초한다. 그러나, 한의 전문가 시스템의 지식은 불확실한 지식 특히 애매한 개념의 지식을 많이 포함하고 있으므로 이에 대한 처리가 요구된다. 본 논문에서는 한의 진단 과정을 추론에 기준하여 분석하고 한의 진단 과정에서 발생하는 불확실한 진단 지식을 제약 조건 논리 프로그래밍언어의 일종인 CLP( R ) 언어를 이용하여 표현하고 처리하는 방법을 제안하였다.
Over the last century, medical education in North America has evolved by identifying educational challenges within its own socio-cultural context and by appropriately responding to these challenges. A discipline-based curriculum, organ-system or integrated curriculum, problem-based curriculum, and competency-based curriculum are historical examples of the educational solutions that have been developed and refined to address specific educational challenges, such as students' lack of basic scientific knowledge, lack of integration between scientific knowledge and clinical practice, and lack of clinical practice. In contrast, Korean medical education has evolved with the influence of two forces: (1) the adoption of educational solutions developed in North America by pioneers who have identified urgent needs for medical education reform in Korea over the last three decades, and (2) the revitalization of Korean medical schools' curricula through medical education accreditation and national medical licensing examination. Despite this progressive evolution in Korean medical education, we contend that it faces two major challenges in order to advance to the next level. First, Korean medical education should identify its own problems in medical education and iteratively develop educational solutions within its own socio-cultural context. Secondly, to raise reflective doctors who have scientific knowledge and professional commitment to deal with different types of medical problems within a continuum from well-defined to ill-defined, medical education should develop innovative ways to provide students with a balanced spectrum of clinical problems, including uncertain, ill-defined problems.
This study analysed what effects conscious role conflict and conscious self-efficacy have on job satisfaction for hospital coordinators working in medical institutions. In order to study this issue, questionnaires were distributed to 154 hospital coordinators. The results from analysing the effects of role conflict and self-efficacy on job satisfaction are as follows: 1) Role conflict and job satisfaction are negatively correlated. The mean score for hospital coordinators' role conflict was 2.82, which was lower than average. Among subfactors for role conflict, personal role conflict had a significant effect on job satisfaction, while role ambiguity had no effect on job satisfaction. 2) The mean score for hospital coordinators' self-efficacy was 3.42, which was slightly higher than average. Other mean scores were as follows: job attitude 3.83, interpersonal skills 3.54, administrative knowledge 3.30, and medical treatment knowledge 3.02. Among subfactors for self-efficacy, job attitude and adminstrative knowledge had significant effects on job satisfaction, while interpersonal skills and medical treatment knowledge had no effect on job satisfaction (p < 0.01). In conclusion various hospital administration techniques, related job training and education needs to be given when introducing a hospital coordinator in order to strengthen the competitiveness of medical institutions. The hospital coordinators need to clearly understand their role so that they can settle into the system at the hospital and develop their job environment.
Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.
This study aims to examine the relative importance of various tasks of EMT and to examine knowledge level and problems associated with AED. It is based on the survey of paramedics and 119 rescures. The results for this study were as follows ; Among the tasks of EMT, 'foreignbody removal from mouth' were rated as the most important, followed by '$O_2$ supply', 'CPR', 'Intubation for CPR', '$O_2$ supply' were rates as the most necessary, followed by 'foreignbody removal from mouth', 'external bleeding control'. In terms of the knowledge level about AED, survey respondents are most knowledgeable about 'role of other rescures during the preparation for AED' and 'treatment after 3 AEDS. The most important reason that the uses of AED is delayed is 'unclear boundary of treatment directed by medical control'. The results of the study suggest that we need guideline for EMT's tasks, efficient communication system between 119 and emergency health are center for prompt AED, and training and education program for AED.
Objectives: "Exploring the origin of acupuncture medicine (針灸逢源)", a classical title of acupuncture medicine in the 19th century, has been reviewed with focus on its impact on the standardization of acupoint in the history of acupuncture medicine as an approach of yin-yang balancing medicine like the Temporomandibular joint Balancing Medicine. Methods: A narrative review of literature was performed with a focus on continuous development and revision of the knowledge system of acupuncture medicine in medical education and clinical application. Results: This title has provided a systematized knowledge on acupoint-acupuncutre including 361 acupoints, acupoint location, and acupoint-meridian association, which was adopted as a frame of core knowledge in modern acupuncture medicine. Critical review and rational reasoning on previously accepted but apparently incongruous strips of knowledge led to the accomplishment of this title. Conclusions: This title provided a revised and standard knowledge system in the field of medical education and clinical practice of acupuncture medicine, and also provided an exemplary model of unrelenting change and development of an approach based on the concept of yin-yang balance such as acupuncture medicine and the Temporomandibular joint Balancing Medicine.
Purpose: This study aimed at developing the problem-based learning packages on the respiratory and cardiac system of an adult-health nursing course, and to examine the effect of PBL on the knowledge, learning attitude and motivation in nursing students. Method: A total of 7 PBL packages were developed through the analysis of learning contents and integration of concepts. Clinical scenarios used in 7 PBL packages were selected and composed at a respiratory and a cardiovascular unit, a medical ICU and a chest-surgery unit of C university hospital in G-city. The PBL method was implemented 3 hours a week for 12 weeks to 35 students of an experimental group, and the conventional lecture was implemented to 38 students at C college of C province from Sept. to Dec. 2002. A pretest-posttest experimental design was used. Result: The PBL students (n=35) scored significantly higher knowledge than conventional students (n=38) in the area of problem solving (t=3.418, p=. 001). But, there is no significant difference in the memory-dependent knowledge. Also, The level of learning attitude (t=3.570, p=. 001) and learning motivation (t=3.446. p=. 001) was significantly higher in PBL students. Conclusion: PBL method appears to be effective in improving nursing students' problem-solving knowledge and positive learning attitude and motivation.
Knowledge which is represented by formal logic are widely used in many domains such like artificial intelligence, information retrieval, e-commerce and so on. And for medical field, medical documentary records retrieval, information systems in hospitals, medical data sharing, remote treatment and expert systems need knowledge representation technology. To retrieve information intellectually and provide advanced information services, systematically controlled mechanism is needed to represent and share knowledge. Importantly, medical expert's knowledge should be represented in a form that is understandable to computers and also to humans to be applied to the medical information system supporting decision making. And it should have a suitable and efficient structure for its own purposes including reasoning, extendability of knowledge, management of data, accuracy of expressions, diversity, and so on. we call it ontology which can be processed with machines. We can use the ontology to represent traditional medicine knowledge in structured and systematic way with visualization, then also it can also be used education materials. Hence, the authors developed an Shanghanlun ontology by way of showing an example, so that we suggested a methodology for ontology development and also a model to structure the traditional medical knowledge. And this result can be used for student to learn Shanghanlun by graphical representation of it's knowledge. We analyzed the text of Shanghanlun to construct relational database including it's original text, symptoms and herb formulars. And then we classified the terms following some criterion, confirmed the structure of the ontology to describe semantic relations between the terms, especially we developed the ontology considering visual representation. The ontology developed in this study provides database showing fomulas, herbs, symptoms, the name of diseases and the text written in Shanghanlun. It's easy to retrieve contents by their semantic relations so that it is convenient to search knowledge of Shanghanlun and to learn it. It can display the related concepts by searching terms and provides expanded information with a simple click. It has some limitations such as standardization problems, short coverage of pattern(證), and error in chinese characters input. But we believe this research can be used for basic foundation to make traditional medicine more structural and systematic, to develop application softwares, and also to applied it in Shanghanlun educations.
To prevent food-borne diseases and ensure food safety, foodservice operators have been implementing the HACCP system in their facilities. Employees' knowledge of food safety can be improved through training and, as a result, their food safety behavior can be positively changed. A nonequivalent pretest and posttest control group model was designed to investigate the effectiveness of HACCP-based training on hospital foodservice employees' food safety knowledge and behavior, and to determine relationships between food safety knowledge and food safety behavior. The subjects used in this study were 84 hospital foodservice employees, assigned either to the intervention group (n=44) or the control group (n=40). Data were analyzed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were computed, while the Student's t-test and ANCOVA (Analysis of Covariance) were used to investigate significant differences between groups, and the Pearson correlation was used to determine significant correlations. There were significant gains in both food safety knowledge and behavior, after the HACCP-based training. However, no significant correlation was found between food safety knowledge and food safety behavior. Based on this study we conclude that HACCP-based training is effective in improving both the food safety knowledge and food safety behavior of hospital foodservice employees.
Currently, we have seen sudden increase of demand for emergency medical services by reason for high-speed economic development increase of traffics, etc. in this society. Consequently the government enforced & operated emergency medical system in 1991 as a link of more positive countermeasure against it, but many problem; still remain in reality. In particular, the regional emergency medical center designated by the Ministry of Health and Welfare falls short of our expectations for its essential role by the reason of such as insufficiency in professional manpower and institutions concerned in small-scale hospital, matters with transportation system, preference of large hospital, etc. Therefore, this study was conducted grasp for the actual conditions of emergency medical system based upon literature research & the preceding studies and interview research the motive of coming hospital, satisfaction & understand to the subject of 150 persons of patients and their guardians who used regional emergency center of Pusan National University Hospital, thereby examining & analysing the cause of emergency room overcrowding by non-emergency cases, one of the problem; enumerated from preceding studies. The main result of this study is as follows. First the actual condition of non-emergency patients coming hospital for examining overcrowding of emergency medical center showed that, of the patients who used the emergency medical center, non-emergency patients accounted for 49.3%, which acted as the main cause of delaying medical care for emergency cases, cases of which medical person or first-aid man decided to come hospital accounted for 36.1 %, thereby suggesting essential need for re-education & wide public information to even the professional manpower besides patients & guardians for their using emergency medical system. Second, as the result of researching patient acknowledgement with reference to their using emergency medical center, the rate of their giving right answer is no more than 60%, which means that non-emergency cases' using as such is due to the shortage of their knowledge of the said emergency medical center, which suggests us that wider P.R for emergency medical system to common people who may be one of the patients of it at any time is still in need. Third, the result of researching for finding out a future remedy of emergency medical system showed that the users who know well of the way of using emergency medical center had relatively high satisfaction of it, ones who have lesser knowledge of it lower satisfaction and users who feel in need of emergency specialized manpower feel the necessity of public information of emergency medical information center(1339) at the same time. The finding of examining the subject of study, in conclusion, showed that the degree of the patients & their guardians' understanding of emergency medical system is lower and the medical persons concerned also had no distinct difference in their understanding of it from the common people's, which suggests us for extensive enforcement of systematic education and public information in aspect of the government via various media for the purpose of effective operation of emergency medical center.
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