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호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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Analysis of Stromal Cells Developed from Cord Blood CD34+ Cells (제대혈 CD34+ 세포에서 유래된 지지세포의 분석)

  • Ryu, Kyung-Ha;Park, Se-Jin;Kim, Kyung Hyo;Seoh, Ju-Young;Khan, Mohammad;Shin, Hee-Young;Ahn, Hyo-Seop
    • IMMUNE NETWORK
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    • v.1 no.1
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    • pp.87-94
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    • 2001
  • Background: Cytokine-mediated ex vivo expansion has been proposed as a means of increasing the number of cord blood (CB) hematopoietic stem cells for transplantation. As well as stem cell number, stromal cells are necessary for functional maturation of hematopoiesis. The purpose of this study was to analyze the development of stromal cells during ex vivo expansion of CB $CD34^+$ cells. Methods : $CD34^+$ cells were purified from CB by magnetic bead selection. The levels of of interleukin-3, interleukin-$1{\beta}$, interleukin-6, granulocyte macrophagecolony stimulating factor and tumor necrosis factor-${\alpha}$ were measured in culture supernatants on 0, 1, 2, and 3 weeks, using ELISA techniques. CB $CD34^+$ cells were expanded in Iscoves modified Dulbeccos medium in the presence of several cytokines. The expression of E-selectin, vascular cell adhesion molecule-1, intercellular adhesion molecule-1, platelet/endothelial cell adhesion molecule-1, von Willebrand factor, vimentin, and CD14 in newly developed stromal cells was examined by immunocytochemical method. Relevant extracellular matrix (ECM) proteins and proper cytokines were also assayed for the most suitable condition for expansion of stromal cells. Results: Several cytokines were found to have been produced by CB $CD34^+$ cells as well as bone marrow-derived $CD34^+$ cells. During ex vivo expansion of CB $CD34^+$ cells, stromal cells appeared in the culture by day 4 and expanded over the following 7-10 days before being confluent by day 2 1. These cells expressed surface markers characteristic of cells of endothelial lineage. Furthermore, these stroaml cells also expanded effectively when treated with thrombopoietin+flt-3 ligand+stem cell factor+leukemia inhibitory factor or 0.1% poly-L-lysine-coated wells. Conclusion: Stromal cells were developed during ex vivo expansion of CB $CD34^+$ cells and that this development could be enhanced further by treating the stromal cells with cytokines or ECM.

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A Comparative Study on Failure Pprediction Models for Small and Medium Manufacturing Company (중소제조기업의 부실예측모형 비교연구)

  • Hwangbo, Yun;Moon, Jong Geon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.11 no.3
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    • pp.1-15
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    • 2016
  • This study has analyzed predication capabilities leveraging multi-variate model, logistic regression model, and artificial neural network model based on financial information of medium-small sized companies list in KOSDAQ. 83 delisted companies from 2009 to 2012 and 83 normal companies, i.e. 166 firms in total were sampled for the analysis. Modelling with training data was mobilized for 100 companies inlcuding 50 delisted ones and 50 normal ones at random out of the 166 companies. The rest of samples, 66 companies, were used to verify accuracies of the models. Each model was designed by carrying out T-test with 79 financial ratios for the last 5 years and identifying 9 significant variables. T-test has shown that financial profitability variables were major variables to predict a financial risk at an early stage, and financial stability variables and financial cashflow variables were identified as additional significant variables at a later stage of insolvency. When predication capabilities of the models were compared, for training data, a logistic regression model exhibited the highest accuracy while for test data, the artificial neural networks model provided the most accurate results. There are differences between the previous researches and this study as follows. Firstly, this study considered a time-series aspect in light of the fact that failure proceeds gradually. Secondly, while previous studies constructed a multivariate discriminant model ignoring normality, this study has reviewed the regularity of the independent variables, and performed comparisons with the other models. Policy implications of this study is that the reliability for the disclosure documents is important because the simptoms of firm's fail woule be shown on financial statements according to this paper. Therefore institutional arragements for restraing moral laxity from accounting firms or its workers should be strengthened.

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Comparison of Association Rule Learning and Subgroup Discovery for Mining Traffic Accident Data (교통사고 데이터의 마이닝을 위한 연관규칙 학습기법과 서브그룹 발견기법의 비교)

  • Kim, Jeongmin;Ryu, Kwang Ryel
    • Journal of Intelligence and Information Systems
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    • v.21 no.4
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    • pp.1-16
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    • 2015
  • Traffic accident is one of the major cause of death worldwide for the last several decades. According to the statistics of world health organization, approximately 1.24 million deaths occurred on the world's roads in 2010. In order to reduce future traffic accident, multipronged approaches have been adopted including traffic regulations, injury-reducing technologies, driving training program and so on. Records on traffic accidents are generated and maintained for this purpose. To make these records meaningful and effective, it is necessary to analyze relationship between traffic accident and related factors including vehicle design, road design, weather, driver behavior etc. Insight derived from these analysis can be used for accident prevention approaches. Traffic accident data mining is an activity to find useful knowledges about such relationship that is not well-known and user may interested in it. Many studies about mining accident data have been reported over the past two decades. Most of studies mainly focused on predict risk of accident using accident related factors. Supervised learning methods like decision tree, logistic regression, k-nearest neighbor, neural network are used for these prediction. However, derived prediction model from these algorithms are too complex to understand for human itself because the main purpose of these algorithms are prediction, not explanation of the data. Some of studies use unsupervised clustering algorithm to dividing the data into several groups, but derived group itself is still not easy to understand for human, so it is necessary to do some additional analytic works. Rule based learning methods are adequate when we want to derive comprehensive form of knowledge about the target domain. It derives a set of if-then rules that represent relationship between the target feature with other features. Rules are fairly easy for human to understand its meaning therefore it can help provide insight and comprehensible results for human. Association rule learning methods and subgroup discovery methods are representing rule based learning methods for descriptive task. These two algorithms have been used in a wide range of area from transaction analysis, accident data analysis, detection of statistically significant patient risk groups, discovering key person in social communities and so on. We use both the association rule learning method and the subgroup discovery method to discover useful patterns from a traffic accident dataset consisting of many features including profile of driver, location of accident, types of accident, information of vehicle, violation of regulation and so on. The association rule learning method, which is one of the unsupervised learning methods, searches for frequent item sets from the data and translates them into rules. In contrast, the subgroup discovery method is a kind of supervised learning method that discovers rules of user specified concepts satisfying certain degree of generality and unusualness. Depending on what aspect of the data we are focusing our attention to, we may combine different multiple relevant features of interest to make a synthetic target feature, and give it to the rule learning algorithms. After a set of rules is derived, some postprocessing steps are taken to make the ruleset more compact and easier to understand by removing some uninteresting or redundant rules. We conducted a set of experiments of mining our traffic accident data in both unsupervised mode and supervised mode for comparison of these rule based learning algorithms. Experiments with the traffic accident data reveals that the association rule learning, in its pure unsupervised mode, can discover some hidden relationship among the features. Under supervised learning setting with combinatorial target feature, however, the subgroup discovery method finds good rules much more easily than the association rule learning method that requires a lot of efforts to tune the parameters.

Effects in Response to on the Innovation Activities of SMEs to Dynamic Core Competencies and Business Performance (중소기업의 혁신활동이 핵심역량과 기업성과에 미치는 영향)

  • Ahn, Jung-Ki;Kim, beom-seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.2
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    • pp.63-77
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    • 2018
  • In the rapidly to change global market in recent years, as the era of merging and integrating industries and the evolution of technology have come to an era in which everything can not be solved as a single company, it is evolving into competition for the enterprise network rather than the competition for the enterprise unit. In a competitive business environment, it is necessary to provide not only for the efforts as an individual companies but also the mutual development efforts to enhance output through the innovation activities based on the interrelationship with the business partners. In spite of the recent efforts and research through core competencies and innovation activities, some of business activities were unable to achieve enough progress in business performance and this study mainly focused to improve business performance for those companies. This study targeted CEOs and Directors who participates in "manufacturing performance innovation partnership project" carried by The foundation of Large, SMEs, Agriculture, Fisheries cooperation Korea and studied the influences of innovation activities to the core competencies and business performance. Detailed variables in this study were extracted from the previous research and used for verification. The study is designed to determine the influence of individual innovation activities to the core competencies and business performance. Innovation activities as a parameter, the relationship between core competencies and business performance was examined. In the examination of the innovation activities as a meditated effect, those activities carried by SMEs (Collaboration in Technology, Manufacturing, and Management innovations with Large Scale Business) through partnership in manufacturing innovation is significantly related business performance. Therefore, the result reveals that the individual SMEs are having own limitation in the achievement of significant progress in business performance with their own capabilities, and using the innovation activities act as catalyst through the collaboration with large scale businesses would result significant progress in business performance. Mutual effort in collaborative innovation activities between large scale businesses and SMEs is one of the most critical issues in recent years in Korea and the main focus of this study is to provide analysis which demonstrates where the SMEs are required to focus in their innovation activities.

Comparison of Reliability and Validity of Three Korean Versions of the 20-Item Toronto Alexithymia Scale (TAS-20의 한국판 3종간의 신뢰도 및 타당도 비교)

  • Chung, Un-Sun;Rim, Hyo-Deog;Lee, Yang-Hyun;Kim, Sang-Heon
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.77-88
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    • 2003
  • Objectives: The purpose of this study was to compare reliability and validity of three Korean versions of the 20-item Toronto Alexithymia scale and to confirm the most reliable and validated Korean translation of the 20-item Toronto Alexithymia Scale for both clinical and research purpose in Korea. The first one was a Korean version of the 20-Item Toronto Alexithymia Scale developed by Lee YH et al in 1996 which was designated as TAS-20K(1996) in this study. This scale had a problem with one item due to the cultural difference regarding the word 'analyzing' between western culture and Korean culture. The second one was the revised version of TAS-20K(1996) on that point by Lee YH et al in 1996 without validation which was designated as TAS-20K(2003) in this study. The third one was a 23-item Korean version developed by Sin HG and Won HT in 1997, which was somewhat different from the 20-item Toronto Alexithymia Scale(TAS-20) in the number of total item, the content of some items and the scoring method. This scale was designated as S-TAS here. Methods: 408 medical students were tested with one scale composed of all the different items randomly arranged from the three versions. We evaluated goodness-of-fit and Cronbach $\alpha$ coefficients of three scales for reliability. We used confirmatory factor analysis to compare validity. Results: TAS-20K(2003) showed that it had better internal consistency than TAS-20K(1996), which implied that the cultural difference should be considered in the Korean translation. Both TAS-20K(2003) and S-TAS replicated three-factor structures and had adequacy of fit, good internal consistency and acceptable validity. However, S-TAS had one item with poor item-factor correlation and didn't show high correlation between item 2 and factor 1 as before in 1997. Conclusion: Although S-TAS had added 3 items and changed the content of two items, it didn't show better reliability and validity than TAS-20K(2003). Therefore it is proposed to use TAS-20K (2003) as the Korean version of the 20-item Toronto Alexithymia Scale(TAS-20K) for international communication of results of Alexithymia research. It has good internal consistency and validity and maintains original items, the same construct and scoring method as the 20-item Toronto Alexithymia Scale.

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Alexithymia in Patients with Ulcerative Colitis and Irritable Bowel Syndrome (궤양성대장염 환자와 과민성대장증후군 환자의 감정표현불능증 비교 연구)

  • Lee, Sang-Bin;Lee, Seong-Yong;Kim, Sang-Heon;Rim, Hyo-Deog
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.69-76
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    • 2003
  • Objectives: Many researches have been done to compare psychopathology of functional gastrointestinal disorder and inflammatory bowel disease which involves structural change. Recently, many studies focused on the topic of alexithymia. The results from these studies were questionable for lack of valid measures of alexithymia and valid diagnostic criteria of functional gastrointestinal disorders. Therefore, we tried to overcome these two problems and to assess alexithymia, personality characteristics, and other psychopathology. Methods: The subjects consisted of ulcerative colitis group(N=28) who were diagnosed by colonoscopy and biopsy, irritable bowel syndrome group(N=27) who were diagnosed by Rome II criteria and normal control group(N=22). All patients were diagnosed at outpatient department of Kyungpook National University Hospital. All these groups completed three psychological tests, including MMPI, Rorschach test, and well validated TAS-20K(The Korean Version of the 20-Item Toronto Alexithymia Scale). Results: Twenty-five percent of the ulcerative colitis group and 22% of the irritable bowel syndrome group scored in the alexithymia range, compared with 0% of the normal group. In Rorschach test, irritable bowel syndrome group showed high levels of weighted Sum C and EA. Most of clinical scales of MMPI were higher in two gastrointestinal groups than the normal control group. And two gastrointestinal groups showed low ego strength level, but there was no statistical significant difference between them. Conclusion: Two gastrointestinal groups showed high rate of alexithymia, other psychopathological profiles, and low ego strength but there was no significant difference between two groups.

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Identifying Landscape Perceptions of Visitors' to the Taean Coast National Park Using Social Media Data - Focused on Kkotji Beach, Sinduri Coastal Sand Dune, and Manlipo Beach - (소셜미디어 데이터를 활용한 태안해안국립공원 방문객의 경관인식 파악 - 꽃지해수욕장·신두리해안사구·만리포해수욕장을 대상으로 -)

  • Lee, Sung-Hee;Son, Yong-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.46 no.5
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    • pp.10-21
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    • 2018
  • This study used text mining methodology to focus on the perceptions of the landscape embedded in text that users spontaneously uploaded to the "Taean Travel"blogpost. The study area is the Taean Coast National Park. Most of the places that are searched by 'Taean Travel' on the blog were located in the Taean Coast National Park. We conducted a network analysis on the top three places and extracted keywords related to the landscape. Finally, using a centrality and cohesion analysis, we derived landscape perceptions and the major characteristics of those landscapes. As a result of the study, it was possible to identify the main tourist places in Taean, the individual landscape experience, and the landscape perception in specific places. There were three different types of landscape characteristics: atmosphere-related keywords, which appeared in Kkotji Beach, symbolic image-related keywords appeared in Sinduri Coastal Sand Dune, and landscape objects-related appeared in Manlipo Beach. It can be inferred that the characteristics of these three places are perceived differently. Kkotji Beach is recognized as a place to appreciate a view the sunset and is a base for the Taean Coast National Park's trekking course. Sinduri Coastal Sand Dune is recognized as a place with unusual scenery, and is an ecologically valuable space. Finally, Manlipo Beach is adjacent to the Chunlipo Arboretum, which is often visited by tourists, and the beach itself is recognized as a place with an impressive appearance. Social media data is very useful because it can enable analysis of various types of contents that are not from an expert's point of view. In this study, we used social media data to analyze various aspects of how people perceive and enjoy landscapes by integrating various content, such as landscape objects, images, and activities. However, because social media data may be amplified or distorted by users' memories and perceptions, field surveys are needed to verify the results of this study.

A Study on 'Verfremdung' effects in visual advertisements with a special reference to the <017-I-Touch series, The Hand Transformed into a Web >, mobile network advertisement (동영상 광고에서 나타나는 '소격화' 효과에 관한 연구 - 광고 <017-I-Touch편 (손이 물갈퀴) >를 중심으로 -관어영시광고중소출현적‘맥생화’효과적연구(關於影視廣告中所出現的‘陌生化’效果的硏究))

  • Jin, Ri-Long;Ahn, Sang-Soo;Kim, Jong-Deok
    • Archives of design research
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    • v.18 no.2 s.60
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    • pp.37-46
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    • 2005
  • Today's advertisement is dominated by visual images, which deliver messages in the most efficient and engaging way. Vivid and live images, through multimedia, attract the viewer to consume the products being advertised. In this course, the effect of 'Verfremdung' or alienation is often detected. This terminology was at first used in a epic play of Bertolt Brecht to signify a specific effect to block the empathy of the audience by reminding them of their position as the audience separate from the play. 'Verfremdung' helps them to have a sense of objectivity and critical attitude toward the performance. Multimedia commercials nowadays exhibit such a quality together with 'viewer participation:' criticism on reality: and 'speed.' In an advertisement for Shinsegi Communications' mobile system titled <017-I-Touch series, the hand transformed into a web>, the copy, 'my blood type is 'i', ' is accompanied by six unrelated fictitious scenes in which the same ocean appears as a common denominator. Because there is no connection between the scenes, free imagination of the viewer has to be involved and thus plays a significant role in making them into a context. This fact dearly exhibit some characteristics of post- modern advertisement. Momentary 'Gap' and 'Difference' between scenes contribute to 'Verfremdung' or alienation' that makes it hard for the consumers to comprehend the content on the spot. Such an uneasy situation, however, keeps the viewers thinking about the advertisement itself. While repeatedly exposed to the alienated images, the viewers come to get involved in the advertisement, trying to make the fragmented images into a coherent context. In addition, the leaps between the scenes produce a sense of 'speed' in a context, which adds more impact to the way of delivering messages using multimedia. With the help of multimedia, 'Verfremdung: which was originally intended to bring about objective and critical altitude of the audience in a play, plays a crucial role in attracting the viewer's attention and conveying a specific message in a moment in contemporary advertisement.

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The Value of Entrepreneurial Orientation and Social Capital for Enhancing Collective Performance in R&D Collaborations of Korean Ventures (벤처기업의 R&D협력에서 사회적 자본과 기업가적 지향성이 협력성과에 미치는 영향)

  • Seo, Ribin
    • Journal of Korea Technology Innovation Society
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    • v.20 no.1
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    • pp.1-33
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    • 2017
  • In the last decades, technology-oriented small firms, i.e. venture businesses, have been increasingly engaged in R&D collaborations with external parties as strategic means for technological innovation. Despite ample evidence on the benefit of such collaborations for the firms, there has been less attention to examining whether and how the firms' social interactions with cooperating partners and their managerial characteristics contribute to that benefit. Drawing on the theories of social capital and entrepreneurial orientation, this study is to remedy this gap. The theory of social capital, referring to a sum of the value and potential resources embedded in social relationships of collectives, provides an integrated view of social factors among cooperating partners, e.g. strong ties, network stability, trust, reciprocity, shared vision and value. It categorizes these factors into structural, relational, and cognitive dimensions of social capital. Entrepreneurial orientation theory captures firms' managerial characteristics as a combination of innovativeness, proactiveness, and risk-taking. This addresses firms' managerial process to utilize and combine internal and external resources for wealth creation and opportunity realization. Against this background, this study investigates what roles social capital among cooperating R&D partners and entrepreneurial orientation of the collaborating firms play for collective performance improvement in R&D collaborations. In terms of the collective performance, this study adopts two indicators: technological competitiveness and business performance. Technological competitiveness refers to the contribution of a technology developed by a cooperative R&D project to competitive advantage of a firm while business performance is defined as the financial and economic outcome of a collaboration. Using a sample of 218 Korean ventures engaging in R&D collaboration with external parties, the author finds the significant effects of social capital (i.e. structural, relational, and cognitive dimensions) and entrepreneurial orientation (i.e. innovativeness, proactiveness, and risk-taking) on both of the technological competitiveness and the business performance. Further, the higher the social capital among R&D partners, the more likely it is to foster the entrepreneurial orientation at firm-level. Most importantly, the entrepreneurial orientation at firm-level is an significant mediator of the relationship between social capital and collective performance. Beyond these novel empirical findings, this study contributes to the literature on R&D collaboration. The findings' implications for management and policy are deeply discussed in the conclusion.