• KSII Transactions on Internet and Information Systems (TIIS)
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• v.10 no.1
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• pp.221-237
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• 2016

The wireless body area networks (WBANs) consist of wearable computing devices and can support various healthcare-related applications. There exist two crucial issues when WBANs are utilized for healthcare applications. One is the protection of the sensitive biometric data transmitted over the insecure wireless channels. The other is the design of effective medical management mechanisms. In this paper, a secure medical information management system is proposed and implemented on a TinyOS-based WBAN test bed to simultaneously address these two issues. In this system, the electronic medical record (EMR) is bound to the biometric data with a novel fragile zero-watermarking scheme based on the modified visual secret sharing (MVSS). In this manner, the EMR can be utilized not only for medical management but also for data integrity checking. Additionally, both the biometric data and the EMR are encrypted, and the EMR is further protected by the MVSS. Our analysis and experimental results demonstrate that the proposed system not only protects the confidentialities of both the biometric data and the EMR but also offers reliable patient information authentication, explicit healthcare operation verification and undeniable doctor liability identification for WBANs.

• The Journal of Korean Academic Society of Nursing Education
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• v.25 no.3
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• pp.331-343
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• 2019

Purpose: This study focuses on investigating the effectiveness of simulation education on emergency management using a low-fidelity simulator as related to clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in new nurses. Methods: A pre-post test experimental design of nonequivalent control group was applied. Fifty-five new nurses were recruited, 28 nurses for the experimental group and 27 nurses for the control group. A simulation education for emergency management comprising knowledge lecture, team learning, skill education, team simulation, and debriefing was developed and implemented from Feb. 14 to 27, 2015. Data were analyzed with percentage, average, and standard deviation, chi-square, and t-test using SPSS. Results: The experimental group showed significantly higher knowledge (t=5.81, p<.001), clinical skill performance (t=10.08, p<.001), self-confidence (t=-6.24, p<.001), critical thinking disposition (t=2.42, p=.019), and learning satisfaction (t=4.21, p<.001) for emergency management compared with the control group who had traditional lecture education. Conclusion: The results indicate that a simulation education using a low-fidelity simulator is an efficient teaching method for new nurses to deepen their clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in learning emergency management.

• Journal of Korean Physical Therapy Science
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• v.17 no.3_4
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• pp.1-9
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• 2010

Purpose: The objectives of this study were to investigate the current status of the pain in and the dysfunction related to the musculoskeletal system experienced by patients with end-stage renal failure receiving hemodialysis. Methods: A questionnaire survey was given to 107 patients undergoing hemodialysis in M Hospital. The survey was conducted by using a brief pain inventory(BPI) to investigate the body parts in pain, degree of pain, difficulty in daily life, correlation with hemodialysis and the degree of satisfaction with their own health. Results: The investigation of the patients undergoing hemodialysis showed that 89(83.2%) of the 107 patients experienced pain in their musculoskeletal system. Their pain's incidence was highest in the knees(46.1%) and 68.5% of the patients reported that the most severe pain they had experienced within the past 24 hours was at a level between "moderate" and "severe." The limitation of daily life by pain is high most as 47.7% in the accomplishment of works. Conclusion: Most hemodialysis patients experience musculoskeletal related pain that affects their daily life. Hemodialysis patient management programs should include an assessment and management of such pain.

• Health Policy and Management
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• v.7 no.2
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• pp.109-146
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• 1997

This study explores the feasibility of activating private health insurance in Korea. The rationale for expanding private supplementary health insurance can be found in many cases of health care reforms in the European countries. Private health insurance can not only relieve the financial distress of the government health insurance programs but also offer the medical institutions incentives to improve the quality of medical care. In Korea there is no supplementary health insurance that reimburses for various kinds of diseases based on a well designed fee schedule. Recently, the cancer insurance is the best seller in the health related insurance market. As observed in the U. S. case, the cancer insurance which pays the predetermined amount (indemnity coverage) regardless of the medical charges incurred to the patient is limited in its coverage for the insured. To provide better protection against catastrophic diseases, the government should give insurance companies incentives to develop health insurance products that cover multiple diseases rather than a single disease. Consumers can hardly understand and compare complex insurance products. To resolve the information asymmetries, the government should publish a consumer report that compare various health insurance products in a user friendly way. In the long run, insurance companies will plan to sell health insurance products that charge risk related premium only when insurers accumulate the underwriting know-hows, the government shares data on various health statistics including claims and demographics, and risk pool for high risk patients is well established and subsidized by the government.

• International journal of thyroidology
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• v.11 no.2
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• pp.78-81
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• 2018

Lenvatinib, an oral multi-kinase inhibitor, is a valuable treatment option for advanced differentiated thyroid carcinoma. However, severe treatment-related adverse events occur up to 30% of the patients receiving lenvatinib, making it a challenge for clinicians to maintain this drug and therefore affecting the outcome of therapy. Blood vessel related events, such as hypertension or proteinuria, are among the most frequent adverse events. We present a case of 65-year-old man with radioactive iodine refractory papillary thyroid carcinoma with cervical lymph node metastasis and tracheal invasion receiving lenvatinib who developed proteinuria and worsening of hypertension. Management with repeated dose reductions and using supportive medications allowed this patient to continue lenvatinib with his disease stably controlled. Early detection of patients at risk for these adverse events and cautious administration of lenvatinib at appropriate level are crucial in managing patients receiving lenvatinib.

• The Korean Journal of Health Service Management
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• v.12 no.4
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• pp.103-113
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• 2018

Objectives: The study aimed to compare the indicators of infrastructure of the whole country with those of Busan through National Medical Care Psychiatric (hospital level) Quality Assesment and to provide the basic evidence for presenting vision and strategies of mental health policy. Methods: National Medical Care Psychiatric (hospital level) Quality Assesment Data was used from 2011 to 2015. A total of 8 indicators were analyzed including facility and workforce. Results: The median value of the capacity per ward was decreasing with years both whole country and Busan. The number of beds out of total inpatient occupancy was improved over the years. There was no clear change in the number of inpatients per toilet in the hospitalized ward, but the indicator was decreasing obviously. Therefore, the median value of whole country and Busan was same with 10.2 in 2015. Conclusions: We confirmed that indicators for infrastructure were improving in a generally positive change over the years. The infrastructure is related to the patient-centered treatment environment, and the workforce is related to the quality of care. Therefore, the structural area should be continuously evaluated and improved.

• Journal of Oral Medicine and Pain
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• v.47 no.1
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• pp.1-9
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• 2022

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of antiresorptive agents and bone-modifying agents. It is of the utmost importance to know the management of the MRONJ to improve the patient's quality of life. This study comprehensively reviews the current definitions of MRONJs, and antiresorptive medications, clinical manifestation and staging, risk factors, treatment strategies, and prevention methods of MRONJ. The disease is defined as an exposure of bone and osteonecrosis of the jaw in the oral cavity for at least 8 weeks in patients taking antiresorptive drugs or antiangiogenic agents and with no history of radiotherapy treatment of the jaws. Many articles have reported risk factors associated with MRONJ such as systemic diseases, antiresorptive medication, oral infection, and poor oral hygiene. Osteonecrosis and antiresorptive medications including bisphosphonate and denosumab have been strongly associated, but the pathology of MRONJ is only limited. Hence, an effective and appropriate management and treatment for MRONJ is still to be defined. The objectives of MRONJ treatment are to minimize osteonecrosis and relieve symptoms, and many treatments are suggested from conservative treatment to marginal resection, but this remains controversial. Appropriate treatment of MRONJ remained difficult, although many studies are being covered.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.177-179
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• 2002

We have developed a scheduling system for heavy ion radiotherapy considering the condition of three treatment rooms and treatment planning for each patient. This system consists of a database (patient information, treatment method and machine schedule), a schedule for radiotherapy and WEB server. All operation of this system, such as data input, to change and to view the schedule, are performed by using a WEB browser. In order to protect personal information for the patients, access privilege to each information are limited by according to the occupational category. This system is connected with a hospital central information management system (AMIDAS) and an irradiation-managing computer for the heavy ion radiotherapy. A basic information for the patient is got from AMIDAS and the daily schedule sends to the treatment control computer at each treatment room through the irradiation-managing computer every morning. The daily, weekly, monthly schedules in the treatment room and the treatment condition of each patient are shared on the WEB browser with the all participants of the heavy ion therapy. This system could be useful to save a time to generate a treatment schedule and to inform us the most up-to-date treatment schedule and the related information at the same time.

• Tuberculosis and Respiratory Diseases
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• v.81 no.2
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• pp.116-122
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• 2018

Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.

• Journal of Korean Academy of Nursing
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• v.51 no.6
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• pp.720-731
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• 2021

Purpose: The purpose of this study was to identify the knowledge structure of health information (HI) for chronic obstructive pulmonary disease (COPD). Methods: Keywords or meaningful morphemes from HI presented on five health-related websites (HRWs) of one national HI institute and four hospitals, as well as HI needs among patients presented in nine literature, were reviewed, refined, and analyzed using text network analysis and their co-occurrence matrix was generated. Two networks of 61 and 35 keywords, respectively, were analyzed for degree, closeness, and betweenness centrality, as well as betweenness community analysis. Results: The most common keywords pertaining to HI on HRWs were lung, inhaler, smoking, dyspnea, and infection, focusing COPD treatment. In contrast, HI needs among patients were lung, medication, support, symptom, and smoking cessation, expanding to disease management. Two common sub-topic groups in HI on HRWs were COPD overview and medication administration, whereas three common sub-topic groups in HI needs among patients in the literature were COPD overview, self-management, and emotional management. Conclusion: The knowledge structure of HI on HRWs is medically oriented, while patients need supportive information. Thus, the support system for self-management and emotional management on HRWs must be informed according to the structure of patients' needs for HI. Healthcare providers should consider presenting COPD patient-centered information on HRWs.