• 제목/요약/키워드: Primary care issues

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Knowledge Based Recommender System for Disease Diagnostic and Treatment Using Adaptive Fuzzy-Blocks

  • Navin K.;Mukesh Krishnan M. B.
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제18권2호
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    • pp.284-310
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    • 2024
  • Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.

Lung Organoid on a Chip: A New Ensemble Model for Preclinical Studies

  • Hyung-Jun Kim;Sohyun Park;Seonghyeon Jeong;Jihoon Kim;Young-Jae Cho
    • International Journal of Stem Cells
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    • 제17권1호
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    • pp.30-37
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    • 2024
  • The lung is a complex organ comprising a branched airway that connects the large airway and millions of terminal gas-exchange units. Traditional pulmonary biomedical research by using cell line model system have limitations such as lack of cellular heterogeneity, animal models also have limitations including ethical concern, race-to-race variations, and physiological differences found in vivo. Organoids and on-a-chip models offer viable solutions for these issues. Organoids are three-dimensional, self-organized construct composed of numerous cells derived from stem cells cultured with growth factors required for the maintenance of stem cells. On-a-chip models are biomimetic microsystems which are able to customize to use microfluidic systems to simulate blood flow in blood channels or vacuum to simulate human breathing. This review summarizes the key components and previous biomedical studies conducted on lung organoids and lung-on-a-chip models, and introduces potential future applications. Considering the importance and benefits of these model systems, we believe that the system will offer better platform to biomedical researchers on pulmonary diseases, such as emerging viral infection, progressive fibrotic pulmonary diseases, or primary or metastatic lung cancer.

Capability for Change at Community Health Centers Serving Asian Pacific Islanders: An Exploratory Study of a Cancer Screening Evidence-based Intervention

  • Sohng, Hee Yon;Kuniyuki, Alan;Edelson, Jane;Weir, Rosy Chang;Song, Hui;Tu, Shin-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7451-7457
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    • 2013
  • Background: Understanding and enhancing change capabilities, including Practice Adaptive Reserve (PAR), of Community Health Centers (CHCs) may mitigate cancer-related health disparities. Materials and Methods: Using stratified random sampling, we recruited 232 staff from seven CHCs serving Asian Pacific Islander communities to complete a self-administered survey. We performed multilevel regression analyses to examine PAR composite scores by CHC, position type, and number of years worked at their clinic. Results: The mean PAR score was 0.7 (s.d. 0.14). Higher scores were associated with a greater perceived likelihood that clinic staff would participate in an evidence-based intervention (EBI). Constructs such as communication, clinic flow, sensemaking, change valence, and resource availability were positively associated with EBI implementation or trended toward significance. Conclusions: PAR scores are positively associated with perceived likelihood of clinic staff participation in cancer screening EBI. Future research is needed to determine PAR levels most conducive to implementing change and to developing interventions that enhance Adaptive Reserve.

2018년 한국 보건의료의 상대적 위치와 추이: 경제협력개발기구 국가와 비교 (Position Value for Relative Comparison of Healthcare Status of Korea in 2018)

  • 윤흰뫼;이현지;박은철
    • 보건행정학회지
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    • 제31권2호
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    • pp.217-224
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    • 2021
  • The objective of this study is to investigate the healthcare status of South Korea and other member countries of the Organization for Economic Cooperation and Development (OECD) using OECD health statistics 2020. We employed the position value for relative comparison index to measure the healthcare status in five following components: demand, supply, accessibility, quality, and cost. The Mann-Kendall test was used to analyze for increasing or decreasing trend of the position value for relative comparison values from 2000 to the recent year. Results showed that Korea was positioned above than the OECD median values in most of components, but lower than the median values in certain indices including healthcare employment, primary care, and mental health care. This study sheds some light on healthcare issues to be improved and the policy-makes can take into account for prior setting process.

Perceptions regarding the multidisciplinary treatment of patients with severe trauma in Korea: a survey of trauma specialists

  • Shin Ae Lee;Yeon Jin Joo;Ye Rim Chang
    • Journal of Trauma and Injury
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    • 제36권4호
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    • pp.322-328
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    • 2023
  • Purpose: Patients with multiple trauma necessitate assistance from a wide range of departments and professions for their successful reintegration into society. Historically, the primary focus of trauma treatment in Korea has been on reducing mortality rates. This study was conducted with the objective of evaluating the current state of multidisciplinary treatment for patients with severe trauma in Korea. Based on the insights of trauma specialists (i.e., medical professionals), we aim to suggest potential improvements. Methods: An online questionnaire was conducted among 871 surgical specialists who were members of the Korean Society of Traumatology. The questionnaire covered participant demographics, current multidisciplinary practices, perceived challenges in collaboration with rehabilitation, psychiatry, and anesthesiology departments, and the perceived necessity for multidisciplinary treatment. Results: Out of the 41 hospitals with which participants were affiliated, only nine conducted multidisciplinary meetings or rounds with nonsurgical departments. The process of transferring patients to rehabilitation facilities was not widespread, and delays in these transfers were frequently observed. Financial constraints were identified by the respondents as a significant barrier to multidisciplinary collaboration. Despite these hurdles, the majority of respondents acknowledged the importance of multidisciplinary treatment, especially in relation to rehabilitation, psychiatry, and anesthesiology involvement. Conclusions: This survey showed that medical staff specializing in trauma care perceive several issues stemming from the absence of a multidisciplinary system for patient-centered care in Korea. There is a need to develop an effective multidisciplinary treatment system to facilitate the recovery of trauma patients.

지역사회 보건사업을 위한 보건교육 (Health Education for Improving the Effectiveness of Community Health Programmes)

  • 김공현
    • 보건교육건강증진학회지
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    • 제15권1호
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    • pp.205-218
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    • 1998
  • Health education is the first of the nine essential services of primary health care which has been advocated as a key in achieving “Health for All” by World Health Organization and its Member States since 1978. The purpose of this paper is to assist community health workers to improve the effectiveness of community health programmes through understanding key issues related to health education, and applying the recommended skills to conducting their health education programmes in the community. Chapter 1 shows the relationship between health and behavior, and the importance of understanding several key factors for people's health behavior in designing and implementing health education programmes in the specific community, and discusses ways to facilitate people's health behavior changes. Chapter 2 deals with conducting face-to-face health education with emphasis on counselling skills, and chapter 3 touches with health education for informal group, in particular at the hospital setting. Chapter 4 introduces how to create a supportive verbal communication climate, and proposes applying these skills to health education so as to improve the effectiveness of health education.

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원격진료 실시에 수반되는 법적 쟁점들에 대한 고찰 (Legal Issues To Be Considered Before Implementing Telehealth in South Korea)

  • 이원복
    • 의료법학
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    • 제22권1호
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    • pp.57-90
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    • 2021
  • 의료인이 직접 환자를 진료하는 형태의 원격진료가 현행 의료법에서 허용이 되는지 여부와 의료법상 허용을 떠나 정책적으로 허용하는 것이 바람직한지의 문제가 오랫동안 논란이 되어 왔다. 그러다가 코비드19라는 인류가 드물게 겪는 팬데믹 상황으로 인하여 우리나라에서 한시적으로 허용이 되었고 외국에서도 이용이 폭발적으로 증가하면서 다시 관심을 받고 있다. 원격진료의 허용 여부에 관하여는 이미 많은 논문이 존재하지만, 막상 원격진료가 실시될 경우 그에 수반되어 발생할 수 있는 부수적인 법적 쟁점들에 관하여는 논의가 부족했던 부분이 있어 이 글에서 다루었다. 필자는 국민건강보험의 수가정책, 환자 본인 확인, 의약품 비대면 구매, 진료장면 녹화에 관하여는 입법적으로 미리 정비를 하는 것이 바람직하다고 보았고, 원격진료에 필요한 시설 기준은 오히려 법제화를 하면 현실에 뒤떨어지거나 변화에 대응하는 탄력성이 떨어지므로 법제화를 하지 않고 대신 의료인이 의료기기법상 승인을 받은 원격진료용 기기를 사용하는 것으로 충분하다고 판단하였으며, 끝으로 원격진료의 맥락에서 발생한 의료사고의 책임이라든가 개인정보 보호는 기존의 민사법이나 개인정보 보호법으로 이미 충분한 대응이 되므로 별도의 특칙을 제정할 필요는 없다는 결론을 내렸다.

한국노년학의 보건·의료·건강영역 연구동향 (Research Trend of the Healthcare and Medical Care for Elders in the Journal of the Korea Gerontological Society)

  • 김현숙;박연환;김영선
    • 한국노년학
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    • 제38권3호
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    • pp.705-723
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    • 2018
  • 본 연구의 목적은 "한국노년학" 학회지에 40년간 게재된 보건 의료 건강분야 연구의 동향을 전반적으로 고찰하고 "한국노년학" 연구의 다학문적 특성과 관련하여 보건 의료 건강 부분이 나아갈 방향을 조망하기 위함이다. 이를 위해 한국노년학 창간호부터 2017년 12월 말까지 40년간 게재된 논문 중 2008년 30주년에 "한국노년학" 1권(1980년)부터 28권(2008년) 2호까지에 게재된 논문 중 건강 간호분야 및 노인보건정책 논문 분석 연구를 검토하고, 최근 10년간 게재된 논문(2008년 3호~2017년 4호) 총 655편 중 237편(전체의 36.2%)을 대상으로 분석하였고, 다음과 같은 연구동향을 확인하였다. 첫째, 최근 10년간의 연구 주제를 대표저자의 전공별로 분석한 결과 보건, 의료, 간호, 체육 분야 저자들은 주로 신체적 건강 주제의 연구를 수행하였고 복지분야 저자들은 정신적 건강 주제의 연구를 주로 다뤘다. 즉, 전반적으로 보건 의료 건강 영역에서는 신체적 건강의 연구가 주로 수행되었다. 둘째, 연구방법 분석결과, 최근 10년간 연구에서는 양적연구가 89.9%를 차지하고 있었고, 지난 30년간(1980-2008)의 연구에서도 양적연구가 81.5%로 대다수를 차지하고 있다. 최근 10년간 수행 된 질적연구는 총 11편으로 나타나 양적연구에 비해 비중이 작은 것으로 나타났으며, 포커스그룹 인터뷰 방법을 활용한 연구가 33.3%로 가장 많은 비중을 차지하는 것으로 나타났다. 셋째, 연구유형은 지난 30년간의 분석에서는 비실험연구가 82.7%였지만, 최근 10년간의 연구에서는 비실험연구가 65.4%를 차지하고 있는 것으로 나타나 보건 의료 건강영역에서 문제해결을 위한 실험연구가 증가하고 있는 것을 알 수 있었다. 넷째, 연구대상은 최근 10년간의 연구에서 건강한 노인, 도시거주 노인, 재가 노인 대상으로 한 연구가 많은 비중을 차지하였으며, 대상노인의 연령은 65세 이상 노인을 대상으로 한 연구가 60.0%로 지난 30년간의 연구에서의 42.7%보다 그 비중이 증가하였다. 대상노인의 성별에 따라 연구동향은 최근 10년간의 연구에서 남녀 모두를 대상으로 한 연구가 81.6%로 나타나 지난 30년 연구의 88.5%에 비해 조금 감소한 것으로 나타났다. 이와 같은 연구결과는 최근 10년간 보다 다양한 연구 접근이 시도되긴 하였으나 여전히 신체건강을 주제로 비실험연구설계를 적용하는 연구가 주를 이루고 있었다. 향후 노인 건강증진연구에서 통합적 다학제적 접근 및 예방적 사전적 관점의 필요성과 함께 급속한 고령화를 경험하고 초고령화가 임박한 한국적 상황을 다각적으로 분석할 수 있는 종단 연구, 질적 연구, 메타 분석 등 다양한 연구방법을 통한 심층적이고 체계적인 연구설계의 필요성을 시사하고 있다.

손자녀를 양육하는 할머니의 양육부담에 관한 현상학적 연구 (A Study of the Caregiving Burden on Grandmothers Who Raise Their Grandchildren: A Phenomenological Research)

  • 김문정
    • 대한간호학회지
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    • 제37권6호
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    • pp.914-923
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    • 2007
  • Purpose: This qualitative study aimed to identify the common, lived experiences of grandmothers who cared for their grandchildren as the primary caregivers. Methods: This study was based on the phenomenological method described by Colaizzi (1978). Results: Seven theme clusters emerged from the data as follows: "grandmother caregivers accept the parenting role of the incessant responsibilities and the distrust of non-kin caregivers.", "grandmother caregivers have a double maternal roles; an instrument-oriented maternal role to their own child and relationship-oriented maternal role to their grandchild.", "grandmother caregivers are partially authorized to make decisions in the matters of their grandchild.", "grandmother caregivers suffer a deterioration in their health by an acceleration of the aging process.", "caregiving causes grandmother caregivers to feel a sense of social isolation, and persue various coping strategies to control this feeling.", "grandmother caregivers have a greater feeling of self-esteem, but they often conflict with their adult children if they don't feel appreciated by them.", "grandmother caregivers have limited social support and their health issues are often overlooked in the family context.' Conclusion: The results of this study can guide nurses and health care workers to understand the experiences of grandmother caregivers and to implement individualized nursing interventions suited for them.

Tinjute [Labiatae; (Otostegia integrifolia)]: A versatile Ethiopian ethnomedicinal plant - a systematic review of the scientific evidences

  • Karunamoorthi, Kaliyaperumal
    • 셀메드
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    • 제4권2호
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    • pp.8.1-8.6
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    • 2014
  • Despite the remarkable advancements of the modern medicine, the traditional system of medicine (TSM) still serves as a potential primary health care modality in the in low- and middle-income countries. The recent reports suggest that there is a renewed interest has been observed towards TSM in the developed countries too, because of the adverse side-effect of modern medicines. Medicinal plants have been widely serving as a rich source of therapeutic agent. Ethiopia is one of the most reserves rich countries in the world. It is renowned for well-diversified and natural resources in terms of its unique flora and fauna. Ethiopian deep-rooted tradition and culture largely depends on the usage of plants for their religious ceremonies, impressive festivals, traditional medicinal uses and other basic necessities. The present scrutiny is an attempt to understand the omnipotent nature of an Ethiopian Ethnomedicinal plant called Tinjute [vernacular name (local native language, Amharic); Otostegia integrifolia]. There are several studies suggest that Tinjute can be used as a natural medicine or health-promoting agents for various disorders and ailments. Nevertheless, in Ethiopia, it is renowned as an insect repellent to drive-away insect vector of diseases, particularly mosquitoes in the early evening. However, there are many more issues and challenges which must be urgently addressed to scientifically formulate various potent, efficacious, safe and highly selective phytotherapeutic agents and insects' repellent from the Tinjute plant in the near future.