• 제목/요약/키워드: Referral system

검색결과 124건 처리시간 0.024초

Community Integration Study through Rehabilitation Medical Support for People with Disabilities

  • Eun-Mee CHOI;Chang-Gun LEE;Lee-Seung KWON
    • 웰빙융합연구
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    • 제7권1호
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    • pp.51-65
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    • 2024
  • Purpose: This study is to propose the establishment and direction of a public health-medical cooperation system for rehabilitation medical services for people with physical and brain disabilities in Gangneung, Korea. Research design, data and methodology: The study focused on 30 individuals with these disabilities registered. Data was collected from December 20, 2021, to December 31, 2021, through structured surveys administered by researchers visiting disability-related facilities, utilizing convenience and random sampling methods. Descriptive statistics and cross-analysis were applied for analysis. Results: Specifically, among respondents with physical disabilities, a total of 20 needs were identified, with 'Visiting health services' (25.0%) and 'Oral health services' (20.0%) ranking highest. The survey results regarding visit-based rehabilitation services for disability support showed a high demand, emphasizing the necessity of service provision tailored to the needs of recipients, focusing on disability prevention, health management, and motor function recovery, rather than solely medical or therapeutic concepts. Conclusions: Gangwon National University Hospital, as the regional referral hospital in Gangwon, should collaborate with Gangwon Province Rehabilitation Hospital to provide prompt acute rehabilitation services. Moreover, cooperation and collaboration with Gangneung Asan Hospital, the tertiary hospital in the region, are essential to ensure continued acute and recovery phase rehabilitation therapy for a certain period in the Gangneung area.

임베디드 기반의 보행자 안전을 위한 전자감응시스템 구현 (Implementation of the Electronic Sensor System for Pedestrian Safety Based on Embedded)

  • 류승한;박성원;문건희;정회경
    • 한국정보통신학회논문지
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    • 제19권8호
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    • pp.1825-1830
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    • 2015
  • 일부 보행자의 경우 보행자 신호등이 적색임에도 불구하고 무단횡단을 하거나 차도에 내려서서 보행 신호를 기다리기도 한다. 이럴 경우 자칫하면 교통사고로 이어질 수 있다. 이에 적외선 센서를 이용하여 보행자가 차도로 진입할 경우 경고 안내 방송을 해주는 방식으로 채택해왔으나, 이 경우 교차로의 곡선형 횡단보도에는 설치가 어렵다. 본 논문에서는 카메라의 영상 검지 방식을 사용하여 보행자를 검지하는 방법에 대해 제안한다. 보행철주 상단에 설치된 카메라를 이용하여 이미지를 획득하고, 획득한 이미지를 이용하여 보행자 검지구간을 설정한다. 또한, 획득한 이미지에 대해 소벨( Sobel) 영상 처리 방식을 이용하여 변환하고 변환한 이미지를 다른 이미지와 비교하여 보행자 검지방법을 선택하였다. 이 영상 검지 방식을 사용하면 곡선형 횡단보도에서 보행자를 검지하는데 효과적이다.

ARMv7 Thumb Architecture 취약성 분석 (Vulnerability analysis on the ARMv7 Thumb Architecture)

  • 김시완;성기택
    • 한국정보통신학회논문지
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    • 제21권5호
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    • pp.1003-1008
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    • 2017
  • 최근 몇 년간 사물인터넷은 중요한 연구적 관심을 끌어왔다. 새로운 IoT 기술이 널리 이용되기 위해서는 정보의 신뢰성과 보호가 전적으로 요구된다. IoT 시스템은 그 특성상 직접적인 접근이 쉬우므로 이로 인한 물리적인 보안에 매우 취약하다. SoC 기술의 발달과 함께 운영체제에 대한 기술도 많이 이루어졌으며 많은 새로운 운영체제가 소개되고 있다. 본 연구에서는 ARMv7 Thumb Architecture 하드웨어 플랫폼에서 동작하는 운영체제에 대한 취약성분석 결과에 대하여 기술하였다. 최근에 소개된 "Windows 10 IoT Core" 운영체제에 대하여, 연구를 통하여 개발된 침투코드를 특정 IoT 시스템에 이식시켜 Zero-Day Attack을 구현하였다. 결과의 침투코드에 대한 바이러스 검출 여부를 "virustotal" 사이트에 의뢰하여 유효성을 입증하였다.

가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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일개 시지역 저소득 골관절염 환자의 보완대체요법 이용실태 및 비용 -의료급여 및 건강보험하위 20% 대상자를 중심으로- (Utilization and Out-of-pocket Expenditure of Complementary and Alternative Medicine in Low-income Patients with Osteoarthritis in a City)

  • 감신;박기수
    • 농촌의학ㆍ지역보건
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    • 제33권2호
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    • pp.181-192
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    • 2008
  • Objective: The use of complementary and alternative medicine (CAM) is common especially among patients with osteoarthritis The aim of this study was to investigate the utilization rate and expenditures of patients who use CAM. Method: Two hundred seventy four patients with osteoarthritis were interviewed by a telephone survey. A structured questionnaire about sociodemographic features and type, cost, satisfaction and reason of CAM utilization was used Results: Among 274 patients with osteoarthritis, 251 patients(91.6%) had used at least one type of CAM during six months. There was a significant difference in sex (female), age (70 years), medical security (insurance), educational level between the user and non-user of CAM. Hyperthermia was the most use. The average cost for CAM utilization was 120 thousands won/person during six months and there was no difference in sociodemographic features among the out-of-pocket cost of users. The scores of satisfaction for CAM use were ranged between 60-70. Conclusions: CAM became a popular source of health care because of elderly and lay referral system. And Korean spent a substantial amount of out-of-pocket money on CAM without benefit. Health care system and professionals should pay more attention to CAM, make a evidence for CAM.

OBD-II WiFi를 이용한 아이폰 기반의 자동차 소모품 진단관리 소프트웨어 구현 (A Implementation of motorcar consumption diagnostic management iPhone based software with OBD-II and WiFi network)

  • 정다운;남재현;장종욱
    • 한국정보통신학회논문지
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    • 제15권11호
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    • pp.2347-2352
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    • 2011
  • 차량 운전자는 안전을 위해 항상 자신의 차량의 상태를 점검하고 파악하는 것이 필수이다. 하지만 운전자가 차량의 상태를 알고자 한다면 전문 업체에게 의뢰하기 때문에 운전자는 시간과 금전적인 비용이 지불되어야 한다. IT 기술의 발달로 인해 스마트폰의 다양한 기능을 이용하여 차량의 상태 점검을 할 수 있게 되었지만, 기존 스마트폰 자동차 진단 시스템은 자동차의 전문적인 지식을 학습해야 차량 상태를 알 수 있기 때문에 사용자들에게 진단기의 필요성이 부각되지 않는다. 본 논문에서는 OBD-II 프로토콜 변환 WiFi 커넥터를 통해 받아오는 OBD-II 정보를 차량 운전자에게 필요한 차량 소모품 교체 주기의 점검, 차량 문제점 진단 정보를 사용자에게 실시간으로 보여주며 손쉽게 사용할 수 있는 자동차 소모품 구현을 iPhone에서 구현 하였다.

질적 연구를 통한 대형병원 환자집중의 영향 요인 분석 : 대형병원 의료이용자와 관리자 관점에서 (A Study on Influencing Factor of Patient Leaning Phenomenon in Tertiary Hospitals through Qualitative Research : From the Perspective of Tertiary Hospital Users and Managers)

  • 이근정;엄혜은;고정애;박다혜
    • 한국병원경영학회지
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    • 제26권1호
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    • pp.55-70
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    • 2021
  • Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

Efficient Sign Language Recognition and Classification Using African Buffalo Optimization Using Support Vector Machine System

  • Karthikeyan M. P.;Vu Cao Lam;Dac-Nhuong Le
    • International Journal of Computer Science & Network Security
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    • 제24권6호
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    • pp.8-16
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    • 2024
  • Communication with the deaf has always been crucial. Deaf and hard-of-hearing persons can now express their thoughts and opinions to teachers through sign language, which has become a universal language and a very effective tool. This helps to improve their education. This facilitates and simplifies the referral procedure between them and the teachers. There are various bodily movements used in sign language, including those of arms, legs, and face. Pure expressiveness, proximity, and shared interests are examples of nonverbal physical communication that is distinct from gestures that convey a particular message. The meanings of gestures vary depending on your social or cultural background and are quite unique. Sign language prediction recognition is a highly popular and Research is ongoing in this area, and the SVM has shown value. Research in a number of fields where SVMs struggle has encouraged the development of numerous applications, such as SVM for enormous data sets, SVM for multi-classification, and SVM for unbalanced data sets.Without a precise diagnosis of the signs, right control measures cannot be applied when they are needed. One of the methods that is frequently utilized for the identification and categorization of sign languages is image processing. African Buffalo Optimization using Support Vector Machine (ABO+SVM) classification technology is used in this work to help identify and categorize peoples' sign languages. Segmentation by K-means clustering is used to first identify the sign region, after which color and texture features are extracted. The accuracy, sensitivity, Precision, specificity, and F1-score of the proposed system African Buffalo Optimization using Support Vector Machine (ABOSVM) are validated against the existing classifiers SVM, CNN, and PSO+ANN.

Follow-Up Intervals for Breast Imaging Reporting and Data System Category 3 Lesions on Screening Ultrasound in Screening and Tertiary Referral Centers

  • Sun Huh;Hee Jung Suh;Eun-Kyung Kim;Min Jung Kim;Jung Hyun Yoon;Vivian Youngjean Park;Hee Jung Moon
    • Korean Journal of Radiology
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    • 제21권9호
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    • pp.1027-1035
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    • 2020
  • Objective: To assess the appropriate follow-up interval, and rate and timepoint of cancer detection in women with Breast Imaging Reporting and Data System (BI-RADS) 3 lesions on screening ultrasonography (US) according to the type of institution. Materials and Methods: A total of 1451 asymptomatic women who had negative or benign findings on screening mammogram, BI-RADS 3 assessment on screening US, and at least 6 months of follow-up were included. The median follow-up interval was 30.8 months (range, 6.8-52.9 months). The cancer detection rate, cancer detection timepoint, risk factors, and clinicopathological characteristics were compared between the screening and tertiary centers. Nominal variables were compared using the chi-square or Fisher's exact test and continuous variables were compared using the independent t test or Mann-Whitney U test. Results: In 1451 women, 19 cancers (1.3%) were detected; two (0.1%) were diagnosed at 6 months and 17 (1.2%) were diagnosed after 12.3 months. The malignancy rates were both 1.3% in the screening (9 of 699) and tertiary (10 of 752) centers. In the screening center, all nine cancers were invasive cancers and diagnosed after 12.3 months. In the tertiary center, two were ductal carcinomas in situ and eight were invasive cancers. Two of the invasive cancers were diagnosed at 6 months and the remaining eight cancers newly developed after 13.1 months. Conclusion: One-year follow-up rather than 6-month follow-up may be suitable for BI-RADS 3 lesions on screening US found in screening centers. However, more caution is needed regarding similar findings in tertiary centers where 6-month follow-up may be more appropriate.