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Study on Medical Records In ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ ("삼국사기(三國史記)"에 기록된 의약내용(醫藥內容) 분석)

  • Shin, Soon-Shik;Choi, Hwan-Soo
    • Journal of The Association for Neo Medicine
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    • v.2 no.1
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    • pp.35-54
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    • 1997
  • We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

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A study on the second edition of Koryo Dae-Jang-Mock-Lock (고려재조대장목록고)

  • Jeong Pil-mo
    • Journal of the Korean Society for Library and Information Science
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    • v.17
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    • pp.11-47
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    • 1989
  • This study intends to examine the background and the procedure of the carving of the tablets of the second edition of Dae-Jang-Mock­Lock(재조대장목록). the time and the route of the moving of the tablets. into Haein-sa, and the contents and the system of it. This study is mainly based on the second edition of Dae-Jang-Mock-Lock. But the other closely related materials such as restored first. edition of the Dae- Jang-Mock-Lock, Koryo Sin-Jo-Dae-Jang-Byeol-Lock (고려신조대장교정별록). Kae-Won-Seok-Kyo-Lock (개원석교록). Sok-Kae­Won-Seok-Kyo-Lock (속개원석교록). Jeong-Won-Sin-Jeong-Seok-Kyo­Lock(정원신정석교록), Sok-Jeong-Won-Seok-Kyo-Lock(속정원석교록), Dea-Jung-Sang-Bu-Beob-Bo-Lock(대중상부법보록), and Kyeong-Woo-Sin-Su-Beob-Bo-Lock(경우신수법보록), are also analysed and closely examined. The results of this study can be summarized as follows: 1. The second edition of Tripitaka Koreana(고려대장경) was carved for the purpose of defending the country from Mongolia with the power of Buddhism, after the tablets of the first edition in Buin-sa(부이사) was destroyed by fire. 2. In 1236. Dae-Jang-Do-Gam(대장도감) was established, and the preparation for the recarving of the tablets such as comparison between the content, of the first edition of Tripitalk Koreana, Gal-Bo-Chik-Pan-Dae­Jang-Kyeong and Kitan Dae- Jang-Kyeong, transcription of the original copy and the preparation of the wood, etc. was started. 3. In 1237 after the announcement of Dae-Jang-Gyeong-Gak-Pan-Gun­Sin-Gi-Go-Mun(대장경핵판군신석고문), the carving was started on a full scale. And seven years later (1243), Bun-Sa-Dae-Jang-Do-Gam(분사대장도감) was established in the area of the South to expand and hasten the work. And a large number of the tablets were carved in there. 4. It took 16 years to carve the main text and the supplements of the second edition of Tripitaka Koreana, the main text being carved from 1237 to 1248 and the supplement from 1244 to 1251. 5. It can be supposed that the tablets of the second edition of Tripitaka Koreana, stored in Seon-Won-Sa(선원사), Kang-Wha(강화), for about 140 years, was moved to Ji-Cheon-Sa(지천사), Yong-San(용산), and to Hae-In-Sa(해인사) again, through the west and the south sea and Jang-Gyeong-Po(장경포), Go-Ryeong(고령), in the autumn of the same year. 6. The second edition of Tripitaka Koreana was carved mainly based on the first edition, comparing with Gae-Bo-Chik-Pan-Dae-Jang-Kyeong(개보판대장경) and Kitan Dae-Jang-Kyeong(계단대장경). And the second edition of Dae-Jang-Mock-Lock also compiled mainly based on the first edition with the reference to Kae-Won-Seok-Kyo-Lock and Sok-Jeong-Won-Seok-Kyo-Lock. 7. Comparing with the first edition of Dae-Jang-Mock-Lock, in the second edition 7 items of 9 volumes of Kitan text such as Weol-Deung­Sam-Mae-Gyeong-Ron(월증삼매경론) are added and 3 items of 60 volumes such as Dae-Jong-Ji-Hyeon-Mun-Ron(대종지현문논) are substituted into others from Cheon chest(천함) to Kaeng chest(경함), and 92 items of 601 volumes such as Beob-Won-Ju-Rim-Jeon(법원주임전) are added after Kaeng chest. And 4 items of 50 volumes such as Yuk-Ja-Sin-Ju-Wang-Kyeong(육자신주왕경) are ommitted in the second edition. 8. Comparing with Kae-Won-Seok-Kyo-Lock, Cheon chest to Young chest (영함) of the second edition is compiled according to Ib-Jang-Lock(입장록) of Kae-Won-Seok-Kyo-Lock. But 15 items of 43 vol­umes such as Bul-Seol-Ban-Ju-Sam-Mae-Kyeong(불설반주삼매경) are ;added and 7 items of 35 volumes such as Dae-Bang-Deung-Dae-Jib-Il­Jang-Kyeong(대방등대집일장경) are ommitted. 9. Comparing with Sok-Jeong-Won-Seok-Kyo-Lock, 3 items of the 47 volumes (or 49 volumes) are ommitted and 4 items of 96 volumes are ;added in Caek chest(책함) to Mil chest(밀함) of the second edition. But the items are arranged in the same order. 10. Comparing with Dae- Jung-Sang-Bo-Beob-Bo-Lock, the arrangement of the second edition is entirely different from it. But 170 items of 329 volumes are also included in Doo chest(두함) to Kyeong chest(경함) of the second edition, and 53 items of 125 volumes in Jun chest(존함) to Jeong chest(정함). And 10 items of 108 volumes in the last part of Dae-Jung-Sang-Bo-Beob-Bo-Lock are ommitted and 3 items of 131 volumes such as Beob-Won-Ju-Rim-Jeon(법원주임전) are added in the second edition. 11. Comparing with Kyeong-Woo-Sin-Su-Beob-Bo-Lock, all of the items (21 items of 161 volumes) are included in the second edition without ;any classificatory system. And 22 items of 172 volumes in the Seong­Hyeon-Jib-Jeon(성현집전) part such as Myo-Gak-Bi-Cheon(묘각비전) are ommitted. 12. The last part of the second edition, Joo chest(주함) to Dong chest (동함), includes 14 items of 237 volumes. But these items cannot be found in any other former Buddhist catalog. So it might be supposed as the Kitan texts. 13. Besides including almost all items in Kae-Won-Seok-Kyo-Lock and all items in Sok-Jeong-Won-Seok-Kyo-Lock, Dae-Jung-Sang-Bo­Beob-Bo-Lock, and Kyeong-Woo-Sin-Su-Beob-Bo-Lock, the second edition of Dae-Jang-Mock-Lock includes more items, at least 20 items of about 300 volumes of Kitan Tripitaka and 15 items of 43 volumes of traditional Korean Tripitake that cannot be found any others. Therefore, Tripitaka Koreana can be said as a comprehensive Tripitaka covering all items of Tripitakas translated in Chinese character.

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Evaluation of Radiation Exposure to Nurse on Nuclear Medicine Examination by Use Radioisotope (방사성 동위원소를 이용한 핵의학과 검사에서 병동 간호사의 방사선 피폭선량 평가)

  • Jeong, Jae Hoon;Lee, Chung Wun;You, Yeon Wook;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.44-49
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    • 2017
  • Purpose Radiation exposure management has been strictly regulated for the radiation workers, but there are only a few studies on potential risk of radiation exposure to non-radiation workers, especially nurses in a general ward. The present study aimed to estimate the exact total exposure of the nurse in a general ward by close contact with the patient undergoing nuclear medicine examinations. Materials and Methods Radiation exposure rate was determined by using thermoluminescent dosimeter (TLD) and optical simulated luminescence (OSL) in 14 nurses in a general ward from October 2015 to June 2016. External radiation rate was measured immediately after injection and examination at skin surface, and 50 cm and 1 m distance from 50 patients (PET/CT 20 pts; Bone scan 20 pts; Myocardial SPECT 10 pts). After measurement, effective half-life, and total radiation exposure expected in nurses were calculated. Then, expected total exposure was compared with total exposures actually measured in nurses by TLD and OSL. Results Mean and maximum amount of radiation exposure of 14 nurses in a general ward were 0.01 and 0.02 mSv, respectively in each measuring period. External radiation rate after injection at skin surface, 0.5 m and 1 m distance from patients was as following; $376.0{\pm}25.2$, $88.1{\pm}8.2$ and $29.0{\pm}5.8{\mu}Sv/hr$, respectively in PET/CT; $206.7{\pm}56.6$, $23.1{\pm}4.4$ and $10.1{\pm}1.4{\mu}Sv/hr$, respectively in bone scan; $22.5{\pm}2.6$, $2.4{\pm}0.7$ and $0.9{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. After examination, external radiation rate at skin surface, 0.5 m and 1 m distance from patients was decreased as following; $165.3{\pm}22.1$, $38.7{\pm}5.9$ and $12.4{\pm}2.5{\mu}Sv/hr$, respectively in PET/CT; $32.1{\pm}8.7$, $6.2{\pm}1.1$, $2.8{\pm}0.6$, respectively in bone scan; $14.0{\pm}1.2$, $2.1{\pm}0.3$, $0.8{\pm}0.2{\mu}Sv/hr$, respectively in myocardial SPECT. Based upon the results, an effective half-life was calculated, and at 30 minutes after examination the time to reach normal dose limit in 'Nuclear Safety Act' was calculated conservatively without considering a half-life. In oder of distance (at skin surface, 0.5 m and 1 m distance from patients), it was 7.9, 34.1 and 106.8 hr, respectively in PET/CT; 40.4, 199.5 and 451.1 hr, respectively in bone scan, 62.5, 519.3 and 1313.6 hr, respectively in myocardial SPECT. Conclusion Radiation exposure rate may differ slightly depending on the work process and the environment in a general ward. Exposure rate was measured at step in the general examination procedure and it made our results more reliable. Our results clearly showed that total amount of radiation exposure caused by residual radioactive isotope in the patient body was neglectable, even comparing with the natural radiation exposure. In conclusion, nurses in a general ward were much less exposed than the normal dose limit, and the effects of exposure by contacting patients undergoing nuclear medicine examination was ignorable.

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Consideration on National Rituals and Folk Beliefs Found in 『Hajaeilgi』 (『하재일기』에 나타난 국가의례와 민간신앙 일고찰)

  • Song, Jae Yong
    • (The)Study of the Eastern Classic
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    • no.69
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    • pp.349-371
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    • 2017
  • "Hajaeilgi(荷齋日記)" was written by Ji Gyu-sik, a gongin of Saongwon(司饔院)'s branch, almost everyday for 20 years and 7 months from January 1st, 1891 until the leap month of June 29th, 1911. It deals with many different areas including domestic and foreign circumstances, custom, rituals, all the affairs related to the branch, and also everyday life events he did see or hear about. Particularly, Ji Gyu-sik did not belong to the yangban class, and we can hardly find diaries written by such class' people. Here, what this author pays attention to among the things written in "Hajaeilgi" is the contents about folklore. Ji Gyu-sik wrote in his "Hajaeilgi" about things related to folklore, for example, seasonal customs, folk plays, rituals, or folk beliefs that were actually practiced then as a person not belonging to the yangban class. Such diaries are rare, and its value is highly appreciated as a material, and it is meaningful in the aspects of folklore as well. Therefore, as part of the work to look into folklore found in "Hajaeilgi", this author focuses on national rituals and folk beliefs in it. The things that have been discussed earlier can be summed up as follows: About national rituals, it is sorry that it only deals with the emperor's enthronement and emperor and crown prince's birthday in garye(嘉禮); however, it is meaningful to know that the people faithfully carried out national ceremonies and celebrations then. Particularly, it is noteworthy that during the national ceremonies or celebrations, students were asked to sing the national anthem. About hyungrye(凶禮), only it deals with the court funeral rite. Aside from Minbi's funeral rite, the court funeral rite was performed properly at the right time according to the procedure like before, and also, it seems that the people fulfilled it faithfully by order of the government. Also, it can be learned from it that Japanese killed Minbi, burned the body with oil, and left the ashes behind. About folk beliefs, the branch held a memorial service at the shrine of the town regularly. The town, too, performed Gocheongsinsa each year. The money needed for the memorial service was collected from the town people differently according to their financial situations, and they prepared for jesu for the ancestral rite altogether. The memorial service was carried out in Sansindang or Bugeundang, too, and it was common that they summoned a shaman to perform a gut. The diary is valuable as material. After being a Christian, Ji Gyu-sik once tried to abolish sinsa jesa held in hoesa and get rid of saesin(賽神), that is, a gut or pudakgeori, but he had no choice but to follow the precedent. Meanwhile, it is also noteworthy that when the town suffered from floor and infectious disease, Ji Gyu-sik installed an altar in front of his house for the town's wellbeing and health, prepared for jesu including offerings and drinks, and held a memorial service to Hwangcheonhuto(皇天后土; the gods of heaven and earth) accompanied with the town people. Also, when he had any hardships in his family, Ji Gyu-sik summoned a shaman for a gut or offered a devout prayer to the mountainous god. Such shamanism or the things like worshiping Gwanseongjegun(關聖帝君) mostly in the beginning of January and telling fortunes about the year were all folk beliefs. This was very popular among the people, and it seems that it was deeply rooted in his life as well. Also, Ji Gyu-sik supported Fengshui beliefs, and it seems that it is not different from the people's general tendencies, either. As described above, "Hajaeilgi" dealing with national rituals and folk beliefs in it is valuable as material and is meaningful for research on forklore, and moreover, it is also significant in the aspects of forklore as well.

Deriving adoption strategies of deep learning open source framework through case studies (딥러닝 오픈소스 프레임워크의 사례연구를 통한 도입 전략 도출)

  • Choi, Eunjoo;Lee, Junyeong;Han, Ingoo
    • Journal of Intelligence and Information Systems
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    • v.26 no.4
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    • pp.27-65
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    • 2020
  • Many companies on information and communication technology make public their own developed AI technology, for example, Google's TensorFlow, Facebook's PyTorch, Microsoft's CNTK. By releasing deep learning open source software to the public, the relationship with the developer community and the artificial intelligence (AI) ecosystem can be strengthened, and users can perform experiment, implementation and improvement of it. Accordingly, the field of machine learning is growing rapidly, and developers are using and reproducing various learning algorithms in each field. Although various analysis of open source software has been made, there is a lack of studies to help develop or use deep learning open source software in the industry. This study thus attempts to derive a strategy for adopting the framework through case studies of a deep learning open source framework. Based on the technology-organization-environment (TOE) framework and literature review related to the adoption of open source software, we employed the case study framework that includes technological factors as perceived relative advantage, perceived compatibility, perceived complexity, and perceived trialability, organizational factors as management support and knowledge & expertise, and environmental factors as availability of technology skills and services, and platform long term viability. We conducted a case study analysis of three companies' adoption cases (two cases of success and one case of failure) and revealed that seven out of eight TOE factors and several factors regarding company, team and resource are significant for the adoption of deep learning open source framework. By organizing the case study analysis results, we provided five important success factors for adopting deep learning framework: the knowledge and expertise of developers in the team, hardware (GPU) environment, data enterprise cooperation system, deep learning framework platform, deep learning framework work tool service. In order for an organization to successfully adopt a deep learning open source framework, at the stage of using the framework, first, the hardware (GPU) environment for AI R&D group must support the knowledge and expertise of the developers in the team. Second, it is necessary to support the use of deep learning frameworks by research developers through collecting and managing data inside and outside the company with a data enterprise cooperation system. Third, deep learning research expertise must be supplemented through cooperation with researchers from academic institutions such as universities and research institutes. Satisfying three procedures in the stage of using the deep learning framework, companies will increase the number of deep learning research developers, the ability to use the deep learning framework, and the support of GPU resource. In the proliferation stage of the deep learning framework, fourth, a company makes the deep learning framework platform that improves the research efficiency and effectiveness of the developers, for example, the optimization of the hardware (GPU) environment automatically. Fifth, the deep learning framework tool service team complements the developers' expertise through sharing the information of the external deep learning open source framework community to the in-house community and activating developer retraining and seminars. To implement the identified five success factors, a step-by-step enterprise procedure for adoption of the deep learning framework was proposed: defining the project problem, confirming whether the deep learning methodology is the right method, confirming whether the deep learning framework is the right tool, using the deep learning framework by the enterprise, spreading the framework of the enterprise. The first three steps (i.e. defining the project problem, confirming whether the deep learning methodology is the right method, and confirming whether the deep learning framework is the right tool) are pre-considerations to adopt a deep learning open source framework. After the three pre-considerations steps are clear, next two steps (i.e. using the deep learning framework by the enterprise and spreading the framework of the enterprise) can be processed. In the fourth step, the knowledge and expertise of developers in the team are important in addition to hardware (GPU) environment and data enterprise cooperation system. In final step, five important factors are realized for a successful adoption of the deep learning open source framework. This study provides strategic implications for companies adopting or using deep learning framework according to the needs of each industry and business.

A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Information Privacy Concern in Context-Aware Personalized Services: Results of a Delphi Study

  • Lee, Yon-Nim;Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.63-86
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    • 2010
  • Personalized services directly and indirectly acquire personal data, in part, to provide customers with higher-value services that are specifically context-relevant (such as place and time). Information technologies continue to mature and develop, providing greatly improved performance. Sensory networks and intelligent software can now obtain context data, and that is the cornerstone for providing personalized, context-specific services. Yet, the danger of overflowing personal information is increasing because the data retrieved by the sensors usually contains privacy information. Various technical characteristics of context-aware applications have more troubling implications for information privacy. In parallel with increasing use of context for service personalization, information privacy concerns have also increased such as an unrestricted availability of context information. Those privacy concerns are consistently regarded as a critical issue facing context-aware personalized service success. The entire field of information privacy is growing as an important area of research, with many new definitions and terminologies, because of a need for a better understanding of information privacy concepts. Especially, it requires that the factors of information privacy should be revised according to the characteristics of new technologies. However, previous information privacy factors of context-aware applications have at least two shortcomings. First, there has been little overview of the technology characteristics of context-aware computing. Existing studies have only focused on a small subset of the technical characteristics of context-aware computing. Therefore, there has not been a mutually exclusive set of factors that uniquely and completely describe information privacy on context-aware applications. Second, user survey has been widely used to identify factors of information privacy in most studies despite the limitation of users' knowledge and experiences about context-aware computing technology. To date, since context-aware services have not been widely deployed on a commercial scale yet, only very few people have prior experiences with context-aware personalized services. It is difficult to build users' knowledge about context-aware technology even by increasing their understanding in various ways: scenarios, pictures, flash animation, etc. Nevertheless, conducting a survey, assuming that the participants have sufficient experience or understanding about the technologies shown in the survey, may not be absolutely valid. Moreover, some surveys are based solely on simplifying and hence unrealistic assumptions (e.g., they only consider location information as a context data). A better understanding of information privacy concern in context-aware personalized services is highly needed. Hence, the purpose of this paper is to identify a generic set of factors for elemental information privacy concern in context-aware personalized services and to develop a rank-order list of information privacy concern factors. We consider overall technology characteristics to establish a mutually exclusive set of factors. A Delphi survey, a rigorous data collection method, was deployed to obtain a reliable opinion from the experts and to produce a rank-order list. It, therefore, lends itself well to obtaining a set of universal factors of information privacy concern and its priority. An international panel of researchers and practitioners who have the expertise in privacy and context-aware system fields were involved in our research. Delphi rounds formatting will faithfully follow the procedure for the Delphi study proposed by Okoli and Pawlowski. This will involve three general rounds: (1) brainstorming for important factors; (2) narrowing down the original list to the most important ones; and (3) ranking the list of important factors. For this round only, experts were treated as individuals, not panels. Adapted from Okoli and Pawlowski, we outlined the process of administrating the study. We performed three rounds. In the first and second rounds of the Delphi questionnaire, we gathered a set of exclusive factors for information privacy concern in context-aware personalized services. The respondents were asked to provide at least five main factors for the most appropriate understanding of the information privacy concern in the first round. To do so, some of the main factors found in the literature were presented to the participants. The second round of the questionnaire discussed the main factor provided in the first round, fleshed out with relevant sub-factors. Respondents were then requested to evaluate each sub factor's suitability against the corresponding main factors to determine the final sub-factors from the candidate factors. The sub-factors were found from the literature survey. Final factors selected by over 50% of experts. In the third round, a list of factors with corresponding questions was provided, and the respondents were requested to assess the importance of each main factor and its corresponding sub factors. Finally, we calculated the mean rank of each item to make a final result. While analyzing the data, we focused on group consensus rather than individual insistence. To do so, a concordance analysis, which measures the consistency of the experts' responses over successive rounds of the Delphi, was adopted during the survey process. As a result, experts reported that context data collection and high identifiable level of identical data are the most important factor in the main factors and sub factors, respectively. Additional important sub-factors included diverse types of context data collected, tracking and recording functionalities, and embedded and disappeared sensor devices. The average score of each factor is very useful for future context-aware personalized service development in the view of the information privacy. The final factors have the following differences comparing to those proposed in other studies. First, the concern factors differ from existing studies, which are based on privacy issues that may occur during the lifecycle of acquired user information. However, our study helped to clarify these sometimes vague issues by determining which privacy concern issues are viable based on specific technical characteristics in context-aware personalized services. Since a context-aware service differs in its technical characteristics compared to other services, we selected specific characteristics that had a higher potential to increase user's privacy concerns. Secondly, this study considered privacy issues in terms of service delivery and display that were almost overlooked in existing studies by introducing IPOS as the factor division. Lastly, in each factor, it correlated the level of importance with professionals' opinions as to what extent users have privacy concerns. The reason that it did not select the traditional method questionnaire at that time is that context-aware personalized service considered the absolute lack in understanding and experience of users with new technology. For understanding users' privacy concerns, professionals in the Delphi questionnaire process selected context data collection, tracking and recording, and sensory network as the most important factors among technological characteristics of context-aware personalized services. In the creation of a context-aware personalized services, this study demonstrates the importance and relevance of determining an optimal methodology, and which technologies and in what sequence are needed, to acquire what types of users' context information. Most studies focus on which services and systems should be provided and developed by utilizing context information on the supposition, along with the development of context-aware technology. However, the results in this study show that, in terms of users' privacy, it is necessary to pay greater attention to the activities that acquire context information. To inspect the results in the evaluation of sub factor, additional studies would be necessary for approaches on reducing users' privacy concerns toward technological characteristics such as highly identifiable level of identical data, diverse types of context data collected, tracking and recording functionality, embedded and disappearing sensor devices. The factor ranked the next highest level of importance after input is a context-aware service delivery that is related to output. The results show that delivery and display showing services to users in a context-aware personalized services toward the anywhere-anytime-any device concept have been regarded as even more important than in previous computing environment. Considering the concern factors to develop context aware personalized services will help to increase service success rate and hopefully user acceptance for those services. Our future work will be to adopt these factors for qualifying context aware service development projects such as u-city development projects in terms of service quality and hence user acceptance.

A Study on the Effective Independent Study of Nursing Student (간호학생의 효과적인 자율학습을 위한 조사연구)

  • 김광주;이향련
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.16-42
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    • 1978
  • This survey was made for a month starting from November 15 to December 15, 1977 covering 711 students taking the junior. (3rd-yea.) and the senior. (4th-year) at nine college of nursing in Seoul concerning their perception and Attitude toward the profession of nursing, motive for the necessity of learning, environment of study, attitude of study and particulars relevant with study performance, particulars of library, references and reading, assignments and particulars of the degree of confidence for the learning achievement. Through the survey of the above Particulars, the following results were obtained by classifying all subject matters and by analysing motive of the selection of their course, awarding or not awarding of scholarships. 1. General characteristics: it was revealed that 406 students (57.1%) were attending at the junior. while 305 students (42.9%) were taking the senior. Thus, the total number was 711 and their average age was 21.4 years. Their dwelling category was; 73.9 percent of them resided at their parent's home, 214 students (30.1%) were awarded with scholarships. The reason to be attracted by nursing science was the possibility of continuing social life after graduation (43.5%). 2. Their perception and attitude toward the profession of nursing: According to the perception of profession by the students of each grade, students of the 4th grade showed comparatively strong conception. Also, students of the 4th grade showed more positive attitude in the purchase and reading of magazines relative with the science of nursing, in the reading of Code for Nurses and in their interest in the activity of nursing field. For the necessity of mission of nurse, 97.7 percent of the entire number of students covered responded to necessity. For the necessity of the particular humanity and particularity in the character of nurses, 95.8 percent of those students responded to necessity. By the each grade, students of the 4th grade showed more response. 3. As to professional field desired after completing the professional course: 57 percent of those students desired for clinician nurse while 55 percents desired for community health-nurse. 4. As to the environment of study: they were mostly satisfied with their present residential environment. However, they complained of inconvenience at their lecture-halls. Students of the 3rd grade showed more complain. As to their attitude toward the adjustment of environment of study, they showed a affirmative response. As to the opinion of factors which interfere with their study, comparatively strong response was showed in their scepticism in the science of nursing, insufficient comprehension in general learning, relation with professors n4 discrepancy in the method of study. According to opinions of students at each grade, students of the 4th grade showed more scepticism. 5. Particulars relative with their attitude and performance of study : As to their knowledge of the objectives of their study of subject, the majority was to study with a partial knowledge of the objectives of their study. As to the plan of study, a low percentage indicated management of routine life under regular scheduling. Students of the 4th grade responded to rather planned life. As to time spent in independent study, response to concentrated study when necessary was stronger than that to regular daily study. Students of the 4th grade showed stronger response to regular study than that of the 3rd grade. As to the contents of their note-taking, 67.4 percents of those students responded to such regulatory procedure performing in the lecture-hall as they listen to lectures. 17.3 percents of those students showed response to adding supplementary informations from references to what was entered in choir note-taking at their lecture-halls. 6. Particulars of library, references and reading books: As to receiving of instruction for the utilization of library and time of receiving such instruction 64.7 percents of those students had received such instruction. 66.7 percents of the those responded received such instruction at orientation conducted for freshmen. As to the convenience of the utilization of library, 49.9 percents of those students responded to convenience. However, students of the 3rd grade showed a much stronger response to inconvenience. As to the time of the utilization of library,92.5 percents of those students showed a response to occasional utilization for particular purpose than regular utilization. 53.2 percents of those students responded to ordinary in quantity that library have references. 34.2 percents of those students responded to insufficient. As to the particular relative with the method and field of reading: 53.5 percents of those students responded to intensive reading and was the majority. As to the reading field, fiction u as the majority. When read any books for their major, they usually rend Korean text-b, oks. 7. Particular relative with giving assignment: All respondents were well aware of the objectives of giving home tasks. As to the attitude toward assignments and performing home tasks, 54.8 percents of those students to making ostentatious study because of an excessive quantity of assignments imposed. For performing assignment, they showed comparatively positive response. Also, 52.2 percents of those students responded that they usually submitted complected assignment with references. 8. As to motive to realize the necessity of study : 55.6 percents of those students responded that they realized such necessity in communication with patients when they were engaged in clinical practice. Also, 8.6, the lowest percents of those students responded that they realized such necessity in the course of conversation with nurses when they were engaged in clinical practice. 9. As to the determination of their confidence in the performance of study relative with clinical experience: They showed a general inclination of having in nursing. The major response was that they came to well comprehend the patients families. the lowest response was that they could apply what was learned at lecture-hall to practice. This response incidentally showed the distance the lecture-hall and practical study. In general items, students of the 4th grade showed more favorable response than students of the 3rd grade and there was a significant difference. 10. As to the perception and attitude toward profession according to the motive of selecting the nursing science : Those who selected the nursing voluntarily showed stronger conception than those who selected the nursing through indirect influence. However, there was no significant difference on this point. Only there was a remarkable difference in the reading of Code for Nurses. 11. Those who showed a stronger conception in the profession of nursing according to the motives of attractive nursing science indicated a strong will and ability to manage stable life and comparatively strong response was shown in the management of good home life because of the good adaptability of the science to their character. This group showed a strong conception of the profession than those who responded that they prefer this profession out of a longing for the work of a hospital and for the easy obtaining of opportunity to immigrate to over seas and for economic cause and for high school grade. There was significant difference between these two groups, 12. As to the conception and attitude toward the profession of nursing according to benefits by scholarships, those who were benefitted by scholarship showed stronger conception of profession than those who did not receive scholarship and there was a remarkable difference between these two categories. However, there was no remarkable difference between these two categories in the extent of interest of the activities of nursing fields and in the reading of Code for Nurses. 13. As activation for study according to the benefits of scholarships, those who were benefitted by scholarships showed stronger response to the motive for study comparing with those who receive. 14. As to tile field of reading according to the benefits by scholarships, those who received scholarships tended to read autobiographies and essayers to a considerable extent. Those who did not receive scholarships tended to read novels. Those who received scholarships more read nursing boots than those who did not receive scholarships. 15. As to the attitude of study and doing of assignment according to benefits of scholarships, those who received scholarships managed a favorable life with schedules for study, More students of receiving scholarship showed a regular study for more than one hour per day. Also, in the method of doing home tasks, more students of receiving scholarship showed reference to relative books frequently for the submission of completed assignments.

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