• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7359-7366
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• 2013

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

• Journal of Korean Neurosurgical Society
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• 제63권5호
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• pp.631-639
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• 2020

Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

• 한국인터넷방송통신학회논문지
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• 제18권1호
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• pp.105-111
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• 2018

공교육의 STEAM과 S/W 교육은 융합 인재와 4차산업혁명 시대의 인재 양성에 효과적이며 이를 위한 전담교사의 확충과 다양한 학습자료의 발굴 및 적용, 융합인재 교육을 위한 교육환경 개선이 필요하다. 그리고, 개방형 학습 플랫폼은 사교육비 절감과 공교육의 보완에 효과적이다. 특히 교실 수업(오프라인)과 결합된 플립러닝에 유용하며 이럴 경우 교사의 역할이 능동적인 교수활동과 연구 활동으로 전환되어 공교육의 정상화를 앞당기고 사교육을 줄일 수 있다. 특히, 초등교육을 위한 MOOC 플랫폼 운영의 핵심 기능으로 '창의적 교수설계와 콘텐츠 개발 기능', '디지털 교수 학습 큐레이션 기능', '빅데이터 기반 학습자 맞춤화 기능', '학습 참여 촉진 플립러닝 및 소셜러닝 기능'을 제시한다. 본 연구를 통해 초등교육을 포함한 청소년의 진로 및 입시교육 MOOC의 도입에 대한 논의의 장이 마련되고 한국형 청소년 MOOC 플랫폼이 구축되어 교육민주화의 세계적 선진 모델로 발전될 수 있기를 기대한다.

• Journal of Communications and Networks
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• 제6권3호
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• pp.269-279
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• 2004

A new online multi-layer integrated routing (MLIR) scheme that combines IP (electrical) layer routing with WDM (optical) layer routing is investigated. It is a highly efficient and cost-effective routing scheme viable for the next generation integrated optical Internet. A new simplified weighted graph model for the integrated optical Internet consisted of optical routers with multi-granularity optical-electrical hybrid switching capability is firstly proposed. Then, based on the proposed graph model, we develop an online integrated routing scheme called differentiated weighted fair algorithm (DWFA) employing adaptive admission control (routing) strategies with the motivation of service/bandwidth differentiation, which can jointly solve multi-layer routing problem by simply applying the minimal weighted path computation algorithm. The major objective of DWFA is fourfold: 1) Quality of service (QoS) routing for traffic requests with various priorities; 2) blocking fairness for traffic requests with various bandwidth granularities; 3) adaptive routing according to the policy parameters from service provider; 4) lower computational complexity. Simulation results show that DWFA performs better than traditional overlay routing schemes such as optical-first-routing (OFR) and electrical-first-routing (EFR), in terms of traffic blocking ratio, traffic blocking fairness, average traffic logical hop counts, and global network resource utilization. It has been proved that the DWFA is a simple, comprehensive, and practical scheme of integrated routing in optical Internet for service providers.

• 보건행정학회지
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• 제8권2호
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• pp.58-75
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• 1998

The hospital is characterized by it's remarkable labor industry and human resources input by unit. Recently, the administrative personnel are recognized as important staff to provide a hospital guidance to consumer and also easiness for consumer's visit to hospital. The objectives of this study is to find the performance of the administrative personnel in hospitals. The unit of analysis is the hospitals and data was collected form 144 staffs in 5 hospitals. Self administered questionnaire was given to analyze the general characteristics of staft such as age, sex, education, experience, and performance level in terms of frequency, ability, necessity of tasks. The major findings are as follows: 1. The 5 major tasks such as general affairs, insurance related affairs, hospital statistics, admission/discharge, and analysis of treatment cost were analyzed. Performance level of these tasks were not showed consistent level. It means that the same task was showed both high level performance and low level one. 2. The higher rates of performance level, ability and necessity were found, below 29 years of age, junior college graduates and university hospital than that of general one. 3. Factors mostly affected to performances were found as characteristics of hospital, age and education. 4. Concerning the various manpower management, On the job training, incentive mechanism and colose relationship among units were somewhat lack. In conclusion, most responded administrative personnel have performed actively in dealing with their tasks. however, the performance level and ability of the same task were showed differently, it means that such routine works were not standardized. Therefore, standardization and specification of tasks should be developed to strength the performance. Finally, this study is the first attempt to find out the performance of the administrative staffs and the study results imply that further study could be neeed to promote the performance of administrative personnel efficiently and effectively.

• Biomolecules & Therapeutics
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• 제14권1호
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• pp.56-65
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• 2006

Adverse drug events (ADEs) are the most common type of adverse events in medical practice. Hospital admissions related to ADEs cost high and should be monitored to prevent them. While concerns about the ADEs are increasing, the frequency and characteristics of admissions related to ADEs have not been reported in Korea. The objective of the study was to assess the rate of hospital admission related to ADEs and their characteristics through ADE signal-based retrospective reviews of medical records. As results, a total of 1,420 patients had ADE signals suggesting potential ADEs from 3,494 patients who discharged from an academic medical center over one month period. Six pharmacists independently assessed the presence of ADEs after the review of patients' medical records. Among the 3,494 discharges, 62 admissions (1.8%) were found to be realted to ADEs. Of admissions with ADEs, 83.9% were moderate (category F by the NCC MERP classification), 37.2% were preventable, and 85.5% were type A reaction. The most frequent suspected drugs causing ADEs were antineoplastics (48.9%), and the most frequent ADE signal detecting hospital admissions related to ADEs was white blood cell count (24.2%). Hospital admissions related to ADEs were found through screening the ADE signals. The ADE signal-based retrospective review could be a practical approach for identifying hospital admissions related to ADEs.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제6권6호
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• pp.1522-1545
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• 2012

Call admission control (CAC) plays an important role in mobile cellular network to guarantee the quality of service (QoS). In this paper, a dynamic hybrid CAC scheme with integrated cutoff priority and handoff queue for mobile cellular network is proposed and some performance metrics are derived. The unique characteristic of the proposed CAC scheme is that it can support any number of service types and that the cutoff thresholds for handoff calls are dynamically adjusted according to the number of service types and service priority index. Moreover, timeouts of handoff calls in queues are also considered in our scheme. By modeling the proposed CAC scheme with a one-dimensional Markov chain (1DMC), some performance metrics are derived, which include new call blocking probability ($P_{nb}$), forced termination probability (PF), average queue length, average waiting time in queue, offered traffic utilization, wireless channel utilization and system performance which is defined as the ratio of channel utilization to Grade of Service (GoS) cost function. In order to validate the correctness of the derived analytical performance metrics, simulation is performed. It is shown that simulation results match closely with the derived analytic results in terms of $P_{nb}$ and PF. And then, to show the advantage of 1DMC modeling for the performance analysis of our proposed CAC scheme, the computing complexity of multi-dimensional Markov chain (MDMC) modeling in performance analysis is analyzed in detail. It is indicated that state-space cardinality, which reflects the computing complexity of MDMC, increases exponentially with the number of service types and total channels in a cell. However, the state-space cardinality of our 1DMC model for performance analysis is unrelated to the number of service types and is determined by total number of channels and queue capacity of the highest priority service in a cell. At last, the performance comparison between our CAC scheme and Mahmoud ASH's scheme is carried out. The results show that our CAC scheme performs well to some extend.

• 한국병원경영학회지
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• 제10권2호
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• pp.1-25
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• 2005

This study purports to investigate the determinants of patient satisfaction and intent to revisit at national university hospitals in Korea. A total of 8 independent variables for outpatients, 9 independent variables for inpatients, and an intervening variable of overall patient satisfaction were selected through literature review. The independent variables for outpatients contain the level of satisfaction with physicians, nurses, ancillary staff, administrative procedure, medical cost, physical environment, facility convenience. and health recovery. With regard to the independent variables for inpatients, the quality of ward services was added to those of outpatients. Each variable contains 3 to 8 items measuring the level of satisfaction with various aspects of the variable. The sample used in this study consisted of 879 outpatients and 821 inpatients. Data were collected with interview survey and analyzed using path analysis. The major findings of the study are as follows: 1) The following variables have significantly positive effect on the intent to revisit of outpatients: health recovery, overall satisfaction, satisfaction with physicians, and ancillary staff. 2) The following variables have significantly positive effect on the intent to revisit of inpatients: health recovery, satisfaction with nurses and physicians, overall satisfaction, and administrative procedure. 3) The following variables of admission procedure, satisfaction with ancillary staff, facility convenience, quality of ward services were found to have significantly positive effect only on the level of overall satisfaction, even though they do not have significant total effect on the intent to revisit. The results of the study indicate that national university hospitals in Korea should make an effort to improve the satisfactory level of patients with clinical outcome, services provided by physicians, nurses, and ancillary staff, and the quality of administrative procedure for enhancing the intent to revisit of patients.

• 대한지역사회영양학회지
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• 제11권6호
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.587-597
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• 2019

우리나라 인구의 빠른 고령화와 일상생활이 어려운 노인들이 증가하여 사회적 연대를 위한 노인장기요양 제도가 실시되었다. 제도 도입 후 나타난 장기요양제도의 구조적 문제 해결을 요구하고 있으며 기관 및 급여유형별로 통합된 요양서비스 제공체계, 노인의료-요양의 연속성 부족에 따른 요양병원-시설 간 기능정립 문제 등도 제기되고 있다. 이 연구에서는 문제점을 개선하기 위하여 입소정원, 종사인력, 제공서비스와 관련한 연구문제를 설정하였으며 FGI를 실시하였다. 연구결과 지역 내 노인 인구와 인정자 수, 노인성 질환자수 등 장기요양 수요를 반영, 지역별 적정 기관 및 인력 수급 정책 방향 제시하고, 지자체별 목표와 수급계획을 수립하여, 장기요양기관 지정요건 절차 강화 및 지정 갱신제 등 인증제도 도입이 검토되어야 하며, 남성요양보호사 육성 및 수가 인상 등을 통한 종사자 처우개선을 통하여 원활한 인력수급이 필요하다고 보았다. 급식비의 보험적용과 유관기관과의 연계를 통한 프로그램 확대제공, 원활한 입소관리를 위한 의료외 사고 중재기구가 필요하다고 나타났다.