• Title/Summary/Keyword: case management

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Effect of Health Promotion and Characteristics of Elderly used Day Care Service in Community Health Practitioner's Post (보건진료소의 주간보호실 이용노인의 특성과 건강증진 정도)

  • Jeong, In-Suk;Cho, Yoo-Hyang;Park, Yoon-Chang
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.127-136
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    • 2002
  • This study was taken to provide data for the approaches of day care service for the elderly in community health practitioner's post through the study on the utilization rate, characteristics and health promotion that the elderly used the day care services. Data collection used three records that case management in take sheet, dementia check list and ADL record during the one year, from June 21, 2001 to June 30, 2002. During the one year, the elderly used day care services were 119 persons that 26.9% of the total elderly population, 1.5 time per used the elderly, and female elderly(88.9%) more used than male elderly. 39.5%of the elderly user have chronic diseases that was arthritis and hypertension and etc. 41.2% of the elderly users have dementia state that score was $17.39{\pm}7.17$(handicapped elderly), $18.43{\pm}7.36$(healthy elderly), but statistically not significant PADL score was $2.18{\pm}0.55$(handicapped elderly), $2.78{\pm}0.30$(healthy elderly), IADL score was $1.78{\pm}0.51$(handicapped elderly), $2.47{\pm}0.60$(healthy elderly) that were statistically significant. One year later, PADL and IADL of the elderly users were improved that statistically significant(p=0.01). The elderly users were wanted rehabilitation service(22.2%), talking service(20.6%), bath service(12.7%), food service(9.5%) of day care services in CHP's post. We are recommended that day care service for the elderly in CHP's post was very useful and contributed to promote ADL functions.

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The Status of Nursing Ethics Education in Korea 4-year-College of Nursing (간호윤리 교육현황 - 4년제 대학교육을 중심으로 -)

  • Han Sung-Suk;Kim Yong-Soon;Um Young-Rhan;Ahn Sung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.376-387
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    • 1999
  • Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.

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Necrotizing Enterocolitis - A Survey by the Korean Association of Pediatric Surgeons - (괴사성 장염 - 대한소아외과학회회원 대상 전국조사 -)

  • Lee, Suk-Koo;Kim, D.Y.;Kim, S.G.;Kim, W.K.;Kim, I.K.;Kim, S.Y.;Kim, S.C.;Kim, J.E.;Kim, J.C.;Park, K.W.;Park, W.H.;Seo, J.M.;Song, Y.T.;Oh, S.M.;Oh, J.T.;Lee, N.H.;Lee, D.S.;Lee, S.C.;Jun, Y.S.;Chung, S.Y.;Chung, S.E.;Choi, K.J.;Choi, S.O.;Choi, S.H.;Han, S.J.
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.70-85
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    • 2006
  • A nationwide survey on necrotizing enterocolitis (NEC) was undertaken among members of the Korean Association of Pediatric Surgeons. The members were required to complete a questionnaire and the case registration form for each patient during the three-year period from July 2001 to June 2004. Eighty one patients were included in the questionnaire, but only 71 patients were registered from 22 members in 16 hospitals. At the same time survey on focal intestinal perforation (FIP) was undertaken and 17 patients were registered from 11 members in 10 hospitals. Total 19,041 newborns were admitted to neonatal intensive care unit during the study period. Eighty one patients (17.27 %) were underwent surgery among 469 babies who were managed under the impression of NEC. The male to female ratio was 2.1:1. The premature were 60.6 %. The most common site of involvement was ileum. Overall and operation survival of NEC were 72 % and 79 %, respectively. The survival was lower in smaller babies, multiple segments involvement and involvement of both the small and large intestine. But there was no difference in survival according to sex or prematurity. The FIP showed very similarity with NEC in terms of incidence, and the age of diagnosis and operation. But the survival was much better and 100 %. The results showed the clinical characteristics of NEC and the trend of management in NEC in Korea. In the future we hope we can discuss about this topic in prospective manner.

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IMMOBILIZATION OF LOWER MANDIBULAR ALVEOLAR BONE FRACTURE USING RESIN-WIRE OPEN CAP SPLINT (하악 유전치부 치조골 골절시 resin-wire open cap splint를 이용한 고정)

  • Kwon, Joung-Hyun;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.1
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    • pp.175-180
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    • 2008
  • Traumatic injuries to the primary dentition are commonly encountered problems in dental practice. It is found that 30% of the children had injuries to the primary dentition and 22% to the permanent dentition. The greatest incidence of trauma to the primary dentition occurs at the ages of 2 and 3 as children start to learn motor coordination. Because teeth and alveolar bone are traumatized simultaneously, alveolar bone fractures are likely to occur when multiple teeth are involved in injuries. Dental splints are indicated for the management of maxillofacial fractures. They enable anatomic reduction of fractured segments and help immobilization and maintenance of the fragments after reduction. They also act as a stabilizer during rehabilitation. Various types of dental splints are available. In this case, routine resin-wire splint technique could not be applied because of the child's uncooperative behavior. Oral sedation was not indicated because N.P.O. had not been preceded. Therefore, we decided to use open-cap acrylic splint instead. Stabilization using open cap acrylic splint requires minimum chair time with reduced discomfort to both patient and dentist. It is an effective means of splint for uncooperative children and especially useful when other means of fixation have been failed. Because trauma on the primary dentition can affect the underlying permanent tooth germ, it is important to monitor eruption process of the permanent dentition.

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Effect of Market Basket Size on the Accuracy of Association Rule Measures (장바구니 크기가 연관규칙 척도의 정확성에 미치는 영향)

  • Kim, Nam-Gyu
    • Asia pacific journal of information systems
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    • v.18 no.2
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    • pp.95-114
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    • 2008
  • Recent interests in data mining result from the expansion of the amount of business data and the growing business needs for extracting valuable knowledge from the data and then utilizing it for decision making process. In particular, recent advances in association rule mining techniques enable us to acquire knowledge concerning sales patterns among individual items from the voluminous transactional data. Certainly, one of the major purposes of association rule mining is to utilize acquired knowledge in providing marketing strategies such as cross-selling, sales promotion, and shelf-space allocation. In spite of the potential applicability of association rule mining, unfortunately, it is not often the case that the marketing mix acquired from data mining leads to the realized profit. The main difficulty of mining-based profit realization can be found in the fact that tremendous numbers of patterns are discovered by the association rule mining. Due to the many patterns, data mining experts should perform additional mining of the results of initial mining in order to extract only actionable and profitable knowledge, which exhausts much time and costs. In the literature, a number of interestingness measures have been devised for estimating discovered patterns. Most of the measures can be directly calculated from what is known as a contingency table, which summarizes the sales frequencies of exclusive items or itemsets. A contingency table can provide brief insights into the relationship between two or more itemsets of concern. However, it is important to note that some useful information concerning sales transactions may be lost when a contingency table is constructed. For instance, information regarding the size of each market basket(i.e., the number of items in each transaction) cannot be described in a contingency table. It is natural that a larger basket has a tendency to consist of more sales patterns. Therefore, if two itemsets are sold together in a very large basket, it can be expected that the basket contains two or more patterns and that the two itemsets belong to mutually different patterns. Therefore, we should classify frequent itemset into two categories, inter-pattern co-occurrence and intra-pattern co-occurrence, and investigate the effect of the market basket size on the two categories. This notion implies that any interestingness measures for association rules should consider not only the total frequency of target itemsets but also the size of each basket. There have been many attempts on analyzing various interestingness measures in the literature. Most of them have conducted qualitative comparison among various measures. The studies proposed desirable properties of interestingness measures and then surveyed how many properties are obeyed by each measure. However, relatively few attentions have been made on evaluating how well the patterns discovered by each measure are regarded to be valuable in the real world. In this paper, attempts are made to propose two notions regarding association rule measures. First, a quantitative criterion for estimating accuracy of association rule measures is presented. According to this criterion, a measure can be considered to be accurate if it assigns high scores to meaningful patterns that actually exist and low scores to arbitrary patterns that co-occur by coincidence. Next, complementary measures are presented to improve the accuracy of traditional association rule measures. By adopting the factor of market basket size, the devised measures attempt to discriminate the co-occurrence of itemsets in a small basket from another co-occurrence in a large basket. Intensive computer simulations under various workloads were performed in order to analyze the accuracy of various interestingness measures including traditional measures and the proposed measures.

An Empirical Study on the Factors Affecting RFID Adoption Stage with Organizational Resources (조직의 자원을 고려한 RFID 도입단계별 영향요인에 관한 실증연구)

  • Jang, Sung-Hee;Lee, Dong-Man
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.125-150
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    • 2009
  • RFID(Radio Frequency IDentification) is a wireless frequency of recognition technology that can be used to recognize, trace, and identify people, things, and animals using radio frequency(RF). RFID will bring about many changes in manufacturing and distributions, among other areas. In accordance with the increasing importance of RFID techniques, great advancement has been made in RFID studies. Initially, the RFID research started as a research literature or case study. Recently, empirical research has floated on the surface for announcement. But most of the existing researches on RFID adoption have been restricted to a dichotomous measure of 'adoption vs. non-adoption' or adoption intention. In short, RFID research is still at an initial stage, mainly focusing on the research of the RFID performance, integration, and its usage has been considered dismissive. The purpose of this study is to investigate which factors are important for the RFID adoption and implementation with organizational resources. In this study, the organizational resources are classified into either finance resources or IT knowledge resources. A research model and four hypotheses are set up to identify the relationships among these variables based on the investigations of such theories as technological innovations, adoption stage, and organizational resources. In order to conduct this study, a survey was carried out from September 27, 2008 until October 23, 2008. The questionnaire was completed by 143 managers and workers from physical distribution and manufacturing companies related to the RFID in South Korea. 37 out of 180 surveys, which turned out unfit for the study, were discarded and the remaining 143(adoption stage 89, implementation stage 54) were used for the empirical study. The statistics were analyzed using Excel 2003 and SPSS 12.0. The results of the analysis are as follows. First, the adoption stage shows that perceived benefits, standardization, perceived cost savings, environmental uncertainty, and pressures from rival firms have significant effects on the intent of the RFID adoption. Further, the implementation stage shows that perceived benefits, standardization, environmental uncertainty, pressures from rival firms, inter-organizational cooperation, and inter-organizational trust have significant effects on the extent of the RFID use. In contrast, inter-organizational cooperation and inter-organizational trust did not show much impact on the intent of RFID adoption while perceived cost savings did not significantly affect the extent of RFID use. Second, in the adoption stage, financial issues had adverse effect on both inter-organizational cooperation and the intent against the RFID adoption. IT knowledge resources also had a deterring effect on both perceived cost savings and the extent of the RFID adoption. Third, in the implementation stage, finance resources had a moderate effect on environmental uncertainty and extent of RFID use while IT knowledge resources had also a moderate effect on perceived cost savings and the extent of the RFID use. Limitations and future research issues can be summarized as follows. First, it is difficult to say that the sample is large enough to be representative of the population. Second, because the sample of this study was conducted among manufacturers only, it may be limited in analyzing fully the effect on the industry as a whole. Third, in consideration of the fact that the organizational resources in the RFID study require a great deal of researches, this research may deem insufficient to fulfill the purpose that it initially set out to achieve. Future studies using performance research are, therefore, needed to help better understand the organizational level of the RFID adoption and implementation.

Context Prediction Using Right and Wrong Patterns to Improve Sequential Matching Performance for More Accurate Dynamic Context-Aware Recommendation (보다 정확한 동적 상황인식 추천을 위해 정확 및 오류 패턴을 활용하여 순차적 매칭 성능이 개선된 상황 예측 방법)

  • Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.51-67
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    • 2009
  • Developing an agile recommender system for nomadic users has been regarded as a promising application in mobile and ubiquitous settings. To increase the quality of personalized recommendation in terms of accuracy and elapsed time, estimating future context of the user in a correct way is highly crucial. Traditionally, time series analysis and Makovian process have been adopted for such forecasting. However, these methods are not adequate in predicting context data, only because most of context data are represented as nominal scale. To resolve these limitations, the alignment-prediction algorithm has been suggested for context prediction, especially for future context from the low-level context. Recently, an ontological approach has been proposed for guided context prediction without context history. However, due to variety of context information, acquiring sufficient context prediction knowledge a priori is not easy in most of service domains. Hence, the purpose of this paper is to propose a novel context prediction methodology, which does not require a priori knowledge, and to increase accuracy and decrease elapsed time for service response. To do so, we have newly developed pattern-based context prediction approach. First of ail, a set of individual rules is derived from each context attribute using context history. Then a pattern consisted of results from reasoning individual rules, is developed for pattern learning. If at least one context property matches, say R, then regard the pattern as right. If the pattern is new, add right pattern, set the value of mismatched properties = 0, freq = 1 and w(R, 1). Otherwise, increase the frequency of the matched right pattern by 1 and then set w(R,freq). After finishing training, if the frequency is greater than a threshold value, then save the right pattern in knowledge base. On the other hand, if at least one context property matches, say W, then regard the pattern as wrong. If the pattern is new, modify the result into wrong answer, add right pattern, and set frequency to 1 and w(W, 1). Or, increase the matched wrong pattern's frequency by 1 and then set w(W, freq). After finishing training, if the frequency value is greater than a threshold level, then save the wrong pattern on the knowledge basis. Then, context prediction is performed with combinatorial rules as follows: first, identify current context. Second, find matched patterns from right patterns. If there is no pattern matched, then find a matching pattern from wrong patterns. If a matching pattern is not found, then choose one context property whose predictability is higher than that of any other properties. To show the feasibility of the methodology proposed in this paper, we collected actual context history from the travelers who had visited the largest amusement park in Korea. As a result, 400 context records were collected in 2009. Then we randomly selected 70% of the records as training data. The rest were selected as testing data. To examine the performance of the methodology, prediction accuracy and elapsed time were chosen as measures. We compared the performance with case-based reasoning and voting methods. Through a simulation test, we conclude that our methodology is clearly better than CBR and voting methods in terms of accuracy and elapsed time. This shows that the methodology is relatively valid and scalable. As a second round of the experiment, we compared a full model to a partial model. A full model indicates that right and wrong patterns are used for reasoning the future context. On the other hand, a partial model means that the reasoning is performed only with right patterns, which is generally adopted in the legacy alignment-prediction method. It turned out that a full model is better than a partial model in terms of the accuracy while partial model is better when considering elapsed time. As a last experiment, we took into our consideration potential privacy problems that might arise among the users. To mediate such concern, we excluded such context properties as date of tour and user profiles such as gender and age. The outcome shows that preserving privacy is endurable. Contributions of this paper are as follows: First, academically, we have improved sequential matching methods to predict accuracy and service time by considering individual rules of each context property and learning from wrong patterns. Second, the proposed method is found to be quite effective for privacy preserving applications, which are frequently required by B2C context-aware services; the privacy preserving system applying the proposed method successfully can also decrease elapsed time. Hence, the method is very practical in establishing privacy preserving context-aware services. Our future research issues taking into account some limitations in this paper can be summarized as follows. First, user acceptance or usability will be tested with actual users in order to prove the value of the prototype system. Second, we will apply the proposed method to more general application domains as this paper focused on tourism in amusement park.

A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs (첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구)

  • Park Yong-Sin;Cho Byung-Hee;Kim Ho;Lee Si-Baek
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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Early Management of Total Parenteral Nutrition Induced Hepatic Dysfunction with Cyclic Parenteral Nutrition (정맥영양 관련 간기능 장애에서 조기 주기성 정맥영양법의 유용성)

  • Lee, Sung Soo;Chang, Ju Young;Yang, Hye Ran;Ko, Jae Sung;Choi, Kyung Hee;Seo, Jeong Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.61-73
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    • 2004
  • Purpose: Liver function test abnormalities have been reported frequently in patients receiving total parenteral nutrition (TPN). In adults, it is known that liver complications decrease with the use of cyclic parenteral nutrition (CPN), especially if the shift to cycling was not too late. However, there are few studies about the effects of cycling on liver injury in children beyond the neonatal period. The aim of this study is to evaluate the effect of the early use of CPN on total parenteral nutrition induced hepatic dysfunction. Methods: Twelve sets of CPN in 11 children (2 months to 17 years) were included in this study. Data on underlying diseases, age, length of time on TPN, macronutrient intake, complications, and biochemical parameters were collected from clinical records. All children had received CPN in the early period of persistent transaminase elevation or cholestasis complicated by previous continuous PN. The duration of infusion off-time in CPN was 2 hours in patients less than 3 months of age and 4 hours in the older children. Results: All 12 cases showed elevated aminotransferase and 5 of them also showed cholestasis. Serum total bilirubin concentration was normalized in all 5 cases with median periods of 8 days (p<0.05) after initiation of CPN. ALT either decreased significantly or was normalized in all cases with median periods of 30 days (p<0.05) on CPN. The CPN was well tolerated without significant complication except for one case of hyperglycemia. Conclusion: The early use of cyclic parenteral nutrition had a beneficial effect in improving hepatic dysfunction complicated by TPN in children.

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Clinical Analysis of Polymicrobial Bloodstream Infections in Pediatric Patients: Epidemiology, Clinical Features, Organisms, and Risk Factors (소아 환자에서 다균혈증에 대한 임상적 고찰)

  • Kim, Jung Min;Park, Hye Jin;Kim, Ki Hwan;Kim, Dong Soo
    • Pediatric Infection and Vaccine
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    • v.17 no.2
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    • pp.83-90
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    • 2010
  • Purpose : Although the incidence of polymicrobial bloodstream infection (PBSI) has increased, only a few studies have so far focused on children. Therefore, in an effort to prevent more serious situations in pediatric patients, we analyzed the clinical features, organisms, and laboratory results of PBSI. Methods : We performed a retrospective review of the case records of 97 patients with polymicrobial bloodstream infection in the Severance hospital, from 2001 to 2008. Using t-test and chi-square test, we analyzed the underlying medical conditions, clinical characteristics, organisms, and laboratory results of those patients. Results : Annual incidence of polymicrobial bloodstream infection increased from 1.4 % in 2001 to 10.9% in 2008 in pediatric patients. Immunocompromised hemato-oncological malignancy was found in 31 (31.9%) patients, and was the most common underlying medical condition; cardiovascular disease was found in 15 patients (15.4%), neurologic disease in 10 patients (10.3%), and so on. Gram positive organisms were recovered in 143 cases and gram negative organisms were recovered in 101 cases of PBSI. Staphylococcus epidermidis was the most common organism. Factors affecting mortality included underlying medical disease, immune status, nosocomial infection, and central catheter-related infection, for which the rate of mortality showed a greater increase (P<0.05). Conclusion : Due to the close connection between PBSI and fatal conditions or high mortality, it requires more aggressive management. Compared with previous studies, we discovered that immunocompromised hemato-oncological malignancy was the most common underlying medical condition and that frequency of gram-positive bacteria and fungus isolated has increased.