• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권3호
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• pp.685-703
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• 2024

Cloud computing provides each consumer with a large-scale computing tool. Different Cyber Attacks can potentially target cloud computing systems, as most cloud computing systems offer services to many people who are not known to be trustworthy. Therefore, to protect that Virtual Machine from threats, a cloud computing system must incorporate some security monitoring framework. There is a tradeoff between the security level of the security system and the performance of the system in this scenario. If strong security is needed, then the service of stronger security using more rules or patterns is provided, since it needs much more computing resources. A new way of security system is introduced in this work in cloud environments to the VM on account of resources allocated to customers are ease. The main spike of Fog computing is part of the cloud server's work in the ongoing study tells the step-by-step cloud server to change the tremendous measurement of information because the endeavor apps are relocated to the cloud to keep the framework cost. The cloud server is devouring and changing a huge measure of information step by step to reduce complications. The Medical Data Health-Care (MDHC) records are stored in Cloud datacenters and Fog layer based on the guard intensity and the key is provoked for ingress the file. The monitoring center sustains the Activity Log, Risk Table, and Health Records. Cloud computing and Fog computing were combined in this paper to review data movement and safe information about MDHC.

• Journal of Trauma and Injury
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• 제18권1호
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• pp.1-16
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• 2005

An ideal trauma care system would include all the components identified with optimal trauma care, such as prevention, access, acute hospital care, rehabilitation, and research activities. Central to an ideal system is a large resource-rich trauma center. The need for resources is primarily based on the concept of being able to provide immediate medical care for unlimited numbers of injured patients at any time. Optimal resources at such a trauma center would include inhouse board-certified emergency medicine physicians, general surgeons, anesthesiologists, neurosurgeons, and orthopedic surgeons. Other board-certified specialists would be available, within a short time frame, to all patients who require their expertise. This center would require a certain volume of injured patients to be admitted each year, and these patients would include the most severely injured patients within the system. Additionally, certain injuries that are infrequently seen would be concentrated in this special center to ensure that these patients could be properly treated and studied, providing the opportunity to improve the care of these patients. These research activities are necessary to enhance our knowledge of the care of the injured. Basic science research in areas such as shock, brain edema, organ failure, and rehabilitation would also be present in the ideal center. This trauma center would have an integrated concurrent performance improvement program to ensure optimal care and continuous improvement in care. This center would not only be responsible for assessing care delivered within its trauma program, but for helping to organize the assessment of care within the entire trauma system. This ideal trauma center would serve as a total resource for all organizations dealing with the injured patient in the regional area.

• 한국학교보건학회지
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• 제1권2호
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• pp.34-49
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• 1988

The purpose of this study is to identify the status of school health and analyze affecting factors of school nurses' self confidence and nursing activities of the secondary school in Seoul. The data was collected from 13th of August to 30th of October. The self reported questionairs were distributed during one of the school nurses seminars held in Seoul and 93 secondary school nurses answered. Analysis of the data was done utilizing SPSS for percentage, mean, T-test ANOVA and Pearson Correlation Coefficients. The results of study are summerized as follows; 1. General Characteristics The mean age of the subjects was 33.4 and mean length of experience as a school nurse was 7.3 years. 79.5 percent of them had clinical experiences and the mean clinic experience was 2.1 years. The majority of them were graduate of the baccalaureate nursing programs and 82.8 percent of them were married. 72.0 percent of the sample had religion, and 60.2 percent of them were in the national or public schools. 90.3 percent of them had independent duty. 2. The status of school health resources In average, there were 2,445 students, 37 classes and 63 teachers per school nurse. 48.4 percent of them were aware of the school budget. The budget for school health was 585,000 won per school in average. 30.0 percent of the schools had school health organization. The schools whose health clinics were on the first floor consisted of 79.3 percent, among them 42.9 percent were on the center of the building office. 3. Activities of school health nursing The average number of students using health clinic were 430 per month. The majority of the problem was digestive problem. There were 7.5 times of mean correspondences with parents per year. The activities of the school nurses were clinic management (29.0%), health care services (23.5%) and health education (14.1%). 4. The degrees of self confidence of the school nurse and nursing activities Self confidence measured by 6 items of self-reported questionaires scored by 4 point Likert Scale revealed. The nurses' self-confidence was 2.922 in clinic management, 2.909 in health education, 2.759 in program planning and evaluation, 2.757 in health care services, 2.692 in management of school environment, and 2.250 in operation of school health organization. The nursing activities scored by 2 point. The nursing activities was 1,870 in program planning and evaluation, 1.853 in health education, 1.843 in clinic management, 1.739 in health care services, 1.696 in management of school environment and 1.265 in operating of school health organization. 5. Factors affecting self confidence and nursing activities of school nurses The general characteristics of the school nurses and the school health resources were related to self confidence and nursing activities. The most significant variable to nurses' self confidence was type of the school ownership and the presence of school health organization was the most significant factor to nursing activities.

• 가정∙방문간호학회지
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• 제6권
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• pp.78-87
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• 1999

From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.

• 인터넷정보학회논문지
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• 제15권3호
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• pp.21-30
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• 2014

고혈압은 전 세계의 심혈관 및 뇌혈관 질환의 중요한 사망 원인으로서 지속적인 혈압관리가 필요하다. 본 연구에서는 급성장하고 있는 모바일 헬스케어 환경에서 지속적으로 혈압 관리를 받을 수 있는 생체정보 교환 서비스 모델로서 HL7 FHIR을 선택하였다. 개발한 HL7 FHIR 프레임워크는 매니저(스마트폰)과 에이전트(혈압계) 간에 블루투스 헬스기기 프로파일과 통하여 IEEE 11073-10407 PHD 프로토콜로 통신하여 혈압정보를 획득한다. 테스트 결과 고혈압 환자의 혈압 모니터링, 측정기록관리, 문서 생성, 측정정보전송을 성공적으로 수행하였다. 실제 임상환경에서는 TCP/IP 프로토콜을 통해 측정정보를 전송할 수 있으므로 모바일 헬스케어에서 지속적인 연구와 활성화가 기대된다.

• 대한간호학회지
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• 제40권6호
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• pp.903-912
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• 2010

Purpose: This study was conducted to examine whether the level of classification for long-term care service under longterm care insurance reflects resource utilization level for residents in nursing homes. Methods: From 2 long-term care facilities, the researchers selected 95 participants and identified description and time of care services provided by nurses, certified caregivers, physical therapists and social workers during a 24-hr-period. Results: Resource utilization level was: 281.04 for level 1, 301.05 for level 2 and 270.87 for level 3. Resource utilization was not correlated with level. Differences in resource utilization within the same level were similar with the coefficient of variance, 22.7-27.1%. Physical function was the most influential factor on long-term care scores (r=.88, p<.001). The level for long-term care service did not reflect differences in resource utilization level of residents on long-term care insurance. Conclusion: The results of this study indicate that present grading for long-term care service needs to be reconsidered. Further study is needed to adjust the long-term care classification system to reflect the level of resource utilization for care recipients on the long-term care insurance.

• 한국보건간호학회지
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• 제12권1호
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• pp.1-12
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• 1998

This study was conducted to grasp the progress of the health management program in small scale industries with phenomenological approach. The industrial health care system compose of manpower, devices, and facilities such as medical resources, organization, service delivery system, financial resources, payments, and management system is important for the industrial health. Especially health management program should be provided feasible conditions to workers. The data collection period was 2 months from September 1 to October 30, 1997. The indepth interview results for health monitor, labors, and occupational health nurses were analyzed by Giorgis' phenomenological method. The major results were as follows: 1. The workers, health monitors and nurses felt that the subsidiary program of health management in small scale industries were necessary. This project for small-size industry can be set-up through complementary education for health monitors and resolvement of nurses' six suggestions. It is necessary to provide followings ; 1) Properly devision of industry 2) More clear guidance for health management at visiting time 3) Legitimate incentive system 4) Health education materials and devices 5) Change of fee and material payments at visiting 6) Budgets and system for medication and vaccination at visiting 2. Above all, it is suggested that the strategics of the health management program should be developed.

• 보건행정학회지
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• 제20권2호
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• pp.104-127
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• 2010

To vitalize the link program of Korean long-term care insurance system to community-based services for non-eligible people, we analysed the claim data from the Korean National Health Insurance Corporation (NHIC), and conducted a questionnaire survey to charging employees of elderly service department at local governments. The subjects were all 81,377 people, 57,454 of them were arranged to community-based services. The link program was more necessary among the missed subjects rather than the arranged people due to the need for physical or psychological assistance. By the result of the survey to the local government employees, 59.5% of subjects responded their proportion of link service was over 10% and under 20%, and 54.3% of them responded their job boundary are not clear. Major type of linking was notification the subject list to local government, 91.4%; proportion of periodical notification on the status of their service link were 57.1%, only 7.1% were followed to manage after the link. Difficult factors at the link process were pointed out the overload by other side work, deficiency of resources, rigidity of priority of link, and so on. Considering these results, to vitalize the community-based services to the non-eligible people, it may be essential the active participation of the subjects, construction of parts working in coordination among the institutions including NHIC, local governments, and service providers; development of various services for maintenance or promotion of the non-eligible peoples' health and functional status; and active participation of institutions from the third sector, and so on.

• 보건행정학회지
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• 제20권2호
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• pp.17-39
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• 2010

This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

• 보건행정학회지
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• 제32권2호
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• pp.205-215
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• 2022

Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.