• Title/Summary/Keyword: medical advice

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A Study on Design of Medical Advice Support System in Emergency using Agent System (에이전트를 활용한 응급의료지도 지원시스템 설계에 관한 연구)

  • Kim, Kyoung-Hwan
    • The Journal of Information Systems
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    • v.19 no.3
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    • pp.263-278
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    • 2010
  • Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.

A Study about the Relationship between Maternal Attachment and Discharge Against Advice in High Risk Infants (모아 애착과 회복이 어려운 환아의 치료 포기와의 관계)

  • 김태임
    • Journal of Korean Academy of Nursing
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    • v.12 no.2
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    • pp.31-44
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    • 1982
  • The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3% of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.

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A Study on the Characteristics of the Patients Discharged Against Medical Advice (한 대학병원 자의퇴원 환자의 특성 연구 - 퇴원환자 지료정보 DB를 이용하여 -)

  • Hong, Joonhyun;Choi, Kwisook;Lee, Jeonghwa;Lee, Eunmee
    • Quality Improvement in Health Care
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    • v.8 no.2
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    • pp.208-217
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    • 2001
  • Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

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A Study on Legal and Regulatory Improvement of Telemedicine Service (원격의료 서비스의 규제개선에 관한 연구)

  • Kwon, Jun Cheol;Choi, Yong Jeon;Jung, Yong Gyu
    • Journal of Service Research and Studies
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    • v.4 no.1
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    • pp.83-93
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    • 2014
  • Telemedicine is performed at a place far away from medical practice with physicians and patients by the means of communication appropriately. It will be identified in general the remote medical service to deliver the medical information and also defined as any action by interactive information communication technology. Medical services can be said to be fused as television, communication, computer, engineering of various technologies of information and communication applications. If doctors can not be reached due to distances away from the patient, Information technologies could be used to get medical information and to give expert advice provided by the system remotely. And it could be used patient care as well as medical administration, medical education, professional advice and consulting. In this paper, we take a look at the legal requirements of telemedicine for improving regulatory in the current law to investigate the matter.

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A study on the typology of the medical claims review in terms of hospital department (진료과목 관련성을 중심으로 분석한 의학적클레임검토 유형론에 관한 연구)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.27 no.1
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    • pp.33-36
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    • 2008
  • BACKGROUND : The medical claims review(MCR) is unique methodology of medical consultation in terms of insurance claim administration in Korean insurance market. The most important practical matter in the MCR is formatted question. In Korea, medical specialty is composed of 26 legally defined hospital departments. It is worth of studying to investigate type of MCR by hospital departments. METHODS : Fifty Cases of the MCR were selected randomly by statistical program SPSS among 1,032 cases which were performed between April 1, 2006 and March 31 2007. All of selected cases were evaluated one insurance doctor and made a score points from 0 to 10 in terms of hospital department. RESULTS : Multidimensional scaling was performed. The MCR types - diagnosis, malignancy and cause of death are located in the same 2-dimensional configuration area. It can be called as verification of benefit. Others are advice. - such as causality, interpretation, translation, independent medical examination, and so on. DISCUSSION : We can conclude the classification of MCR typology are two main subjects, verification and advice. Theses results are same as previous article which was based on experience.

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Mongolism and the "Oriental Imaginary" of Modern America (몽고증과 미국 사회의 '오리엔트적 상상'(Oriental Imaginary))

  • Shin, Ji-Hye
    • American Studies
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    • v.44 no.1
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    • pp.39-79
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    • 2021
  • This paper examines professional and popular medical discourse on "mongolism" (Down syndrome) in the early twentieth century to delve into the history of mongolism and the "Oriental imaginary" of modern America. The Oriental imaginary is a concept to explore the ways in which Americans, who had heard of mongolism or seen a "Mongol" themselves, imagined and conceptualized the defect in terms of the contemporary race relations. Moving beyond the interests of medical professionals discussed in the previous scholarship, this paper aims to include views and perceptions of the American public. The second section reviews the existing studies of the history of mongolism in the West. The third section discusses the mongolism of Asians and African Americans, among whom it had long been believed not to occur. Lastly, an analysis of American newspaper health advice columns on mongolism sheds light on the public reception and transmission of medical knowledge.

Determinants of Adherence to Diabetes Screening in Iranian Adults With a Positive Family History of Diabetes

  • Malih, Narges;Sohrabi, Mohammad-Reza;Abadi, Alireza;Arshi, Shahnam
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.3
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    • pp.190-198
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    • 2021
  • Objectives: Insufficient evidence exists regarding factors that affect screening adherence among people with a family history of diabetes, who comprise roughly half of all patients with diabetes. Therefore, we aimed to identify the determinants of diabetes screening adherence in adults with a family history of diabetes who had not yet been diagnosed with diabetes. Methods: This cross-sectional study was conducted at selected urban primary healthcare facilities in Tehran, Iran. The study population was clinically non-diabetic adults above 20 years of age with a family history of diabetes in at least 1 first-degree relative. All eligible people identified on randomly-selected days of the month were invited to join the study. Results: Among 408 participants, 128 (31.4%) had received a fasting blood glucose check during the last year. Using binary logistic regression, the independent predictors of screening adherence were knowledge of adverse effects of diabetes such as sexual disorders (odds ratio [OR], 3.05) and renal failure (OR, 2.73), the impact of family members' advice on receiving diabetes screening (OR, 2.03), recommendation from a healthcare provider to have a fasting blood glucose check (OR, 2.61), and intention to have a fasting blood glucose check within the next 6 months (OR, 2.85). Other variables that predicted screening adherence were age (OR, 1.05), job (being a housekeeper; OR, 3.39), and having a college degree (OR, 3.55). Conclusions: Knowledge of the adverse effects of diabetes, physicians' and healthcare providers' advice about the benefits of early disease detection, and family members' advice were independent predictors of screening adherence.

Nurse's Power and Tactics in Nursing Practice (간호사의 업무수행상의 권한과 행사전략)

  • Han, Hye-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.1
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    • pp.23-37
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    • 1999
  • This study is to understand and to describe the power that a nurse experiences on nursing practice and then. to present a basic data for nurse's power-development, power improving and empowering. Ethnography was used to understand and to describe experience on exercising various powers occurred on nursing practice. and to analyze and to understand the meaning of a nurse's power. The objects was nurses. Ten nurses who have more than three year's experience were selected as objects from Cuniversity's hospital in Seoul from May of 1996 to August of 1997 through in-depth interview. participant observation, and phone interview. Instruments werw a portable recorder and field notes. I described a case appeared in a data using Agar's 'Pencil and scissors' method right after collecting materials. Then, Idescribed a theme discovered commonly. Followings are the results of the study. 1. There were three categories of relationships with main objects when nurses exercised their power on their practices: a therapeutic caring relationship with patients, a relationship of companion, vertical cooperation, and a constituent person with a doctor, and a relationship of cooperation, and a constituent person with administrative workers and medical technicians. 2. There were many types of nurse's power, tactics and various patient's responses about them. 1) Types of nurse's power to patients were giving information, controling environment, helping for cure, emotional support, and performing discretion. 2) Nurse's tatics for performing power were positive tactics neutral tactics, and negative tactics. 3) Patient's responses were appeared as compliance and noncompliance. Compliance were agreeing. taking nurse's advice, trusting, understanding, being admitted, exposuring himself, and appreciating. 3. There were types of nurse's power and performing tactics. 1) Types of power to a doctor were advice, informing, demanding and mediation. 2) Performings of tactics to a doctor were positive tactics, neutral tactics, and negative tactics. 3) Doctor's responses were appeared as accepting and unaccepting. Acceptings were taking in and appreciating, and unacceptings were denying nurse's advice and authoritative. 4. There were types of nurse's power and tactics about administrative workers and medical technicians and responses about them. 1) Types of power about administrative workers and medical technicians were suggestions and demands. 2) Power performings tactics were positive tactics.neutral tactics, and negative tactics. 3) Responses of administrative workers and medical technicians about nurse's power performing were appeared appeared as accepting and unacce pting. Acceptings were taking in, and unacceptings were denying. Therefore, it can be said that types of nurse's power and performing tactics on nursing practice and nurse's power based on responses of a patient, a doctor, an administrative worker, and a medical technicians are power or influence for agreeing, taking advice, trusting, understanding, exposuring himself, appreciating, and taking in to objects. The results of this study helped to understand nurse's power. I expect that this study will improve nure's power by using expert power, referent power, and legitimate power effectively among powers acmpanied with the origin and that nurses make ef-ort to improve professional knowledge and human nature so that they use this study as a chance to develope expert nursing practice.

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De Lege Frenda for Improvement of Marine Telemedicine Service System (해양원격의료 지원제도 개선을 위한 관련 법령정비 방안)

  • JEON, Yeong-Woo;HONG, Sung-Hwa;KIM, Jae-Ho
    • Journal of Fisheries and Marine Sciences Education
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    • v.28 no.4
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    • pp.994-1005
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    • 2016
  • Expansion and spreading of marine telemedicine is rather restricted due to the conflict of laws relating to medical service and lack of provisions in the Seafarers' Act, Medical Service Act, etc. Thus, this study is intended to reveal the current status and problems of marine emergency medical advice system for the furtherance of health care of seafarers and emergency medical assistance conditions and deduce relevant proposals for legislative improvements thereof in order to resolve underlying problems and issues. The results of this study can be summated as follows. First, in respect of directions to provide marine emergency service based on marine telemedicine system, emergency radio medical advice system needs to be strengthened to meet domestic and international instrument, marine telemedicine system needs to be provided through integrating u-Health technology and special marine medical center needs to be established. Second, regarding directions to provide health promotion service based on the marine telemedicine system, a new process of health care service for seafarers needs to be devised and provided involving seafarers' life cycle covering from prior to boarding to after leaving a ship. The conclusions of this study can be given as follows. First, the following new provisions need to be introduced in the Seafarers' Act. (1) The Minister of Oceans and Fisheries and a shipowner shall conduct matters pertaining to preventive health promotion and care for seafarers; (2) a provisions regarding establishment of seafarers' health promotion center by the Minister; (3) a special exemption permitting marine telemedicine service and qualification requirements for marine telemedicine assistant; (4) shipowner's obligation of carrying seafarers' health measuring equipment on board. Second, the relevant provisions regarding medical care persons needs to be revised in such a way that master or chief officer shall be appointed to be in charge of medical care on board. Last but not least, it is also essential to amend and update the minimum standards on drug and medicines to be carried on board and medicine chest and equipment on board.

A Study on Telemedicine Service Issues (원격의료 서비스의 쟁점사항에 관한 연구)

  • Jung, Yong Gyu;Kim, Jang IL;Kwon, Jun Cheol;Choi, Young Jin
    • Journal of Service Research and Studies
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    • v.4 no.2
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    • pp.57-67
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    • 2014
  • Because telemedicine is also the medical care, it is limited by law to allow medical personnel only physician because there would cause a risk to health and hygiene. Since the work dealing with the life and honor the human body involving a small mistake, it may be difficult to recover the damages can be recovered even if the telemedicine. Therefore, systematically it is to allow remote medical care only proven national healthcare only clinical practice starting with basic medical medicine, and received training as a systematic study of the body and life of humans. The patient information could get far away in the distance to provide medical information and professional advice to the remote system, even if you can not be reached due to several issues such as the number of differences that occur in time. We Mentioned various opinions on regulatory issues and information gathered for the development of the medical industry in this respect.

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