• Title/Summary/Keyword: severity classification

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A Study of the Family Caregiver's Burden for the Elderly with Chronic disease in a Rural Area (일부 농촌 지역 노인 만성질환자 가족의 부담감에 관한 연구)

  • Jang, In-Sun
    • Journal of Home Health Care Nursing
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    • v.2
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    • pp.19-34
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    • 1995
  • The purpose of this study was to analysis level on family caregiver's burden for the elderly with chronic disease in a rural area and to choose priority care group, thereby facilitating the development of interventions to reduce the caregiver's burden. For this purpose, data were collected by questionaire from June 10 to October 8, 1994. The instruments for data collection were Caregiver Burden Inventory by Novak(1989) and Zarit et al(1982), severity of dementia by Hughes Scales(1982), ADL by Lawton(1971), patients' family caregiving activity by pre-survey and reference review(Lee, 1993 ; Jang, 1990 ; Yoo, 1982). The subjects were 213 family caregiver of elderly with chronic disease in a rural area. The data was analysed by the use of t-test, ANOVA, correlation and multiple regression. The results were as follows ; 1. Total burden was evaluated below average, the mean of family burden was 46.98. By the diagnostic classification, Hypertension was 27.37, DM 32.46, CVA 62.96, Dementia 61.24. 2. Significant variables which were correlated to the family caregiver's burden were the patient's disease diagnosis (F=33.82, p<0.001), severity of dementia(F=30.52, p<0.001), the status of disease management(F=11.53, p<0.001), ADL(F=10.54, p<0.001), PADL(F=7.50, p<0.001), income(F=7.17, p<0.001), caregiver's health status(F=24.53, p<0.001), a view of patient's prognosis (F=22.17, p<0.001), relationship with the patient(F=33.82, p<0.001), the number of hours per day spent on caregiving(F=77.52, p<0.001), level of intimacy of caregiver and patients(F=8.75, p<0.001), level of helping(F=4.90, p<0.01), the frequency of caregiving activity(F=3.80, p<0.01), the number of admission(F=5.54, p<0.01), the length of caregiving(F=4.43, p<0.01), other chronic patient in family(t=2.81, p<0.01), caregiver's job(F=3.11, p<0.01), the duration of illness(F=2.98, p<0.05), caregiver's religion(F=2.93, p<0.05), medical security(F=3.89, p<0.05), caregiving's helper(t=2.42, p<0.05). 3. PADL was the most important predictor to family caregiver burden(R2=0.6611). In addition to this, IADL, caregiver's health status, the length of caregiving. level of intimacy of caregiver and patients, patient's age, the patient's disease diagnosis and patient's job accounted for 76% of family caregiver burden. 4. The criteria of priority care group were as follows ; the mean of family caregiver burden was above 58, above of moderate ADL, the number of hours per day spent on caregiving above of 8 hours, above of moderate dementia. By the diagnostic classification, number of priority care group, Hypertension was 4 (8.0%), DM 4(8.0%), CVA 34(64.1%), Dementia 45(75.0%).

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Increased Incidence of Endometrial Polyps in Women with Endometriosis; the Association with Severity (자궁내막증 여성에서 증가된 자궁내막용종의 빈도; 질환의 중증도와의 관련성)

  • Chang, Hye Jin;Hwang, Kyung Joo;Kim, Mi Ran;Ahn, Sang Tae;Byun, Jae Guang;Lee, Eun Hee;Park, Jin Young
    • Clinical and Experimental Reproductive Medicine
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    • v.33 no.3
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    • pp.199-205
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    • 2006
  • Objective: The aim of this study was to evaluate the correlation between severity of endometriosis and the incidence of endometrial polyp. Methods: The study population consisted of six hundred thirty-one women who had undergone laparoscopic operation due to infertility, severe dysmenorrhea or ovarian tumors. We divided two groups: 434 women with endometriosis (study group) and 197 women without the disease (control group). The presence of endometriosis was documented by diagnostic or therapeutic laparoscopic operation and the disease severity was scored according to revised The American Fertility Society classification. We confirmed the endometrial polyps by pathologic examination after hysteroscopic polypectomy, and compared endometrial polyp incidence according to severity of endometriosis. Results: There was no significant difference between groups with regard to age, mean duration of infertility. Endometrial polyps were found in 274 women (63.0%) with endometriosis and in 58 controls (29.8%, p=0.0000). The incidence of endometrial polyps differed significantly according to stage of endometriosis. The incidence of endometrial polyps were 77/142 (54.2%), 58/90 (64.4%), 73/108 (67.6%, p<0.05), 66/94 (70.2%, p<0.05) in endometriosis stage I, II, III, and IV. There was a linear correlation between stage of endometriosis and endometrial polyps incidence (p=0.008). Conclusion: Endometriosis is accompanied by endometrial polyps. This results showed positive correlation between severity of the endometriosis and incidence of endometrial polyps. It is the possible mechanism for low pregnancy rate in the severe endometriosis.

Measuring Quality of Life in Cerebral Palsy Children According to the Severity Using the Visual Analogue Scale, Time Trade-Off, and EQ-5D-Y Proxy (뇌성마비 환아 중증도별 시각화척도, 시간교환법, EQ-5D-Y Proxy를 이용한 삶의 질 측정)

  • Lee, Go-Eun;Kim, Nam Kwen;Yun, Young Ju;Wang, Hye Min;Kim, Jeong Hun;Lee, Dong Hyo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.49-59
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    • 2017
  • Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.

Development for rainfall classification based on local flood vulnerability using entropy weight in Seoul metropolitan area (엔트로피 가중치를 활용한 지역별 홍수취약도 기반의 서울지역 강우기준 산정기법)

  • Lee, Seonmi;Choi, Youngje;Lee, Eunkyung;Ji, Jungwon;Yi, Jaeeung
    • Journal of Korea Water Resources Association
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    • v.55 no.4
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    • pp.267-278
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    • 2022
  • Recently Flood damage volume has increased as heavy rain has frequently occurred. Especially urban areas are a vulnerability to flooding damage because of densely concentrated population and property. A local government is preparing to mitigate flood damage through the heavy rain warning issued by Korea Meteorological Administration. This warning classification is identical for a national scale. However, Seoul has 25 administrative districts with different regional characteristics such as climate, topography, disaster prevention state, and flood damage severity. This study considered the regional characteristics of 25 administrative districts to analyze the flood vulnerability using entropy weight and Euclidean distance. The rainfall classification was derived based on probability rainfall and flood damage rainfall that occurred in the past. The result shows the step 2 and step 4 of rainfall classification was not significantly different from the heavy rain classification of the Korea Meteorological Administration. The flood vulnerability is high with high climate exposure and low adaptability to climate change, and the rainfall classification is low in the northern region of Seoul. It is possible to preemptively respond to floods in the northern region of Seoul based on relatively low rainfall classification. In the future, we plan to review the applicability of rainfall forecast data using the rainfall classification of results from this study. These results will contribute to research for preemptive flood response measures.

Analysis of Factors that will Ensure Effective Health Care Delivery System (효율적인 의료전달체계 확보를 위한 요인 분석)

  • Rhee, Hyun-Sill;Kim, Mi-Sun;Oh, Jin-Yong;Lee, Seung-Yoon;Jeong, Dong-Jin;Lee, Tae-Ro
    • Journal of Digital Convergence
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    • v.10 no.6
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    • pp.303-310
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    • 2012
  • In order to analyze factors that support effective health care delivery system, this study aimed to research general public's perception on the functions of medical institutions(based on the levels of treatment: primary care, secondary care, and tertiary care), choices of medical institution when contracted with an unfamiliar disease, and recognition of diseases based on their severities. We collected data using self-administered survey from 400 general public living in Seoul, S. Korea from April 25 to May 18, 2011. The analysis was conducted using frequency analysis, chi-square test, and t-test; we analyzed the data to see if there are differences based on gender, age, and level of education. The result of both recognition of functional differences of medical institutions and selection of medical institutions when contracted with unfamiliar diseases showed that there were no significant differences based on the gender; however there were significant differences when considering the age and education. Looking at the result of the knowledge of the disease classification based on its severity, there were significant differences in age, gender, and education. In order to provide sustainable and effective health care delivery system, utilization of primary care as well as education and promotion regarding the functional differences of medical institutions and classification of disease based on its severity need to be encouraged.

Study on optimal treatment payment by cost accounting in the artificiality kidney center in medical institutions (의료기관 인공신장실의 원가계산에 의한 적정수가에 관한 연구)

  • Moon, Seung-Kwon;Lee, Yun-Seok
    • Korea Journal of Hospital Management
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    • v.18 no.2
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    • pp.81-103
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    • 2013
  • This study is to research cost accounting practice and to analyze propriety of patients' medical payment in artificiality kidney center. The researched cost datum of the year 2012 are as follows. - Hemodialysis medical treatment was reimbursed as much as 158,001 won in case of health insured patients, but payed-off as much as 135,810 won. - The average figure of the total hospitals and clinic center is 1,603,303 won, and one time cost of hemodialysis treatment is 154,487 won. Optimal treatment pay are suggested as follows. First, Regardless of the notified classification from MOHW(Ministry of Health and Welfare), 136,000 won of fixed price payment classification needs to be reclassified by patients, severity and tobe rearranged by fixed price payment system of hospitals. Second, Fixed payment code notified by the Ministry of Health and Welfare is recommended to be simplifies and to reflect according to contents of the medical treatment rendered to patients. Third, Establishment of artificial kidney center has to be risk managed because of its huge investment. Fourth, Cost analysis model has to be maintained as basis together with appropriate application of conversion index model mixed with SGR model.

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On the Feasibility of a RUG-III based Payment System for Long-Term Care Facilities in Korea (한국의 장기요양서비스에 대한 RUG-III의 적용가능성)

  • 김은경;박하영;김창엽
    • Journal of Korean Academy of Nursing
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    • v.34 no.2
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    • pp.278-289
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    • 2004
  • Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.

Soft tissue reconstruction in wide Tessier number 3 cleft using the straight-line advanced release technique

  • Kim, Gyeong Hoe;Baek, Rong Min;Kim, Baek Kyu
    • Archives of Craniofacial Surgery
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    • v.20 no.4
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    • pp.255-259
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    • 2019
  • Craniofacial cleft is a rare disease, and has multiple variations with a wide spectrum of severity. Among several classification systems of craniofacial clefts, the Tessier classification is the most widely used because of its simplicity and treatment-oriented approach. We report the case of a Tessier number 3 cleft with wide soft tissue and skeletal defect that resulted in direct communication among the orbital, maxillary sinus, nasal, and oral cavities. We performed soft tissue reconstruction using the straight-line advanced release technique that was devised for unilateral cleft lip repair. The extension of the lateral mucosal and medial mucosal flaps, the turn over flap from the outward turning lower eyelid, and wide dissection around the orbicularis oris muscle enabled successful soft tissue reconstruction without complications. Through this case, we have proved that the straight-line advanced release technique can be applied to severe craniofacial cleft repair as well as unilateral cleft lip repair.

Fault detection and classification of permanent magnet synchronous machine using signal injection

  • Kim, Inhwan;Lee, Younghun;Oh, Jaewook;Kim, Namsu
    • Smart Structures and Systems
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    • v.29 no.6
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    • pp.785-790
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    • 2022
  • Condition monitoring of permanent magnet synchronous motors (PMSMs) and detecting faults such as eccentricity and demagnetization are essential for ensuring system reliability. Motor current signal analysis is the most commonly used precursor for detecting faults in the PMSM drive system. However, the current signature responds sensitively to the load and temperature of the motor, thereby making it difficult to monitor faults in real- applications. Therefore, in this study, a condition monitoring methodology that detects motor faults, including their classification with standstill conditions, is proposed. The objective is to detect and classify faults of PMSMs by using programmable inverter without additional sensors and systems for detection. Both DC and AC were applied through the d-axis of a three-phase motor, and the change in incremental inductance was investigated to detect and classify faults. Simulation with finite element analysis and experiments were performed on PMSMs in healthy conditions as well as with eccentricity and demagnetization faults. Based on the results obtained from experiments, the proposed method was confirmed to detect and classify types of faults, including their severity.

Binary Classification of Hypertensive Retinopathy Using Deep Dense CNN Learning

  • Mostafa E.A., Ibrahim;Qaisar, Abbas
    • International Journal of Computer Science & Network Security
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    • v.22 no.12
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    • pp.98-106
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    • 2022
  • A condition of the retina known as hypertensive retinopathy (HR) is connected to high blood pressure. The severity and persistence of hypertension are directly correlated with the incidence of HR. To avoid blindness, it is essential to recognize and assess HR as soon as possible. Few computer-aided systems are currently available that can diagnose HR issues. On the other hand, those systems focused on gathering characteristics from a variety of retinopathy-related HR lesions and categorizing them using conventional machine-learning algorithms. Consequently, for limited applications, significant and complicated image processing methods are necessary. As seen in recent similar systems, the preciseness of classification is likewise lacking. To address these issues, a new CAD HR-diagnosis system employing the advanced Deep Dense CNN Learning (DD-CNN) technology is being developed to early identify HR. The HR-diagnosis system utilized a convolutional neural network that was previously trained as a feature extractor. The statistical investigation of more than 1400 retinography images is undertaken to assess the accuracy of the implemented system using several performance metrics such as specificity (SP), sensitivity (SE), area under the receiver operating curve (AUC), and accuracy (ACC). On average, we achieved a SE of 97%, ACC of 98%, SP of 99%, and AUC of 0.98. These results indicate that the proposed DD-CNN classifier is used to diagnose hypertensive retinopathy.