• Journal of Intelligence and Information Systems
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• v.16 no.2
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• pp.73-94
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• 2010

The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Oriental Neuropsychiatry
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• v.26 no.3
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• pp.211-224
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• 2015

Objectives: This study aimed to investigate gender differences in the Korean Medical Community. Methods: Participants in the research study included 90 students regularly attending the fourth grade in Korean Medicine College, of which 48 were male and 42 were female. Results: 1. Patient's preferences for female KMD (Korean Medicine Doctor) had the lowest response rate in Korean Medical Society. Preferences for male KMD were due to factors including comfort level, rationality, good training, and patient's preference. 2. Patient's preferences for female KMD had the highest response rate in Gynecology, and Pediatrics. On the other hand, patient's preferences for female KMD had the lowest response rate in the other 7 specialty subjects. 3. The reasons for gender discrimination against male KMD were lack of subtlety, lack of empathy, authoritative attitude, and lack of patient management skills. The reasons for gender discrimination, against female KMD were childcare burden, social prejudices, lack of physical strength, and housekeeping burdens. Conclusions: The study results indicated that there was a lower preference for female KMD than male KMD among the Korean Medical Society and in patients' consciousness. Male-centered culture of Korean Medical Society had no role in this finding, but masculine image for KMD jobs and work-family double burden for female KMD were important contributing factors.

• Journal of Nutrition and Health
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• v.28 no.7
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• pp.675-687
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• 1995

The purpose of this study were to analyze work patterns of clinical dietitians by time study, to investigate labor time used in each clinical dietetic activity, and to develop standardized indices of clinical dietetic staffing needs. Two general hospitals(A & B) in Seoul were selected for study. The results of this study can be summarized as follows. 1) For the A hospital, the percentage of clinical dietetic activities such as attending meeting, professional research, foodservicemanagement, clerical activity for the foodservice, administrative activity and delay were 17.5%, 1.3%, 14.5%, 23.4%, 21.3%, 4.6%, and 17.3% respectively, while 22.4% 3.5%, 23.7%, 10.9%, 15.8%, 4.2%, and 19.5% respectively for the B hospital. 2) For the A hospital, the percentage of direct patient care like outpatient nutrition education, group nutrition education, and patient meal planning were 69.5%, 10.5%, 7.6%, and 12.4% respectively while 78.9%, 7.3%, 8.9%, and 5.1% respectively for the B hospital. 3) Time spent for performing direct patient care such as basic care, intermediate care, and indepth care per patient were 28.0min, 73.1min, and 53.0 min respectively for the A hospital, while 45.3 min, 76.2 min, and 52.6 min respectively for the B hospital. 4) Full time clinical dietitian staffing needs were calculated for the three parts ; basic care, intermediate care, and in-depth care. For A hspital, the appropriate numbers of full time clinical dietitian were 3.5 persons in basic care, 3.6 persons in intermediate care, and 1.3 persons in in-depth care, while 6.1 persons, 6.3 persons, 3.2 persons respectively for B hospital.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.77-81
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• 2024

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4457-4461
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• 2016

Purpose: To determine the prevalence of abnormal cervical cytology, as diagnosed using a liquid-based cytology technique, in pregnant women attending the Antenatal Care (ANC) clinic at Siriraj Hospital. Materials and Methods: This cross-sectional study included 655 first-visit pregnant women who attended ANC clinic at Siriraj Hospital during June to November 2015 study period. After receiving routine antenatal care, cervical cytology screening was performed with the Siriraj liquid-based cytology technique. All specimens were reviewed by a certified cytopathologist using Bethesda System 2001 criteria. Patients with abnormal PAP results characterized as epithelial cell abnormalities were referred to a gynecologic oncologist for further management according to ASCCP Guidelines 2012. Results: Mean age of participants was $28.9{\pm}6.2$ years. Prevalence of abnormal cervical cytology was 3.4% (95% CI: 2.0-4.7). Among this group, there were ASC-US, ASC-H, LSIL, HSIL for 12(1.8%), 2(0.3%), 7(1.1%) and 1(0.2%), respectively. In 633 specimens of the normal group, infection was identified in 158 specimens (24.1%) which were caused by Candida spp. and Trichomonas vaginalis. Regarding patient perception about the importance of cervical cancer screening, although most women perceived screening to be important, 54% of participants had never been screened for cervical cancer. Rate of loss to follow-up in the postpartum period was as high as 41.8%. Conclusions: Prevalence of abnormal cervical cytology in pregnant women attending the ANC clinic at Siriraj Hospital was 3.4%. Inclusion of cervical cancer screening as part of antenatal assessment can help to identify precancerous lesions or cervical cancers in patients who might otherwise not be screened, thereby facilitating early treatment and improved patient outcomes.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.1 no.1
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• pp.75-83
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• 1995

Traction is the treatment of choice for a small nuclear protrusion. The nucleus is soft and can be influenced by suction. Traction provides a method of improving on recumbency-the only effective treatment before traction was devised. The intention is to achieve rapid reduction by distraction the joint surfaces mechanically-a positive purpose-instead of merely avoiding the compression of the upright posture by putting the patient to bed and leaving him there. Recumbency, usually successful in the end, wastes an endless amount of the patient's time and money. Traction carries the further advantage of enabling the patient to be up and about, attending to his bussiness, during treatment. Traction brings the joint surfaces much farther apart than just lying in bed, a greater centripetal force acts on the protruded part of the nucleus. Traction has three beneficial effects; 1. Suction : a sub-atmospheric pressure induces a centripetal effect on the contents. 2. Distraction : increases the distance between the articular edges. X -rays have shown an increase in width of the joint of 2.5 mm. 3. Ligamentous tightening : the posterior longitudinal ligament tightens which then exerts centipetal force on a central protrusion.

• Journal of Korean society of Dental Hygiene
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• v.22 no.5
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• pp.443-450
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• 2022

Objectives: This study was conducted to investigate the effect of professional self-concept and ethical awareness of dental hygiene (department) students attending a university located in Gwangju and Jeollanam-do on patients' willingness to protect personal information. Methods: Professional self-concept, ethical disposition, and patients' personal information protection intention according to general characteristics were analyzed using t-tests and one-way ANOVA. After confirming the correlation through Pearson's correlation analysis, the effect on the patient's personal information protection intention was confirmed using multiple regression analysis. Results: Professional self-concept, ethical disposition, and the patients' willingness to protect personal information all showed positive correlations. The higher the communication skills of professional self-concept and the higher the idealism of ethical orientation, the higher the patients' willingness to protect personal information. Conclusions: This study, ascertained the effect of dental hygiene students' professional self-concept and ethical consciousness on patients' personal information protection practices. The results suggest that it is necessary to develop an educational program that can enhance the practice of dental hygienists to protect patients' personal information, and to develop and conduct continuous policy development and research.

• The Journal of the Korea Contents Association
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• v.9 no.8
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• pp.158-165
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• 2009

Counselling between a patient and a doctor is crucial in telemedicine. In order for the doctor to examine the patient accurately, it needs an auscultation, at least. Currently, some video conference systems are implemented but it is hard to use them in the case of an cardiac disorder, because the patients suffering from cardiac disorder cannot be examined by a stethoscope over Internet. To solve this problem, the remote counselling service has to support real time transmission of the heart sound of the patient. In this paper, we present a remote counselling system with stethoscope. We also design and implement the system in order for health monitor to connect the patient with his attending physician for the environment of u-healthcare service. The proposed system supports a mobility for doctor and patient by exchanging IP addresses at an user authentication protocol. The system implemented by this paper can be used for cardiac patients in remote clinical setting in the future.

• Archives of Plastic Surgery
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• v.42 no.6
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• pp.735-740
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• 2015

Background Botulinum toxin (BT) chemodenervation and anterior belly of digastric muscle (ABD) transfer are both treatment options in the management of an isolated marginal mandibular branch of the facial nerve (MMB) palsy. We compare the patient satisfaction following either BT injections or ABD transfer in the management of their isolated MMB palsy. Methods Patients in the ABD-arm of the study were identified retrospectively from September 2007 to July 2014. The patients in the BT-arm of the study were identified prospectively from those attending the clinic. Both groups of patients completed a validated patient satisfaction survey. Statistical analysis was performed and a P-value <0.05 was considered statistically significant. Results Seven patients were in the ABD-arm and 11 patients in the BT-arm of the study. The patient satisfaction in both groups was high with 45% of ABD-arm patients and 40% of BT-arm patients rating their overall outcome as 'better' or 'much better', which was significantly more than the proportion rating their outcome as 'worse' or 'much worse' (P<0.001), although there was a significant trend towards those in the ABD-arm being more likely to be dissatisfied with their outcome (P=0.01). Conclusions BT therapy is a good first-line intervention in the management of isolated MMB palsy. We have, however, shown that the overall satisfaction in both groups is high. Therefore, in patients who would prefer a more permanent solution to manage their facial asymmetry, ABD transfer remains a satisfactory treatment option with a good level of patient satisfaction.