• Title/Summary/Keyword: Data Models

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A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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Associations between Characteristics of Green Spaces, Physical Activity and Health - Focusing on the Case Study of Changwon City - (공원녹지의 특성과 신체활동 및 건강의 상호관련성 - 창원시를 대상으로 -)

  • Baek, Su-Kyeongq;Park, Kyung-Hun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.3
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    • pp.1-12
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    • 2014
  • Urban Green space takes charge of the important role for the physical activity and promotion of health to the residents. Therefore, this study is trying to examine the relationship between the various characteristics of green space and green space usage for physical activity and health promotion. A questionnaire survey was conducted to obtain the information about patterns of green space usage and perceived neighborhood environments for the residents living in Changwon-si, Gyeongsangnam-do(n=541). Geographic Information System(GIS) was used to construct spatial data about green space accessibility and physical neighborhood environments. A Multiple Linear Regression model was used to examine the association between the characteristics of green space and physical activity, perceived health status and BMI(Body Mass Index). The study results revealed that the residents' physical activities are positively and directly influenced by the number of available public parks and green spaces in the vicinity(${\leq}200m$). The frequency at which residents witness others exercising nearby or the perceived abundance of low-cost gym facilities also factor as positive influences. The closer to the park, the higher the number of parks and area of green spaces, the more comfortable the walk thereto and the denser the neighboring residential area distribution, the perceived health level was found to be the more positively influenced. Further, it was verified that BMI is correlated with the number of public parks and green spaces within 400 m of the resident's home as well as the safety of walkways, the density of neighboring residential areas, the ratio of road, and the density of crosswalk. The significant multiple regression models between the characteristics of green spaces and physical activities and perceived health level were extracted within the significance level of 10%. This study will contribute to provide better understanding the ways in which green space and neighborhood characteristics are associated with physical activity and health. The result of this research will be available in the landscape architecture plan aimed at improving the use of green space for physical activity and reducing obesity.

A Model based Vocational Evaluation for People with Psychiatric Disabilities (정신장애인 직업재활모델과 직업평가 - 직업기능척도 개발을 위한 예비연구 -)

  • Lee, Seong-Gyu;Kim, Sang-Hee
    • Korean Journal of Social Welfare
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    • v.54
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    • pp.123-147
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    • 2003
  • It is well known that one of essential features of psychiatric disability is vocational impairment. Since the year of 2000 when psychiatric disability was declared as one of disability categories in Korea, vocational rehabilitation programs have been actively administered. At this point, it is compelling that vocational evaluation serves as a means of screening out the most promising candidates, identifying their vocational deficits and strengths, designing the individualized vocational interventions, and evaluating vocational outcomes. Still, vocational evaluation for people with psychiatric disabilities has been more problematic than for any other group with disabilities. The authors argued that vocational evaluation for people with psychiatric disabilities should be based on a certain vocational rehabilitation model to address those problems. It is because there exists an indispensible relationship between the vocational rehabilitation model and vocational evaluation. In other words, the main purposes, measurement time points, and focus of vocational evaluation may depend on which of vocational rehabilitation models to make a choice of. In addition, the vocational rehab model(i.e., vocational readiness model or graduation model) underlying traditional vocational evaluation does not seem to work for people with psychiatric disabilities. Authors argued that accelerating model fits for psychiathric characteristics which are often unpredictable and turbulent. As a preliminary step of developing vocational functioning instrument incorporating the demand characteristics of the accelerating model, post-hoc analyses were done on data from a vocational functioning measure and the results were critically examined from viewpoints of accelerating model. For these purposes, discussions were made about a) general functioning of vocational evaluation, (b) relation between vocational rehabilitation model and vocational evaluation, (c) the reasons why the accelerating model is more appropriate to the characterstics of psychiatric clients than the graduation model, (d) post-hoc analytic results reviewed from viewpoints of accelerating model-based vocational evaluation This study is significant in that it attempted model-based, model-specific vocational evaluation as a preliminary step for developing vocational functioning assessment instruments ill future.

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Prognostic Factors for Survival in Patients with Stage IV non-small Cell Lung Cancer (제 IV병기 비소세포폐암의 예후인자)

  • Kim, Myung-Hoon;Park, Hee-Sun;Kang, Hyun-Mo;Jang, Pil-Soon;Lee, Yun-Sun;An, Jin-Yong;Kwon, Sun-Jung;Jung, Sung-Soo;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.379-388
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    • 2002
  • Background : Although patients with stage IV non-small cell lung cancer are known to have a poor prognosis, the prognostic factors for survival have not been well evaluated. Such factors may be different from those for overall survival. This study was performed to analyze the prognostic factors for survuval and the variation of survival according to metastatic organ, in patients with stage IV non-small cell lung cancer. Materials and Methods : From January 1997 to December 2000, 151 patients with confirmed stage IV non-small cell lung cancer were enrolled into this study retrospectively. The clinical and laboratory data were analyzed using univareate Kaplan-Meied and Multivariate Cox regression models. Results : On univariate analysis, age, performance status, serum albumin level, weight loss, forced expiratory volume in one second (FEV1), systemic chemotherapy, the number of metastatic organs and serum lactate dehydrogenase (LDH) level were significant factors (p<0.05). In multivariate analysis, important factors for survival were ECOG performance (relative risk of death [RR]: 2.709), systemic chemotherapy (RR: 1.944), serum LDH level (RR: 1.819) and FEV1 (RR: 1.774) (p<0.05), Metastasis to the brain and liver was also a significant factor on univariate analysis). The presence of single lung metastasis was associated with better survival than that of other metastatic organs (p=0.000). Conclusion : We confirmed that performance status and systemic chemotherapy were independent prognostic factors, as has been recognized. The survival of stage IV non-small cell lung cancer patients was different according to the metastatic organs. Among the metastatic sites, only patients with metastasis to the lung showed bettrer survival than that of other sites, while metastasis of the brain or liver was associated with worse survival than that of other sites.

Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

A Tool Box to Evaluate the Phased Array Coil Performance Using Retrospective 3D Coil Modeling (3차원 코일 모델링을 통해 위상배열코일 성능을 평가하기 위한 프로그램)

  • Perez, Marlon;Hernandez, Daniel;Michel, Eric;Cho, Min Hyoung;Lee, Soo Yeol
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.107-119
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    • 2014
  • Purpose : To efficiently evaluate phased array coil performance using a software tool box with which we can make visual comparison of the sensitivity of every coil element between the real experiment and EM simulation. Materials and Methods: We have developed a $C^{{+}{+}}$- and MATLAB-based software tool called Phased Array Coil Evaluator (PACE). PACE has the following functions: Building 3D models of the coil elements, importing the FDTD simulation results, and visualizing the coil sensitivity of each coil element on the ordinary Cartesian coordinate and the relative coil position coordinate. To build a 3D model of the phased array coil, we used an electromagnetic 3D tracker in a stylus form. After making the 3D model, we imported the 3D model into the FDTD electromagnetic field simulation tool. Results: An accurate comparison between the coil sensitivity simulation and real experiment on the tool box platform has been made through fine matching of the simulation and real experiment with aids of the 3D tracker. In the simulation and experiment, we used a 36-channel helmet-style phased array coil. At the 3D MRI data acquisition using the spoiled gradient echo sequence, we used the uniform cylindrical phantom that had the same geometry as the one in the FDTD simulation. In the tool box, we can conveniently choose the coil element of interest and we can compare the coil sensitivities element-by-element of the phased array coil. Conclusion: We expect the tool box can be greatly used for developing phased array coils of new geometry or for periodic maintenance of phased array coils in a more accurate and consistent manner.

Effects of Ethanol Extracts from Commonly Consumed Vegetables in Korea on Differentiation and Secretion of MCP-1 and Adiponectin in 3T3-L1 Adipocytes and Lipid Accumulation in HepG2 Hepatocytes (한국인 다소비 채소의 에탄올 추출물이 3T3-L1 지방세포와 HepG2 간장세포의 지질축적, MCP-1과 Adiponectin의 분비에 미치는 영향)

  • Ahn, Eun Mi;Kang, Hyun Ju;Kim, Young;Choe, Jeong Sook;Kang, Min-Sook
    • Journal of the East Asian Society of Dietary Life
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    • v.25 no.1
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    • pp.99-110
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    • 2015
  • The purpose of this study was to evaluate the inhibitory effects of commonly consumed vegetables in Korea on lipid accumulation and production of pro-inflammatory cytokines related to obesity/metabolic syndrome. Using KNHANES (Korea National Health and Nutrition Examination Survey) raw data ($1^{st}$; 1998, $5^{th}$; 2010, 2011) and a literature search, we selected vegetables for study. Edible portions of samples were prepared, ethanol-extracted, and then freeze-dried. 3T3-L1 adipocytes and HepG2 hepatocytes cells were used as in vitro models. Lipid accumulation determined by Oil-red O staining showed that all samples except bracken had inhibitory effects on lipid accumulation in 3T3-L1 adipocytes. Especially, crown daisy and mugwort effectively reduced accumulation of lipids, and their inhibition rates were more than 60% of the control group. Young pumpkin, leeks, crown daisy, and mugwort showed significantly decreased MCP-1 levels compared to the control group. However, adiponectin protein level did not increase in the vegetables experimental group. In HepG2 hepatocytes, all samples showed inhibitory effects on lipid accumulation at one of the two concentrations. Although adiponectin protein levels did not increase, MCP-1 protein levels decreased in adipocytes. Further, lipid accumulation in adipocytes and hepatocytes decreased. In conclusion, all samples showed one or more improved obesity/metabolic syndrome indicators. Among them, young pumpkin, leeks, crown daisy, and mugwort were selected as the most effective portions of vegetables based on improvement of obesity/metabolic syndrome-related indicators.

Case studies of shallow marine investigations in Australia with advanced underwater seismic refraction (USR) (최신 수중 탄성파 굴절법(USR)을 이용한 호주의 천부해양탐사 사례연구)

  • Whiteley, Robert J.;Stewart, Simon B.
    • Geophysics and Geophysical Exploration
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    • v.11 no.1
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    • pp.34-40
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    • 2008
  • Underwater seismic refraction with advanced interpretation approaches makes important contributions to shallow marine exploration and geotechnical investigations in Australia's coastal areas. A series of case studies are presented to demonstrate the recent applications of continuous and static USR methods to river crossing and port infrastructure projects at various sites around Australia. In Sydney, static underwater seismic refraction (USR) with bottom-placed receivers and borehole seismic imaging assisted the development of improved geotechnical models that reduced construction risk for a tunnel crossing of the Lane Cove River. In Melbourne, combining conventional boomer reflection and continuous USR with near-bottom sources and receivers improved the definition of a buried, variably weathered basalt flow and assisted dredging assessment for navigation channel upgrades at Geelong Ports. Sand quality assessment with continuous USR and widely spaced borehole information assisted commercial decisions on available sand resources for the reclamation phase of development at the Port of Brisbane. Buried reefs and indurated layers occur in Australian coastal sediments with the characteristics of laterally limited, high velocity, cap layers within lower velocity materials. If these features are not recognised then significant error in depth determination to deeper refractors can occur. Application of advanced refraction inversion using wavefront eikonal tomography to continuous USR data obtained along the route of a proposed offshore pipeline near Fremantle allowed these layers and the underlying bedrock refractor to be accurately imaged. Static USR and the same interpretation approach was used to image the drowned granitic regolith beneath sediments and indurated layers in the northern area of Western Australia at a proposed new berthing site where deep piling was required. This allowed preferred piling sites to be identified, reducing overall pile lengths. USR can be expected to find increased application to shallow marine exploration and geotechnical investigations in Australia's coastal areas as economic growth continues and improved interpretation methods are developed.

Evaluation and interpretation of the effects of heterogeneous layers in an OBS/air-gun crustal structure study (OBS/에어건을 이용한 지각구조 연구에서 불균질층의 영향에 대한 평가와 해석)

  • Tsuruga, Kayoko;Kasahara, Junzo;Kubota, Ryuji;Nishiyama, Eiichiro;Kamimura, Aya;Naito, Yoshihiro;Honda, Fuminori;Oikawa, Nobutaka;Tamura, Yasuo;Nishizawa, Azusa;Kaneda, Kentaro
    • Geophysics and Geophysical Exploration
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    • v.11 no.1
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    • pp.1-14
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    • 2008
  • We present a method for interpreting seismic records with arrivals and waveforms having characteristics which could be generated by extremely inhomogeneous velocity structures, such as non-typical oceanic crust, decollement at subduction zones, and seamounts in oceanic regions, by comparing them with synthetic waveforms. Recent extensive refraction and wide-angle reflection surveys in oceanic regions have provided us with a huge number of high-resolution and high-quality seismic records containing characteristic arrivals and waveforms, besides first arrivals and major reflected phases such as PmP. Some characteristic waveforms, with significant later reflected phases or anomalous amplitude decay with offset distance, are difficult to interpret using only a conventional interpretation method such as the traveltime tomographic inversion method. We find the best process for investigating such characteristic phases is to use an interactive interpretation method to compare observed data with synthetic waveforms, and calculate raypaths and traveltimes. This approach enables us to construct a reasonable structural model that includes all of the major characteristics of the observed waveforms. We present results here with some actual observed examples that might be of great help in the interpretation of such problematic phases. Our approach to the analysis of waveform characteristics is endorsed as an innovative method for constructing high-resolution and high-quality crustal structure models, not only in oceanic regions, but also in the continental regions.

Part-time Employment in Japan and Taiwan (일본과 대만의 시간제 고용에 관한 연구)

  • 이혜경;장혜경
    • Korea journal of population studies
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    • v.23 no.2
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    • pp.79-112
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    • 2000
  • This study was focused on the contrasting pattern of part-time employment between Japan and Taiwan where the environments are similar in terms of expanding service industries and increasing flexibility of labor. In Japan, the expansion of part-time employment and its feminization have occurred, whereas they have not at all in Taiwan. The purpose of this study was to examine the reasons behind this phenomena, and to explore what relations they might have with the supply of women\`s labor in each country. Data analysis showed the following results. First, when the phenomena of part-time employment in Japan and Taiwan are summarized as \`active\` and \`inactive\` models, the difference could be explained by a structure-oriented approach rather than an individual-oriented approach. In other words, the difference between the two countries is mainly because of the structural characteristics of the labor market. a combination of capitalism and patriarchy, and an effect of state welfare and family policies rather than a \`voluntaristic choice\` due tn household work and child rearing. In light of this. the labor market segmentation and flexibility of labor theory in particular provided a useful frame for explanation. Second, with regard to the supply of women\`s labor, the difference between Japan and Taiwan could be found in the structure of the labor market and in family response strategies. The large corporation-oriented and strictly divided labor market structure in Japan activated part-time employment and its feminization, whereas, the small family-oriented businesses and less divided labor market in Taiwan supported the continuity of full-time employment of married women. There was also a room for informal employment in Taiwan which made part-time employment unnecessary. This study showed that even within similar environments of expanding service industry and pursuing flexibility of labor different measures and adaptations were possible. The case of Taiwan in particular, showed the significance of an informal labor market which was a part of industrialization process and a strategy of producing various products through a subcontracting network.

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