• Title/Summary/Keyword: Elderly Welfare

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Research Trend of the Healthcare and Medical Care for Elders in the Journal of the Korea Gerontological Society (한국노년학의 보건·의료·건강영역 연구동향)

  • Kim, Hyun Sook;Park, Yeon-Hwan;Kim, Young Sun
    • 한국노년학
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    • v.38 no.3
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    • pp.705-723
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    • 2018
  • In this study we review the selected articles on elderly health and medical care published in the Journal of the Korea Gerontological Society (JKGS) in the last 40 years, and make suggestions for future research directions for gerontological health and medical care issues. Of all the 40 year publications from volume 1 (1980) to 38 (2017), we first examined the 30th anniversary review on the subject of gerontological nursing care and healthcare policies published in JKGS from 1980 (vol. 1, No. 1) to 2008 (vol. 28, No. 2), and reviewed recent 237 researches of this decade (out of all 655 articles from 2008, vol. 28, No. 3 to 2017, vol. 38, No. 4). We could find the following trends. Firstly, the analysis of the primary authors in the past 10 years revealed that those in public health, nursing and other health-related including physical education areas have dealt the subjects focusing on physical health while those in social welfare mostly on mental health. That is, physical health has been the prime subject of researches in the health and medical care area. Secondly, in the same period quantitative researches were accounted for 89.9%, which is similar to the trend of the first 30 years 81.5 %. On the other hand, qualitative studies were only 11 cases and the focus group interview were the most frequently used method comprising 33.3% among them. Thirdly, the non-experimental researches in the past 10 years comprise 65.4%, which was 82.7% in 1980 2008 period, indicating the increasing trend in experimental researches to deal with the issues in medical and healthcare fields. Lastly, the subjects of the researches were mostly the elders who are healthy, residents of city areas, or home dwellers, and 60% of them were over 65 years old in the past 10 years while the proportion was 42.7% in the previous review period. 81.6 % of the researches in the past 10 years was dealing both genders, slightly decreased trend compared to 88.5% of the previous review period. This study reveals that the researches in non-experimental physical health remains the main stream of JKGS despite the efforts by some researchers to diversify the methods and subjects. Systematic and in-depth researches employing multidisciplinary, qualitative, longitudinal and meta-analytical approaches are called for to guide the gerontolgical health issues with preventive and proactive perspectives.

Ensemble of Nested Dichotomies for Activity Recognition Using Accelerometer Data on Smartphone (Ensemble of Nested Dichotomies 기법을 이용한 스마트폰 가속도 센서 데이터 기반의 동작 인지)

  • Ha, Eu Tteum;Kim, Jeongmin;Ryu, Kwang Ryel
    • Journal of Intelligence and Information Systems
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    • v.19 no.4
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    • pp.123-132
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    • 2013
  • As the smartphones are equipped with various sensors such as the accelerometer, GPS, gravity sensor, gyros, ambient light sensor, proximity sensor, and so on, there have been many research works on making use of these sensors to create valuable applications. Human activity recognition is one such application that is motivated by various welfare applications such as the support for the elderly, measurement of calorie consumption, analysis of lifestyles, analysis of exercise patterns, and so on. One of the challenges faced when using the smartphone sensors for activity recognition is that the number of sensors used should be minimized to save the battery power. When the number of sensors used are restricted, it is difficult to realize a highly accurate activity recognizer or a classifier because it is hard to distinguish between subtly different activities relying on only limited information. The difficulty gets especially severe when the number of different activity classes to be distinguished is very large. In this paper, we show that a fairly accurate classifier can be built that can distinguish ten different activities by using only a single sensor data, i.e., the smartphone accelerometer data. The approach that we take to dealing with this ten-class problem is to use the ensemble of nested dichotomy (END) method that transforms a multi-class problem into multiple two-class problems. END builds a committee of binary classifiers in a nested fashion using a binary tree. At the root of the binary tree, the set of all the classes are split into two subsets of classes by using a binary classifier. At a child node of the tree, a subset of classes is again split into two smaller subsets by using another binary classifier. Continuing in this way, we can obtain a binary tree where each leaf node contains a single class. This binary tree can be viewed as a nested dichotomy that can make multi-class predictions. Depending on how a set of classes are split into two subsets at each node, the final tree that we obtain can be different. Since there can be some classes that are correlated, a particular tree may perform better than the others. However, we can hardly identify the best tree without deep domain knowledge. The END method copes with this problem by building multiple dichotomy trees randomly during learning, and then combining the predictions made by each tree during classification. The END method is generally known to perform well even when the base learner is unable to model complex decision boundaries As the base classifier at each node of the dichotomy, we have used another ensemble classifier called the random forest. A random forest is built by repeatedly generating a decision tree each time with a different random subset of features using a bootstrap sample. By combining bagging with random feature subset selection, a random forest enjoys the advantage of having more diverse ensemble members than a simple bagging. As an overall result, our ensemble of nested dichotomy can actually be seen as a committee of committees of decision trees that can deal with a multi-class problem with high accuracy. The ten classes of activities that we distinguish in this paper are 'Sitting', 'Standing', 'Walking', 'Running', 'Walking Uphill', 'Walking Downhill', 'Running Uphill', 'Running Downhill', 'Falling', and 'Hobbling'. The features used for classifying these activities include not only the magnitude of acceleration vector at each time point but also the maximum, the minimum, and the standard deviation of vector magnitude within a time window of the last 2 seconds, etc. For experiments to compare the performance of END with those of other methods, the accelerometer data has been collected at every 0.1 second for 2 minutes for each activity from 5 volunteers. Among these 5,900 ($=5{\times}(60{\times}2-2)/0.1$) data collected for each activity (the data for the first 2 seconds are trashed because they do not have time window data), 4,700 have been used for training and the rest for testing. Although 'Walking Uphill' is often confused with some other similar activities, END has been found to classify all of the ten activities with a fairly high accuracy of 98.4%. On the other hand, the accuracies achieved by a decision tree, a k-nearest neighbor, and a one-versus-rest support vector machine have been observed as 97.6%, 96.5%, and 97.6%, respectively.

Patient Satisfaction with Cancer Pain Management (암성통증관리 만족도)

  • Lee, So-Woo;Kim, Si-Young;Hong, Young-Seon;Kim, Eun-Kyung;Kim, Hyun-Sook
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.22-33
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    • 2003
  • Purpose : The purpose of this study was to evaluate the present status of patients' satisfaction and the reasons for any satisfaction or dissatisfaction in cancer pain management Methods : A cross-sectional survey was used to obtain the feedback about pain management. The results of the survey were collected from 59 in- or out-patient who had cancer treatment at two of the teaching hospitals in Seoul from July, 2002 to November, 2002. The data was obtained by a structured questionnaire based on the American Cancer Society Patient Outcome Questionnaire(APS-POQ) and other previous research. The clinical information for all patients were compiled by reviewing their medical records. Resuts : 1) The subjects' mean score of the worst pain was 6.77, the average pain score was 3.80, and the pain score after management was 2.93 for the past 24 hours. The mean score of total pain interference was $25.03{\pm}12.82$. Many of the subjects had false beliefs about pain such as 'the experience of pain is a sign that the illness has gotten worse', 'pain medicine should be 'saved' in case the pain gets worse' and 'people get addicted to pain medicine easily'. 2) 66.1% of the subjects were properly medicated with analgesics. 33.9% of the subjects reported use of various methods in controlling pain other than the prescribed medication. Only 33.9% of the subjects had a chance to be educated about pain management by doctors or nurses. 3) The mean score of patients' satisfaction with pain management was $4.19{\pm}1.14$. 72.9% of the subjects answered 'satisfied' with pain management. The reasons for dissatisfaction were 'the pain was not relieved even after the pain management', 'I was not quickly and promptly treated when I complained of pain', 'doctors and nurses didn't pay much attention to my complaints of pain.', and 'there was no appropriate information given on the methods of administration, effect duration and side effects of pain medicine.' The reasons for satisfaction were: 'the pain was relieved after the pain management.', 'doctors and nurses quickly and promptly controlled my pain.', 'doctors and nurses paid enough attention to my complaints of pain.' and 'trust in my physician'. 4) In pain severity or pain interference, no significant difference was found between the satisfied group and dissatisfied group. On the belief 'good patients avoid talking about pain', a significant difference was found between the satisfied group and dissatisfied group. Conclusions : The patients' satisfaction with cancer pain management has increased over the years but still about 30% of patients reported to be 'not satisfied' for various reasons. The results of this study suggest that patients' education should be done to improve satisfaction in the pain management program.

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Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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