• Title/Summary/Keyword: Health Care Operations

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Nicotine dependence and the International Association for the Study of Pain neuropathic pain grade in patients with chronic low back pain and radicular pain: is there an association?

  • Schembri, Emanuel;Massalha, Victoria;Spiteri, Karl;Camilleri, Liberato;Lungaro-Mifsud, Stephen
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.359-377
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    • 2020
  • Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

Considerations for the Migration of Electronic Medical Records to Cloud Based Storage (전자의무기록의 클라우드 기반 저장소 이동시 고려사항)

  • Yi, Myongho
    • Journal of Korean Library and Information Science Society
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    • v.47 no.1
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    • pp.149-173
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    • 2016
  • As cloud computing becomes more and more popular and ubiquitous, many organizations are deciding to move their whole information infrastructure to the cloud. The healthcare industry is one of those that is beginning to utilize cloud-based solutions en masse. Cloud based computing and storage offers numerous benefits including scalability, cost efficiency, and accessibility, which in turn have the potential to streamline hospital operations. Despite the potential benefits of acquiring this system, considerations must still be given to the migration of the massive amounts of personal and highly protected data to a cloud-based solution. Health care organizations must consider all matters of security, reliability, and availability, to ensure that patients' data remains compliant to the Health Insurance Portability and Accountability Act (HIPAA) compliant. This paper will examine the benefits and challenges of such operation to determine the best practices for the utilization of Electronic Medical Record (EMR) cloud based networking and storage for small to mid-sized hospitals.

Analysis of Factors Influencing on Food Supplier Selection Criteria in the Health-care Foodservice Operations (의료기관의 식자재 공급자 선정기준에 영향을 미치는 요인 분석)

  • Kim, Jeong-Ri;Choe, Seong-Gyeong;Gwak, Dong-Gyeong
    • Journal of the Korean Dietetic Association
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    • v.8 no.4
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    • pp.372-386
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    • 2002
  • The purposes of this study were to find factor which influence on the selection criteria of food supplier. Questionnaire were distributed to 52 general hospitals with more than 400 beds located in Seoul and Kyongin province, and responded questionnaires were collected from 44 dietetic departments (84.6%) and 18 purchasing departments (34.6%). The main results of this study can be summarized as follows: (1) supplier selection criteria include quality, service, cost and supplier competency. (2) With having been met with tight competition and market opening, hospitals plan a strategy to improve quality, service and they tend to have more interest in various supplier selection criteria. (3) Purchasing departments estimate more highly the rate of reflection in considering supplier selection criteria than the rate of importance about cost criteria, which reveals that purchasing departments sensitively respond to cost cutdown. (4) When selecting suppliers, a significant(p<.01) influence of stability of supplier industry environment on the selecting criteria such as the importances of quality, service, and supplier quality are recognized only after recognizing the stability of food delivery industry. Food supplier industry secures stability more quickly through major companies' participation in food distribution industry and this will reveal the importance of supplier selection criteria. (5) Suppliers which are selected by the quality criteria, service criteria, supplier quality criteria make efforts to communicate with foodservice departments, to give more proper information about substitute food, new product, and to make commitments, while suppliers which are decided by cost criteria do not establish supportive relationships with foodservice departments.

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Chronic postsurgical pain: current evidence for prevention and management

  • Thapa, Parineeta;Euasobhon, Pramote
    • The Korean Journal of Pain
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    • v.31 no.3
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    • pp.155-173
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    • 2018
  • Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

A Study on Stress Incontinence in Women in Korea (여성의 긴장성 요실금에 관한 연구)

  • Lee, Young-Sook
    • 모자간호학회지
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    • v.4 no.1
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    • pp.12-23
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    • 1994
  • This study was done to determine the situations of stress incontinence(SI) and the differences in general characteristics, obstetrical history and SI related variables between women with stress incontinence and normal women. The design for study was a descriptive study. The number of subjects consisted of 156 women who were selected by systematic random sampling in Kwangju city. Data collection was done with the modified Hendrickson's Stress Incontinence Scale(1981) which was analyzed using frequency and percentiles. The results were as follows : 1. The stress incontinence (SI) rate of the sample was 64.1% and the majority of the women(40.9%) had experienced SI for a period of five years(the mean period was 2.7 years) without any treatment or care(83.0%). The amount of SI was from one drop(40.0%) to one teaspoon(16.7%) daily. 2. Items on the SI scale had the scores ranging from 4 to 44 with a mean score of 13.7 which showed mild SI. 3. The priority of provocative factors for SI were abdominal tightening(83%), coughing(58%), laughing(52%), sneezing(40%), steeping(18%), sudden standing(17%), nose blowing(13%), heavy exercise(11%), rapid walking up-stairs(10%) and excitment (9%) in that order. 4. There were no significant differences in age, education, spouse, job and income between the women with SI and the normal women. 5. There were no significant differences in the age at the last delivery, age of last baby. number of vaginal, or cesarean deliveries, or abdominal operations between the women with SI and the normal women. It can be concluded that SI in women has a high incidence nth various provocative factors but it is relatively mild SI on a daily basis and generally there has been no treatment. It is suggested that a descriptive study of emotional problems and precipitating variables in SI women will increase the knowledge of SI.

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Distributed Processing of Big Data Analysis based on R using SparkR (SparkR을 이용한 R 기반 빅데이터 분석의 분산 처리)

  • Ryu, Woo-Seok
    • The Journal of the Korea institute of electronic communication sciences
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    • v.17 no.1
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    • pp.161-166
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    • 2022
  • In this paper, we analyze the problems that occur when performing the big data analysis using R as a data analysis tool, and present the usefulness of the data analysis with SparkR which connects R and Spark to support distributed processing of big data effectively. First, we study the memory allocation problem of R which occurs when loading large amounts of data and performing operations, and the characteristics and programming environment of SparkR. And then, we perform the comparison analysis of the execution performance when linear regression analysis is performed in each environment. As a result of the analysis, it was shown that R can be used for data analysis through SparkR without additional language learning, and the code written in R can be effectively processed distributedly according to the increase in the number of nodes in the cluster.

Physician's Responsibilities in Medical Dispute (의료분쟁(醫療紛爭)에 있어서 의사(醫師)의 주의의무(注意義務))

  • Lee, Joon-Sang;Choi, Baik-Hi
    • Journal of Preventive Medicine and Public Health
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    • v.15 no.1
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    • pp.17-31
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    • 1982
  • A physician assumes toward his patient the obligation to use such reasonable care and skill as is commonly possessed and exercised by physicians in the same general line of practice in the same or similar localities and to use his best judgment at the times. Medical disputes between physicians and patients are, ever more increased in these days as human body, happens to cause a variety of changes in body unlike the function of machine. Such increased trends of medical disputes became a problem in common across the word under the influence of affluent living standard, high consciousness of life value and right by today's people. The aim of this dissertation is oriented to forming a physician's responsibilities in medicalcare accidents arising between physicians and patients. A general physician, for example, has not been negligent merely because, a specialist might have treated the patient with greater skill and knowledge. However, the fact that a physician may have acted to the best of his ability will not avoid legal problems for damages resulting from substandard treatment, that is the degree of care and skill which is to be expected of the ordinary practitioner in his field of practice. The duty of a physician who is, or holds himself out to be, a specialist is greater in the field of his specialty than one who is a general physician. A patient's consent to routine medical procedures is implied from the fact that patient comes to the physician with a medical problem and voluntarily submits to the procedures. For the more serious medical procedures and for major operations, however, it is preferable for the physician to have the patient's consent in writing, to facilitate proof of the consent in the event of a dispute or litigation. Suppose that mistakes on the part of physicians are likely to be blamed in all cases of malpractice. Then it will create a sort of shrinkage in activities of medical treatment. There should be some limitation on excessive application of 'The thing speaks for itself' on mistakes by physicians and availablity of cause and effect. It is a matter of complicity as well as a matter of importance to draw a definite boundary on responsibilities of physician. A series of further research on this particular aspect is strongly urged.

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Design and Development of IoT-based Indoor Environment Management Platform (IoT 기반의 실내환경 관리 플랫폼 설계 및 개발)

  • Lee, Wan-Jik;Kim, Se-Jin;Yoon, Jun-Keun;Jeong, Ja-Woon;Heo, Seok-Yeol
    • The Journal of the Convergence on Culture Technology
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    • v.7 no.1
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    • pp.654-661
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    • 2021
  • Air pollution caused by industrial development has become a level that can seriously threaten human health. In general, indoor air pollution is considered to be lower than outdoors, but modern people live indoors most of the time, thus it is essential to keep the indoor air quality comfortable in order to take care of one's own health and improve the quality of life. Therefore, the development of an indoor environment management platform using Internet of Things and data processing technology, which is currently drawing attention, is considered a very meaningful study. In this paper, we designed an IoT-based management platform that can remotely monitor and control indoor environments. In addition, the functions of the IoT terminal, gateway, and data server constituting the platform were implemented using open source and open libraries, and all functional operations were also verified. In particular, the IoT terminal and the gateway in this paper exchange data using BLE communication, so they can operate with relatively low power and since the gateway uses the BLE Advertising mode, it has the advantage of automatically recognizing IoT terminals that have not been previously configured.

Market in Medical Devices of Blockchain-Based IoT and Recent Cyberattacks

  • Shih-Shuan WANG;Hung-Pu (Hong-fu) CHOU;Aleksander IZEMSKI ;Alexandru DINU;Eugen-Silviu VRAJITORU;Zsolt TOTH;Mircea BOSCOIANU
    • Korean Journal of Artificial Intelligence
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    • v.11 no.2
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    • pp.39-44
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    • 2023
  • The creativity of thesis is that the significance of cyber security challenges in blockchain. The variety of enterprises, including those in the medical market, are the targets of cyberattacks. Hospitals and clinics are only two examples of medical facilities that are easy targets for cybercriminals, along with IoT-based medical devices like pacemakers. Cyberattacks in the medical field not only put patients' lives in danger but also have the potential to expose private and sensitive information. Reviewing and looking at the present and historical flaws and vulnerabilities in the blockchain-based IoT and medical institutions' equipment is crucial as they are sensitive, relevant, and of a medical character. This study aims to investigate recent and current weaknesses in medical equipment, of blockchain-based IoT, and institutions. Medical security systems are becoming increasingly crucial in blockchain-based IoT medical devices and digital adoption more broadly. It is gaining importance as a standalone medical device. Currently the use of software in medical market is growing exponentially and many countries have already set guidelines for quality control. The achievements of the thesis are medical equipment of blockchain-based IoT no longer exist in a vacuum, thanks to technical improvements and the emergence of electronic health records (EHRs). Increased EHR use among providers, as well as the demand for integration and connection technologies to improve clinical workflow, patient care solutions, and overall hospital operations, will fuel significant growth in the blockchain-based IoT market for linked medical devices. The need for blockchain technology and IoT-based medical device to enhance their health IT infrastructure and design and development techniques will only get louder in the future. Blockchain technology will be essential in the future of cybersecurity, because blockchain technology can be significantly improved with the cybersecurity adoption of IoT devices, i.e., via remote monitoring, reducing waiting time for emergency rooms, track assets, etc. This paper sheds the light on the benefits of the blockchain-based IoT market.

An Adaptive Temporal Suppression for Reducing Network Traffic in Wireless Sensor Networks (무선 센서 네트워크에서 통신량 감소를 위한 적응적 데이터 제한 기법)

  • Min, Joonki;Kwon, Youngmi
    • Journal of the Institute of Electronics and Information Engineers
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    • v.49 no.10
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    • pp.60-68
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    • 2012
  • Current wireless sensor networks are considered to support more complex operations ranging from military to health care which require energy-efficient and timely transmission of large amounts of data. In this paper, we propose an adaptive temporal suppression algorithm which exploits a temporal correlation among sensor readings. The proposed scheme can significantly reduce the number of transmitted sensor readings by sensor node, and consequently decrease the energy consumption and delay. Instead of transmitting all sensor readings from sensor node to sink node, the proposed scheme is to selectively transmit some elements of sensor readings using the adaptive temporal suppression, and the sink node is able to reconstruct the original data without deteriorating data quality by linear interpolation. In our proposed scheme, sensing data stream at sensor node is divided into many small sensing windows and the transmission ratio in each window is decided by the window complexity. It is defined as the number of a fluctuation point which has greater absolute gradient than threshold value. We have been able to achieve up about 90% communication reduction while maintaining a minimal distortion ratio 6.5% in 3 samples among 4 ones.