• Title/Summary/Keyword: Health care efficiency

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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Dental Hygienists' Turnover Intention and its Related Factors (치과위생사의 이직요인에 대한 조사연구)

  • Yoon, Mi-Sook;Lee, Kyung-Hee;Choi, Mi-Sook
    • Journal of dental hygiene science
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    • v.6 no.1
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    • pp.11-17
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    • 2006
  • The purpose of this study was to help prevent the turnover of competent dental hygienists in a bid to boost the efficiency of personnel management for dental health care workers and provide higher-quality oral health services. After relevant literature and data were reviewed, a survey was conducted on dental hygienists, who worked at dental institutes, for approximately four months from September to December 2004 to identify what affected their turnover. The findings of the study were as below: 1. Regarding turnover experience, 39.7 percent of the dental hygienists investigated had such an experience. As to turnover frequency, those who took up another employment once made up the largest group(28.2%), followed by twice(8.0%) and three times(2.9%). The most dominant turnover reason was working conditions(66.7%), followed by seeking being hired by larger institutes(36.2%), pay(21.7%), relationship with dentists(11.6%) and commuting distance(11.6%). 2. As for their hope for turnover, 82.8 percent hoped to take up another employment, and working conditions were cited as the most common reason(44.4%), followed by pay(33.3%), commuting distance(18.1%), marriage(13.2%), health/use of leisure time(11.8%), and commuting time(10.4%). 3. Concerning preference for future workplace, 38.5 percent, the largest group, wanted to work at public health clinics. As to a preferred term of working as dental hygienists, 50.0 percent, the greatest group, hoped to serve as dental hygienists until they are financially secure. 34.5 percent, the second largest group, intended to keep working until they reach the age limit. In regard to their responsibility for family economy, 47.7 percent, the greatest percentage, shouldered the partial responsibility for that, and 31.6 percent assumed no responsibility. 4. As to their intention to quit working as dental hygienists, 61.5 percent were willing to do that, and marriage(29.0%) was singled out as the most frequent reason, followed by working conditions(27.1%), child birth(22.4%), health/housework(18.7%), pay(15.9%) and learning/use of free time(15.0%).

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A SURVEY OF DENTAL TREATMENT UNDER OUTPATIENT GENERAL ANESTHESIA IN DEPARTMENT OF PEDIATRIC DENTISTRY AND CLINIC FOR DISABLED AT YONSEI UNIVERSITY DENTAL HOSPITAL (연세대학교 치과대학병원 소아치과 및 장애인 클리닉에서 시행된 외래 전신마취하의 치료에 대한 연구)

  • Lee, Dong-Woo;Song, Je-Seon;Choi, Hyung-Jun;Kang, Jeong-Wan;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.1
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    • pp.65-72
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    • 2010
  • General anesthesia has been researched and developed in dentistry as on type of management technique to sedate patients who may be uncontrollable or require medical consideration. There has been continuous research into this area, but analysis of large set of patients over a sustained period of time is lacking. Thus, this study analyzes the records of patients who received general anesthesia at the Yonsei University Dental Hospital Department of Pediatric and Clinic for the Disabled. 1. Patient's age ranged from 1 to 66, with under 5 being the largest group with 410 members(38.5%). The study included more men than women, with 695 male members(65.3%). 2. Type of dental procedure performed were as follows(per person) : 5.6 Dental restoration; 2.3 Endodontic treatment of deciduous and primary teeth; 2.5 preformed crowning; and 1.6 extractions. Procedures took an average of 100 minutes. 3. 1022 patients(95.9%) received dental care under general anesthesia once and 43 patients(4.1%) received dental care under general anesthesia two or more times. Dentistry under general anesthesia has the many benefit. However, without appropriate post-treatment care, it is difficult to maintain good oral health. Therefore, it is important to improve the efficiency and safety of general anesthesia through future research.

A Review on the Dominant Undertaking's Abuse in the Medical Device Market (시장지배적 의료기기 사업자의 경쟁제한적 차별행위 - 지멘스 사건을 중심으로 -)

  • Jeong, Jae Hun
    • The Korean Society of Law and Medicine
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    • v.23 no.1
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    • pp.81-119
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    • 2022
  • Medical device market is strongly related with health care market. Public regulation in medical device market tends to be more lenient than health care market. In this market, competition law, administrative law and intellectual property law are intertwined, and thereby a variety of legal issues could be developed. Recently, dominant undertaking's abuse case was dealt with KFTC(Korea Fair Trade Commission) and Seoul High Court. The issues were whether dominant undertaking discriminated trading partners and this discrimination was anticompetitive. In this case, Seoul High Court revoked the KFTC's decision, holding that the undertaking did not harm competition, though it has dominant power in the relevant medical device market. This decision would be a meaningful precedent, not only that there have been small numbers of dominance abuse cases in Korea, but also that this case happened in medical device market. This case dealt with various issues like market definition, market power, alleged abuse and its anticompetitive effect. The court held that medical device markets are distinguished from medical device repairing market. However, the court did not clarify that medical device repairing market is a single branded market only for repairing the plaintiff's medical devices. Second, plaintiff's dominance is based on the lock-in effect, which means that hospitals could not switch devices like CT or MRI from plaintiff to other competitors. This could be supplemented from the fact that medical devices are expensive and the using period are significantly long. However market definition based on single branded market theory could be applied in rare and exceptional cases. Therefore the general application of single branded market theory might result in overestimate of market power. This type of abuse pattern requires improper condition contrary to resonable trade practice. KFTC asserted free charge for plaintiff's copy right. However, it is not clear whether the cases for free charge are general or not. Even if so, the intention and motive of providers for free charge should be proved. The main issue of anticompetitive effect was whether plaintiff raised rival's cost. Competitor's cost was increased due to plaintiff's copy right and its license fee. However the charge for license could be within the scope of fair and legal exercise of copy right. If competitors are excluded due to legal exercise of copy right or efficiency, the exclusionary abuse could not be proved.

Process Development of Red Ginseng Production by Microwave-assisted Low Temperature Vacuum Dry and Characteristics of Products (마이크로파 저온진공건조 기술을 이용한 홍삼제조공정 개발 및 제품특성에 관한 연구)

  • Lee, Sang-Ho;Ji, Joong-Gu
    • Journal of the Korean Applied Science and Technology
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    • v.34 no.2
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    • pp.305-314
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    • 2017
  • The purpose of this study was to develop the high efficiency of ginseng by using microwave low temperature vacuum drying technology. In red ginseng manufacturing processes, the study results compared the hot-air drying red ginseng dried during 24hours in $60-70^{\circ}C$ and redried during 72hours in $40^{\circ}C$ after the steaming ginseng with the red ginseng dried in microwave low temperature vacuum dryer on condition that 900 watt, 2.45 MHz, 50 mmHg during 5 hours and redried during 2 hours on 750 mmHg after the steaming ginseng about observation of tissue, sensory evaluation and a change of ginsenoside and crude saponin content. As a result, the red ginseng in microwave low temperature vacuum was had high brightness, the surface turned into porosity tissue and added more flavor, decreased bitterness highly on the contrary increased sweetness at the same time that elevated the comprehensive preference. Moreover, In a short time, the content of ginsenosides $Rg_1$ and $Rb_1$ increased about sixfold, eightfold in one time zone but there were no wide difference in content of $Rg_3$ as compared to the hot-air drying red ginseng. Finally, content of crude saponin was increased widely at 10-20 minutes and stayed high crude saponin content consistently. Therefore, this result indicated that the red ginseng in microwave low temperature vacuum increased extraction yields of the ginsenosides and crude saponin through a change of porosity tissue and improved flavor and texture compare with the general hot air dried red ginseng in a short time. According to these results, that provided that could increase the preference about red ginseng.

Effects of Jerusalem Artichoke (Helianthus tuberosus L.) Extracts on Blood Glucose and Lipid Metabolism in STZ-induced Diabetic Rats (돼지감자 추출액이 Streptozotocin으로 유발된 당뇨쥐에서 혈당 및 지질대사에 미치는 효과)

  • Kim, Hye-Jeong;Kim, Dong-Il;Yon, Jung-Min
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.203-208
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    • 2015
  • This study investigated the effect of Jerusalem artichoke (Helianthus tuberosus L.) extract on Blood Glucose and Lipid Metabolism in Streptozotocin (70 mg/kg B.W., i.p.)-induced Diabetic Rats. Sprague-Dawley male rats (200~220 g) were divided into normal control group (NC), diabetic control group (DC) and Jerusalem artichoke treated diabetic group (DJ). Diabetes was induced by single intraperitoneal injection of streptozotocin as a dose of 70 mg/kg body weight. Food (p<0.001) and water (p<0.05) intakes were higher in diabetic groups than the normal group. Body weight gain and food efficiency ratio were significantly lower in diabetic groups than normal group (p<0.01). However, they were higher in the DJ group than in the DC group. The serum levels of AST and ALT were significantly lower in the DJ group than in the DC group (p<0.05). The serum level of HDL-C was significantly higher in the DJ group than in the DC group (p<0.001). The serum levels of Triglyceride (p<0.05), LDL-C (p<0.001), and glucose (p<0.001) were significantly lower in the DJ group than in the DC group. At 3 and 4 weeks after the experiment, blood glucose level in the DJ group was significantly lower than the DC group (p<0.05). In conclusion, these results indicated that Jerusalem artichoke can prevent or retard the development of diabetic complications via its beneficial effects for alleviating the hyperglycemia and improved lipid metabolism.

A Study on the Introduction of Electronic Commerce for Purchasing Section in Hospitals - Focused on the Understanding of Purchasing Managers - (병원구매업무에 있어서의 전자상거래 도입에 관한 연구 - 구매부서 관리자의 인식도를 중심으로 -)

  • Hwang, Eun-Bum;Nam, Sang-Yo;Ha, Ho-Uk;Lee, Chang-Eun
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.69-89
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    • 2001
  • This study is focused that the electronic commerce(EC) on the purchasing section may improve the efficiency and transparency of the hospitals management. After reviewing the purchasing activity of hospitals, I study the introduction, expected effects, and problems of EC. So, I am going to provide basic information for activating EC. The samples are managers of 170 hospitals, which are located on Seoul. As a result of collection this survey, I analyze 79 hospitals. For data analysis, I use $X^2$-test and ANOVA for purchasing management and the relevance of EC according to the level of care. The results of this study are 1. The problems on the management of purchasing section are: firstly, they don't have sufficient time to study market. Secondly, it is difficult to find competitive suppliers. And, lastly, they cannot gather a lot of information about the price of products. 2. There are many answers of the needs on the introduction of B2B. However, some hospitals think they don't need it. But, the most answers are that the EC will be settled within 4 years. So, we can realize that these hospitals are getting interested on the EC. On the other hand, I find that they prefer outside EC companies for the introduction of EC. 3. On the expected effects on EC, first is the effectiveness of the market survey. The next is to collect information of adequate price of products owing to clear transaction, find easier new suppliers and gather useful data. 4. On the external problems of the introduction of EC, there is low credibility related to the security and the weakness of suppliers' information system. Especially, on the Real Transaction Price Payment system, the bigger bed size, the higher understanding on these problems. On the internal problems of the introduction of EC, first is the burden of the introduction of EC and operating cost. Especially, on the burden of the disclosure of revenue source, the smaller bed size, the higher understanding on this problem So, this is a point which deserves my attention statistically. However, this shows relatively little understanding about incomplete the standard of product category and the weak information system of hospital. Through this study, I am going to suggest 3 points for the activation of the introduction of EC on hospitals. 1. The reform of the Real Transaction Price Payment System on medical supplies and materials for medical treatment 2. The establishment of the standard of product category 3. The promotion of information system based on network.

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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.

mSFP: Multicasting-based Inter-Domain Mobility Management Scheme in Sensor-based Fast Proxy Mobile IPv6 Networks (센서기반 FPMIPv6 네트워크에서 멀티캐스팅 기반의 도메인간 이동성관리 기법)

  • Jang, Hana;Jeong, Jongpil
    • KIPS Transactions on Computer and Communication Systems
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    • v.2 no.1
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    • pp.15-26
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    • 2013
  • IP-based Wireless Sensor Networks (IP-WSNs) are gaining importance for their broad range of applications in health-care, home automation, environmental monitoring, industrial control, vehicle telematics and agricultural monitoring. In all these applications, mobility in the sensor network with special attention to energy efficiency is a major issue to be addressed. Because of the energy inefficiency of networks-based mobility management protocols can be supported in IP-WSN. In this paper we propose a network based mobility supported IP-WSN protocol called Multicasting-based inter-Domain Mobility Management Scheme in Sensor-based Fast Proxy Mobile IPv6 Networks (mSFP). Based on [8,20], We present its network architecture and evaluate its performance by considering the signaling and mobility cost. Our analysis shows that the proposed scheme reduces the signaling cost, total cost, and mobility cost. With respect to the number of IP-WSN nodes, the proposed scheme reduces the signaling cost by 7% and the total cost by 3%. With respect to the number of hops, the proposed scheme reduces the signaling cost by 6.9%, the total cost by 2.5%, and the mobility cost by 1.5%. With respect to the number of IP-WSN nodes, the proposed scheme reduces the mobility cost by 1.6%.

Design and Implementation of a Real-time Bio-signal Obtaining, Transmitting, Compressing and Storing System for Telemedicine (원격 진료를 위한 실시간 생체 신호 취득, 전송 및 압축, 저장 시스템의 설계 및 구현)

  • Jung, In-Kyo;Kim, Young-Joon;Park, In-Su;Lee, In-Sung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.4
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    • pp.42-50
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    • 2008
  • The real-time bio-signal monitoring system based on the ZigBee and SIP/RTP has proposed and implemented for telemedicine but that has some problems at the stabilities to transmit bio-signal from the sensors to the other sides. In this paper, we designed and implemented a real-time bio-signal monitoring system that is focused on the reliability and efficiency for transmitting bio-signal at real-time. We designed the system to have enhanced architecture and performance in the ubiquitous sensor network, SIP/RTP real-time transmission and management of the database. The Bluetooth network is combined with ZigBee network to distribute traffic of the ECG and the other bio-signal. The modified and multiplied RTP session is used to ensure real-time transmission of ECG, other bio-signals and speech information on the internet. The modified ECG compression method based on DWLT and MSVQ is used to reduce data rate for storing ECG to the database. Finally we implemented a system that has improved performance for transmitting bio-signal from the sensors to the monitoring console and database. This implemented system makes possible to make various applications to serve U-health care services.