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A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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A Study on Woman's Experience of Being Bereaved of Her Husband by an Accident (사고로 남편을 잃은 여성의 경험)

  • Park, Sung-Hark;Choi, Mi-Hye;Chung, Yeon-Kang
    • Research in Community and Public Health Nursing
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    • v.7 no.2
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    • pp.294-312
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    • 1996
  • Relatively young widows, who are left with young children by a sudden death of their husbands, will be faced with not only psychological troubles such as individual anxiety and frustration but also the dual burden of playing both father and mother roles in a family, Also, family members have difficulty in adapting themselves to new circumstances of the family system, the training and raising of family members, and management of the family economy. In this study, the realistic resources on the experience of middle-aged women who are bereaved of their husbands by accidents were explored. The purpose of this study is to help widows adapt to life in society and live a more positive life by setting a new goals and recovering from a lost and twisted life. 11 women, who have experienced the loss their husbands and live in the Seoul metropolitan area were studied. The research took 116 days from December 15, 1995 to April 8, 1996. The method of research was direct interviews. While having interviews with them, the contents were recorded with their consent. The ground theory was that used by Strauss & Corbin(1990) in the analysis of the data. 81 concepts were analyzed and they were subdirided into 22 subordinate categories through the course of the analysis. These were then classified into 9 general categories. In the course of being categorized, 'absurdity' was showed as a core category. The subordinate categories 'surprise', 'gloom', 'grudge', 'helplessness', 'emptiness', and 'loss' were united in the core category 'absurdity'. Ominous presentiment, belated notice, death, surprise, gloom, grudge, helplessness, emptiness, loss, the situation of the children, lack of support from neighbors, support from neighbors, mulling over ways to live, choosing a job, strengthening, reinforcement, burden, sadness, smoldering, yearning, overcoming these 22 subordinate categories were re-composed into 9 general ones the husband's death, absurdity, presence of children, existence of support, self-support ability, preparation of countermeasures, self-reinforcement, toilsomeness, and overcoming. 'Absurdity' widows experience was shown in the results of 'toilsomeness' and 'overcoming' through reaction, confrontation, and adaptation. According to the analysis the central phenomenon was absurdity, the causal condition of the death of a husband, the presence of children and the existence of support, and the meditated situation of self-support. To solve absurdity, the preparation of countermeasures and self-reinforcements were shown resulting in toilsomeness and overcoming. Through the contrast in the data, the following statements were deduced: (1) If the death of the husband is expected, the more a widow will feel absurdity. (2) The more children she has and the younger she is, the more a widow will feel absurdity. (3) The lower support she is given, the more a widow will feel absurdity. (4) The larger self-ability she has, the more actively she will prepare countermeasures. (5) The smaller self-ability she has, the more passively she will prepare countermeasures. (6) The larger self-ability she has, the weaker self-reinforcement she will preform. (7) The smaller self-ability she has, the stronger self-reinforcement she will perform. (8) The more actively she prepares countermeasures for absurdity, the better she will overcome. (9) The more passively she prepares counter measure for absurdity, the worse she will overcome. (10) The stronger self-reinforcement for absurdity she performs, the better she will overcome. (11) The weaker self-reinforcement for absurdity she performs, the worse she will overcome. Through the results in this study, the following suggested: 1) A study whose object is all family members, and a comparative study on the case of a husband who has lost his wife should be done. These studies can be expected to develop a more refined theory. 2) Because of the collapse of the extended family system and the changes of family culture in Korea, a widow's status and position are apt to be ambiguous between her husband's home and her parent's. Therefore a new study on family culture should be made. 3) A continuous study on growing social Self Help Groups should be requested for the widows of this study to re-establish and recover from their twisted and scattered lives.

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A Study of School Nursing Activity Performed by School Nurses and Teachers Holding Additional School Health (부산지역 중등학교 양호교사 및 양호겸직교사의 학교보건업무 활동 양상)

  • Park Jung Za;Jung Moon Sook
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.17-32
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    • 1995
  • The purpose of this study was to improve upon school health by understanding the present status of school health and escpecially to investigate the performance rate of regular health instruction. 261 schools, including middle and high schools enrolled in the Busan Educational Association, were sent Questionnaires. Data was collected from the 25th of January to the 10th of April, 1994. 229 subjects who responded to the Questionnaires were finally analyzed as samples. Among them, 127 were school nurses and 102 were teachers acting in a school health capacity. The results of this study are summerized as follows: Of the teachers holding additional school health responsibilities, $85.6\%$ worked in private schools. Many of them $(74.5\%)$ were formally dissatisfied with their ability to provide care because $85.3\%$ of them had never studied any school health. Some of them$(30.4\%)$ didn't know about the annual school nursing budget and $23.5\%$ of them hadn't taught any health education to students. In spite of this fact, they were placed in charge of a school health activity against their own will. There were statistically significant differences in the performance of school health affairs between nurses and teachers holding additional school health (p<0.001) as follows: annual school nursing budget, Health Program Planning and Evaluation, annual purchase price for medicines, average students cared for per day, average students who held at least one consultation per month and extra. Surely, the self-confidence of school nurses was higher than that of teachers with school health as an assigned responsibility. This was demonstrated by a significant statistical difference (p<0.01) in the responses by the two groups. $88.2\%$ of the school nurses and $73.5\%$ of teachers for school health thought that regular health instruction was necessary. But regular health education had been performed only by $32.8\%$ of respondents. Among them, 84% were school nurses and $16\%$ were teachers holding additional school health. Of the persons who performed regular health education, $69.3\%$ used less than $60\%$ of the health content of the athletic textbook. And $64\%$ of them said teaching materials were insufficient. Most of them $(69.4\%)$used home made lesson plans. which they compiled from various sources. There was a significant difference in the formality of the health lesson according to the concern of the school principal (p<0.01) and there was a significant difference in performing health education between school nurses and teachers holding additional school health (p<0.001) It appears that there are a lot of problems with providing school health care using people who are untrained. In a word, school health nurses with professional training are needed in order to perform the qualitative management for the health of the students. These days, regular health education is an indispensable part in making students improve their self-care abilities. Therefore a more effective and better defined program should be prepared for regular systematic health education. To resolve these problems, present laws and regulations related to school health should be revised considering the specialist's request for the improvement of school health. In addition, the concern and financial support of the government are essential.

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A Study on the Actual Conditions of Smoking in Middle and High School Students in One Region (일 지역 중·고등학생의 흡연실태)

  • Kim, Hyeon-Ok
    • Journal of the Korean Society of School Health
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    • v.12 no.1
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    • pp.149-167
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    • 1999
  • To investigate the actual conditions of smoking in middle and high school students in Chinan County, I used a sturctured questionnaire for 1,579 students attending twelve middle-high schools from December 1, 1998 to December 20, 1998. I collected and data correlated the using an $SPSS-PC^+$ 1. The smoking rate of middle-high schoo1 students in Chinan County was 17.9%, relatively high. This smoking rate was different according to the gender, grade, religion, and economic situation. In mals, high school students, non-religious, students low income family students, the smoking rate was higher. The smoking rate of high school students was almost the same as the smoking rate of adults, generally higher than that of foreign teenagers. Because the smoking rat of studinets in the third grade of middle school and in the first grade of high School was six times higher, increased education should be conducted during this time in an attempt to curb the sudden increase of the smoking rate. The smoking rate of girl students was 5.0%; this has increased mor than three times from ten years ago. Consequently, counter measures should be taken against the smoking of female students as well as juvenile smoking in general. In addition, the smoking rate of middle-high school students showed interesting differences when correnated with enviornmental factors. Students with low grades, who are not satisfied with school life, who don't have both parents, who have uncaring parents who nare too strict or too arbitary, who have smoking parents, or who have experienced smoking commonly smoked. Therefore, to lower the smoking rate we should improve the school environment, improve a student's interest in school life. And parents or siblings should lead by example and quit smoking at home. Schools should educate students more effectively concerning the harmful effects of smoking and create an accurate understanding of its dancers. From the beginning, we should teach students never ever to touch cigaretts. 2. The surve discovered that most students started out of curiosity, or solicitantion from friends or elders at middle school, and had been smoking one to five cigarettes for more than a year. They obtained cigarettes at stores and most of them have friends who smoke. As a result anti-smoking education should be conducted at elementary schools prior to middle school. More than 95% of the teenagers who smoke had friends who smote and smoked out of curiosity or the recommendation of elders. Thus, we must focus on teenagers who smoke in group, rather than individually. Fuyrthermore, the strict application of the regulation of tobacco sales as well as tobacco cooperation from retailers are needed. While students did not show any mood or academic achievement difference after beginning smoking, 58.1% of the students a health situdation that was worse. Juvenile smoking is more harmful to the juvenile than adult smoking is to the adult. This should be focused on in an anti-smoking campaign. 3. Students who smoke hada more positive attitude toward smoking than students who don't smoke. Students who smoke had a tendency to have a nuetral position and are not concerned about smoking compared to non-smoking students. The survey showed that the great number of students had a nuetral position. Because this nuetrality may increase Juvenile smoking, education that provides an exact understanding of smoking should be performed to build the correct attidude toward smoking. 4. Middle school students smoke when angry, gloomy, anxious, a lone and when they have some problems to solve, on when they feel inconveniened in other wores, they smoke to reliver stress. They also smok due to addiction. Because smoking is not a praetical method to relieve stress, a program which helps to acquire positive relief stress should be provided to help reduce smoking. 5. About 65% of students who smoke want to quit smoking because of health problem, 78% of them have tried mor than once to quit but failed due to weak will power and peer pressure from friends who smoke. Juvenile smoking is group, oriented. Thus, the program that advances less smoking will be the one that focuseds on groups. 6. As for advice to students who want to quit smoking, "persuasion" was used most commonly, followed by a "presentation on how to quit smoking". Another method were severe punishment. About 70% of the students wanted the anti-smoking guide at school. 7. Most students (73.5%) had a position that more anti-smoking education at school is needed. Obriously, then, anti-smoking education at middle-high schools should be reinfoced. Although the education which explains the harmful influence of tobacco is known as an efficient way prevent smoking; it does not influence students who already smoke. Therefore, for students who smoke, multi-dimensional approaches must be attempted that include physical training, phychokogical approache, consultation and discussion, medical chek-ups, audio-visual education technigues, and professonal instructors, in addition, because smoking students have more negative on lukewarm attitude to anti-smoking education anti-smoking education should be conducted through a communicative style by dedicated teachers who care about students. In order to increase the effectiveness of this program.

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A study on the developmental plan of Alarm Monitoring Service (기계경비의 발전적 대응방안에 관한 연구)

  • Chung, Tae-Hwang;So, Seung-Young
    • Korean Security Journal
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    • no.22
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    • pp.145-168
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    • 2010
  • Since Alarm Monitoring Service was introduced in Korea in 1981, the market has been increasing and is expected to increase continually. Some factors such as the increase of social security need and the change of safety consciousness, increase of persons who live alone could be affected positively on Alarm Monitoring Service industry. As Alarm Monitoring Service come into wide use, the understanding of electronic security service is spread and consumer's demand is difficult, so consideration about new developmental plan is need to respond to the change actively. Electronic security system is consist of various kinds of element, so every element could do their role equally. Alarm Monitoring Service should satisfy consumer's various needs because it is not necessary commodity, also electronic security device could be easily operated and it's appearance has to have a good design. To solve the false alarm problem, detection sensor's improvement should be considered preferentially and development of new type of sensor that operate dissimilarly to replace former sensor is needed. On the other hand, to settle the matter that occurred by response time, security company could explain the limit on Alarm Monitoring System to consumer honestly and ask for an understanding. If consumer could be joined into security activity by security agent's explanation, better security service would be provided with mutual confidence. To save response time the consideration on the introduction of GIS(Global Information System) is needed rather than GPS(Global Positioning System). Although training program for security agents is important, several benefits for security agents should be considered together. The development of new business model is required for preparation against market stagnation and the development of new commodity to secure consumer for housing service rather than commercial facility service. for the purpose of those, new commodity related to home-network system and video surveillance system could be considered, also new added service with network between security company and consumer for a basis is to be considered.

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The Health Status of Rural Farming Women (농촌여성(農村女性)의 건강실태(健康實態)에 관한 연구(硏究))

  • Park, Jung-Eun
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.97-106
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    • 1990
  • 1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

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A Study on the Knowledge. Attitude and Behavior of Commercial Girl's High School Students Toward Sex (서울시내 실업계 여고생들의 성지식 태도 및 행위에 관한 조사연구)

  • Bae, Nam-Sook
    • Korean Journal of Health Education and Promotion
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    • v.1 no.1
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    • pp.57-71
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    • 1983
  • Sex education is necessary for the youth that they should have an adequate sexual knowledge, attitudes and behaviors in their adolescent period. Four major objectives of this study are as follows; 1. To know the level of sexual knowledge of commercial girl's high school students in Seoul. 2. To know their actual state for the attitudes and behaviors toward sex. 3. To compare the sexual knowledge, attitudes and behaviors of day time school students with those of night time school students. 4. To compare the factors associated with their sexual knowledge, attitudes and behaviors with the individual level. Data were collected on 986 students in Seoul from April 1 to April 10, 1983. As the result of this survey, the following conclusions were obtained. 1. The level of sexual knowledge. (1) The level of knowledge of day time high school students about the physiology of female and pregnancy is shown higher than those of night time students. 64.2% of the respondents are aware of the organ producing ovum. 56.4% the ovulation period. 95.6% the cause of pregnancy. 74.5% the pregnantable period and 12.7% the place of fetilization. (2) Out of 986 respondents. 71.8% knew about contraceptive method correctly, and day time school students knew litter better than night time school students, by showing 73.9% and 69.7% respectively. They knew about contraceptive method with 'oral pills'. 'menstrual cycles', 'condoms'. and 'loops' in the same order. 3) Kinds of veneral disease was correctly known by 37.9%. Day time students knew much better than night time school students. by showing 67.8% and 7.9%. respectively. Transmission method of veneral disease was correctly known by 28.3%. Day time students knew much better than night time students, by showing 51.2% and 5.3%, respectively. (4) The major information source of sexual knowledge was 'book and magazine' (39.9%) and 'friends' (27.4%). 2. Actual state of attitudes and behaviors toward sex. (1) Out of 986 respondents, 84.0% answered that premarital purity should be kept. (2) Out of 986 respondents, 60.8% had an acquaintance of the opposite sex. 45.2% of students with opposite sex reported introduction of their friends as the main channel of making an acquaintance of the opposite sex. (3) Of those who responded to this study 13.8% reported having masturbation, 21.5% kissing, 6.2% petting and 3.7% sex intercourse. (4) 64.8% had sexual problems, which was mensturance (27.2%), aquaintance of the opposite sex (25.4%). The main method to solve the problems were consultation with 'friends' and 'books and magazine' percentage being 39.1% and 30.8%, respectively, whereas very small students discussed with 'teachers' and 'parents' percentages being 0.3% and 5.9%, respectively. (5) Out of 986 respondents, 62.2% had experience in educating about sex, the percentage of day time school was higher than that of night time school. (6) 88.2% of students wanted sex education in school, which were 'general information about sex' (35.4%), 'sexual morality and solution of sexual desire' (18.5%), 'aquaintance of the opposite sex' (13.3%) and 'marriage and role of man and woman' (12.4%) in the same order. They wanted to be instructed about sexes in the lecture of physical education, home economics, biology, military training (59.9%), regular curriculum (17.5%), special lecture (16.9%) and by the counselor or school nurse (5.7%). 3. Analyse concerning the factors about the knowledge, attitudes and behaviors. (1) The better school record was, the higher the level of sexual knowledge. (2) Those who have the religion considered the permarital purity more important than those who have not, the percentage showing 86.7% and 80.7%, respectively. (3) The result of dyad analysis of making acquaintance of the opposite sex in the friendship network showed that a high index of the acquaintance of the opposite sex tends to be a high adoption of making one at the individual level in the group, while the low index tends to be a low adoption of making one in the group.

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Socio-Medical Approach to the Welfare of Rural Residents Through the Education of Community Health Personnel (농촌지역사회 보건요원의 교육을 통한 주민의 보건복지향상에 관한 사회의학적 연구)

  • Yum, Yong-Tae;Lee, Myung-Sook;Cho, Byung-Hee
    • Journal of agricultural medicine and community health
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    • v.17 no.1
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    • pp.34-45
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    • 1992
  • In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

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Product Recommender Systems using Multi-Model Ensemble Techniques (다중모형조합기법을 이용한 상품추천시스템)

  • Lee, Yeonjeong;Kim, Kyoung-Jae
    • Journal of Intelligence and Information Systems
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    • v.19 no.2
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    • pp.39-54
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    • 2013
  • Recent explosive increase of electronic commerce provides many advantageous purchase opportunities to customers. In this situation, customers who do not have enough knowledge about their purchases, may accept product recommendations. Product recommender systems automatically reflect user's preference and provide recommendation list to the users. Thus, product recommender system in online shopping store has been known as one of the most popular tools for one-to-one marketing. However, recommender systems which do not properly reflect user's preference cause user's disappointment and waste of time. In this study, we propose a novel recommender system which uses data mining and multi-model ensemble techniques to enhance the recommendation performance through reflecting the precise user's preference. The research data is collected from the real-world online shopping store, which deals products from famous art galleries and museums in Korea. The data initially contain 5759 transaction data, but finally remain 3167 transaction data after deletion of null data. In this study, we transform the categorical variables into dummy variables and exclude outlier data. The proposed model consists of two steps. The first step predicts customers who have high likelihood to purchase products in the online shopping store. In this step, we first use logistic regression, decision trees, and artificial neural networks to predict customers who have high likelihood to purchase products in each product group. We perform above data mining techniques using SAS E-Miner software. In this study, we partition datasets into two sets as modeling and validation sets for the logistic regression and decision trees. We also partition datasets into three sets as training, test, and validation sets for the artificial neural network model. The validation dataset is equal for the all experiments. Then we composite the results of each predictor using the multi-model ensemble techniques such as bagging and bumping. Bagging is the abbreviation of "Bootstrap Aggregation" and it composite outputs from several machine learning techniques for raising the performance and stability of prediction or classification. This technique is special form of the averaging method. Bumping is the abbreviation of "Bootstrap Umbrella of Model Parameter," and it only considers the model which has the lowest error value. The results show that bumping outperforms bagging and the other predictors except for "Poster" product group. For the "Poster" product group, artificial neural network model performs better than the other models. In the second step, we use the market basket analysis to extract association rules for co-purchased products. We can extract thirty one association rules according to values of Lift, Support, and Confidence measure. We set the minimum transaction frequency to support associations as 5%, maximum number of items in an association as 4, and minimum confidence for rule generation as 10%. This study also excludes the extracted association rules below 1 of lift value. We finally get fifteen association rules by excluding duplicate rules. Among the fifteen association rules, eleven rules contain association between products in "Office Supplies" product group, one rules include the association between "Office Supplies" and "Fashion" product groups, and other three rules contain association between "Office Supplies" and "Home Decoration" product groups. Finally, the proposed product recommender systems provides list of recommendations to the proper customers. We test the usability of the proposed system by using prototype and real-world transaction and profile data. For this end, we construct the prototype system by using the ASP, Java Script and Microsoft Access. In addition, we survey about user satisfaction for the recommended product list from the proposed system and the randomly selected product lists. The participants for the survey are 173 persons who use MSN Messenger, Daum Caf$\acute{e}$, and P2P services. We evaluate the user satisfaction using five-scale Likert measure. This study also performs "Paired Sample T-test" for the results of the survey. The results show that the proposed model outperforms the random selection model with 1% statistical significance level. It means that the users satisfied the recommended product list significantly. The results also show that the proposed system may be useful in real-world online shopping store.

The Effect of Family-Centered Coaching Based on Sensory Integration on the Performance of Children with Autism Spectrum Disorder (감각통합 기반의 가족중심코칭이 자폐스펙트럼장애 아동의 작업수행에 미치는 효과)

  • Kim, Yoon-Sung;Kim, Kyeong-Mi;Chang, Moon-Young;Hong, So Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.19 no.2
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    • pp.12-25
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    • 2021
  • Objective : This study explored the effects of family-centered coaching using a sensory integration-based approach on the levels of performance and satisfaction for children with autism spectrum disorder (ASD). Methods : From April 16, 2020 to August 6, 2020, participants included 10 children with ASD, between the ages of three to six who met the inclusion criteria, and their guardians. I used the Canadian Occupational Performance Measure (COPM) to evaluate the children's levels of performance and satisfaction and the Goal Attainment Scaling (GAS) to evaluate their occupational performance. The experimental group (n=5) continued the sensory integration therapy while receiving their personalized family-centered coaching training for 60 minutes per week. This continued for four weeks via home visits and video calls. The control group (n=5) also continued to receive the sensory integration therapy while receiving sensory integration-based general counseling in relation to activity objectives. Results : Statistically significant differences were found in the scores of COPM performance and satisfaction and the GAS scores between the experimental group and the control group, before and after the intervention (p<.05). Statistically significant differences were found in score changes in COPM and GAS, between the two groups (p<.05). Cohen's d also showed a big effect size on the scores of COPM satisfaction (d=2.768) and the GAS scores (d=2.786). Conclusion : This study demonstrated that the sensory integration-based, family-centered coaching had more positive effects on the level of performance and satisfaction of children with ASD, than general counseling.