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A Study on Differences of Opinions on Home Health Care Program among Physicians, Nurses, Non-medical personnel, and Patients. (가정간호 사업에 대한 의사, 간호사, 진료관련부서 직원 및 환자의 인식 비교)

  • Kim, Y.S.;Lim, Y.S.;Chun, C.Y.;Lee, J.J.;Park, J.W.
    • The Korean Nurse
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    • v.29 no.2
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    • pp.48-65
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    • 1990
  • The government has adopted a policy to introduce Home Health Care Program, and has established a three stage plan to implement it. The three stage plan is : First, to amend Article 54 (Nurses for Different Types of Services) of the Regulations for Implementing the Law of Medical Services; Second, to tryout the new system through pilot projects established in public hospitals and clinics; and third, to implement at all hospitals and equivalent medical institutions. In accordance with the plan, the Regulation has been amend and it was promulgated on January 9,1990, thus establishing a legal ground for implementing the policy. Subsequently, however, the Medical Association raised its objection to the policy, causing a delay in moving into the second stage of the plan. Under these circumstances, a study was conducted by collecting and evaluating the opinions of physicians, nurses, non-medical personnel and patients on the need and expected result from the home health care for the purpose of help facilitating the implementation of the new system. As a result of this study, it was revealed that: 1. Except the physicians, absolute majority of all other three groups - nurses, non-medical personnel and patients -gave positive answers to all 11 items related to the need for establishing a program for Home Health Care. Among the physicians, the opinions on the need for the new services were different depending on their field of specialty, and those who have been treating long term patients were more positive in supporting the new system. 2. The respondents in all four groups held very positive view for the effectiveness and the expected result of the program. The composite total of scores for all of 17 items, however, re-veals that the physicians were least positive for the- effectiveness of the new system. The people in all four groups held high expectation on the system on the ground that: it will help continued medical care after the discharge from hospitals; that it will alleviate physical and economic burden of patient's family; that it will offer nursing services at home for the patients who are suffering from chronic disease, for those early discharge from hospital, or those who are without family members to look after the patients at home. 3. Opinions were different between patients( who will receive services) and nurses (who will provide services) on the types of services home visiting nurses should offer. The patients wanted "education on how to take care patients at home", "making arrangement to be admitted into hospital when need arises", "IV injection", "checking blood pressure", and "administering medications." On the other hand, nurses believed that they can offer all 16 types of services except "Controlling pain of patients", 4. For the question of "what types of patients are suitable for Home Health Care Program; " the physicians, the nurses and non-medical personnel all gave high score on the cases of "patients of chronic disease", "patients of old age", "terminal cases", and the "patients who require long-term stay in hospital". 5. On the question of who should control Home Health Care Program, only physicians proposed that it should be done through hospitals, while remaining three groups recommended that it should be done through public institutions such as public health center. 6. On the question of home health care fee, the respondents in all four groups believed that the most desireable way is to charge a fixed amount of visiting fee plus treatment service fee and cost of material. 7. In the case when the Home Health Care Program is to be operated through hospitals, it is recommended that a new section be created in the out-patient department for an exclusive handling of the services, instead of assigning it to an existing section. 8. For the qualification of the nurses for-home visiting, the majority of respondents recommended that they should be "registered nurses who have had clinical experiences and who have attended training courses for home health care". 9. On the question of if the program should be implemented; 74.0% of physicians, 87.5% of non-medical personnel, and 93.0% of nurses surveyed expressed positive support. 10. Among the respondents, 74.5% of -physicians, 81.3% of non-medical personnel and 90.9% of nurses said that they would refer patients' to home health care. 11. To the question addressed to patients if they would take advantage of home health care; 82.7% said they would if the fee is applicable to the Health Insurance, and 86.9% said they would follow advises of physicians in case they were decided for early discharge from hospitals. 12. While 93.5% of nurses surveyed had heard about the Home Health Care Program, only 38.6% of physicians surveyed, 50.9% of non-medical personnel, and 35.7% of patients surveyed had heard about the program. In view of above findings, the following measures are deemed prerequisite for an effective implementation of Home Health Care Program. 1. The fee for home health care to be included in the public health insurance. 2. Clearly define the types and scope of services to be offered in the Home Health Care Program. 3. Develop special programs for training nurses who will be assigned to the Home Health Care Program. 4. Train those nurses by consigning them at hospitals and educational institutions. 5. Government conducts publicity campaign toward the public and the hospitals so that the hospitals support the program and patients take advantage of them. 6. Systematic and effective publicity and educational programs for home heath care must be developed and exercises for the people of medical professions in hospitals as well as patients and their families. 7. Establish and operate pilot projects for home health care, to evaluate and refine their programs.

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A Study on Risk Parity Asset Allocation Model with XGBoos (XGBoost를 활용한 리스크패리티 자산배분 모형에 관한 연구)

  • Kim, Younghoon;Choi, HeungSik;Kim, SunWoong
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.135-149
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    • 2020
  • Artificial intelligences are changing world. Financial market is also not an exception. Robo-Advisor is actively being developed, making up the weakness of traditional asset allocation methods and replacing the parts that are difficult for the traditional methods. It makes automated investment decisions with artificial intelligence algorithms and is used with various asset allocation models such as mean-variance model, Black-Litterman model and risk parity model. Risk parity model is a typical risk-based asset allocation model which is focused on the volatility of assets. It avoids investment risk structurally. So it has stability in the management of large size fund and it has been widely used in financial field. XGBoost model is a parallel tree-boosting method. It is an optimized gradient boosting model designed to be highly efficient and flexible. It not only makes billions of examples in limited memory environments but is also very fast to learn compared to traditional boosting methods. It is frequently used in various fields of data analysis and has a lot of advantages. So in this study, we propose a new asset allocation model that combines risk parity model and XGBoost machine learning model. This model uses XGBoost to predict the risk of assets and applies the predictive risk to the process of covariance estimation. There are estimated errors between the estimation period and the actual investment period because the optimized asset allocation model estimates the proportion of investments based on historical data. these estimated errors adversely affect the optimized portfolio performance. This study aims to improve the stability and portfolio performance of the model by predicting the volatility of the next investment period and reducing estimated errors of optimized asset allocation model. As a result, it narrows the gap between theory and practice and proposes a more advanced asset allocation model. In this study, we used the Korean stock market price data for a total of 17 years from 2003 to 2019 for the empirical test of the suggested model. The data sets are specifically composed of energy, finance, IT, industrial, material, telecommunication, utility, consumer, health care and staple sectors. We accumulated the value of prediction using moving-window method by 1,000 in-sample and 20 out-of-sample, so we produced a total of 154 rebalancing back-testing results. We analyzed portfolio performance in terms of cumulative rate of return and got a lot of sample data because of long period results. Comparing with traditional risk parity model, this experiment recorded improvements in both cumulative yield and reduction of estimated errors. The total cumulative return is 45.748%, about 5% higher than that of risk parity model and also the estimated errors are reduced in 9 out of 10 industry sectors. The reduction of estimated errors increases stability of the model and makes it easy to apply in practical investment. The results of the experiment showed improvement of portfolio performance by reducing the estimated errors of the optimized asset allocation model. Many financial models and asset allocation models are limited in practical investment because of the most fundamental question of whether the past characteristics of assets will continue into the future in the changing financial market. However, this study not only takes advantage of traditional asset allocation models, but also supplements the limitations of traditional methods and increases stability by predicting the risks of assets with the latest algorithm. There are various studies on parametric estimation methods to reduce the estimated errors in the portfolio optimization. We also suggested a new method to reduce estimated errors in optimized asset allocation model using machine learning. So this study is meaningful in that it proposes an advanced artificial intelligence asset allocation model for the fast-developing financial markets.

Evaluation of Dose Distributions Recalculated with Per-field Measurement Data under the Condition of Respiratory Motion during IMRT for Liver Cancer (간암 환자의 세기조절방사선치료 시 호흡에 의한 움직임 조건에서 측정된 조사면 별 선량결과를 기반으로 재계산한 체내 선량분포 평가)

  • Song, Ju-Young;Kim, Yong-Hyeob;Jeong, Jae-Uk;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Nam, Taek-Keun
    • Progress in Medical Physics
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    • v.25 no.2
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    • pp.79-88
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    • 2014
  • The dose distributions within the real volumes of tumor targets and critical organs during internal target volume-based intensity-modulated radiation therapy (ITV-IMRT) for liver cancer were recalculated by applying the effects of actual respiratory organ motion, and the dosimetric features were analyzed through comparison with gating IMRT (Gate-IMRT) plan results. The ITV was created using MIM software, and a moving phantom was used to simulate respiratory motion. The doses were recalculated with a 3 dose-volume histogram (3DVH) program based on the per-field data measured with a MapCHECK2 2-dimensional diode detector array. Although a sufficient prescription dose covered the PTV during ITV-IMRT delivery, the dose homogeneity in the PTV was inferior to that with the Gate-IMRT plan. We confirmed that there were higher doses to the organs-at-risk (OARs) with ITV-IMRT, as expected when using an enlarged field, but the increased dose to the spinal cord was not significant and the increased doses to the liver and kidney could be considered as minor when the reinforced constraints were applied during IMRT plan optimization. Because the Gate-IMRT method also has disadvantages such as unsuspected dosimetric variations when applying the gating system and an increased treatment time, it is better to perform a prior analysis of the patient's respiratory condition and the importance and fulfillment of the IMRT plan dose constraints in order to select an optimal IMRT method with which to correct the respiratory organ motional effect.

Characteristics and development plan of Home Economics teachers' culture (가정과교사 문화의 특징과 발전 방안)

  • Kim, Seung-Hee;Chae, Jung-Hyun
    • Journal of Korean Home Economics Education Association
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    • v.30 no.2
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    • pp.77-102
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    • 2018
  • The purpose of this study was to contribute to Home Economics(HE) teachers' culture by figuring out acknowledging characteristics of cultures of HE teachers and impeding factors on development of HE education. For this intensive interview were used. Intensive interviews were made with 14 HE teachers who completed coursework for master's or doctor's program of graduate school and belong to HE Teachers' Study Associations of each region or Korean Home Economics Education Association and analyzed by subject analysis method. The results of the study are as follows. First, HE teachers establish the philosophy of HE education, and practice education to provide profit to adolescents, their families, as well as society through HE class with their belief that HE is a practical and critical subject to benefit individual adolescents, families, and society. Second, HE teachers form culture to make an effort to continue to improve their expertises by attending graduate school, joining HE teachers' associations to enhance teaching methods, evaluation methods, and work ability or disclosing their own class. Third, HE teachers settle culture to conduct classes focusing on practical issues by converting the paradigm of HE education to that of practical critique. They also see that the system of three actions(technical action, communicative action, and emancipative action) should be applied in circulating ways to improve quality and value of life. Forth, for impeding factors of development of HE education, there are educational system and social recognition. However, with HE teachers' efforts, HE education settles well, as it reflects demands from students and society, finds students' talents, and actualizes its own goals. HE teachers believe that student will recognize that HE education is necessary for happiness of individuals and families. As a way to develop Home Economics teacher culture, Home Economics teachers should have the opportunity to develop more Home Economics teachers by participating in and working in research sessions in each area. It also called for a control tower to enable and lead collaborative networks between local Home Economics curriculum research committees. The Korean Home Economics Education Association should play a central role in the academic research community of each region and be able to help Home Economics teachers by moving more quickly and systematically to cope with the upcoming changes in education. Finally, participants said that in order to prepare a basic framework for the change in Home Economics education, practical critical Home Economics teacher training are needed. To this end, students can understand the essence of Home Economics education and establish their identity by taking a deeper Home Economics education curriculum philosophy for Home Economics teacher training.

Viability test and bulk harvest of natural zooplankton communities to verify the efficacy of a ship's ballast water treatment system based on USCG phase-II (USCG phase-II 선박평형수 처리장치 성능 평가를 위한 자연 해수의 동물플랑크톤 대량 확보 및 생사판별)

  • Jang, Min-Chul;Baek, Seung Ho;Shin, Kyoungsoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.9-15
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    • 2016
  • We investigated >$50-{\mu}m$ marine planktonic organisms (mainly zooplankton) using a bongo net in Masan Bay and Jangmok Bay in order to harvest 75% of natural communities based on Phase-II approval regulations by the United States Coast Guard (USCG). The concentrated volume (in 1 ton) and abundance of zooplankton were $1.8{\times}10^7ind.ton^{-1}$ and $2.3{\times}10^7ind.ton^{-1}$, and their survival rates were 82.6% and 80.1%, respectively. The community structure in Jangmok Bay was similar to that in Masan Bay, and dominant species were adult and immature groups (stage IV) of genus Acartia. Harvested populations were inoculated in a 500-ton test tank. Although the population abundances were $6.0{\times}10^4ind.ton^{-1}$ for both bay samples, the mortality rates were higher in the Masan Bay population (32%) than the Jangmok Bay population (20%). We considered the reason to be that there were 30% more immature individuals of Acartia from Masan Bay than from Jangmok Bay. The younger population may have been greatly stressed by the moving process and netting gear. After applying a Ballast Water Treatment System (BWTS) using a sample form Jangmok Bay, the mortality rates in the treatment groups were found to be 100% after 0 days and 5 days, implying that the BWTS worked well. During the winter season, the zooplankton concentration method alone did not easily satisfy the approval standards of USCG Phase II (> $10{\times}10^4ind.ton^{-1}$ in the 500 ton tank). Increasing the netting frequency and additional fishing boats may be helpful in meeting the USCG Phase II biological criteria.

Implementation of a Self Controlled Mobile Robot with Intelligence to Recognize Obstacles (장애물 인식 지능을 갖춘 자율 이동로봇의 구현)

  • 류한성;최중경
    • Journal of the Institute of Electronics Engineers of Korea SP
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    • v.40 no.5
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    • pp.312-321
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    • 2003
  • In this paper, we implement robot which are ability to recognize obstacles and moving automatically to destination. we present two results in this paper; hardware implementation of image processing board and software implementation of visual feedback algorithm for a self-controlled robot. In the first part, the mobile robot depends on commands from a control board which is doing image processing part. We have studied the self controlled mobile robot system equipped with a CCD camera for a long time. This robot system consists of a image processing board implemented with DSPs, a stepping motor, a CCD camera. We will propose an algorithm in which commands are delivered for the robot to move in the planned path. The distance that the robot is supposed to move is calculated on the basis of the absolute coordinate and the coordinate of the target spot. And the image signal acquired by the CCD camera mounted on the robot is captured at every sampling time in order for the robot to automatically avoid the obstacle and finally to reach the destination. The image processing board consists of DSP (TMS320VC33), ADV611, SAA7111, ADV7l76A, CPLD(EPM7256ATC144), and SRAM memories. In the second part, the visual feedback control has two types of vision algorithms: obstacle avoidance and path planning. The first algorithm is cell, part of the image divided by blob analysis. We will do image preprocessing to improve the input image. This image preprocessing consists of filtering, edge detection, NOR converting, and threshold-ing. This major image processing includes labeling, segmentation, and pixel density calculation. In the second algorithm, after an image frame went through preprocessing (edge detection, converting, thresholding), the histogram is measured vertically (the y-axis direction). Then, the binary histogram of the image shows waveforms with only black and white variations. Here we use the fact that since obstacles appear as sectional diagrams as if they were walls, there is no variation in the histogram. The intensities of the line histogram are measured as vertically at intervals of 20 pixels. So, we can find uniform and nonuniform regions of the waveforms and define the period of uniform waveforms as an obstacle region. We can see that the algorithm is very useful for the robot to move avoiding obstacles.

Analysis of Site Condition in Domestic Trade Port for Operation of Mobile Harbor (모바일하버 운영을 위한 국내 무역항 후보지 분석)

  • Lee, Joong-Woo;Gug, Seung-Gi;Jung, Dae-Deug;Yang, Sang-Young;Kim, Tae-Hyung
    • Journal of Navigation and Port Research
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    • v.34 no.10
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    • pp.781-786
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    • 2010
  • In this study, a new concept of ocean transport system, called the mobile harbor serving for a short distance transport of containers with cargo handling cranes between mother containerships and coastal ports, is introduced. Instead of direct berthing a very large containership at the coastal port, Mobile Harbor is moving to the offshore mooring basin with enough water depth condition. Therefore, investigation of the coastal environment, technical condition and limitation of the domestic trade ports for the application of Mobile Harbor, is essential process. To figure out the accessibility of mobile harbor, the environmental conditions, the cargo handling capacity and marine traffic volume and flow pattern has been analyzed with the tools for marine traffic simulation and virtual navigation aids system. The most proper Mobile Harbor mooring areas among trade ports of the south and east coast are selected by analyzing the obtained information and evaluating its application: (1) Under natural environmental conditions such as air and sea weather, three candidate areas are selected such as Masan port, Ulsan port, and Busan(New port) port. (2) Under marine traffic and appropriateness of water facilities, three candidate areas are selected as Mokpo port, Busan(New port) port, and Donghae & Mookho port (3) For a region-based analysis considering handling capacity and the local managed trade ports in vicinity, three candidate areas are selected as Busan region, Yosu & KwangYang region, and Mokpo region. Through this study, the basic guideline for selection of optimum trade port and offshore mooring basin for mothership and Mobile Harbor is recommended. In order to apply the Mobile Harbor to the real water, navigaton aids as the virtual route identification with AIS must be introduced for maritime safety in the vicinity of Mobile Harbor area which berthing and cargo handling is being conducted.

The Cross-sectional Mass Flux Observation at Yeomha Channel, Gyeonggi Bay at Spring Tide During Dry and Flood Season (단면 관측을 통한 경기만 염하수로의 대조기 평수시와 홍수시 유출입량 변화특성 조사)

  • Lee, Dong-Hwan;Yoon, Byung-Il;Kim, Jong-Wook;Gu, Bon-Ho;Woo, Seung-Buhm
    • Journal of Korean Society of Coastal and Ocean Engineers
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    • v.24 no.1
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    • pp.16-25
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    • 2012
  • To calculate the total mass flux that change in dry and flood season in the Yeomha Channel of Gyeonggi Bay, the 13 hour bottom tracking observation was performed from the southern extremity. The value of the total mass flux(Lagrange flux) was calculated as the sum of the Eulerian flux value and stroke drift value and the tidal residual flow was harmonically analyzed through the least-squares method. Moreover, the average during the tidal cycle is essential to calculate the mass flux and the tidal residual flow and there is the need to equate the grid of repeatedly observed data. Nevertheless, due to the great differences in the studied region, the number of vertical grid tends to change according to time and since the horizontal grid differs according to the transport speed of the ship as a characteristic of the bottom tracking observation, differences occur in the horizontal and vertical grid for each hour. Hence, the present study has vertically and horizontally normalized(sigma coordinate) to equate the grid per each hour. When compared to the z-level coordinate system, the Sigma coordinate system was evaluated to have no irrationalities in data analysis with 5% of error. As a result of the analysis, the tidal residual flow displayed the flow pattern of sagging in the both ends in the main waterway direction of dry season. During flood season, it was confirmed that the tidal residual flow was vertical 2-layer flow. As a result of the total mass flux, the ebb properties of 359 cm/s and 261 cm/s were observed during dry and flood season, respectively. The total mass flux was moving the intertidal region between Youngjong-do and Ganghwa-do.

Home Range Size and Habitat Environment Related to the Parturition of Roe Deer at Warm-Temperate Forest in Jeju Island Using GPS-CDMA Based Wildlife Tracking System (GPS와 CDMA를 이용한 난대림의 출산 전후 암노루 행동권 및 서식환경 조사)

  • Kim, Eun-Mi;Kwon, Jin-O;Kang, Chang-Wan;Song, Kuk-Man;Min, Dong-Won
    • Journal of the Korean Association of Geographic Information Studies
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    • v.16 no.2
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    • pp.65-74
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    • 2013
  • A research program for the roe deer (Capreolus pygargus) has been set up at the Jeju Experimental Forest of Warm-temperate and Subtropical Forest Research Center in Jeju Island. To explore the home range size and habitat environment, 3 males and 3 females have been captured and released with GPS-CDMA based telemetry since 24th April 2012. Among them 2 females were captured at Hannam Forest of Seoguipo, were pregnant and monitored by the tracking system. There are significantly different patterns in behavior around the parturition. After parturition they show recurrence behavior toward one point in the forest, while they have irregular patterns in moving before. To calculate the home range size, the MCP (minimum convex polygon) and Kernel Method are applied through the extension of ESRI ArcView GIS 3.2a. The pregnant female captured 9th May 2012 has the size of MCP=67ha and Kernel 95%=0.5ha and the pregnant female captured 12th July 2012 has the size of MCP=82ha and Kernel 95%=0.9ha. Although a fawn could move immediately just after the birth likely others to avoid any risks, they stay at very narrow space significantly, and the size become wider when more time goes by. Furthermore, they mainly have a home range away from human activity area such as forest tracking roads. The habitat environment for the parturition is summarized as 40years old cryptomeria forests with new sprouting shrubs for foods, which are the controlled forest through the thinning and removing shrubs 2 years ago. This means that forest works could cause positive results for the parturition and survival of young. The period of parturition is earlier than highland in Jeju Island, the size of home range is narrower than other countries, and the habitat environment of the shelter for a fawn is similar to previous research in other countries.

Evaluation of Pedestrian Space Ion Index by Land Use Type in Heat wave - Focused on ChungJu - (폭염시 토지이용유형별 보행공간 이온지수 평가 - 충주시를 대상으로 -)

  • Yoon, Yong Han;Yoon, Ji Hun;Kim, Jeong Ho
    • Korean Journal of Environment and Ecology
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    • v.33 no.3
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    • pp.354-365
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    • 2019
  • This study measured and analyzed the weather characteristics and the air-ion characteristics of walking space by land use type in Chungju, Chungcheongbuk Province during the heat wave. We used the land registration map to classify the type of land use in walking areas in the studied into the production and green area, the residential area, and the commercial area. We then selected 44 measurement points in about 4.1 km. They included 12 walking space points in the green area, 14 in the residential area, and 18 in the commercial area. Moreover, we calculated the ion index by analyzing the impact of weather factors such as temperature, relative humidity, solar radiation, and net radiation in the walking space on the anion generation and cation generation by land use type during the heat wave. Comparison of air ion characteristics in walking space by type of land use during the heat wave showed that the average cation generation was in the order of commercial area ($700.73cations/cm^3$) > residential area ($600.76cations/cm^3$) > green area ($589.73cations/cm^3$). The average anion generation was in the order of green area ($663.95anions/cm^3$) > residential area ($628.48anions/cm^3$) > commercial area ($527.48anions/cm^3$). The average ion index was in the order of green area (1.13) > residential area (1.04) > commercial area (0.75). This study checked the weather characteristics, cation generation, and anion generation in walking space according to the land use type during the heat wave and checked the difference of ion indexes in the walking space according to the land use type. However, there were limitations in the lack of accurate comparison according to the land use due to the moving measurement and the insufficient quantitative comparison according to the change of road width. Therefore, we recommend further studies that consider the road characteristics.