• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.568-583
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• 1994

In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

• The Journal of Bigdata
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• v.4 no.2
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• pp.159-173
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• 2019

Last-Mile delivery optimization plays a key role in the urban supply chain operation, which is the most expensive and time-consuming and most complicated part of the whole delivery process. The urban consolidation center (UCC) is regarded as a significant asset for supporting customer demand in the last-mile delivery service. It is the key benefit of UCC to improve the load balance of vehicles and to reduce the total traveling distance by finding the better route with the well-organized multi-leg vehicle journey in the urban area. This paper presents the model using multiple scenario analysis integrated with mathematical optimization techniques using Geographic Information System (GIS). The model aims to find the best solution for the distribution network consisted of DC and UCC, which is applied to the case of Ulaanbaatar Mongolia. The proposed methodology integrates two sub-models, location-allocation model and vehicle routing problem. The multiple scenarios devised by selecting locations of UCC are compared considering the general performance and delivery patterns together. It has been adopted to make better decisions the quantitative metrics such as the economic value of capital cost, operating cost, and balance of using available resources. The result of this research may help the manager or public authorities who should design the distribution network for the last mile delivery service optimization using UCC within the urban area.

• Communications of Mathematical Education
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• v.27 no.4
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• pp.357-367
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• 2013

It is important to make students do research for oneself. But the practice of inquiry activity is not easy in the mathematics education field. Intellectual curiosities of students are unpredictable. It is important to meet intellectual curiosities of students. We could get a sequence in the process solving a problem. This sequence was expressed in a form of the recurrence relation $a_n=a_{n-1}+a_{n-3}$ ($n{\geq}4$), $a_1=a_2=a_3=1$. We tried to look for the general terms of this sequence. This sequence is similar to Fibonacci sequence, but the process finding the general terms is never similar to Fibonacci sequence. We can get two general terms expressed in different form after our a great deal of effort. We hope that this study will give the spot of education energy.

• Journal of muscle and joint health
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• v.1 no.1
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• pp.71-87
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• 1994

The purpose of this study was to assess pain, discomfort, depression and coping patterns and the relations between these in chronic arthritis patients. The sampling method was a purposive sampling technique. 1) Who have been diagnosed as having chronic arthritis and. 2) Who were at the out patients clinic of rheumatoid arthritis departments of one University hospital in seoul between september, 11, 1993 to september, 18, 1993. The instruments used for this study were Graphic Rating Scales of pain, discomfort level of the activities of daily living(ADL) developed by Lee, Eun Ok and The Beck Depression inventory. The research used to measure coping patterns was a tool developed by the present study researcher. Analysis of data was done frequency, Pearson correlation coefficients, ANOVA, regression and ANCOVA. The results were summerlized as follows ; 1. Female exceed male patients in number and onset of joint pain were more prevalent in the age groups of the 40s and the 50s. The average duration of suffering from the pain were seven years six mounths. 2. The mean pain score : The mean sensory score was 119mm and the affective score was 109mm. 3. The discomfort level of ADL, the mean score was 2.95 out of a possible score of 5.0 and depression syndrome subjects were 62.2%. 4. The coping responses for each pattern were as follows : 1) "Active coping" mean score was 2.28. 2) "Wishful coping" mean score was 2.89. 3) "Receptive coping" mean score was 3.31. 4) "Negative coping" mean score was 1.82. 5. Significant differences were found in age, religion, marriage status and the coping patterns of patients. 1) In the coping pattern of "receptive coping", the score of the age groups of the 50s were higher than that of 20s, and in the coping pattern of "negative coping", the score of the age groups of the 20s were higher than other age groups. 2) In the coping pattern of "wishful coping", the score of the christian were higher than other religion groups. 3) In the coping pattern of "negative coping", the score of the marrieds were lower than other groups. 6. Patients who scored low on factor 2, wishful coping, were much more likely to report having pain sensory than patioets scoring high on this factor. 7. Patients who scored high on factor 4, negative coping, were significantly more likely to report having pain sensory than patients scoring high on this factor. Consider overall, chronic arthritis patients report using a wide varity of strategies, certain strategies such as receptive, wishful and active coping are used frequently, whereas other strategies such as negative coping are rarely used. One of the most important finding of present study is that the reported use of coping strategies is related to adjustment to a chronic pain problem. The present study suggests that negative coping is related to poor emotional adjustment as assessed by depression, but not pain ratings. Considered overall, this pattern of findings suggests that counseling patients to decreased their use of negative coping may be useful. The present study has a number of limitations. First, the sample is restricted to chronic arthritis patients. Weather chronic pain patients suffering from other types of pain syndromes use similar coping strategies needs to be determined in subsequent research. Second, the tool of coping pattern must be studied further to obtain reliability.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1311-1315
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• 2012

Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.

• Journal of the Institute of Electronics and Information Engineers
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• v.54 no.5
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• pp.65-73
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• 2017

In this paper, we propose a stereo matching method to improve the image quality at the hole and the disparity discontinuity regions. The stereo matching method extracts disparity map finding corresponding points between stereo image pair. However conventional stereo matching methods have a problem about the tradeoff between accuracy and precision with respect to the length of the baseline of the stereo image pair. In addition, there are hole and disparity discontinuity regions which are caused by textureless regions and occlusion regions of the stereo image pair. The proposed method extracts initial disparity map improved at disparity discontinuity and miss-matched regions using modified AD-Census-Gradient method and adaptive weighted cost aggregation. And then we conduct the disparity map refinement to improve at miss-matched regions, while also improving the accuracy of the image. Experimental results demonstrate that the proposed method produces high-quality disparity maps by successfully improving miss-matching regions and accuracy while maintaining matching performance compared to existing methods which produce disparity maps with high matching performance. And the matching performance is increased about 3.22(%) compared to latest stereo matching methods in case of test images which have high error ratio.

• Journal of Digital Convergence
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• v.15 no.8
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• pp.455-463
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• 2017

Background/Objectives: The purpose of the study is to derive a goal usable in the field by exploring the case management success experiences of case managers. Civil case managers state that what is still important in case management practice is qualitative change made in the practice process. Therefore, the study will deal with detailed contents about case management that civil domain case managers consider to be important. Methods/Statistical analysis: For data collection, the study used focus group interview on 20 professional case management social workers and used Grounded theory method by Glaser for data analysis. The analysis of collected data consisted of a process of finding the categories and characteristics of the research problem. Findings: As a result of analysis, 4 categories, 10 subcategories, and 25 elements were derived for success experiences of case management practice. The categories were divided into satisfaction and ability improvement of client, case manager ability improvement, establishment of organization and environment function, and multilateral trust relationship strengthening. Improvements/Applications: The results of this study further clarified the goal of field case management practice and it was suggested as a plan to reflect on future case management related institutions evaluation.

• 한국지구물리탐사학회:학술대회논문집
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• 2006.06a
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• pp.117-122
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• 2006

In the geophysical monitoring to understand the change of subsurface material properties with time, the time-invariant static subsurface model is commonly adopted to reconstruct a time-lapse image. This assumption of static model, however, can be invalid particularly when fluid migrates very quickly in highly permeable medium in the brine injection experiment. In such case, the resultant subsurface images may be severely distorted. In order to alleviate this problem, we develop a new least-squares inversion algorithm under the assumption that the subsurface model will change continuously in time. Instead of sampling a time-space model into numerous space models with a regular time interval, a few reference models in space domain at different times pre-selected are used to describe the subsurface structure continuously changing in time; the material property at a certain space coordinate are assumed to change linearly in time. Consequently, finding a space-time model can be simplified into obtaining several reference space models. In order to stabilize iterative inversion and to calculate meaningful subsurface images varying with time, the regularization along time axis is introduced assuming that the subsurface model will not change significantly during the data acquisition. The performance of the proposed algorithm is demonstrated by the numerical experiments using the synthetic data of crosshole dc resistivity tomography.

• Journal of the Korea Society for Simulation
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• v.23 no.4
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• pp.51-64
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• 2014

Small and medium Enterprises (SMEs), which have a manufacturing method of small quantity batch production produce goods using a general-purpose equipment and attached auxiliary tools. Many previous studies have focused on finding the effective resource allocations for improving the firms' productivity. It is very important for SMEs to keep costs low in assigning jobs to each resource, because they should meet the future uncertain demand of consumers under the limited budget. Using the concept of salvage cost, this paper proposes how to effectively allocate the tasks to main resources in the production process. The salvage cost is defined that purchasing cost minus decrease in value by workload, the method considering this is expected to reduce total purchasing costs during business period. To validate the effect of the proposed method, we proceed the real case study targeting on S company, PCB manufacturer to compare purchase amounts and its costs between the allocation proposed based salvage cost and current allocation method of current S company. As a results, In short-term (3 year) business period, salvage allocation have remarkable superior outcome to existing method, but gradually have cancelled out the effects in long-term (8 year) plans. Unlike the cycle allocation method, there exists the idle-equipments in allocation based salvage value. we additionally analyze the profits with respect to rental strategy of them during business period.