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호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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Real-World Application of Artificial Intelligence for Detecting Pathologic Gastric Atypia and Neoplastic Lesions

  • Young Hoon Chang;Cheol Min Shin;Hae Dong Lee;Jinbae Park;Jiwoon Jeon;Soo-Jeong Cho;Seung Joo Kang;Jae-Yong Chung;Yu Kyung Jun;Yonghoon Choi;Hyuk Yoon;Young Soo Park;Nayoung Kim;Dong Ho Lee
    • Journal of Gastric Cancer
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    • v.24 no.3
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    • pp.327-340
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    • 2024
  • Purpose: Results of initial endoscopic biopsy of gastric lesions often differ from those of the final pathological diagnosis. We evaluated whether an artificial intelligence-based gastric lesion detection and diagnostic system, ENdoscopy as AI-powered Device Computer Aided Diagnosis for Gastroscopy (ENAD CAD-G), could reduce this discrepancy. Materials and Methods: We retrospectively collected 24,948 endoscopic images of early gastric cancers (EGCs), dysplasia, and benign lesions from 9,892 patients who underwent esophagogastroduodenoscopy between 2011 and 2021. The diagnostic performance of ENAD CAD-G was evaluated using the following real-world datasets: patients referred from community clinics with initial biopsy results of atypia (n=154), participants who underwent endoscopic resection for neoplasms (Internal video set, n=140), and participants who underwent endoscopy for screening or suspicion of gastric neoplasm referred from community clinics (External video set, n=296). Results: ENAD CAD-G classified the referred gastric lesions of atypia into EGC (accuracy, 82.47%; 95% confidence interval [CI], 76.46%-88.47%), dysplasia (88.31%; 83.24%-93.39%), and benign lesions (83.12%; 77.20%-89.03%). In the Internal video set, ENAD CAD-G identified dysplasia and EGC with diagnostic accuracies of 88.57% (95% CI, 83.30%-93.84%) and 91.43% (86.79%-96.07%), respectively, compared with an accuracy of 60.71% (52.62%-68.80%) for the initial biopsy results (P<0.001). In the External video set, ENAD CAD-G classified EGC, dysplasia, and benign lesions with diagnostic accuracies of 87.50% (83.73%-91.27%), 90.54% (87.21%-93.87%), and 88.85% (85.27%-92.44%), respectively. Conclusions: ENAD CAD-G is superior to initial biopsy for the detection and diagnosis of gastric lesions that require endoscopic resection. ENAD CAD-G can assist community endoscopists in identifying gastric lesions that require endoscopic resection.

Introduction of Child and Adolescent Mental Health Services in Korea and Their Role During the COVID-19 Pandemic: Focusing on the Ministry of Education Policy

  • Seo Jung Kim;Jongha Lee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.1
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    • pp.4-14
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    • 2023
  • This study aimed to discuss mental health services for children and adolescents that are being implemented as initiatives of the Korean government and to review the functions and roles of these projects during the COVID-19 pandemic. Three government departments are in charge of providing mental health services for children and adolescents: Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare. The Ministry of Education has implemented several policies to facilitate the early detection of mental health issues among school students (from preventive interventions to selective interventions for high-risk students). The Ministry of Gender Equality and Family additionally serves out-of-school children and adolescents by facilitating early identification of adolescents in crises and providing temporary protection or emergency assistance (as required) through the Community Youth Safety-Net Project. Furthermore, the Ministry of Health and Welfare operates relevant mental health agencies for individuals of all ages including children and adolescents. Any high-risk students who have been screened through the projects of the Ministry of Education are supported through referrals to the following institutions for appropriate treatment of their symptoms: specialized hospitals, the Youth Counseling and Welfare Center operated by the Ministry of Gender Equality and Family, the National Youth Healing Center, the Mental Health Welfare Center operated by the Ministry of Health and Welfare, the Suicide Prevention Center, and the Child Welfare Center. To assist students who are facing any psychological difficulties because of the COVID-19 pandemic, the Ministry of Education has established a psychiatric support group for providing emergency mental health care; furthermore, schools are promoting psychological surveillance (e.g., provision of non-face-to-face counseling services that are centered around the Wee Center). The Ministry of Education, Ministry of Gender Equality and Family, and Ministry of Health and Welfare have provided varied mental health support services in order to address the challenges faced by children and adolescents during the pandemic. Nevertheless, the mental health services operated by each ministry do show some limitations because their service provision system is insufficiently collaborative. The present study discussed the positive effects of each initiative as well as its limitations; furthermore, it suggested improvements for facilitating the healthy development of children and adolescents' mental health.

Toward understanding learning patterns in an open online learning platform using process mining (프로세스 마이닝을 활용한 온라인 교육 오픈 플랫폼 내 학습 패턴 분석 방법 개발)

  • Taeyoung Kim;Hyomin Kim;Minsu Cho
    • Journal of Intelligence and Information Systems
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    • v.29 no.2
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    • pp.285-301
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    • 2023
  • Due to the increasing demand and importance of non-face-to-face education, open online learning platforms are getting interests both domestically and internationally. These platforms exhibit different characteristics from online courses by universities and other educational institutions. In particular, students engaged in these platforms can receive more learner autonomy, and the development of tools to assist learning is required. From the past, researchers have attempted to utilize process mining to understand realistic study behaviors and derive learning patterns. However, it has a deficiency to employ it to the open online learning platforms. Moreover, existing research has primarily focused on the process model perspective, including process model discovery, but lacks a method for the process pattern and instance perspectives. In this study, we propose a method to identify learning patterns within an open online learning platform using process mining techniques. To achieve this, we suggest three different viewpoints, e.g., model-level, variant-level, and instance-level, to comprehend the learning patterns, and various techniques are employed, such as process discovery, conformance checking, autoencoder-based clustering, and predictive approaches. To validate this method, we collected a learning log of machine learning-related courses on a domestic open education platform. The results unveiled a spaghetti-like process model that can be differentiated into a standard learning pattern and three abnormal patterns. Furthermore, as a result of deriving a pattern classification model, our model achieved a high accuracy of 0.86 when predicting the pattern of instances based on the initial 30% of the entire flow. This study contributes to systematically analyze learners' patterns using process mining.

Increasing Accuracy of Classifying Useful Reviews by Removing Neutral Terms (중립도 기반 선택적 단어 제거를 통한 유용 리뷰 분류 정확도 향상 방안)

  • Lee, Minsik;Lee, Hong Joo
    • Journal of Intelligence and Information Systems
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    • v.22 no.3
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    • pp.129-142
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    • 2016
  • Customer product reviews have become one of the important factors for purchase decision makings. Customers believe that reviews written by others who have already had an experience with the product offer more reliable information than that provided by sellers. However, there are too many products and reviews, the advantage of e-commerce can be overwhelmed by increasing search costs. Reading all of the reviews to find out the pros and cons of a certain product can be exhausting. To help users find the most useful information about products without much difficulty, e-commerce companies try to provide various ways for customers to write and rate product reviews. To assist potential customers, online stores have devised various ways to provide useful customer reviews. Different methods have been developed to classify and recommend useful reviews to customers, primarily using feedback provided by customers about the helpfulness of reviews. Most shopping websites provide customer reviews and offer the following information: the average preference of a product, the number of customers who have participated in preference voting, and preference distribution. Most information on the helpfulness of product reviews is collected through a voting system. Amazon.com asks customers whether a review on a certain product is helpful, and it places the most helpful favorable and the most helpful critical review at the top of the list of product reviews. Some companies also predict the usefulness of a review based on certain attributes including length, author(s), and the words used, publishing only reviews that are likely to be useful. Text mining approaches have been used for classifying useful reviews in advance. To apply a text mining approach based on all reviews for a product, we need to build a term-document matrix. We have to extract all words from reviews and build a matrix with the number of occurrences of a term in a review. Since there are many reviews, the size of term-document matrix is so large. It caused difficulties to apply text mining algorithms with the large term-document matrix. Thus, researchers need to delete some terms in terms of sparsity since sparse words have little effects on classifications or predictions. The purpose of this study is to suggest a better way of building term-document matrix by deleting useless terms for review classification. In this study, we propose neutrality index to select words to be deleted. Many words still appear in both classifications - useful and not useful - and these words have little or negative effects on classification performances. Thus, we defined these words as neutral terms and deleted neutral terms which are appeared in both classifications similarly. After deleting sparse words, we selected words to be deleted in terms of neutrality. We tested our approach with Amazon.com's review data from five different product categories: Cellphones & Accessories, Movies & TV program, Automotive, CDs & Vinyl, Clothing, Shoes & Jewelry. We used reviews which got greater than four votes by users and 60% of the ratio of useful votes among total votes is the threshold to classify useful and not-useful reviews. We randomly selected 1,500 useful reviews and 1,500 not-useful reviews for each product category. And then we applied Information Gain and Support Vector Machine algorithms to classify the reviews and compared the classification performances in terms of precision, recall, and F-measure. Though the performances vary according to product categories and data sets, deleting terms with sparsity and neutrality showed the best performances in terms of F-measure for the two classification algorithms. However, deleting terms with sparsity only showed the best performances in terms of Recall for Information Gain and using all terms showed the best performances in terms of precision for SVM. Thus, it needs to be careful for selecting term deleting methods and classification algorithms based on data sets.

Predicting the Performance of Recommender Systems through Social Network Analysis and Artificial Neural Network (사회연결망분석과 인공신경망을 이용한 추천시스템 성능 예측)

  • Cho, Yoon-Ho;Kim, In-Hwan
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.159-172
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    • 2010
  • The recommender system is one of the possible solutions to assist customers in finding the items they would like to purchase. To date, a variety of recommendation techniques have been developed. One of the most successful recommendation techniques is Collaborative Filtering (CF) that has been used in a number of different applications such as recommending Web pages, movies, music, articles and products. CF identifies customers whose tastes are similar to those of a given customer, and recommends items those customers have liked in the past. Numerous CF algorithms have been developed to increase the performance of recommender systems. Broadly, there are memory-based CF algorithms, model-based CF algorithms, and hybrid CF algorithms which combine CF with content-based techniques or other recommender systems. While many researchers have focused their efforts in improving CF performance, the theoretical justification of CF algorithms is lacking. That is, we do not know many things about how CF is done. Furthermore, the relative performances of CF algorithms are known to be domain and data dependent. It is very time-consuming and expensive to implement and launce a CF recommender system, and also the system unsuited for the given domain provides customers with poor quality recommendations that make them easily annoyed. Therefore, predicting the performances of CF algorithms in advance is practically important and needed. In this study, we propose an efficient approach to predict the performance of CF. Social Network Analysis (SNA) and Artificial Neural Network (ANN) are applied to develop our prediction model. CF can be modeled as a social network in which customers are nodes and purchase relationships between customers are links. SNA facilitates an exploration of the topological properties of the network structure that are implicit in data for CF recommendations. An ANN model is developed through an analysis of network topology, such as network density, inclusiveness, clustering coefficient, network centralization, and Krackhardt's efficiency. While network density, expressed as a proportion of the maximum possible number of links, captures the density of the whole network, the clustering coefficient captures the degree to which the overall network contains localized pockets of dense connectivity. Inclusiveness refers to the number of nodes which are included within the various connected parts of the social network. Centralization reflects the extent to which connections are concentrated in a small number of nodes rather than distributed equally among all nodes. Krackhardt's efficiency characterizes how dense the social network is beyond that barely needed to keep the social group even indirectly connected to one another. We use these social network measures as input variables of the ANN model. As an output variable, we use the recommendation accuracy measured by F1-measure. In order to evaluate the effectiveness of the ANN model, sales transaction data from H department store, one of the well-known department stores in Korea, was used. Total 396 experimental samples were gathered, and we used 40%, 40%, and 20% of them, for training, test, and validation, respectively. The 5-fold cross validation was also conducted to enhance the reliability of our experiments. The input variable measuring process consists of following three steps; analysis of customer similarities, construction of a social network, and analysis of social network patterns. We used Net Miner 3 and UCINET 6.0 for SNA, and Clementine 11.1 for ANN modeling. The experiments reported that the ANN model has 92.61% estimated accuracy and 0.0049 RMSE. Thus, we can know that our prediction model helps decide whether CF is useful for a given application with certain data characteristics.

Studies on the Physiological Chemistry of the Spring Growth Habits in Naked Barley V. Changes in the Isozyme Patterns and Activities of Peroxidase During the Differentiation (과맥의 파성에 대한 생리화학적 연구 V. 유수의 분화, 발육과정중 Peroxidase의 활성 및 Isozyme Pattern)

  • 최선영;이강수;박기훈
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.31 no.3
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    • pp.375-382
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    • 1986
  • This study was carried out to obtain the basic information for the clarification of spring growth habits mechanism of naked barleys. The isozyme patterns and activities of peroxidase in the young spike and leaf blade were analyzed during the differentiation and development of young spike. The characteristic differences between the normal and rosetted type were in c and g isozymes in young spike, and in i isozyme in the leaf blade. In the normal type, c and i isozymes disappeared at the stage of spi-kelet differentiation, g isozyme at the stage of flolet differentiation. But, in the rosetted type, those three isozymes remained in dark stained condition until the time of final sampling. Especially, those three isozymes were higher in the rosetted type than those in the normal type even at the stage of bract differentiation(BDS), just prior to the reproductive stage. The activities of peroxidase decreased slowly after BDS in the young spike and leaf blade in the normal type, While, in the rosetted type, increased linearly, and the degree of increasing was remarkable in the young spike. It was interesting that the degree of activities in young spike was higher in the rosetted type than that in the normal type even at BDS. From the above results, the remarkable differences of the isozyme patterns and activities at BDS between the normal and rosetted type were considered to be the physiological expression of the varieties concerned with the degree of spring growth habits.

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Management of plant genetic resources at RDA in line with Nagoya Protocol

  • Yoon, Moon-Sup;Na, Young-Wang;Ko, Ho-Cheol;Lee, Sun-Young;Ma, Kyung-Ho;Baek, Hyung-Jin;Lee, Su-Kyeung;Lee, Sok-Young
    • Proceedings of the Korean Society of Crop Science Conference
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    • 2017.06a
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    • pp.51-52
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    • 2017
  • "Plant genetic resources for food and agriculture" means any genetic material of plant origin of actual or potential value for food and agriculture. "Genetic material" means any material of plant origin, including reproductive and vegetative propagating material, containing functional units of heredity. (Internal Treaty on Plant Genetic Resources for Food and Agriculture, ITPGRFA). The "Nagoya Protocol on Access to Genetic Resources and the Fair and Equitable Sharing of Benefits Arising from their Utilization (ABS) to the Convention on Biological Diversity (shortly Nagoya Protocol)" is a supplementary agreement to the Convention on Biological Diversity. It provides a transparent legal framework for the effective implementation of one of the three objectives of the CBD: the fair and equitable sharing of benefits arising out of the utilization of genetic resources. The Nagoya Protocol on ABS was adopted on 29 October 2010 in Nagoya, Japan and entered into force on 12 October 2014, 90 days after the deposit of the fiftieth instrument of ratification. Its objective is the fair and equitable sharing of benefits arising from the utilization of genetic resources, thereby contributing to the conservation and sustainable use of biodiversity. The Nagoya Protocol will create greater legal certainty and transparency for both providers and users of genetic resources by; (a) Establishing more predictable conditions for access to genetic resources and (b) Helping to ensure benefit-sharing when genetic resources leave the country providing the genetic resources. By helping to ensure benefit-sharing, the Nagoya Protocol creates incentives to conserve and sustainably use genetic resources, and therefore enhances the contribution of biodiversity to development and human well-being. The Nagoya Protocol's success will require effective implementation at the domestic level. A range of tools and mechanisms provided by the Nagoya Protocol will assist contracting Parties including; (a) Establishing national focal points (NFPs) and competent national authorities (CNAs) to serve as contact points for information, grant access or cooperate on issues of compliance, (b) An Access and Benefit-sharing Clearing-House to share information, such as domestic regulatory ABS requirements or information on NFPs and CNAs, (c) Capacity-building to support key aspects of implementation. Based on a country's self-assessment of national needs and priorities, this can include capacity to develop domestic ABS legislation to implement the Nagoya Protocol, to negotiate MAT and to develop in-country research capability and institutions, (d) Awareness-raising, (e) Technology Transfer, (f) Targeted financial support for capacity-building and development initiatives through the Nagoya Protocol's financial mechanism, the Global Environment Facility (GEF) (Nagoya Protocol). The Rural Development Administration (RDA) leading to conduct management agricultural genetic resources following the 'ACT ON THE PRESERVATION, MANAGEMENT AND USE OF AGRO-FISHERY BIO-RESOURCES' established on 2007. According to $2^{nd}$ clause of Article 14 (Designation, Operation, etc. of Agencies Responsible for Agro-Fishery Bioresources) of the act, the duties endowed are, (a) Matters concerning securing, preservation, management, and use of agro-fishery bioresources; (b) Establishment of an integrated information system for agro-fishery bioresources; (c) Matters concerning medium and long-term preservation of, and research on, agro-fishery bioresources; (d) Matters concerning international cooperation for agro-fishery bioresources and other relevant matters. As the result the RDA manage about 246,000 accessions of plant genetic resources under the national management system at the end of 2016.

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A Study on the Experience of Physical Therapy Accident in The Physiotherapist (물리치료사에 있어서 물리치료 사고의 경험에 관한 연구)

  • Kim, Jong-Dae
    • Journal of Korean Physical Therapy Science
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    • v.9 no.1
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    • pp.69-80
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    • 2002
  • The objective of research provides the physical therapy of good quality to the patients to search for the problem pant against a physical therapy accident and it simultaneously respects physical therapy company law, the possibility of preparing a system defensive ability in order to be. The data were collected from 2000 October 1 to December 30th, and analyzed by a frequency and a percentage, oneway ANOVA, Scheffe method, $x^2$ official approvals. Conclusion (1) the accident where the patient falls from inside the treatment 'room is many and occasionally' 29.3% (63 people) with was many most. (2) Because of a mistake by a part-time therapist in holiday or a colleague therapist to do, the fracture or bum accident happens 12.5% (27 people), by a assist nurse due to more showed 12.1% (26 people) experience degree in the patient. (3) From physical therapy process breakdown of the medical treatment machinery and tools or it is in malfunction to do and the experience which has a failure to physical therapy is one enemy 68.1% (147 people) was in item. Also it treats and the patient or in the protector it sends an explanation in advance not to be, the experience which it enforces 50% (108 people), of service hour treatment equipment the medical treatment directives broad way of the doctor is accurate in insufficiency and does not enforce the experience is 45.4% (98 people), the patient whom I am treating Hot Pack (electricity has pack inclusion) with to do, the art dealer (over at 1 buffoonery) the experience which it puts on 27.1% (58 people), The patient whom I am treating is the electrotherapy flag (electricity has pack exclusion) with to do, the art dealer (1 degree art dealer over) the experience which it puts on 16.3% (35 people), the experience boat song the patient against a fracture from physical therapy process 9 person (4.2%) was visible an experience degree. (4) With hospital infection to do, from the patient the experience and the therapist which receive a problem proposal were caused by with hospital infection and the answer back regarding the experience which tries to receive a treatment appeared 6% (13 people), 42% (9 people) with each. (5) It listened to the treatment hour patient or the appeal of the protector and especially it does not appear to be being important it was not and and the management which is special it did not take, also the experience where the condition of the patient is deteriorated after that was 10.3% (22 people). (6) The condition or state of the patient does not agree with the medical treatment instruction of the doctor not to be, amendment one experience was 67.5% (145 people). (7) The experience degree of the physical therapy accident which relates with physical therapy recording and a secret maintenance 59.7% (129 people) 'is many and occasionally it is,' it showed an answer back and e it showed a most high accident experience degree. (8) The business overweight of physical therapy company 43.3% (93 people) with was high most from recognition degree of the physical therapy company against a physical therapy accident. (9) Against the question which asks the responsibility subject matter of physical therapy accident the whole answer back volition 42.8% did it is a joint responsibility where the multi person relates. (10) The accident occurs most the hour unit which plentifully in the afternoon 64.3% (133 people) with appeared from the recognition degree against the frequency hour unit of physical therapy accident. (11) Physical therapy it bought and after the various medical treatment accident which relates against the attitude of the, patient side against the physical therapy company it understood and trillion it was many most with 33.3% to be finished. (12) After physical therapy accident the management against the physical therapy company of the hospital authorities concerned above all do not experience 70.6% (149 people), from event right and wrong submission 22.7% (48 people), warning management 2.8% (6 people), the event report requirement and money compensation were each 0.5% (1 person). (13) As the prevention book of physical therapy accident most it is important, the fact which it thinks that, the persons supplement of physical therapy company 58.8% (127 people) with was high most. (14) It related with a physical therapy accident and the medical law 43.5%, civil law 23.9%, was visible the answer back ratio of the criminal law 13.7% from the degree which probably is a relation law.

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