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Evaluation on Management of Unified Health Subcenters (통합보건지소 운영 평가)

  • Kang, Pock-Soo;Lee, Kyeong-Soo;Hwang, Tae-Yoon;Kim, Chang-Yoon
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.67-77
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    • 2003
  • Objectives: This study is designed to suggest the health service goals necessary for providing the more efficient services relevant to the requests of the community, through the evaluation on the operating status of the unified health subcenters. Methods: We visited total 5 unified health subcenters comprising 3 ones located in Gyeongsangbuk-do and 2 ones located in Gyeongsangnam-do from December 2000 to January 2001, and interviewed about the pre- and post-unified status related to manpower, facilities, equipment, medical service and health service quality, and the problems and improvement plans of the unified management. Results: According to the evaluation on the manpower before and after the unification of the health subcenters, the total employees increased by 2.8 persons on average from 6.8 to 9.6 persons in the investigated subjects. The numbers of doctors, dentists and nurses were almost the same as before. There were no clinical pathologic technician and radiological technician before but they were appointed to duty in 3 unified health subcenters later. The unification of the health subcenters has produced slight increases in the frequency of the medical service and dental treatment and considerable increases in that of the physical therapy and laboratory tests. In relating to the changes of the health service, the cases of visiting health care and ambulatory medical service, and the total number of health education participants were greatly increased after the unification. The number of cases undergoing the vaccination and cervical cancer screening was similar to that of the pre-unification while the patient number of the registration to hypertension or diabetes showed a tendency to increase a little. Since the unification of the health subcenters, the frequency of laboratory tests has been increased, but the quality of health service has not been improved yet. Nevertheless, the unification seems to be positive according to the result of the great improvement in visiting health care, ambulatory medical service and health education service. The problems of the unification of the health subcenters were indicated in indefiniteness of the service details between the workers; excessively large building hard to be effectively managed; insufficient medical instruments, inappropriation of working expenses, lack of professional training for the health education, etc. Conclusions: For further active functions of the unified health subcenters, the minimal allocation basis to appoint doctors, nurses and administrative workers to do the duty should be differentiated from the basis for a health subcenter, and the fundamental instruments needs to be expanded to improve the quality of the medical service and visiting health care service. Moreover, the unified health subcenter needs to have definite service details between the workers, and should improve the working efficiency through the development of service-related guidelines.

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

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

Histomorphometric Study of Sinus Bone Graft using Various Graft Material (다양한 골이식재료를 이용한 상악동 골이식 4개월 후 조직형태계측학적 평가)

  • Lee, Ji-Young;Kim, Young-Kyun;Kim, Su-Gwan;Lim, Sung-Chul
    • Journal of Dental Rehabilitation and Applied Science
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    • v.27 no.2
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    • pp.141-147
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    • 2011
  • The aim of this study was to evaluate histomorphometrically and compare the efficiency of various bone graft material and autogenous tooth bone graft material which were used in sinus bone graft procedure. Subjects were the 24 patients who had treated with sinus bone graft using lateral approach from October 2007 to September 2009 at SNUBH. The average age was $52.51{\pm}11.86$ years. All cases was taken after 4month of procedure and divided into 3 groups according to bone graft material. Group 1: autogenous tooth bone graft material, Group 2: OrthoblastII(integra lifescience corp. Irvine, US)+Biocera(Osscotec, seoul, korea), group 3: DBX(Synthes, USA)+BioOss(Geistlich Pharm AG, Wolhusen, Switzerland). Total 37 implant placement area were included and evaluated(7 in group 1, 10 in group 2, 20 in group 3). Evaluation of new bone formation, ratio of woven bone to lamellar bone, ratio of new bone to graft material were performed on each tissue section. Kruskal-Wallis test was used for statistical analysis(SPSS Ver. 12.0, USA). New bone formation were $52.5{\pm}10.7%$ in group 1, $52.0{\pm}23.4%$ in group 2, $51.0{\pm}18.3%$ in group 3. There were no statistical significant differences between each groups. Ratio of woven bone to lamella bone were $82.8{\pm}15.3%$ in group 1, $36.7{\pm}59.3%$ in group 2, $31.0{\pm} 51.2%$ in group 3. Ratio of new bone to graft material were $81.3{\pm}10.4%$ in group 1, $72.5{\pm}28.8%$ in group 2, $80.3{\pm}24.0%$ in group 3. After 4 month of healing period, all group showed favorable new bone formation and around graft material and implant. Within limitation of our study, it is suggested that autogenous tooth bone graft material might be used as novel bone graft material for sinus bone graft.

Callus formation and multiple shoot induction of Hovenia dulcis Thunb. (헛개나무의 캘러스 형성 및 multiple shoot 유기)

  • Eom, Seung-Hee;Kang, Won-Hee;Shin, Dong-Yong;Heo, Kwon;Choi, Won-Cheol;Lee, Hyeon-Yong;Yu, Chang-Yeon
    • Korean Journal of Plant Resources
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    • v.15 no.3
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    • pp.237-242
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    • 2002
  • Loaves, stems, cotyledons, and roots of Hovenia dulcis Thunb grown in test tube were cultured on media containing different concentrations of single or combined growth regulators. In MS media containing 2mg/ι BA, the shoot formation rate was 95.5% and it was the highest frequency of shoot formation. MS media showed most efficiency in the shoot formation at 0.01mg/ι TDZ for the callus formation, but the color of callus changed to brown at a higher concentration of TDZ. Callus formation was 89.% at 0.5mg/ 2.4-D, but IAA, IBA, and NAA were not effective on the formation of callus. Calli were formed only on wound area when IAA, IBA, and NAA were added into MS media. Combined growth regulators (BA + auxin) were more effective in roots and nodes than leaves and cotyledons on the formation of shoot. More than 97% of shoot formation was obtained on MS media containing BA and auxin. For the production of multiple shoot, nodes of Hovenia dulcis were used and effect of growth regulators on the formation of multiple shoot was evaluated on MS media. Highest shoots (5.3) of Hovenia dulcis were induced on MS media supplied with 0.1mg/ι BA and 0.1mg/ι NAA, and an average of 6.4 shoots per explant were obtained in 1/2 MS media containing same concentration and growth regulators. An average of 7 shoots per explant after 4 weeks of culture from nodes of Hovenia dulcis was produced on a woody plant medium(WPM) containing 0.1mg/ι BA and 0.1mg/ι NAA. Shoot length was 6.0 cm in average.

Treatment of Malodorous Waste Air by a Biofilter Process Equipped with a Humidifier Composed of Fluidized Aerobic and Anoxic Reactor (폐가스 가습조(유동상호기 및 무산소조)를 포함한 바이오필터공정을 이용한 악취폐가스의 처리)

  • Lim, Kwang-Hee
    • Korean Chemical Engineering Research
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    • v.56 no.1
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    • pp.85-95
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    • 2018
  • In this research, a biofilter system equipped with a biofilter process and a humidifier composed of a fluidized aerobic and an anoxic reactor, was constructed to treat odorous waste air containing hydrogen sulfide, ammonia and VOC, frequently generated from pig and poultry housing facilities, compost manufacturing factories and publicly owned facilities. Its optimum operating condition was revealed and discussed. In the experiment of complex feed, the ammonia of fed-waste air was removed by ca. 75% and more than 20% at the stage of the humidifier and the biofilter, respectively. The toluene of the fed-waste air was removed by ca. 20% and more than 70% at the stage of the humidifier and the biofilter, respectively. Therefore the water-soluble ammonia and the water-insoluble toluene were treated mainly at the stage of the humidifier and the biofilter, respectively. In addition, hydrogen sulfide was almost absorbed at the stage of the humidifier so that it was not detected at the biofilter process. In the experiment of ammonia-containing feed, the ammonia of fed-waste air was removed by ca. 65% and 35% at the stage of the humidifier and the biofilter, respectively. Its removal efficiency of ammonia at the stage of the humidifier was 10% less than that in the experiment of complex feed, due to no supply of such carbon source as toluene required in the process of denitrification. In the experiments of complex feed, ammonia-containing feed with and without (instead, glucose) the addition of yeast extract, the absorption rates of ammonia-nitrogen were ca. 0.28 mg/min, 0.23 mg/min and 0.27 mg/min, respectively. The corresponding denitrification rates in the anoxic reactor were 0.42 mg/min, 0.55 mg/min and 0.27 mg/min, respectively. In addition, in the modeling of bubble column(the fluidized aerobic reactor of the humidifier) process, the value of specific surface area(a) of bubbles multiplied by enhanced mass transfer coefficient (E $K_y$) was evaluated to be 0.12/hr.

The Development and Features of Discussion about Community Design (커뮤니티디자인의 전개와 논의의 특징)

  • Kim, Yun-Geum;Reigh, Young-Bum
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.3
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    • pp.22-31
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    • 2012
  • This study was prompted by the recognition that the tenn "Community design" has recently been used in diverse practical fields without prior discussion about its underpinnings, a potentially problematic state of affairs. Based on these problems, this study studied the special quality about the concept of community design. Community design can be discussed from two perspectives. The first views community design as a design that concerns the community, an inhabited area populated with people who have common interests, at least in part because of geographic proximity to each other. The second sees community design as a movement that started in the 1960s and places a great importance on democratic decision making, communication, and collaboration. This study will focus on the latter. This branch of community design encompasses an advocacy planning approach, in which design professionals represent deprived communities in their resistance against comprehensive redevelopment. This was associated to the wider social protest movements of the mid and late 1960s. In the 1970s, this branch of community design was developed alongside community design centers, which provided local-level technical assistance to the communities on a number of issues, such as design and planning. The discussion about community design started in earnest from the early 1980s. A review of the literature m community design reveals several characteristics. First, community design deals with the relationship between the physical environment and several aspects of a region, including the social and cultural. Second, it involves community participation, which many scholars believe is the core of community design. Specifically, community design has been characterized by increased participation and democratic debate and decision making. The Third is about communication methods. Since the 1960s, diverse methods had been developed to promote communication effectively. Finally, community design must consider the relationship between designers, who typically value aesthetics and efficiency of form, and the needs of the community with which they are working. Indeed, some scholars believe that this relationship is generally contentious, although the designer can also be thought of as the facilitator of the community's needs. As community design practice becomes more prevalent, a review of the foundation of institution and policy and the role of experts is also needed. The community design movement bas been theorized ex post facto through diverse discussion that has sought to ascribe meaning and direction to its practice. In other words, the relationship between this theory and practice is cyclical. Therefore, this study can contribute to the virtuous circle.

Evaluation Criteria and Preferred Image of Jeans Products based on Benefit Segmentation (진 제품 구매자의 추구혜택에 따른 평가기준 및 선호 이미지)

  • Park, Na-Ri;Park, Jae-Ok
    • Journal of the Korean Society of Clothing and Textiles
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    • v.31 no.6 s.165
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    • pp.974-984
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    • 2007
  • The purpose of this study was to find differences in evaluation criteria and to find differences in preferred images based on benefits segmented groups of jeans products consumers. Male and female Korean university students participated in the study. Quota sampling method was used to collect the data based on gender and a residential area of the respondents. Data from 492 questionnaires were used in the analysis. Factor analysis, Cronbach's alpha coefficient, cluster analysis, one-way ANOVA, and post-hoc test were conducted. As a result, respondents who seek multi-benefits considered aesthetic criteria(e.g., color, style, design, fit) and quality performance criteria(e.g., durability, ease of care, contractibility, flexibility) more importantly when evaluating and purchasing jeans products. Respondents who seek brand name considered extrinsic criteria(e.g., brand reputation, status symbol, country of origin, fashionability) more importantly than respondents who seek economic efciency. Respondents who seek multi-benefits such as attractiveness, fashion, individuality, and utility tend to prefer all the images: individual image, active image, sexual image, sophisticated image, and simple image when wearing jeans products. Respondents who seek fashion are likely to prefer individual image, and respondents who seek brand name more prefer both individual image and polished image. Mean while, respondents who seek economical efficiency less prefer sexual image and polished image.

Behavior and Decomposition Velocity of Pollutants on Various Forms from Domestic Sewage in Small-scale Sewage Treatment Plant by Natural Purification Method (자연정화공법에 의한 농촌 전원독립가구 하수처리장에서 하수 중 오염물질의 존재형태별 거동과 분해속도)

  • Seo, Dong-Cheol;Kim, Hyung-Jun;Park, Woo-Young;Lim, Jong-Sir;Hwang, Seung-Ha;Park, Chan-Hoon;Choi, Jeong-Hwan;Lee, Hong-Jae;Lee, Do-Jin;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Environmental Agriculture
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    • v.27 no.1
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    • pp.18-26
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    • 2008
  • Behavior and decomposition velocity of pollutants on various forms from domestic sewage in sewage treatment plant were investigated in order to obtain the basic data for improving the removal efficiency of pollutants and to reduce the area in constructed wetland by natural purification method. The removal amounts of BODs and CODs in aerobic bed were significantly higher than those of the other beds. In aerobic bed, the removal amounts of IBOD and ICOD were more than those for SBOD and SCOD, respectively, whereas the removal amounts of BODs and CODs in anoxic and anaerobic beds were little different. The removal amounts of SSs in aerobic bed were also higher than those for the other beds, and the removal amounts of VSS in all beds were more than those for FSS. The removal amounts of DTN and DTP in all beds were more than those for STN and STP, respectively. In addition, the decomposition velocities of TBOD, TCOD and TSS in aerobic bed were 30.79, 17.15 and 29.96 $day^{-1}$. Moreover, the decomposition velocities of BODs, CODs and SSs in aerobic bed were very rapid than those in the other beds. On the other hand, the decomposition velocities of BODs, CODs and SSs in anoxic and anaerobic beds were a little different regardless of the forms of pollutant. The decomposition velocities constants of T-N in aerobic, anoxic and anaerobic beds were 4.78, 0.12 and 0.10 $day^{-1}$, respectively. Moreover, the decomposition velocities constants of T-P in aerobic, anoxic and anaerobic beds were 13.09, 0.12 and 0.13 $day^{-1}$ respectively. The decomposition velocity of T-Ns and T-Ps in aerobic bed were slightly rapid than those in the other beds, whereas the decomposition velocities of T-Ns and T-Ps in anoxic and anaerobic beds were slightly different regardless of the forms of pollutant.

Feasibility Study of Wetland-pond Systems for Water Quality Improvement and Agricultural Reuse (습지-연못 연계시스템에 의한 수질개선과 농업적 재이용 타당성 분석)

  • Jang, Jae-Ho;Jung, Kwang-Wook;Ham, Jong-Hwa;Yoon, Chun-Gyeong
    • Korean Journal of Ecology and Environment
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    • v.37 no.3 s.108
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    • pp.344-354
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    • 2004
  • A pilot study was performed from September 2000 to April 2004 to examine the feasibility of the wetland-pond system for the agricultural reuse of reclaimed water. The wetland system was a subsurface flow type, with a hydraulic residence time of 3.5 days, and the subsequent pond was 8 $m^3$ in volume (2 m ${\times}$ 2 m ${\times}$ 2 m) and operated with intermittent-discharge and continuous flow types. The wetland system was effective in treating the sewage; median removal efficiencies of $BOD_5$ and TSS were above 70.0%, with mean effluent concentrations of 27.1 and 16.8 mg $L^{-1}$, respectively, for these constituents. However, they did often exceed the effluent water quality standards of 20 mg $L^{-1}$. Removal of T-N and T-P was relatively less effective and mean effluent concentrations were approximately 103.2 and 7.2 mg $L^{-1}$, respectively. The wetland system demonstrated high removal rate (92 ${\sim}$ 90%) of microorganisms, but effluent concentrations were in the range of 300 ${\sim}$ 16,000 MPN 100 $mL^{-1}$ which is still high for agricultural reuse. The subsequent pond system provided further treatment of the wetland effluent, and especially additional microorganisms removal in addition to wetland-pond system could reduce the mean concentration to 1,000 MPN 100 $mL^{-1}$ from about $10^5$ MPN 100 $mL^{-1}$ of wetland influent. Other parameters in the pond system showed seasonal variation, and the upper layer of the pond water column became remarkably clear immediately after ice melt. Overall, the wetland system was found to be adequate for treating sewage with stable removal efficiency, and the subsequent pond was effective for further polishing. This study concerned agricultural reuse of reclaimed water using natural systems. Considering stable performance and effective removal of bacterial indicators as well as other water quality parameters, low maintenance, and cost-effectiveness, wetland- pond system was thought to be an effective and feasible alternative for agricultural reuse of reclaimed water in rural area.

Development of the Model for Total Quality Management and Cost of Quality using Activity Based Costing in the Hospital (병원의 활동기준원가를 이용한 총체적 질관리 모형 및 질비용 산출 모형 개발)

  • 조우현;전기홍;이해종;박은철;김병조;김보경;이상규
    • Health Policy and Management
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    • v.11 no.2
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    • pp.141-168
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    • 2001
  • Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ₩35,880, evaluation/preventive cost was ₩72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

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