• Title/Summary/Keyword: Benefit Evaluation

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Current Management Status of 'Day and Night Care Facilities' for Long-Term Care Insurance Benefit (노인장기요양보험 급여 주야간보호사업소의 운영현황)

  • Chin, Young Ran;Jeon, Gyeong Suk;Lee, Hyo Young
    • 한국노년학
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    • v.31 no.4
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    • pp.985-998
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    • 2011
  • This study was conducted to understand current management status of 'day and night care' facilities and to explore the related factors with rates of operation of them. The nationwide mailing survey was conducted with structured questionnaires from July, 14, 2010 to July, 28, 2010. The subjects were 277 facilities (response rate 24.5%). Regarding the types of operating, 79.1% of faculties was run by cooperation, and 17.8% and 3.6% for individuals and national/public institutes respectively. The average of operation rate was 70.15%. National/public institutes showed higher in the rate of operation(79.08%) than 72.49% of cooperations and 57.78% of individuals. The number of manpower was not nearly different by the types of operating bodies, but the number of nurse was significantly different among them. The national/public institutions had 1.07 nurses while individual institutions have only 0.08. We found that facilities run by national/public institutes and founded before 2008 years showed higher rate of operation. In case of providing regular monitoring and evaluation services, and music program for patients showed higher rate of operation. In addition, the number of managers, social workers, and nurses increase the rate of operation. We suggest that quality management and monitoring program for the facilities which run by individuals or established after 2008 years would be developed. We also call for development of programs for facilitating utilization of 'day and night care' facilities such as expanding the family support.

Feasibility of TRPM8 Agonist Agent for Management of Skin Graft Donor Site (화상 재건을 위한 식피술 공여부의 반흔 관리에 있어 TRPM8 Agonist 제재의 유용성)

  • Choi, Jangyoun;Jung, Ee Room;Cho, Jin Tae;Seo, Bommie Florence;Choi, Jong Yun;Kwon, Ho;Jung, Sung-No
    • Journal of the Korean Burn Society
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    • v.22 no.2
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    • pp.30-33
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    • 2019
  • Purpose: Wound healing and scar management of donor site after skin graft should not be overlooked. Patients continue to complain of dryness, itching sensation. Such discomfort can cause irritation to the patients and lead to delayed healing or secondary infection. Thus, the author predicted Eucalyptus Oil, which acts on Transient Receptor Potential Melastatin 8 would be effective in regulating scar by reducing itching sensation in donor site when combining conventional silicone materials. Methods: The study was performed on 30 patients who underwent split thickness skin graft with lateral thigh as donor site between January 2017 and August 2018. First, primary evaluation of fully epithelized donor site scar three weeks after surgery was conducted. Control group (n=15) applied silicone gel (Kelo-cote, USA) solely two times a day. study group (n=15) applied Eucalyptus oil, combined with silicone gel. After 3 months of follow up, donor scar was evaluated using Vancouver scar scale and VAS scores of subjective patient reports regarding pain and itching sensation. Results: It was confirmed that both groups showed stable scar improvement comparing scar quality for 3 months. After 3 months, scar quality in study group showed superiority in pigmentation, pliability and pruritus compared to control group. Conclusion: Application of Eucalyptus Oil combined with conventional silicone gel is favorable to scar management and may give additional benefit of alleviating pruritis symptoms.

Pilot Evaluation for the Introduction of Ecosystem Accounting for Flood Control (홍수조절 생태계 계정 도입을 위한 전국 단위 시범 평가)

  • Tae-Ho Lee;Hee-Jin Moon;Gumsung Cheon;Jung-In Kim
    • Journal of Environmental Impact Assessment
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    • v.32 no.6
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    • pp.488-502
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    • 2023
  • Ecosystem service accounting must measure ecosystem supply functions, demand, and the actual service flows that occur between them. In order to measure flows, supply and demand relationships must be defined, and a methodology that can objectify complex connections is needed. Although various studies on ecosystem services have been conducted in Korea, but researches on accounting for ecosystem services are not enough. The purpose of this study is to evaluate flood control ecosystem services by applying the EU methodology studied in the Experimental Ecosystem Account (EEA) of System of Environmental Economy Account (SEEA) and explore ways to introduce ecosystem account. To conduct the study, the ecosystem's runoff retention potential, social and economic demand for flood control, and actual service benefit flows formed from the relationships between them were modeled and quantified on a spatial basis. As a result of calculating the actual flow of flood control ecosystem services, the total domestic service amount was calculated to be 165,595 (ha), and it was confirmed that much of it was concentrated in agricultural land. In order to account for domestic flood control services in the future, key spatial data such as land cover maps must be continuously established and managed, and researches on input data and methodologies applicable to various spatial scopes such as national, regional, and unit watersheds are expected to be necessary.

Comparison of Radiological Tumor Response Based on iRECIST and RECIST 1.1 in Metastatic Clear-Cell Renal Cell Carcinoma Patients Treated with Programmed Cell Death-1 Inhibitor Therapy

  • Bingjie Zheng;Ji Hoon Shin;Hailiang Li;Yanqiong Chen;Yuan Guo;Meiyun Wang
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.366-375
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    • 2021
  • Objective: To evaluate the radiological tumor response patterns and compare the response assessments based on immune-based therapeutics Response Evaluation Criteria in Solid Tumors (iRECIST) and RECIST 1.1 in metastatic clear-cell renal cell carcinoma (mccRCC) patients treated with programmed cell death-1 (PD-1) inhibitors. Materials and Methods: All mccRCC patients treated with PD-1 inhibitors at Henan Cancer Hospital, China, between January 2018 and April 2019, were retrospectively studied. A total of 30 mccRCC patients (20 males and 10 females; mean age, 55.6 years; age range, 37-79 years) were analyzed. The target lesions were quantified on consecutive CT scans during therapy using iRECIST and RECIST 1.1. The tumor growth rate was calculated before and after therapy initiation. The response patterns were analyzed, and the differences in tumor response assessments of the two criteria were compared. The intra- and inter-observer variabilities of iRECIST and RECIST 1.1 were also analyzed. Results: The objective response rate throughout therapy was 50% (95% confidence interval [CI]: 32.1-67.9) based on iRECIST and 30% (95% CI: 13.6-46.4) based on RECIST 1.1. The time-to-progression (TTP) based on iRECIST was longer than that based on RECIST 1.1 (median TTP: not reached vs. 170 days, p = 0.04). iRECIST and RECIST 1.1 were discordant in 8 cases, which were evaluated as immune-unconfirmed PD based on iRECIST and PD based on RECIST 1.1. Six patients (20%, 6/30) had pseudoprogression based on iRECIST, of which four demonstrated early pseudoprogression and two had delayed pseudoprogression. Significant differences in the tumor response assessments based on the two criteria were observed (p < 0.001). No patients demonstrated hyperprogression during the study period. Conclusion: Our study confirmed that the iRECIST criteria are more capable of capturing immune-related atypical responses during immunotherapy, whereas conventional RECIST 1.1 may underestimate the benefit of PD-1 inhibitors. Pseudoprogression is not rare in mccRCC patients during PD-1 inhibitor therapy, and it may last for more than the recommended maximum of 8 weeks, indicating a limitation of the current strategy for immune response monitoring.

PASTELS project - overall progress of the project on experimental and numerical activities on passive safety systems

  • Michael Montout;Christophe Herer;Joonas Telkka
    • Nuclear Engineering and Technology
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    • v.56 no.3
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    • pp.803-811
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    • 2024
  • Nuclear accidents such as Fukushima Daiichi have highlighted the potential of passive safety systems to replace or complement active safety systems as part of the overall prevention and/or mitigation strategies. In addition, passive systems are key features of Small Modular Reactors (SMRs), for which they are becoming almost unavoidable and are part of the basic design of many reactors available in today's nuclear market. Nevertheless, their potential to significantly increase the safety of nuclear power plants still needs to be strengthened, in particular the ability of computer codes to determine their performance and reliability in industrial applications and support the safety demonstration. The PASTELS project (September 2020-February 2024), funded by the European Commission "Euratom H2020" programme, is devoted to the study of passive systems relying on natural circulation. The project focuses on two types, namely the SAfety COndenser (SACO) for the evacuation of the core residual power and the Containment Wall Condenser (CWC) for the reduction of heat and pressure in the containment vessel in case of accident. A specific design for each of these systems is being investigated in the project. Firstly, a straight vertical pool type of SACO has been implemented on the Framatome's PKL loop at Erlangen. It represents a tube bundle type heat exchanger that transfers heat from the secondary circuit to the water pool in which it is immersed by condensing the vapour generated in the steam generator. Secondly, the project relies on the CWC installed on the PASI test loop at LUT University in Finland. This facility reproduces the thermal-hydraulic behaviour of a Passive Containment Cooling System (PCCS) mainly composed of a CWC, a heat exchanger in the containment vessel connected to a water tank at atmospheric pressure outside the vessel which represents the ultimate heat sink. Several activities are carried out within the framework of the project. Different tests are conducted on these integral test facilities to produce new and relevant experimental data allowing to better characterize the physical behaviours and the performances of these systems for various thermo-hydraulic conditions. These test programmes are simulated by different codes acting at different scales, mainly system and CFD codes. New "system/CFD" coupling approaches are also considered to evaluate their potential to benefit both from the accuracy of CFD in regions where local 3D effects are dominant and system codes whose computational speed, robustness and general level of physical validation are particularly appreciated in industrial studies. In parallel, the project includes the study of single and two-phase natural circulation loops through a bibliographical study and the simulations of the PERSEO and HERO-2 experimental facilities. After a synthetic presentation of the project and its objectives, this article provides the reader with findings related to the physical analysis of the test results obtained on the PKL and PASI installations as well an overall evaluation of the capability of the different numerical tools to simulate passive systems.

A Study on Improving the Estimation of Social Benefits Using the Economic Valuation of Ecosystem Services in Preliminary Feasibility Analyses for Ecological Restoration Projects - Focused on the Case of Janghang Wetland Restoration Project - (생태계서비스 가치평가를 활용한 예비타당성조사 편익분석 개선 방향 연구 - 장항습지복원사업 사례를 중심으로 -)

  • Oh, Chi-Ok;Joo, Woo-yeong;Park, Chang-seok
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.26 no.6
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    • pp.33-50
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    • 2023
  • This study is to propose the ecosystem service valuation method as a complementary or alternative tool to overcome the limitations of the contingent valuation method(CVM), typically used to assess social benefits in preliminary feasibility studies. With an increasing interest in natural and environmental restoration projects, we assessed social benefits with theses CVM and ecosystem service valuation method from a case of Janghang wetland restoration project and compared the extent of the two social benefits. For quantitative evaluation of ecosystem services, the biophysical quantity for each ecosystem service indicator was calculated and then converted into currency (KRW) units to estimate the economic value of ecosystem services. The four ecosystem regulating service indicators were selected including greenhouse gas capture/storage, air pollution, water quantity and quality regulation. The amounts of CO2 sequestration and storage as a ecosystem's greenhouse gas regulating service in the study area were 73.04 tCO2/yr and 5,867.53 tCO2/yr respectively. The reduction of SO2, one of air pollutant gases by ecosystems was calculated to be 180.27 kg/yr, the reduction of NO2 to be 378.90 kg/yr, and the reduction of fine dust (PM10) to be 9,713.92 kg/yr. The amount of freshwater regulating service by the ecosystem was estimated to be 459,394,319ℓ/yr, and the amount of nitrogen in freshwater removed by the ecosystem was 78.00kg/yr. Study results show that the benefits derived from the CVM were KRW 227.8 billion over the 30-year analysis period and those from the ecosystem service valuation method were KRW 41.4 billion for regulatory services and KRW 148.8 billion for cultural services, totaling KRW 189.5 billion. With KRW 184.8 billion of the total costs, the benefit/cost ratio using the CVM was 1.23 and that with the ecosystem service valuation method was 1.03. This study implications include that the CVM and ecosystem service valuation method can be applied together to assess and compare social benefits for natural and environmental restoration projects.

Environmental Evaluation for the Remanufacturing of Rental Product Using the LCA Methodology (LCA기법을 이용한 랜탈 재제조품의 환경성 평가)

  • Kwak, In-Ho;Hwang, Young-Woo;Park, Kwang-Ho;Park, Ji-Hyoung;Seol, So-Young;Shin, Hwa-Jeong;Yang, Eun-Hyeok;Min, Gon-Sik
    • Journal of Korean Society of Environmental Engineers
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    • v.38 no.11
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    • pp.611-617
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    • 2016
  • Remanufacturing that is the rebuilding of a product to specifications of the original manufactured product by collecting used-product, completely disassembling, cleaning and repairing or replacing with a new part and reassembling has been received attention in aspects of resource, recycling because it is a great environmental improvement. Remanufacturing is the rebuilding of a product to specifications of the original manufactured product by collecting used-product, completely disassembling, cleaning and repairing or replacing with a new part and reassembling. With a great environmental improvement and resource recycling and conservation, many studies were conducted. Up to date, remanufacturing activities are mainly applied to automobile parts and printer toner cartridge in South Korea. However, remanufacturing of rental product is not well conducted although rental products are collected in good condition and could be remanufactured in the same condition as a new product. Therefore, in this study, we conducted life cycle assessment (LCA) to an air cleaner product that is one of rental products. This study attempts to identify the processes in new products and remanufacturing life cycles that contribute the most environmental impacts. The results show that air cleaner remanufacturing could reduce about 20% of environmental impacts compared to new product. The greatest benefit related to environmental impact is with regard to ozone layer depletion potential (ODP), which is reduced by 94%. In the life cycle of air cleaner, raw material extraction stage had the most environmental impacts, especially with regard to abiotic depletion potential (ADP) and global warming potential (GWP). In the environmental impacts in each part, the ABS power had the highest environmental impacts.

A Study on the Implementation Status of CBD Program of Work on Protected Area (생물다양성협약의 보호지역 실행프로그램 이행상황 고찰 - 국립공원을 중심으로 -)

  • Heo, Hag-Young;Park, Mun-Gyu
    • Journal of Environmental Policy
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    • v.6 no.1
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    • pp.1-40
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    • 2007
  • The research in this paper, for the effective implementation of CBD PoW PA(Program of Work on Protected Areas of Convention on Biological Diversity) that was adopted by CBD COP7(Conference of the Parties) in 2004, shows the objectives and activities of 9 each subject in PoW PA regarding domestic status and cases of national park management. Before anything else, according to the result of the review on the status of protected areas in Korea, there are 1,119 protected areas which are classified into 14 types and the total area is about $15,621km^2$. After a thorough review on 9 each subject about the implementation of CBD PoW PA, we found out that some parts such as management planning, prevention and alleviation of threats, and establishment of PAs system, are improved while financial support, improved social benefit, and MEE(Management Effectiveness Evaluation} fields are need to be improved. Especially regarding time-bound, ecological gap analysis on national level and MEE are need to be improved immediately. This paper could help us to understand the current status of PAs management system in Korea and to prepare national reports of CBD and implementation report of PoW PA. Based on research and results of this paper, we need to find the fields that have gaps in order to meet the requirements of the CBD PoW PA and the implementation tools that are suitable for managing Korea's protected areas. To effectively implement the various activities which require a systematic approach on the national level, the establishment of the networks among relevant organizations for protected areas are vital. To effectively reach the ultimate goal of CBD PoW PA, reducing the rate of biodiversity loss, it is essential that lots of plans established by authorities must be carried out in a constant manner to achieve goals of CBD PoW PA.

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Nuclear Imaging Evaluation of Galactosylation of Chitosan (핵의학 영상을 이용한 chitosan의 galactosylation 효과에 대한 평가)

  • Jeong, Hwan-Jeong;Kim, Eun-Mi;Park, In-Kyu;Cho, Chong-Su;Kim, Chang-Guhn;Bom, Hee-Seung
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.253-258
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    • 2004
  • Purpose: Chitosan has been studied as a non-viral gene delivery vector, drug delivery carrier, metal chelator, food additive, and radiopharmaceutical, among other things. Recently, galactose-graft chitosan was studied as a non-viral gene and drug delivery vector to target hepatocytes. The aim of this study was to investigate the usefulness of nuclear imaging for in vivo evaluation of targeting the hepatocyte by galactose grafting. Methods and Materials: Galactosyl methylated chitosan (GMC) was produced by methylation to lactobionic acid coupled chitosan. Cytotoxicity of $^{99m}Tc$-GMC was determined by MTT assay. Rabbits were injected via their auricular vein with $^{99m}Tc$-GMC and $^{99m}Tc$-methylated chitosan (MC), the latter of which does not contain a galactose group, and images were acquired with a gamma camera equipped with a parallel hole collimator. The composition of the galactose group in galactosylated chitosan (GC), as well as the tri-, di-, or mono-methylation of GMC, was confirmed by NMR spectroscopy. Results: The results of MTT assay indicated that $^{99m}Tc$-GMC was non-toxic. $^{99m}Tc$-GMC specifically accumulated in the liver within 10 minutes of injection and maintained high hepatic uptake. In contrast, $^{99m}Tc$-MC showed faint liver uptake. $^{99m}Tc$-GMC scintigraphy of rabbits showed that the galactose ligand principally targeted the liver while the chitosan functionalities led to excretion through the urinary system. Conclusion: Bioconjugation with a specific ligand endows some degree of targetability to an administered molecule or drug, as in the case of galactose for hepatocyte in vivo, and evaluating said targetabililty is a clear example of the great benefit proffered by nuclear imaging.

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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