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Enhancement of the Working Capacity and Selectivity Factor of Calcium-Exchanged Y Zeolites for Carbon Dioxide Pressure Swing Adsorption (이산화탄소 압력순환흡착을 위한 칼슘 이온교환 Y 제올라이트의 작업용량과 선택계수 향상)

  • Kim, Moon Hyeon
    • Clean Technology
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    • v.24 no.1
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    • pp.41-49
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    • 2018
  • Y zeolites with different extra-framework cations, such as $Na^+$, $N^+$, $Ca^{2+}$, and $Cu^{2+}$, with different charge and ionic radius have been investigated to greatly enhance a working capacity (W) of $CO_2$ adsorption at $25^{\circ}C$ and a $CO_2/CO$ selectivity factor (S). A sample of NaY with a very small amount of 0.012% $Ca^{2+}$ was fully reversible for seven times repeated $CO_2$ adsorption/desorption cycles, thereby forming no surface carbonates unlikely earlier reports. Although at pressures above 4 bar, 2.00% CaY, 1.60% CuY and 1.87% LiY all showed a $CO_2$ adsorption very similar to that measured for NaY, they gave a significant decrease in the adsorption at lower pressures, depending on the metal ion. At 0.5 ~ 2.5 bar, the extent of $CO_2$ adsorption was in the order NaY > 1.60% CuY > 2.00% CaY > 1.87% LiY. All the $Na^+-based$ metals-exchanged zeolites have a FAU (faujasite) framework and a Si/Al value near 2.6; thus, there is no discernible difference in the framework topology, framework chemical compositions, effective aperture size, and channel structure between the zeolite samples. Therefore, the distinctive behavior in the adsorption of $CO_2$ with a character as a weak Lewis acid is associated with the site basicity of the zeolites, and the interaction potentials of the cations. Different trend was shown for a CO adsorption due to weaker quadrupole interactions. Adsorption of $CO_2$ and CO on samples of CaY with 0.012 to 5.23% Ca disclosed a significant dependence on the Ca loading. The $CO_2$ adsorption increased when the cation exists up to ca. 0.05%, while it decreased at higher Ca amounts. However, values for both W and S could greatly increase as the bare zeolite is enriched by $Ca^{2+}$ ions. The 5.23% CaY had $W=2.37mmol\;g^{-1}$ and S = 4.37, and the former value was comparable to a benchmark reported in the literature.

A Study on Design of Agent based Nursing Records System in Attending System (에이전트기반 개방병원 간호기록시스템 설계에 관한 연구)

  • Kim, Kyoung-Hwan
    • Journal of Intelligence and Information Systems
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    • v.16 no.2
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    • pp.73-94
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    • 2010
  • The attending system is a medical system that allows doctors in clinics to use the extra equipment in hospitals-beds, laboratory, operating room, etc-for their patient's care under a contract between the doctors and hospitals. Therefore, the system is very beneficial in terms of the efficiency of the usage of medical resources. However, it is necessary to develop a strong support system to strengthen its weaknesses and supplement its merits. If doctors use hospital beds under the attending system of hospitals, they would be able to check a patient's condition often and provide them with nursing care services. However, the current attending system lacks delivery and assistance support. Thus, for the successful performance of the attending system, a networking system should be developed to facilitate communication between the doctors and nurses. In particular, the nursing records in the attending system could help doctors monitor the patient's condition and provision of nursing care services. A nursing record is the formal documentation associated with nursing care. It is merely a data repository that helps nurses to track their activities; nursing records thus represent a resource of primary information that can be reused. In order to maximize their usefulness, nursing records have been introduced as part of computerized patient records. However, nursing records are internal data that are not disclosed by hospitals. Moreover, the lack of standardization of the record list makes it difficult to share nursing records. Under the attending system, nurses would want to minimize the amount of effort they have to put in for the maintenance of additional records. Hence, they would try to maintain the current level of nursing records in the form of record lists and record attributes, while doctors would require more detailed and real-time information about their patients in order to monitor their condition. Therefore, this study developed a system for assisting in the maintenance and sharing of the nursing records under the attending system. In contrast to previous research on the functionality of computer-based nursing records, we have emphasized the practical usefulness of nursing records from the viewpoint of the actual implementation of the attending system. We suggested that nurses could design a nursing record dictionary for their convenience, and that doctors and nurses could confirm the definitions that they looked up in the dictionary through negotiations with intelligent agents. Such an agent-based system could facilitate networking among medical institutes. Multi-agent systems are a widely accepted paradigm for the distribution and sharing of computation workloads in the scientific community. Agent-based systems have been developed with differences in functional cooperation, coordination, and negotiation. To increase such communication, a framework for a multi-agent based system is proposed in this study. The agent-based approach is useful for developing a system that promotes trade-offs between transactions involving multiple attributes. A brief summary of our contributions follows. First, we propose an efficient and accurate utility representation and acquisition mechanism based on a preference scale while minimizing user interactions with the agent. Trade-offs between various transaction attributes can also be easily computed. Second, by providing a multi-attribute negotiation framework based on the attribute utility evaluation mechanism, we allow both the doctors in charge and nurses to negotiate over various transaction attributes in the nursing record lists that are defined by the latter. Third, we have designed the architecture of the nursing record management server and a system of agents that provides support to the doctors and nurses with regard to the framework and mechanisms proposed above. A formal protocol has also been developed to create and control the communication required for negotiations. We verified the realization of the system by developing a web-based prototype. The system was implemented using ASP and IIS5.1.

Ground Security Activities for Prevention of Aviation Terrorism -Centered on San Francisco International Airport of the U.S.A.- (항공테러방지를 위한 지상 보안활동 -미국 샌프란시스코국제공항을 중심으로-)

  • Kang, Maeng-Jin;Kang, Jae-Won
    • The Journal of the Korea Contents Association
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    • v.8 no.2
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    • pp.195-204
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    • 2008
  • With the growth of airline management, as well as computer and IT security, the international trade in this modern society has been rapidly increasing, Along with the advancing, airplanes have become a universal means of communication. However, the complications associated with airplane safety have also been brought up as a result, the most concerning of which is terrorism. One of the main counterplans for preventing terrorism is Ground security activities the core of Ground security activities is absolute safety for passengers in both passenger terminal and freight terminal. Subastral security refers to physical protection, proximity control and 100% security search and freight guarding of the passengers' possessions, and the personnel's duties to perform such jobs are be! coming more crucial. On the other hand, Airport security check has bee n gradually developing since the 1960's, when hijacking began to take place. Although the airports have been providing more safe and comfortable services to their customers, terrorism is still happening today. When Ground security activities is minute, the users feel displeasure and discomfort, yet considering solely their convenience can brings problems in achieving safety. Since the 9.11 terror in 2001, the idea of improving and strengthening airport security was reinforced and a considerable amount of estate is being spent today for invention and application of new technology. Various nations, including the United States, have been improving their systems of security through public services; public police department is actively carrying out their duties in airports as well. In San Francisco International Airport, private police department is in charge of collection of data, national events, VIP protection, law enforcement, cooperation within facilities, daily-based patrol and traffic control. Under guidance and supervision of national organizations, such as TSA, general police department interprets X-Rays, operates metal detectors, checks passports or IDs and observes reactions to explosives. Under these circumstances, studies about advancement of cooperation and duties of general police department and private police department necessitated: especially about private police department and their training for searching equipments, decrease in number of turn over rate, invention of technology and prior settlement in estate for security. The privacy of the public, who make up the major population of airport passengers, must also be minimized. In the following research, the activities of police departments in San Francisco International Airport will be analyzed in order to understand recent actions of the United States on airport security.

Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement (Westgard Multi-Rules의 효율적 적용과 조치사항의 개선)

  • Jung, Heung Soo;Oh, Youn Jung;Bae, Jin Soo;Baek, Jin Young;Hwang, Bo ra;Shin, Yong Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.60-64
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    • 2017
  • Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

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A Study on Improvement of Vital Registration and Statistics System in Korea (인구동태신고 및 통계조사의 개선방안)

  • 신윤재
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.58-75
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    • 1988
  • 1.Objectives of the Study It is a well known fact that a prompt and reliable data on demographic information is essential in a proper planning and evaluation of any program of national or community level. Especially vital statistics are an important demographic component among demographic information. Realizing the importance of vital statistics, the government has made some efforts for years to improve the vital registration system which has a close relationship with the production of vital statistics. However, it is still observed that there are some limitations in utilizing vital registration data due to considerable amount of vital events which are never registered and registered but not in time or inaccurately, even though vital registration system in Korea has sound legal basis. In this connection, the objectives of the study is as follows :(1) To examine some problems of the vital registration system in various aspects, (2) To make improvement programme of continuous Demographic Survey as a supplementary source of vital statistics, and (3) To find out some alternatives for making it possible to produce and utilize the reliable vital statistics by developing analytical methodologies on that. 2. Current Situation of Vital Registration System All the vital events, i.e. births, deaths, marriages and divorces, are to be registered in time under the Civil Registration Law, Statistics Law and Regulation on Vital Statstics as a duty of people. Some recent tendencies in each of recent registration are summarized as below: (1) The completeness of vital registration .Out of all births which are occurred during a year, around 75% of those compared to the estimates are registered in the year of occurrence. .In case of death registration, the percentage of registration in the year of occurrene has been gradually increased from 86.2% in the year of 1980, but it is still below the level of 90% compared to the estimates. .The percentage of registration for marriages and divorces in the year of occurrence out of total registered numbers was revealed to be 69% and 73% respectively in 1985. (2) Continuous Demographic Survey .It is a kind of sample survey for the purpose of producing reliable vital statistics which could not be provided by the vital registration. .It covers about 17, 000 sample households at national level and important information for vital events are collected in every month by 323 expertized enumerators who are regular staff of the government. .Although the result of the survey seems to be more reliable than of vital registration, the reliability of the data is still bellow the acceptable level if compared with relevant information from other sources such as population census or special surveys. 3. Problems of Vital Registration System There are four major obstacles in improving vital registration system in Korea; (1) In general, policy priority is not given on any programme of improving vital registration system. It is, therefore, very difficult to formulate comprehensive programme through having cooperation from related authorities and sufficient financial assistance. (2) In all the laws related and system itself, there is substantial degree of overlap and irrationality. Registration of each vital event is maintained according to several laws and regulation such as Civil Registration Law, Statistics Law, Resident Registration Law and Regulation on Vital Statistics. However they are mutually overlapped and overall supervision can not be done systematically due to lack of co-operation among the authorities concerned. (3) The administration of vital registration system seems to be working inefficiently, because of most of civil servants who are in charge of vital registration are lacking of conception on vital statistics and also there is a certain extent of regidity in handling the works. Therefore, they are doing their jobs in a passive way. (4) A substantial proportion of vital events occurred is not registered within the legal time limit (i.e. within one month after the occurrence in case of birth and death) or not registered forever. Some of social customs and superstitution seem to be the potential causes especially in case of births and deaths. 4. Recommendations for the Improvement of Vital Statistics (1) Reporting systems such as civil registration, vital statistics and resident registration should be integrated under the single law. Also, administrative supervision, personnel and budget with regard to the registration system should be under the control of a single ministry. (2) It is necessary to simplify the procedures and methods of reporting vital events, i.e., reducing number of sheets of the form, making corrections easily, reducing registration items, etc. (3) Continuous Demographic Survey as a supplementary source of vital registration should be improved and special ad-hoc surveys should be conducted wth regular interval. (4) In-depth analysis should be done using various sources of data on vital statistics. 5. Concluding Remarks From this study, we can notice that temporary campaign and motivation programs are not sufficient to improve the quality of vital statistics. Strong intentions and continuous efforts of the government are needed for the improvement of the vital registration system. Furthermore, most of the data collected through the registration are not properly analyzed and utilized, partly due to the lack of appreciation among high-level governmental officials of the need for vital statistics. It is, therefore, requested that long-term improvement programs of vital statistics be implemented with policy priority and continuous efforts be given to this purpose as a long-term goal of development in Korea.

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Air-staging Effect for NOx Reduction in Circulating Fluidized Bed Combustion of Domestic Unused Biomass (국내 미이용 바이오매스 순환유동층 연소에서 NOx 저감을 위한 air-staging 효과)

  • Yoon, Sang-Hee;Beak, Geon-Uk;Moon, Ji-Hong;Jo, Sung-Ho;Park, Sung-Jin;Kim, Jae-Young;Seo, Myung-Won;Yoon, Sang-Jun;Yoon, Sung-Min;Lee, Jae-Goo;Kim, Joo-Sik;Mun, Tae-Young
    • Korean Chemical Engineering Research
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    • v.59 no.1
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    • pp.127-137
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    • 2021
  • Air emission charge for nitrogen oxide as a precursor of fine dust has been introduced and implemented within the country from 2020. Therefore, the development of economical combustion technology for NOx reduction has got more needed urgently. This study investigated the air-staging effect as a way to reduce the NOx during combustion of domestic unused forest biomass, recently possible to secure REC (Renewable Energy Certification) as a substitute for overseas wood pellets in a 0.1 MWth circulating fluidized bed combustion test-rig. Operating conditions were comparison with and without air-staging, the supply position of tertiary air (6.4 m, 8.1 m, 9.4 m in the combustor) and variation of air-staging ratio (Primary air:Secondary air:Tertiary air=91%:9%:0%, 82%:9%:9%, 73%:9%:18%). NO and CO concentrations in flue gas, profiles of temperature and pressure at the height of the combustion, unburned carbon in sampled fly ash and combustion efficiency on operating conditions were evaluated. As notable results, NO concentration with air-staging application under tertiary air supply at 9.4 m in the combustor reduced 100.7 ppm compared to 148.8 ppm without air-staging while, CO concentration increased from 52.2 ppm without air-staging to 99.8 ppm with air-staging. However, among air-staging runs, when tertiary air supply amount at 6.4 m in the combustor increased by air-staging ratio (Primary air:Secondary air:Tertiary air=73%:9%:18%), NO and CO concentrations decreased the lowest 90.8 ppm and 66.1 ppm, respectively. Furthermore, combustion efficiency at this condition was improved to 99.3%, higher than that (98.3%) of run without air-staging.

The Restoration and Conservation of Indigo Paper in the Late Goryeo Dynasty: Focusing on Transcription of Saddharmapundarika Sutra(The Lotus Sutra) in Silver on Indigo Paper, Volume 7 (고려말 사경의 감지(紺紙) 재현과 수리 - 이화여자대학교 소장 감지은니묘법연화경을 중심으로 -)

  • Lee, Sanghyun
    • Korean Journal of Heritage: History & Science
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    • v.54 no.1
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    • pp.52-69
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    • 2021
  • The transcriptions of Buddhist sutra in the Goryeo Dynasty are more elaborate and splendid than those of any other period and occupy a very important position in Korean bibliography. Among them, the transcriptions made on indigo paper show decorative features that represent the dignity and quality that nobles would have preferred. Particularly, during the Goryeo Dynasty, a large number of transcriptions were made on indigo paper, often in hand-scrolled and folded forms. If flexibility was not guaranteed, the hand-scrolled form caused inconvenience and damage when handling the transcription because of the structural limitations of the material that is rolled up and opened. It was possible to overcome these shortcomings by changing from the hand-scrolled to the folded form to obtain convenience and structural stability. The folded form of the transcription utilizes the same principle as the folding screen, so it is a structure that can be folded and unfolded, and it is made by connecting parts at regularly spaced intervals. No matter how small the transcription is, if it is made of thin paper, it is difficult to handle it and to maintain its shape and structure. For this reason, the folded transcription was usually made of thick paper to support the structure, and the cover was made thicker than the inner part to protect the contents. In other words, the forded form was generally manufactured to suit the characteristics of maintaining strength by making the paper thick. Because a large amount of indigo paper was needed to make this type of transcription, it is assumed that there were craftsmen who were in charge only of dark dyeing the papers. Usually, paper dyeing requires much more dye than silk dyeing, and dyeing dozens of times would be required to obtain the deep indigo color of the base of the transcription of Buddhist sutra in the Goryeo Dynasty. Unfortunately, there is no record of the Goryeo Dynasty's indigo blue paper manufacturing technique, and the craftsmen who made indigo paper no longer remain, so no one knows the exact method of making indigo paper. Recently, Hanji artisans, natural dyers, and conservators attempted to restore the Goryeo Dynasty's indigo paper, but the texture and deep colors found in the relics could not be reproduced. This study introduces the process of restoring indigo paper in the Goryeo Dynasty through collaboration between dyeing artisans, Hanji artisans, and conservators for conservation of the transcription of Buddhist sutra in the late Goryeo dynasty, yielding a suggested method of making indigo paper.

Mineral Precipitation and the Behavioral Changes of Trace Elements in Munkyeong Coal Mine Drainage (문경 석탄광 배수의 광물 침전 및 미량 원소의 거동 변화)

  • Shin, Ji-Hwan;Park, Ji-Yeon;Kim, Ji-Woo;Ju, Ji-Yeon;Hwang, Su-Hyeon;Kim, Yeongkyoo;Park, Changyun;Baek, YoungDoo
    • Korean Journal of Mineralogy and Petrology
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    • v.35 no.3
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    • pp.355-365
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    • 2022
  • Precipitation and phase transition of iron minerals in mine drainage greatly affect the behavior of trace elements. However, the precipitation of ferrihydrite, one of the major iron minerals precipitated in drainage, and the related behavior of trace elements have hardly been studied. In this study, the effects of pH change and time on mineral precipitation characteristics in mine drainage from the Munkyeong coal mine were investigated, and the behavioral changes of trace elements related to the precipitation of these minerals were studied. In the case of precipitated mineral phases, goethite was observed at pH 4, and 2-line ferrihydrite mixed with small amount of 6-line ferrihydrite was mainly identified at pH 6 or higher. In addition, it was observed that the precipitation of calcite additionally increased as the pH increased in the samples at pH 6 or higher. The occurrence of goethite was probably due to the phase change of initially precipitated ferrihydrite within a short time under the influence of low pH. Our results showed that the concentration of trace elements was strongly influenced by pH and time. With increasing time, Fe concentration in the drainage showed a abrupt decrease due to the precipitation of iron minerals, and the concentration of As existing as oxyanions in the drainage, also decreased rapidly like Fe regardless of the pH values. This decrease in As concentration was mainly due to co-precipitation with ferrihydrite, and also partly to surface adsorption on goethite at low pH in drainage. Contrary to this observation, the concentration of other trace elements, such as Cd, Co, Zn, and Ni was greatly affected by the pH regardless of the mineral species. The lower the pH value, the higher the concentration of these trace elements were observed in the drainage, and vice versa at higher pH. These results indicate that the behavior of trace elements present as cations is more greatly affected by the mineral surface charge influenced by the pH values than the type of the precipitated mineral.

Social division of labor in the traditional industry district - foursed on Damyang bamboo ware industry of Damyang and Yeoju pottery industry of Yeoju, South Korea (우리나라 재래공업 산지의 사회적 분업 - 담양죽제품과 여주 도자기 산지를 사례로 -)

  • ;;;Park, Yang-Choon;Lee, Chul-Woo;Park, Soon-Ho
    • Journal of the Korean Geographical Society
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    • v.30 no.3
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    • pp.269-295
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    • 1995
  • This research is concerned with the social division of labor within the traditional industry district: Damyang bamboo ware industry district and Yeoju pottery industry district in South Korea, Damyang bamboo ware and Yeoju pottery are well known of the Korean traditional industry. The social division of labor in an industry district is considered as an important factor. The social division of labor helps the traditional industry to survive today. This summary shows five significant points from the major findings. First, Damyang bamoo ware industry and Yoeju pottery industry have experienced the growth stages until 1945, the stagnation in the 1960s, and the business recovery in the 1980s. Most Korean traditional industries had been radically declined under the Japanese colonization; while, Damyang bamboo ware industry and Yeoju pottery industry district have been developed during above all stages. The extended market to Japan helped the local government to establish a training center, and to provide financial aids and technical aids to crafts men. During the 1960s and 1970s, mass production of substitute goods on factory system resulted in the decrease of demand of bamboo ware and pettery. During the 1980s, these industries have slowly recovered as a result of the increased income per capita. The high rate of economic growth in the 1960s and 1970s was playing an important role in the emerging the incleased demand of the bamboo ware and pottery. Second the production-and-marketing system in a traditional industry district became diversified to adjust the demand of products. In Damyang bamboo ware industry district, the level of social division of labor was low until the high economic development period. Bamboo ware were made by a farmer in a small domestic system, The bamboo goods were mainly sold in the periodic market of bamboo ware in Damyang. In the recession period in the 1960s and 1970s, the production-and-marketing system were diversified; a manufacturing-wholesale type business and small-factory type business became established; and the wholesale business and the export traders in the district appeared. In the recovery period in the 1980s, the production-and-marketing systems were more diversified; a small-factory type business started to depend On subcontractors for a part of process of production; and a wholesale business in the district engaged in production of bamboo ware. In Yeoju pottery industry district, the social division of labor was limited until the early 1970s. A pottery was made by a crafts man in a small-business of domestic system and sold by a middle man out of Yeoju. Since the late 1970s, production-and-marketing system become being diversified as a result of the increased demand in Japan and South Korea. In the 1970s, Korean traditional craft pottery was highiy demanded in Japan. The demand encouraged people in Yoeju to become craftsmen and/or to work in the pottery related occupation. In South Korea, the rapid economic growth resulted in incline to pottery due to the development of stainless and plastic bowls and dishes. The production facilities were modernized to provide pottery at the reasonable price. A small-busineas of domestic system was transformed into a small-factory type business. The social division of labor was intensified in the pottery production-and-maketing system. The manufacturing kaoline began to be seperated from the production process of pottery. Within the district, a pottery wholesale business and a retail business started to be established in the 1980s. Third the traditional industry district was divided into "completed one" and "not-completed one" according to whether or not the district firms led the function of the social division of labor. The Damyang bamboo ware industry district is "completed one": the firm within the district is in charge of the supply of raw material, the production and the marketing. In the Damyang bamboo ware district, the social division of labor w and reorganized labor system to improve the external economics effect through intensifying the social division of labor. Lastly, the social division of labor was playing an important role in the development of traditional industry districts. The subdivision of production process and the diversification of business reduced the production cost and overcame the labor shortage through hiring low-waged workers such as family members, the old people and housewives. An enterpriser with small amount of capital easily joined into the business. The risk from business recession were dispersed. The accumulated know-how in the production and maketing provided flexiblility to produce various goods and to extend the life-cycly of a product.d the life-cycly of a product.

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

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

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