• Title/Summary/Keyword: Comprehensive assessment

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Analysis of the Issues received by Quality Improvement Department and their Management in a Medical Center (일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Chun, Ja-Hae;Kang, Eun-Sook;Moon, Ju-Young;Choi, Mi-Young;Kim, Hyun-Ju;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.118-131
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    • 2000
  • Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

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An Evaluation on the Operating of Fisheries Extension Services (어촌지도사업의 평가)

  • 최정윤
    • The Journal of Fisheries Business Administration
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    • v.17 no.2
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    • pp.65-106
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    • 1986
  • 1, The Purpose of Study This is a study on the Evaluation of the operating of Fisheries Extension Services of Korea, for performing the activities such as guiding fisheries technique as well as offering industrial information to the fishermen in fishing village. By doing so, the Fisheries Extension Sevices(FES) can materialize the continued growth of fisheries, the social and economic development of fishing village, and the increase in income by enhancing the knowledge level of Fishermen, etc. In performing fisheries policy, this activity plays a great role on the research and development activity, and it has become practical since 1976 in Korea. In order to meet immediately with the problem of fisheries technical innovation and rapid environmental changes surrounding the fisheries, the fishermen should not only enhance their scientific and comprehensive capacity in fisheries technique but abtain various effective information. Generally, as most of all the fishemen are poor in the managerial structure and scattered in fishing villages, they have little opportunity in the contact of information. As a result, it is nessessary for the FES to perform the fishing business by the extension service officials who has received special training and acquired fisheries know-how in these fields. And yet, FES is under the unfullfilled circumstance in such factors as manpower, technical know-how, equipment, and the service system etc., which is required in promoting the social, economic development of fishing village and in resolving the high technique demand of fisherman. This study on the fisheries extension services have been studied from those backgrounds. 2. Research Method The data of collecting methods which were necessary in carrying out this study was adopted by the questionaire research on the present extension service activity, through the subject of the extension services (driving agency of the work and the officials), the object(fishemen) and the 3rd observers to the extension services (the authorities concerned). The research sample was taken by the sampling extraction of total 1, 774 men from the above 3 groups. And the research was carried out from August, 1986 to October, 1986, supported from the Fisheries Extension Office (FEO) located in field during the research process. In this study, the levels of the extension operating were determined and estimated in accordance with the extension service method, morale of extension service officials and the extension service system, etc. through the collected data of the research questionaire paper. And based on this result, the essential conditions of the extension services were grasped, and also we tried to present the various activity plan necessary to promote the operating of the extension services. The questionaire research data was calculated by the computer center of National Fisheries University of Pusan, and the total result was again tried on the one demension analysis along with two dimension analysis to search out the relativity between the questionaire, and the statistical test was done $\chi$$^2$test in significance level of l~5%. 3. Contents of Study This study consists of 7 chapters and the contents are as follows : Chapter I : The object and method of the study Chapter II : The assessment and analysis of the extension services Chapter III : The contents and method of the extension services Chapter IV : Analysis of the essential conditions for the extension services Chapter V : The evaluation of activities of extension services Chapter Ⅵ : Conclusion.4. Results and RecommendationTherefore, the results of this study estimated by logical process and analysis are as follows : 1) Most of Korean fishing villages and coastal fishermen have shown much concerns about fisheries technique and social changes, thus many of them were confronted with new problems on how to adapt and to meet changes. 2) Majority of fishermen estimated FEO as an organization of specific technologies with all the thing concerning the fisheries technique in general. Therefore the fishermen wanted to utilize the FEO as an adaptable method for the modern fisheries techniques as well as the environmental changes. 3) In contrast with the fast changes of the fisheries technique, the complexity and variety of technical system and the broadness of fishing village and fishermen, it was revealed that the necessary factors such as the facilities, manpower, budget, and the level of applying techniques of the FEO located in field were highly insufficient. Accordingly, the guiding efficiency was low and the extension services did not provide full solution to the various request from fishermen. 4) It is possible to classify the activation factor for the extension service into two large dimension ; personal dimension relevant to guidance officials and work dimension relevant to the organization. And it was found that the activation level of the work dimension was far lower than the personal dimension between them. So, the activation should be done first in the dimesion to promote the activation of the extension services. 5) The extension services officials are now demoralized in general, thus it is necessary to take reality into consideration : the expense of activity, the adequate endowment of activity scope and the reasonable operation of the position class, etc to enhance its morale. However, in order to do the FES activation, first of all, the systems should be established which is lain unsettled stage until now. And there must be change in the understanding of government i.e. the fisheries extension services are the essential policy subject to build up the base of fisheries growth and modernize the fisheries management. And it should be driven positively with the recognition of the "lasting project".g project".uot;.

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THE STUDY ON RELATIONSHIP BETWEEN PSYCHOPATHOLOGY AND NEUROLOGICAL FACTORS IN CHRONIC EPILEPTIC CHILDREN (경련 질환 환아의 정신병리와 신경학적 요인과의 관계에 대한 연구)

  • Kim, Bung-Nyun;Cho, Soo-Churl;Hwang, Yong-Seung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.92-109
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    • 1996
  • The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

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The status of 「Logic and Writing in Home Economics Education」 course and the students' perception about the course (「가정과 논리 및 논술」 교과목의 운영 실태 및 가정교육과 학생의 인식)

  • Choi, Min-Ji;Chae, Jung-Hyun;Jun, Mi-Kyung
    • Journal of Korean Home Economics Education Association
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    • v.27 no.1
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    • pp.51-65
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    • 2015
  • The purpose of the study was to describe the operating status of "Logic and Writing in Home Economics Education(HEE)" course and the students' perception about the course. For this study, the syllabuses of "Logic and Writing" course in HE education department were reviewed. The survey method was used in this descriptive study. Respondents in this study were 116 students taking the "Logic and Writing in Home Economics Education" course. Questionnaires from the students were collected through on-line and off-line mail. The results of the study were as the follows: First, goals of the "Logic and Writing in HE Education" course were as the follows in order: to enhance writing skill about various subjects related to Home Economics; to foster HE teachers' professionalism through persuasive power logically; to foster writing skill logically; to prepare HE teacher recruitment exam; and to foster teaching skills to enhance students' writing. The student evaluation methods in the course were mainly attendance, examination, tasks, discussion and presentation, and class participation. Second, degree of satisfaction of students taking the course was higher than average. The student respondents perceived that the course was helpful to improve their logical thinking and critical analytical skill, writing skill related to HE education and education, ability to express one's opinion clearly and exactly, understanding of the fundamental concept of logic and the structure and method of the essay, comprehensive understanding of HE education, and ability to solve the problems specifically. However, they responded that it was difficult to practice writing, to discuss and debate frequently, to follow uncertain assessment criteria, and to present frequently. They wanted the instructor to give the feedback more frequently.

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A Double-Blind Comparison of Paroxetine and Amitriptyline in the Treatment of Depression Accompanied by Alcoholism : Behavioral Side Effects during the First 2 Weeks of Treatment (주정중독에 동반된 우울증의 치료에서 Paroxetine과 Amitriptyline의 이중맹 비교 : 치료초기 2주 동안의 행동학적 부작용)

  • Yoon, Jin-Sang;Yoon, Bo-Hyun;Choi, Tae-Seok;Kim, Yong-Bum;Lee, Hyung-Yung
    • Korean Journal of Biological Psychiatry
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    • v.3 no.2
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    • pp.277-287
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    • 1996
  • Objective : It has been proposed that cognition and related aspects of mental functioning are decreased in depression as well as in alcoholism. The objective of the study was to compare behavioral side effects of paroxetine and amitriptyline in depressed patients accompanied by alcoholism. The focused comparisons were drug effects concerning psychomotor performance, cognitive function, sleep and daytime sleepiness during the first 2 weeks of treatment. Methods : After an alcohol detoxification period(3 weeks) and a washout period(1 week), a total of 20 male inpatients with alcohol use disorder (DSM-IV), who also had a major depressive episode(DSM-IV), were treated double-blind with paroxetine 20mg/day(n=10) or amitriptyline 25mg/day(n=10) for 2 weeks. All patients were required to have a scare of at least 18 respectively on bath the Hamilton Rating Scale far Depression(HAM-D) and Beck Depression Inventory(BDI) at pre-drug baseline. Patients randomized to paroxetine received active medication in the morning and placebo in the evening whereas those randomized to amitriptyline received active medication in the evening and placebo in the morning. All patients performed the various tasks in a test battery at baseline and at days 3, 7 and 14. The test battery included : critical flicker fusion threshold for sensory information processing capacity : choice reaction time for gross psychomotor performance : tracking accuracy and latency of response to peripheral stimulus as a measure of line sensorimotor co-ordination and divided attention : digit symbol substitution as a measure of sustained attention and concentration. To rate perceived sleep and daytime sleepiness, 10cm line Visual analogue scales were employed at baseline and at days 3, 7 and 14. The subjective rating scales were adapted far this study from Leeds sleep Evaluation Questionnaire and Epworth Sleepiness Scale. In addition a comprehensive side effect assessment, using the UKU side effect rating scale, was carried out at baseline and at days 7 and 14. The efficacy of treatment was evaluated using HAM-D, BDI and clinical global impression far severity and improvement at days 7 and 14. Results : The pattern of results indicated thai paroxetine improved performance an mast of the lest variables and also improved sleep with no effect on daytime sleepiness aver the study period. In contrast, amitriptyline produced disruption of performance on same tests and improved sleep with increased daytime sleepiness in particular at day 3. On the UKU side effect rating scale, mare side effects were registered an amitriptyline. The therapeutic efficacy was observed in favor of paroxetine early in day 7. Conclusion : These results demonstrated thai paroxetine in much better than amitriptyline for the treatment of depressed patients accompained by alcoholism at least in terms of behavioral safety and tolerability, furthermore the results may assist in explaining the therapeutic outcome of paroxetine. For example, and earlier onset of antidepressant action of paroxetine may be caused by early improved cognitive function or by contributing to good compliance with treatment.

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Assessment of the Quality of Esophago-gastric Anastomosis by Endoscopic Examination -Cervical Versus Intrathoracic Anastomosis- (내시경을 통한 식도-위 문합술의 질 평가-경부와 흉부 문합의 비교-)

  • Shim, Jae-Hoon;Kim, Hyun-Koo;Baek, Man-Jong;Kim, Hark-Jei;Choi, Young-Ho
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.920-926
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    • 2006
  • Background: Mortality and morbidity of anastomotic complications after esophagectomy have gradually decreased in recent years. However, swallowing difficulties and reflux symptoms after esophagogastrostomy continue to be a burden jeopardizing the quality of life. In the present study, we evaluated the quality of esophagogastrostomy by analyzing anastomotic stenosis and reflux esophagitis. Material and Method: A retrospective analysis was made in 74 patients who underwent esophagogastrostomy after esophagectomy by one surgeon between January 1995 and December 2004. 53 patients of them received endoscopic examination during follow-up($29{\pm}23.6$ months, range $5{\sim}111$ months). Reflux esophagitis and stenosis at anastomostic site were analyzed according to the techniques and locations of esophagogastrostomy. Result: The median age at the time of repair was $60.3{\pm}8.87$ years(range $39{\sim}81$ years). 23 patients received a hand-sewn esophagogastric anastomosis and 30 patients a circular stapled one. There was no significant statistical difference in terms of anastomotic stenosis(p=0.64) and reflux esophagitis(p=0.41) between the two groups. Cervical anastomosis was peformed in 26 patients and intrathoracic anastomosis in 27 patients. No significant statistical difference in anastomotic stenosis between the two groups was found(p=0.44), but reflux esophagitis was noted in 3 patients in the cervical anastomosis group and 14 patients in the intrathoracic anastomosis group(p=0.003). Conclusion: Cervical anastomosis was supposed to have a better quality of esophagogastrostomy by lowering the risk of reflux esophagitis. In the future, the comprehensive study including a patient's subjective symptom and Barrett's metaplasia should be performed in larger cases.

Ttrosine Hydroxylase in Japanese Medaka (Oryzias latipes): cDNA Cloning and Molecular Monitoring of TH Gene Expression As a Biomarker (송사리 Tyrosine Hydroxylase: cDNA 클로닝 및 생물지표로서의 TH 유전자 발현의 분자생물학적 추적)

  • Shin, Sung-Woo;Kim, Jung-Sang;Chon, Tae-Soo;Lee, Sung-Kyu;Koh, Sung-Cheol
    • Environmental Analysis Health and Toxicology
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    • v.15 no.4
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    • pp.131-137
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    • 2000
  • The release of hazardous waste materials into the environment poses serious risks in humans and ecosystems. The risk assessment of environmental pollutants including hazardous chemicals requires a comprehensive measurement of hazard and exposure of the chemicals that can be achieved by toxicity evaluation using a biological system such as biomarkers. In this report we have tried to develop a biomarker used to elucidate a molecular basis of, and to monitor abnormal behaviors caused by diazinon in Japanese medaka (Oryzias latipes) as a model organism. First, an attempt was made to clone tyrosine hydroxylase gene from Japanese medaka that would be a candidate for a biomarker for neuronal modulations and behaviors. For monitoring experiments at behavioral and molecular biological levels, the fish were treated under different sublethal conditions of diazinon and their behavioral responses were observed . In this study we have successfully cloned a partial TH gene from the medaka fish through PCR screening of an ovary cDNA library. DNA sequencing analysis revealed that the amplified fragment was 327 bp encoding 109 amino acids. Comparing the DNA sequence of medaka TH with other species, TH gene revealed the DNA sequence was completely identical to that of rat TH. In the RT-PCR, 330 Up of mRNA was consistently amplified in all the treated samples including control There were no significant differences in the TH expression level regardless of treating concentrations (1∼5,000 ppb) and time (0∼48 hr) The reason appeared to be that RT-PCR was not performed using through a quantitative analysis normalized against an actin gene expression. Organ or tissue - specific detection of TH activity and mRNA as biomarkers will be a useful monitoring tool for neurobehavioral changes in fish influenced by toxic chemicals. Furthermore, quantitative analysis of locomotive patterns and its correlation with the neurochemical and molecular data would be highly useful in measuring toxicity and hazard ofvarious environmental pollutants.

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Factors Influencing on the Cognitive Function in Type 2 Diabetics (2형 당뇨병 환자의 인지 기능에 영향 미치는 인자)

  • Goh, Dong Hwan;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.59-67
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    • 2018
  • Objectives : The aims of this study were to know the frequency and the nature of cognitive dysfunction in type 2 diabetics, and to reveal influencing variables on it. Methods : From eighty type 2 diabetics (42 males and 38 females), demographic and clinical data were obtained by structured interviews. Cognitive functions were measured using the MMSE-K (Korean Version of the Mini-Mental State Examination) and the Korean Version of the Montreal Cognitive Assessment (MoCA-K) tests. Severity of depression was evaluated by the Korean Version of the Hamilton Depression Rating Scale (K-HDRS). Results : 1) Among eighty type 2 diabetics, 13.75% were below 24 on the MMSE-K, while 38.8% were below 22 on the MoCA-K. 2) The total scores and subtest scores of the MoCA-K including visuospatial/ executive, attention, language, delayed recall and orientation were significantly lower in type 2 diabetics with cognitive dysfunction (N=31) than those without cognitive dysfunction (N=49) (p<0.001, respectively). 3) There were significant difference between type 2 diabetics with and those without cognitive dysfunction in age, education, economic status, body mass index, duration of diabetes, total scores of the K-HDRS, the MMSE-K and the MoCA-K (p<0.05, respectively). 4) The total scores of the MoCA-K had significant correlation with age, education, body mass index, family history of diabetes, duration of diabetes, total scores of the K-HDRS (p<0.05, respectively). 5) The risks of cognitive dysfunction in type 2 diabetics were significantly influenced by sex, education, fasting plasma glucose and depression. Conclusions : The cognitive dysfunction in type 2 diabetics seemed to be related to multiple factors. Therefore, more comprehensive biopsychosocial approaches needed for diagnosis and management of type 2 diabetes.

Valuation of the Water Pollution Reduction: An Application of the Imaginary Emission Market Concept (수질오염물질 감소의 편익 추정 -수질총량제하 가상배출권시장 개념의 적용-)

  • Han, Tak-Whan;Lee, Hyo Chang
    • Environmental and Resource Economics Review
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    • v.23 no.4
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    • pp.719-746
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    • 2014
  • This study attempts to estimate the value of the water quality improvement by deriving the equilibrium price of the water pollutant emission permit for the imaginary water pollutant emission trading market. It is reasonable to say that there is already an implicit social agreement for the unit value of water pollutant, when the government set the Total Water Pollutant Loading System for the major river basin as a part of the Comprehensive Measures for Water Management, particularly for the Nakdong River Basin. Therefore, we can derive the unit value of water pollutant emission, which is already implied in the pollution allowance for each city or county by the Total Water Pollutant Loading System. Once estimated, it will be useful to the economic assessment of the water quality related projects. An imaginary water pollutant emission trading system for the Nakdong River Basin, where Total Water Pollutant Loading System is already effective, is constructed for the estimation of the equilibrium price of water pollutant permit. By estimating marginal abatement cost curve or each city or county, we can compute the equilibrium price of the permit and then it is regarded as the economic value of the water pollutant. The marginal net benefit function results from the relationship between the emission and the benefit, and then the equilibrium price of permit comes from constructing the excess demand function of the permit by using the total allowable permit of the local government entity. The equilibrium price of the permit would be estimated to be $1,409.3won/kg{\cdot}BOD$. This is within reasonable boundary compared for the permit price compared to foreign example. This permit price would be applied to calculate for the economic value of the water quality pollutants, and also be expected to use directly for the B/C analysis of the business involved with water quality change.

A Study of Efficient Measures for Installing and Managing Traditional Market Arcades (전통시장 아케이드의 설치 및 관리 효율화 방안 연구)

  • Kim, Young-Ki;Kang, Heon-Soo;Kim, Seung-Hee
    • Journal of Distribution Science
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    • v.10 no.3
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    • pp.15-30
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    • 2012
  • It has been 10 years since the facility modernization projects of traditional markets was rigorously undertaken. Although more than 835 traditional Korean markets nationwide have already completed these projects, there does not exist a specific set of standards of installation, future maintenance, and management. As a result, the complaints made by civil stakeholders in accordance of the actual facility installation caused problems and delays of related projects. In addition, while some local governments secured and implemented their own differing standards, others have not yet established their own separate standards for maintenance and management. Specifically, 694 traditional markets nationwide were supported for the cost of installing arcades by 2010. For the short period of time after the arcade-supported projects were deployed, the number of the traditional markets had been rapidly growing as a prime example of the facility modernization projects. The arcade facilities are being planned and installed merely for screening the rain or the sun. Without fundamental data for the newly landscaped environments or information on the actual conditions of usage and assessment, there is a lack of comprehensive approaches that could possibly organize the public environments. Furthermore, the amount of support needed for repairs, maintenance, and management from the central and local governments is gradually increasing. Thus, it becomes both crucial and necessary to complement the current set of standards. The purpose of this study is to examine the actual conditions of usage, maintenance, and management among those traditional market facilities that were installed with the supports of the facility-modernization projects, especially for arcades. This will be carried out through investigating the local problems, issues, and considering international case studies. The results of this study will provide measures for effective and efficient installation and management of traditional market arcades. Improvements in the use of public resources could be directed towards transforming public business, as well as public enhancement and functional maintenance and reinforcement. Under this condition, the arcade is not a simple area to avoid rain or sunlight; it becomes a public space. It is highlighted that the arcade should establish its public business not only to activate markets but also to refine street environments and revitalize local communities. A more specific way to improve is introduced through systematic supplementation. This is needed to attract effective participation from local residents and is done so by conducting a fair procedure from the first stage of business and by providing guidelines for establishing arcades as public facilities. The study points out to the problem of merchants-centered plans and street use. It presents the need to expand to involve residents and customers. Given that the arcade is a public facility and merchants' ability to maintain it is limited, manuals and systems for its maintenance needs to be introduced through multi-party agreement of merchants, government, residents and customers.

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