• Title/Summary/Keyword: Continuous improvement

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Task Status of Dental Hygienists of Health Centers and Subcenters (일개 도지역 보건기관 근무 치과위생사의 직무실태와 개선방안)

  • Eun, Jong-Young;Kam, Sin;Lim, Ji-Seun;Yang, Jin-Hoon;Kim, Jong-Yeon;Han, Chang-Hyun;Yoo, Yoon-Sun;Cha, Byung-Jun;Song, Keun-Bae
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.35-54
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    • 2002
  • This study was performed to investigate the task status and performance improvement plan of dental hygienists of Health Centers and Subcenters. The Data collected by self-administered Questionnaire survey of 203 dental hygienists of Health Centers and Subcenters located in Gyeongsangbuk-do were analyzed. The major results are as follows: For the degree of satisfaction in tasks, 73.9% of dental hygienists of Health Centers and Subcenters felt proud, 52.2% felt overwork, 32.0% hoped transferring to other worksite and the major reason of transferring was lack of promotion opportunity in officials of dental hygiene department. Dental hygienists received job education in addition continuous job education in last 3 years were 47.3%, 19.2% of dental hygienists performed the special dental health program for residents in last 3years. Almost half(53.7%) of dental hygienists replied that dental hygienists who were not engaged in dental health tasks should be engaged in dental health tasks. The major dental hygienic tasks performed by dental hygienic officials were support for dental treatment(41.6%). Dental hygienic officials answered that dental health tasks, school dental health program, vertical dental health program should be conducted as important tasks in order. And they replied that the most serious problem of dental hygienic tasks was not conducting dental health affairs due to 'lack of dental doctor'(40.9%), 'lack of concern for dental health tasks'(26.4%), and 'lack of budget and personnels for dental tasks'(19.0%), and the most important thing to improve dental hygienic tasks was 'posting dental hygienists in ministry of health and welfare(MOHW) and province', 'securing of budget and personnels for dental health tasks'.

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A Study on the Engineering Property and Durability of Recycled Concrete with Replacement Ratio of Recycled Fine Aggregate and Fly-ash (재생잔골재 및 플라이애시 대체율에 따른 재생콘크리트의 공학적 특성 및 내구성능에 관한 연구)

  • Kim, Moo-Han;Kim, Gyu-Yong;Kim, Jae-Whan;Cho, Bong-Suk;Kim, Young-Sun;Moon, Hyung-Jae
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.1 no.1
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    • pp.89-97
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    • 2005
  • Recently, for the problem solution of demand and supply imbalance of fine aggregate due to the shortage of natural fine aggregate resource and the environment regulation on sea sand extraction in the construction field, the studies for the application of recycled fine aggregate using waste concrete are being progressed versatilely. On the other hand, the treatment of fly-ashes that of industrial by-product originated in the steam power plant is discussed by the continuous increasing of origination quantities. In the ease of using fly-ash, advantages are the improvement of workability, viscosity and long-time strength, and the reduction of hydration heat under the early ages, as the admixtures for concrete, but the studies for the application of fly-ash as recycled concrete admixtures are inadequacy. There fore, in this study, through investigating the properties of fresh, hardened and durability according to the replacement of recycled fine aggregate and fly-ash, it is intended to propose the fundamental data for structural application of recycled concrete using recycled fine aggregate and fly-ash. As the result of this study, they arc shown that the engineering properties and durability, in the case of replacement ratio 100% of recycled fine aggregate, arc similar to those of concrete using natural fine aggregate, so it is considered that recycled fine aggregate could be used as the fine aggregate for concrete. Also, the performances of recycled concrete are improved by replacing fly-ash.

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Change of Dose Exposure and Improvement of Image Quality by Additional Filtration in Mammography (유방촬영용장치 부가필터에 따른 선량변화 및 화질개선)

  • Cho, Woo Il;Kim, Young Kuen;Lee, Gil Dong
    • Journal of Radiation Protection and Research
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    • v.38 no.2
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    • pp.78-90
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    • 2013
  • Recently, the interest on exposure to radiation is rising. The radiation exposure of mammography is higher in absorbed dose than of X-ray, therefore unnecessary exposure needs to be reduced, and higher image quality is needed. Generally, ray quality of the radiation imaging is an important factor that determines image quality and the amount of ray exposure, and they are affected by tube voltage and added filter. The X-ray energy that is exposed from mammography device is generally a continuous spectrum, which includes low energy that has minute influence on the image quality, and high energy that hinders contrast on image. Currently, molybdenum (Mo) and rhodium (Rh) are the most used added filters for mammography device, and they are used differently according to the energy region of X-ray. This study aims to find out the degree of reduction in exposure dose according to the thickness of aluminum (Al), and to study the changes in image quality and dose when the added filter plates that are made with niobium (Nb) or zirconium (Zr) are used, other than molybdenum (Mo) and rhodium (Rh), the two most used added filters that have similar atomic number and K-absorption regions as Nb and Zr. In this study, single-added filters of molybdenum (Mo), niobium (Nb), and zirconium (Zr) are used, and in some cases, Aluminum (Al) is combined with the single filters. In this case, image quality is considered to be improved depending on the type of added filters, and by using Aluminum (Al) filter together with the others, unnecessary X-ray of low energy would be absorbed, therefore the dose is expected to decrease without any influence when the concentration level becomes identical.

A Dynamic Study of Women's Labor Market Transitions: Career Interruptions and its Determinants (여성의 동태적 노동공급 - 취업연속성과 첫 노동시장 퇴출행태를 중심으로 -)

  • 김영옥
    • Korea journal of population studies
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    • v.25 no.2
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    • pp.5-40
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    • 2002
  • Using detailed data of women's work history, this study analyses the transition process between employment and non-employment over the life history in order to identity individual and structural determinants in the processes. Korean women comprise very heterogeneous groups in terms of work continuity: one group having a continuous work history and another having an interrupted work experience. While 4.0% of total women have stayed in the labor market since leaving school, 17.3% have not worked outside at all and remaining 87.9% have experienced into and out of the labor market at least once. On the average, the cumulated time of employment per woman is 8.2 years and the cumulated time of unemployment is 13.1 years. Thus Korean women work a total of only 38.5% of their whole lifetime after leaving school. We can conclude that the increase of the employment rate of married women in Korea since the 1970s has been due to the increase of the new entrants with short or little working careers into the labor market, not to the increase of women's work continuity on the whole. A women's educational achievement does not seem to be positively related to employment duration, contrary to the suggestion of the human capital theory, Rather, family variables, especially the existence of the child under 6 yens old, is a more significant determining factor for an individual's exit from employment. And there is little difference among different age cohorts which implies little improvement in the employment continuity of younger women. This study also documents the importance of structural variables, such as the type of occupation, as significant determining factors for the hazard rate. Specially women with professional jobs tend to stay longer in the labor market. Therefore, women's entry into more professional occupations is expected to contribute to the continuity of employment. Our results also show that duration-dependence is not spurious. When unobserved heterogeneity is controlled, the negative relation between the rate from employment and the duration of employment does not disappear.

Pediatric Renal Transplantation in Asia (아시아 소아 신장이식 현황)

  • Kim Ji-Hong;Choi Yong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.131-141
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    • 2002
  • Purpose : Renal transplantation which allows children normal growth and development and a return to normal life. is now proven to be the best modality for children with ESRD Up to Recently, the number of renal transplantations in Asia has rapidly increased and the outcome has also improved. This investigation was planned to estimate the current status of pediatric renal transplantation in Asia and to find the keys for better improvement of outcome in pediatric renal allograft in Asian countries. Material and methods : The participating countries and institutions for this investigation were China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, Thailand, Korea, KSPN (Korean Society of Pediatric Nephrology), KONOS (Korean Network for Organ Sharing). Results : Many countries in Asia still do not have a well organized nation wide renal transplantation registration system independently in the pediatric field. So it's very difficult to evaluate the real state of pediatric transplantation among Asian countries. According to the estimation with fragmented data from each countries, in the front running countries of pediatric renal transplantation in Asia, about 40 or more transplants were performed in each country per year and the five year actuarial renal allograft survival was around 80% which is similar to that of western countries. But there were large gaps among the behind groups. Conclusion : Vigorous attempts to perform renal transplantation for children especially younger than 5 years old would be encouraged as well as organ donation from brain dead donor and non heart beating cadaveric donor also should be activated to cope effectively with the shortage of living donor supply. Large number of recent reports shows the favorable outcome of pre-emptive renal transplantation, we should make more efforts toward pre-emptive renal transplantation. First of all, in order to improve the outcome and to narrow the gap between Asian countries in pediatric renal transplantation, effective and continuous efforts to establish nationwide pediatric renal transplantation registration program as well as official, nation-to-nation data sharing program should be needed.

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Direct Intratumoral Injection of Ethanol in the Patients with Obstruction of Major Bronchus (주기관지 폐색환자에서 종양내 ETHANOL 주입치료 효과)

  • Lee, Bong-Chun;Yum, Ho-Kee;Choi, Soo-Jeon;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.5
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    • pp.495-500
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    • 1993
  • Background: For the relief of the occlusion of major bronchi, laser therapy, radiation therapy or combined therapy is generally used. But the effect of radiation therapy is very slow and not consistent and laser therapy requires expensive equipments and technical expertise with occasional serious side effects. Direct ethanol injection has been widely used for the control of bleeding in gastrointestinal lesion, esophageal varices or renal cell carcinoma with good results. So we tried direct injection of ethanol into the tumor to relieve the obstruction of major bronchus in 11 patients. Method: All procedures were done under the fiberoptic bronchoscopy with continuous oxygen supplement and aliquoted 0.5-1.0 ml of absolute ethanol directly into the tumor through the endobronchial aspiration needle. The tumor was endoscopically removed with a biopsy forceps immediately after ethanol injection. The whole procedure was repeated 3-4 days interval until the lumen opens. Usually after 2-3 trials of ethanol injection, the lumen opened up. Results: The immediate effect of ethanol injection was whitening of the mucosa and prompt cessation of bleeding. The late effect was necrosis of the tumor. The final results of this procedure were improvement of symptoms and reexpnasion of the lung in all patients. $FEV_{1.0}$ and FVC were improved and $PaO_2$ was increased from $68.1{\pm}9.2$ mmHg to $83.9{\pm}8.1$ mmHg, $SaO_2$: from $94{\pm}8.5%$ to $96.6{\pm}1.1%$, and $AaDO_2$ was reduced from $26.5{\pm}8.5$ mmHg to $10.9{\pm}9.1$ mmHg. Conclusion: Direct ethanol injection into the tumor tissue is a rapid, cheap and relatively safe method of relieving the complete occlusion of major bronchus.

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A Study on Utilization and Perceived Service Quality of the University Foodservice (대학급식 이용실태 및 급식서비스 품질이 고객만족과 고객태도에 미치는 영향)

  • Jung, Hyun-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.4
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    • pp.633-643
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    • 2013
  • This study investigated the efficiency of university foodservice operations by analyzing the effect of consumer's perception towards university foodservice quality. University students in the Jeonnam area were surveyed and 571 out of 700 surveys were chosen (response rate: 97.0%). SPSS (ver. 20.0) was used to conduct descriptive analysis, factor analysis, reliability analysis, t-test, and multiple regression analysis. The results show that 21.9% of university students have never used the university foodservice, while 48.7% of university students have eaten there 1~2 times per week. The most common reasons reported for avoiding the university foodservice were a limited menu selection (51.5%) and an untasty food (45.8%). The perception of overall service quality at the university foodservice scored relatively low (3.01 points), compared with its importance (3.89 points). The food taste, menu variety, and quality of food ingredients are factors that require improvement for operational strategies by the importance-performance analysis (IPA). The food factors (taste, variety, and quality) among university foodservice qualities had a significantly positive effect on consumers' overall satisfaction (p<0.001), perceived value (p<0.01), intent to recommend (p<0.001), and intent to revisit (p<0.01). These result indicate that the university foodservice management should focus on developing food factors and strive to meet the needs of university students through continuous customer surveys.

Results of Arthroscopic-assisted Minimally Invasive Removal of a Lateral Periarticular Plate used for the Treatment of AO Type-C Distal Femoral Fractures (AO C-형 원위 대퇴골 골절의 치료로 삽입된 관외측 금속판의 절경 보조하 최소 침습적 제거의 결과)

  • Kim, Young-Mo;Lee, June-Kyu;Yang, Jae-Hoon;Kim, Bo-Kun;Lee, Won-Gu
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.46-52
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    • 2009
  • Purpose: To evaluate the usefulness of minimally invasive arthroscopy-assisted plate removal of a laterally inserted periarticular distal femur plate used for the treatment of AO type-C distal femur fractures. Materials and Methods: From October 2002 to November 2005, we evaluated 17 patients whose plates were removed through minimally invasive arthroscopy-assisted plate-removal technique and 15 patients who got their plates removed through conventional method without using arthroscopy, 32 patients in total. All these patients included in this study initially underwent open reduction and internal fixation of the distal femoral fractures with a lateral plate, and complained of continued pain over the lateral femoral condyle after the fracture fixation. The average age was 42.6 (ranges: 20~66) and initial fracture types included 16 cases of C1, 11 cases of C2, and 5 cases of C3 following AO/ASIF classification guidelines. Measured outcomes included: associated intra-articular pathologies, time needed to return to activities of daily living, patients' overall satisfaction, complications following the removal of hardware, and pain before and 6 months after the operation. Results: The distal-most end of the plate was placed in the knee joint in all cases and damage of the lateral articular capsule was found in 23 cases. Continuous wound discharge after surgery was found in one case who underwent arthroscopy-assisted plate removal, and it was treated by irrigation and re-suture. Average time needed to return to activities of daily living was 7 days in arthroscopy assisted group and 7.6 days in conventionally removed group. Fourteen patients (82.4%) who underwent arthroscopyassisted plate-removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 4.9 to 1.9, six months after the plate removal. Thirteen patients(86.7%) who underwent conventional plate removal reported above 'fair' satisfaction and the Visual analog scale pain score decreased from 5.2 to 2.5, six months after the operation. Conclusion: Through minimally invasive arthroscopic-assisted plate removal, intrarticular pathology of the knee joint was able to be simultaneously identified and treated at the time of hardware removal. Damage of lateral capsule of the knee joint caused by the inserted plate for the treatment of type C distal femoral fracture was very frequently found and following the plate removal, patients experienced an improvement in pain score. We therefore recommend routine lateral distal femoral plate removal if the bony union is attained in such cases as type C distal femoral fractures whose distal most end of the plates are located in the joint.

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Effects of a Critical Pathway of Posterolateral Fusion in Patients with Lumbar Spinal Stenosis (측후방융합술을 시행한 요추관협착증 환자의 Critical Pathway 적용효과)

  • Park, Hae-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.265-284
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    • 2001
  • The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.

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The Study on the Change of Iron Concentration and the Reaction Mechanism of the 1,4-Dioxane Degradation using Zero Valent Iron and UV (영가철(Fe$^0$)과 UV를 이용한 1,4-dioxane 분해 반응시 철농도의 변화와 반응 메커니즘의 연구)

  • Son, Hyun-Seok;Im, Jong-Kwon;Zoh, Kyung-Duk
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.3
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    • pp.323-330
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    • 2008
  • The study presents the results of 1,4-dioxane degradation using zero valent (Fe$^0$) or Fe$^{2+}$ ions with and without UV. During the reaction, the change of [Fe$^{2+}$] and [Fe$^{2+}$]/[Fe(t)], the concentration ratio of ferrous ion to total iron ion in solution was measured. Less than 10% degradation of 1,4-dioxane was observed by UV-only, Fe$^0$-only, and Fe$^{2+}$-only conditions, and also the changes of [Fe$^{2+}$] and [Fe$^{2+}$]/[Fe(t)] were minimal in each reaction. However, the oxidation of Fe$^0$ was enhanced with the irradiation of UV by approximately 25% and the improvement of 1,4-dioxane degradation was observed. Fenton reaction ($Fe^{2+}+H_2O_2$) showed higher degradation efficiency of 1,4-dioxane until 90 min, which of the degradation was stopped after that time. In the reaction of Fe$^{2+}$ and UV, the ratio of [Fe$^{2+}$]/[Fe(t)] decreased then slowly increased after a certain time indicating the reduction of Fe3+ to Fe$^{2+}$. In case of Fe$^0$ in the presence of UV, the first-order rate constant was found to be 1.84$\times$10$^{-3}$ min$^{-1}$ until 90 min, and then changed to 9.33$\times$10$^{-3}$ min$^{-1}$ when the oxidation of Fe$^{2+}$ mainly occurred. In this case [Fe$^{2+}$]/[Fe(t)] kept decreasing for the reaction. However, the addition of perchlortae (ClO$_4^-$) in the reaction of Fe$^0$ and UV induced the continuous increase of [Fe$^{2+}$]/[Fe(t)] ratio. The results mean the primary degradation factor of 1,4-dioxane is the oxidation by the radicals generated from the redox reaction between Fe$^{2+}$ and Fe$^{3+}$. Also, both UV and ClO$_4^-$ played the role inducing the reduction of Fe$^{3+}$, which is important to degrade 1,4-dioxane by enhancing the generation of radicals.