• 가정∙방문간호학회지
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• 제6권
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• pp.5-18
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• 1999

This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• 환경영향평가
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• 제33권1호
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• pp.30-41
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• 2024

디지털 기술의 급속한 발달로 일하는 방식이 크게 변화하고 있으며, 종이 문서가 전자 문서로 대체되고 있다. 그러나 환경영향평가서는 환경영향평가법 시행령과 시행규칙에 따라 사업과 관련 있는 기관에 정해진 부수의 종이보고서를 제출해야 하고, 이렇게 종이보고서로 제출한 지 약 42년이 경과하였다. 국립생태원에서는 2022년도에 디지털 전환이라는 시대의 흐름에 따라 종이보고서를 전자문서로 검토하는 시스템을 도입하였다. 2022년에 접수하여 검토한 1,398건의 환경영향평가서를 대상으로 전자문서 검토에 따른 비용 절감과 탄소 배출저감 효과를 분석하였다. 전자문서의 검토로 직접적 영향을 받는 제1종 환경영향평가업체를 대상으로 만족도 설문조사를 실시하였으며 총 134명이 응답하였다. 전자문서 검토 효과 분석 결과, 비용은 연간 총 101,424,900원이 절감되고 탄소 배출은 약 59.7톤이 저감되는 것으로 나타났다. 만족도 설문조사 결과, 전자문서 검토가 매우 도움이 된다고 응답한 비율은 94.8%로 매우 높게 나타났고, 도움이 된다고 응답한 비율은 4.5%로 매우 긍적적이었다. 경제적 측면과 업무시간 단축에 도움이 된다고 응답한 비율이 각각 94.8%와 91.8%로 전자문서 검토의 긍정적 효과가 높게 나타났다. 환경영향평가법 시행령과 시행규칙의 개정으로 전자문서 검토를 실시하면 국가 전체적으로 비용 절감과 탄소 저감뿐만 아니라 행정 소요 시간 감소와 보관 공간 절약 등의 파급 효과가 발생할 것으로 예상된다. 디지털 전환 시대에 적합한 법과 행정의 신속한 변화가 필요하다.

• 종양간호연구
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• 제3권1호
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• pp.24-44
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• 2003

The purposes of this study was to identify and propose the expected role of the oncology nurse specialist by embodying role theory to oncology nurse specialist. The subjects of this study were 149 persons in 14 hospitals, who were classified to 4 groups, oncology nurse specialists(ONS) group, head nurses and charge nurses(HN & CN) group in hemato-oncology ward, registered nurses(RN) group in hemato-oncology ward, and hematologists & oncologists(H&O) group. The questionnaire which was consisted of 89 items for role of oncology nurse specialist, was made by researcher with a field study and literature review about role of oncology nurse specialist and verified by matrix delphi technique about content validity and construct validity. The data were collected from October 22, 2002 to November 5, 2002. All 4 groups proposed that ONS should perform an expert practitioner role first of all. But ONS group, RN group and H&O group proposed orderly expert practitioner, educator, researcher, consultant, and administrator & change agent, but HN & CN group did expert practitioner, educator, consultant, researcher, administrator & change agent. Expert practitioner had the most highest necessary degree in all groups and most highest performance degree in ONS group. That was consistent with results that all groups proposed role of expert practitioner at first. 4 items out of 20 items showed the meaningful differences between groups. For role of educator, oncology nurse specialist group proposed necessary degrees over 4.0 point out of 5.0 in all items. 4 items out of 18 items showed the meaningful differences between groups. For role of researcher, 3 nurses groups proposed a high necessary degree, but performance of ONS group was most lowest among 5 roles. 6 items out of 14 items showed the meaningful differences between groups. The role of consultant had high necessary degree in some items related to hematopoietic stem cell transplantation. 2 items out of 17 items showed the meaningful differences between groups. In nursing behaviors of administrator & change agent, those items about enacting principle, cost development and participation of professional academy had a high necessary degree. 4 items out of 18 items showed the meaningful differences between groups. Oncology nurse specialists group performed 5 roles orderly, expert practitioner, consultant, educator, administrator & change agent, researcher. This result was different from expected role of themselves as well as the other groups. There was a different necessary degree between role and embodied nursing behaviors of role. ONS group and RN group proposed orderly educator, researcher, administrator & change agent, expert practitioner, consultant, but the other groups did educator, expert practitioner, researcher, consultant, administrator & change agent. The expected standards of oncology nurse specialist in this study were usually master's degree, total career of 5-7 years, oncology career of 3-5 years and certification. But for the post, qualification and qualification institution, various opinions were suggested. In the conclusion, there was a different necessary degree between role and embodied nursing behaviors of role. All groups proposed expert practitioner at first in abstract role, but educator at first in embodied nursing behaviors of role. So we have to consider this difference carefully in the future research. ONS acted the role of expert practitioner first of all, but we should develope and expand the roles of researcher, and administrator & change agent. We should enact roles by role behaviors induced from mutual agreements in necessary degree and performance degree, and bargain the role behaviors that showed the meaningful differences between groups But, we should consider carefully which group's opinion we have to select. I suggested 36 items out of 89 items, in which ONS proposed necessary degree over 4.0 out of 5.0 and half of them performed as the nursing behaviors of oncology nurse specialist that did not induce role stress. For the future, We should role bargain the role with other groups based on these items.

• 대한환경공학회지
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• 제30권9호
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• pp.961-972
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• 2008

2004년 기준, 온실가스(GHG; Greenhouse Gas) 총 배출량 약 5억9,060만톤(t)$CO_2$로 배출량 세계 10위권인 우리나라는 국제 환경의 변화를 볼 때 향후 반드시 GHG를 감축해야한다. 2004년 국내 에너지 부문 중, 전력 발전 및 산업 부분에서 배출된 이산화탄소(CO$_2$)량은 총 2억9,685만t으로 우리나라 GHG 전체 발생량의 53.3%를 차지하여 이 두 분야에서 CO$_2$ 배출을 감축시키는 것이 가장 시급하고 중요한 문제이다. 또한 이 두 분야는 산업의 특성상 CCS(Carbon Capture and Storage) 기술을 적용하여 효율적으로 CO$_2$를 저감할 수 있는 가장 잠재력이 높은 분야이다. 두 분야에서 효율적으로 적용될 수 있는 CCS 기술로 단기적으로는 amine을 이용한 화합흡수법이, 중, 장기적으로는 ATR(Autothermal reforming), 또는 MSR-H2(Methane steam reformer with hydrogen separation membrane reactor)가 장착된 연소 전 기술과, SOFC+GT(Solid oxide fuel cell-Gas turbine) 같은 순산소 연소 기술이 가장 유리 할 것으로 예상된다. 이와 같은 최신 연소 전 및 순산소 연소 기술을 이용하면 향후 CO$_2$ 포집 비용을 $US 8.5-43.5/tCO$_2$로 줄일 수 있으며 이를 이용하여 전력 발전 및 산업 부분에서 발생하는 CO$_2$의 10%만을 감축하더라도 약 3,000만t의 CO$_2$를 저감할 수 있겠다.

• 한국물환경학회지
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• 제26권2호
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• pp.191-199
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• 2010

Introduction of Technology-Based Effluent Limitations (TBELs) concepts into Korea requires extensive and through analyses on the expected pollutants reduction effects and the cost factor for the industry side. In addition, the TEBLs should be optimized for the regulatory environments of Korea and be applied in a progressive manner to minimize the undesirable effects. It is also necessary to assess the contribution of each industrial categories's to the pollution of natural water bodies to find the priority of TEBLs application. For these purposes, the pollution loads of various industrial categories were analyzed using risk assessment indicator based on Toxic Weighting Factors (TWFs). First, the TWFs were calculated for the pollutants regulated using the method adopted by USEPA. And the effluent characteristics of the eighty two categories of industry in Korea were investigated. Although the analytical data on the wastewater from different industrial categories are relatively limited, the results from two previous studies were used. The first study, conducted by the National Institute of Environmental Research in 2001~2004, investigated the wastewater characteristics from 255 industrial sources covering the major 20 industrial categories. The second study includes more recent analytical data for the wastewater from 500 industrial sources, covering all the 82 industrial categories. In the result of the pollution loads analyses, the category of 'Synthetic and Chemical manufacture' was found to show the highest raw pollution load. On the other hand the category of 'Ion & Steel manufacture' was found to show the highest effluent pollution loads, which can be considered as the real impacts on natural water streams. The top five categories occupied 62.2% of the total effluent pollution loads. Through the analyses, the relative importances of each industrial categories and the priorities of TEBL-based pollution reduction were determined.

• Asian-Australasian Journal of Animal Sciences
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• 제27권2호
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• pp.187-193
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• 2014

As a result of the cost of grains, the replacement of grains by co-products (i.e. DDGS) in feedlot diets is a common practice. This change produces diets that contain a lower amount of starch and greater amount of fibre. Hypothetically, combining feed grade urea (U) with slow release urea (Optigen) in this type of diet should elicit a better synchrony between starch (high-rate of digestion) and fibre (low-rate of digestion) promoting a better microbial protein synthesis and ruminal digestion with increasing the digestible energy of the diet. Four cannulated Holstein steers ($213{\pm}4$ kg) were used in a $4{\times}4$ Latin square design to examine the combination of Optigen and U in a finishing diet containing different starch:acid detergent fibre ratios (S:F) on the characteristics of digestive function. Three S:F ratios (3.0, 4.5, and 6.0) were tested using a combination of U (0.80%) and Optigen (1.0%). Additionally, a treatment of 4.5 S:F ratio with urea (0.80% in ration) as the sole source of non-protein nitrogen was used to compare the effect of urea combination at same S:F ratio. The S:F ratio of the diet was manipulated by replacing the corn grain by dried distillers grain with solubles and roughage. Urea combination did not affect ruminal pH. The S:F ratio did not affect ruminal pH at 0 and 2 h post-feeding but, at 4 and 6 h, the ruminal pH decreased as the S:F ratio increased (linear, p<0.05). Ruminal digestion of OM, starch and feed N were not affected by urea combination or S:F ratio. The urea combination did not affect ADF ruminal digestion. ADF ruminal digestion decreased linearly (p = 0.02) as the S:F ratio increased. Compared to the urea treatment (p<0.05) and within the urea combination treatment (quadratic, p<0.01), the flow of microbial nitrogen (MN) to the small intestine and ruminal microbial efficiency were greater for the urea combination at a S:F ratio of 4.5. Irrespective of the S:F ratio, the urea combination improved (2.8%, p = 0.02) postruminal N digestion. As S:F ratio increased, OM digestion increased, but ADF total tract digestion decreased. The combination of urea at 4.5 S:F improved (2%, p = 0.04) the digestible energy (DE) more than expected. Combining urea and Optigen resulted in positive effects on the MN flow and DE of the diet, but apparently these advantages are observed only when there is a certain proportion of starch:ADF in the diet.

• 한국의료질향상학회지
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• 제7권1호
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• 한국측량학회지
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• 제32권5호
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• pp.495-503
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• 2014

주차장은 교통시스템의 일부분으로, 최근 차량이 급증하면서 주차장의 안전성과 효율적 운영이 중요해 지고 있다. 이동 차량을 탐지하여 주차 현황을 안내하기 위한 다양한 연구가 진행되어 왔지만 영상 내에 빠르게 이동하는 다수의 차량을 동시에 탐지하는 것은 여전히 도전적인 문제이다. 이에 본 연구에서는 공영 주차장이나 대형 주차장에 주차 구역이 분명하고 주차 구역 내에 감시 카메라가 설치되어있는 것에 착안하여, 참조 템플릿 기반 실시간 영상처리 기법을 이용한 무인 주차 가용 정보 제공 및 안내 시스템을 개발하고자 하였다. 즉, 주차 공간 내에 참조 표식 마커로써 주정차 중인 차량의 움직임과 상황을 인지하여 차량의 크기, 형태 등 직접적인 탐지 여부에 관계없이 주차 관제가 가능한 대안적 방법을 제시하였다. 또한, 주차 정보와 층별 주차 현황을 시뮬레이션하기 위한 프로토타입 시스템을 구현하여 본 연구에서 제시한 방법론의 실제 적용 가능성을 검토하고 성능 분석을 수행하였다. 결과적으로 실시간 영상 정보를 처리하여 주차장의 총 주차 공간 수, 주차된 차량 수와 같은 주차장 통계 정보의 저장 관리가 가능하였다. 향후, 본 연구 결과는 주차 상황 분석을 통해 주차 관리를 체계적이고 효율적으로 운영하는데 있어 비용 절감과 사용자 편의를 보다 증진 시킬 수 있을 것으로 기대된다.

• 한국산학기술학회논문지
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• 제19권5호
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• pp.640-649
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• 2018

본 연구는 빅데이터 분석방법 중 하나인 웹마이닝을 이용하여 사이클웨어의 요구성능 및 착용 현황 및 소비자 감성을 분석하였다. 이를 위해 네이버 카페인 '자전거로 출퇴근하는 사람들'을 대상으로 2006년~2017년 기간 동안 사이클웨어와 관련 있는 게시글과 댓글을 R 패키지를 사용하여 크롤링하였다. 수집된 데이터는 데이터 전처리 과정을 거쳐 선별된 15,321건의 문서를 데이터를 분석에 사용하였다. 추출된 데이터에서 텍스트는 한국어형태소분석기(KoNLP)를 사용하여 키워드를 추출한 후 TDM(Term Document Matrix)과 co-occurrence matrix로 변환하여 키워드별 출현 빈도수와 키워드 간 관계를 계산하였다. 사이클웨어에서 가장 출현빈도수가 높았던 키워드는 '타이츠'로 전문적인 사이클웨어에 대한 높은 관심을 나타내었으나 몸에 달라붙어 착용 시 민망하다는 의견이 많았다. 사이클웨어 '구매'와 관련하여 '가격', '사이즈', '브랜드' 등과 관련이 많았으며 '가격'과 관련하여 '저가'와 '가성비'에 대한 출현빈도수가 높았다. 이것은 최근 고가의 브랜드보다는 가격대비 성능을 만족시키는 실용적인 제품들이 선호되는 경향을 나타내주었다. 사이클웨어에서 소재의 흡한속건성이나 패드의 기능성, 불편함 등에 대한 소재나 디자인 등에 대한 개선이 요구되었다. 이처럼 웹마이닝을 이용하여 사이클웨어에 대한 소비자의 의견을 분석할 수 있었으며 기존의 설문조사와도 유사한 결과를 보여주었다. 그러므로 웹마이닝을 이용하여 소비자의 의견이나 요구사항을 실시간으로 분석하여 제품개발에 반영할 수 있는 객관적 지표로 사용할 수 있을 것으로 기대된다.