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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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DEVELOPMENT OF THREE DIMENSIONAL MEASURING PROGRAM WITH FRONTAL AND LATERAL CEPHALOMETRIC RADIOGRAPHS -PART 1. COMPUTATION OF THE THREE-DIMENSIONAL COORDINATES BY COMPENSATION OF THE ERROR OF THE HEAD POSITION IN ORDINARY NON-BIPLANAR CEPHALOSTAT- (정모 및 측모 두부 방사선 규격사진을 이용한 3차원 계측 프로그램의 개발 -1. 단일 방사선원으로 촬영된 두부 방사선사진의 두부 위치 보정을 이용한 3차원 좌표의 산출-)

  • Lee, Geun-Ho;Lee, Sang-Han;Jang, Hyon-Joong;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.214-220
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    • 2001
  • The clinical application of the three-dimensional radiographic technique had been limited to standard Broadbent-Bolton cephalometer with biplanar stereoradiography. We developed a new method for compensating the error of head position in ordinary non-biplanar cephalostat. It became to possible to use the three dimensional cephalogram commonly in clinical bases. 1. The method of methemetical compensation of head positioning error in non-biplanar condition was evaluated with dry skull. The error of the method of first and the second trial was $0.46{\pm}1.21$, $0.33{\pm}0.90mm$, which means the error of the head positioning correction in conventional cephalogram was within clinical acceptance. 2. The reproducibility of this system for clinical application was 0.54 mm ($-2.99{\sim}2.26mm$) which defines the absolute mean difference of the first and second trial. Compare to the The landmark identification error $1.2{\pm}1.6mm$, the error of the measurement was within the range of landmark identification error. The result indicates the adequate clinical accuracy of the computation of three-dimensional coordinates by compensation of the error of the head position in ordinary non-biplanar cephalostat.

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THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF STRESS DISTRIBUTION AND DEFORMATION IN MANDIBLE ACCORDING TO THE POSITION OF PONTIC IN TWO IMPLANTS SUPPORTED THREE-UNIT FIXED PARTIAL DENTURE (두 개의 임플란트를 이용한 3본 고정성 국소의치에서 가공치 위치에 따른 하악골에서의 응력 분포 및 변형에 관한 삼차원 유한요소법적 연구)

  • Kim, Dong-Su;Kim, Il-Kyu;Jang, Keum-Soo;Park, Tae-Hwan;Kim, Kyu-Nam;Son, Choong-Yul
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.166-179
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    • 2008
  • Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture sup-ported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior posi-tion, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly $30{\sim}35%$ higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were $160{\sim}170%$ higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively $20{\sim}25%$ higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically accept-able design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.

Preliminary Landscape Improvement Plan for Gu-ryong Village (구룡 해안마을 경관형성 기본계획)

  • Kim, Yun-Geum;Choi, Jung-Min
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.6
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    • pp.23-34
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    • 2012
  • This Study is about the "Comprehensive Landscape Improvement Plan for Gu-ryoung Seaside Village that was one of most exhibited projects for developing sea villages." The formulations of the plan were supervised by the Ministry of Land, Transport, and Maritime Affairs and were executed by the Goheung Country. Rather than proposing renovations for the landscape, this study maintains the existing order and attempts to examine the plan by scrutinizing the vernacular design language of the landscape. In the study, community members had the opportunity to express their opinions and ideas about the community through workshops composed of community participation programs, and participated in the decision-making process through consultation meetings. The conclusion of this study was relevant to the activities of the committee on landscape improvement. The Comprehensive Landscape Improvement Plan has three objectives: (1) resorting and modifying the natural landscape, (2) restructuring the roadways, and (3) modifying key spaces. In the end, the role of Gu-ryong Mountain as a background of the landscape was focused on tree planting drives that were undertaken, and accessibility to the sea front was improved. Second, in restructuring the roadways, rough roads were restored and unconnected roads were connected to ensure a network of roads along the sea front, inner roads in the village, roads at the Fringes Mountains, and stone roads on the mud flat. In addition, roads were named according to the character of the landscape and signs were installed. Finally, the existing key spaces, in which community members came together, were restored and new key spaces were created for the outdoor activities of the inhabitants and the diverse experience of visitors. A guideline was also created to regulate private areas such as roofs, walls, fences of residential buildings, and private container boxes and fishing gear along the sea front. The strength of this study is that it is seeking to determine the greatest potential of the landscape and set the plan by examining the lives of community members. Some problems were found during the development of this study. Further, there were problems in the community's understanding as elaborated below. First is the gap between community members' awareness and practice. Even though they were aware of the problems with the village landscape, they hesitated to implement improvements. Second, community members have misunderstandings about the landscape the improvement plan. The local government and the residents have understood this plan as a development project; for example, new building construction or the extension of roads. Third, residents are not aware that continuous attention and improvements are required for the upkeep of the landscape in the sea village. The plan to improve the landscape should promote a balance between making the area as a tourist attraction and maintaining the lives and cultural activities, because the sea village system incorporates settlements, economy, and culture.

A Study on the Adaptation and Change of Amusement Culture on the Case of Wolmido Pleasure Ground during the Japanese Colonial Era (일제강점기 월미도유원지를 통한 행락 문화의 수용과 변화에 관한 연구)

  • Kim, Jeoung-Eun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.5
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    • pp.134-147
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    • 2014
  • Pleasure grounds, which were introduced during the Japanese colonial era, were places for organizing new amusement activities, and developed into a large-scale private spaces and a new type of public space at the same time. This study explores the scenery and accommodations of pleasure grounds and the changes of the amusement culture through the Wolmido Pleasure Grounds, which was a typical pleasure grounds of the time. At that time, Wolmido became a comprehensive amusement/entertainment place with many elements of both Western and Japanese pleasure grounds such as exotic buildings harmonized with trees, a beach, a seaside school, public playing field, and zoo constructed on the Island. Wolmido Pleasure Ground, which was connected with Kyungsung by Kyungin railroad during the Japanese colonial era, is a good example showing the process of the popularization and commercialization of the amusement culture. The process of popularization of amusement shows the spreading of the enjoyment of leisure time with amusement activities through appreciating the beautiful scenery of the pleasure grounds among various social classes. The caste system was broken and anyone could use the pleasure grounds by paying the fee, of which there were many kinds, so the distinction between genders and the different classes, such as the Chosun people and Japanese, regarding amusement in pleasure grounds disappeared gradually. Also, pleasure grounds were a place for Western hobby-sports activities and were the means to generalize collective and dynamic activities through summer school and various sport games. At the same time, there were places for deviation from the existing social norms when it was combined with entertainment facilities. The commercialization of amusement took place in the form of an artificial entertainment culture within an artificial environment. First, the scenery was artificially constructed and this scenery created the image of paradise such as 'captivating summer vacation spot' and 'water kingdom'. This was the result of the combined intentions of the colonial authority, the railroad company and the amusement corporation to produce economic profits and encourage development in the area. Second, an artificial spectacle was constructed using nature as the backdrop. Buildings of various styles created a modernized and exotic image when they were combined with each other. Artifacts such as breakwaters and arcades created new attractions for people that enabled them to view both nature and the crowds from a whole different perspective. Third, pleasure grounds contributed to the advent of passive users who would just follow the given use and instructions. In this way, one can find the prototype of popular entertainment places of today such as sightseeing complexes, amusement parks, and theme parks through the construction of amusement grounds as a place for providing dynamic activities.

An Analysis of Process-oriented Design in the Invited Entries of International Competition for the Master Plan of the Yongsan Park, Korea (용산공원 설계 국제공모 출품작에 나타난 프로세스적 설계 분석)

  • So, Jin;Sung, Jong-Sang;Pae, Jeong-Hann
    • Journal of the Korean Institute of Landscape Architecture
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    • v.41 no.2
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    • pp.11-26
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    • 2013
  • Designing large parks such as Yongsan Park requires the open-ended process-oriented design approach in complex layers rather than the conventional self-completed master plan method. This study aims to examine the characteristics of process-oriented design in the eight invited entries of "International Competition for the Master Plan of the Yongsan Park, Korea"(2012). For this purpose, it analyzed each entry according to three criteria: objects of process-oriented approach, time factor and its features of phasing plan, and presentation method of the process. This analysis can not only critically review the current level of the process-centered design methodology but also suggest strategic future directions for Yongsan Park. The objects of process-oriented design in the eight works were order of physical space development, restoration process of ecosystem, recovering process of publicity, and economic operation and management. Main considerations in the objects were connections to adjacent urban fabrics, links to regional green and water system, reuse of existing buildings and infrastructures in the site. The temporal criteria of the phasing plan had two aspects. One was planning a certain time and period, and the other was just establishing an order of phases. Most of the presentation method of process was the phasing plan, but some of the entries suggested a scenario plan. The eight works of "International Competition for the Master Plan of Yongsan Park" did not attempt process-oriented designs entirely and completely. Rather, they tried to introduce the phasing plan as part of a process-centered design. Also, they took an eclectic approach between master plan and process-oriented design instead of rejecting the conventional master plan approach.

Effects of Nutrient Strength and Light Intensity on Nutrient Uptake and Growth of Young Kalanchoe Plants (Kalanchoe blossfeldiana 'Marlene') at Seedling Stage (배양액의 농도와 광강도가 단일처리전 칼랑코에 유묘의 양분흡수와 생육에 미치는 영향)

  • Lu, Yin-Ji;Son, Jung-Eek
    • Journal of Bio-Environment Control
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    • v.14 no.3
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    • pp.149-154
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    • 2005
  • It is very important to make shorter and healthier pot plants with increased numbers of branch at a growing stage before short-day exposure. Especially light and nutrient conditions directly affect the growth and quality of the plants as described above. In this study, the effects of nutrient strength and light intensity on the nutrient uptake and growth of young Kalanchoe plants (Kalanchoe blossfeldiana 'Marlene') during this growth stage were investigated. The plants were grown under two radiation integral (15.8 and 7.9 $mol{\cdot}m^{-2}{\cdot}d^{-1}$, PPF) and three EC (0.8, 1.6 and 2.4 $dS{\cdot}m^{-1}$) conditions. Leaf area, fresh weight, dry weight and number of branch were higher at a higher PPF, and this tendency was more evident at an EC above 1.6$dS{\cdot}m^{-1}$. The plants became higher at a lower PPF. When the EC was at 0.8 $dS{\cdot}m^{-1}$, the plants did not grow so healthy regardless of PPF conditions. EC decrement in the nutrient solution was increased with increase of nutrient strength. With growth stage, the nutrient uptake was increased with increases of nutrient strength and PPF. At a higher PPF, $NO_3-N,\;K^{+}\;and\;Ca^{2+}$ were much more absorbed, and especially the uptake of $K^{+}$ was 1.1 to 1.5 times greater than that or $NO_3-N$. From the results, the EC needed above 1.6 $dS{\cdot}m^{-1}$ during the seedling stage in order to make more healthy Kalanchoe plants having more leaf area, fresh weight, dry weight and number of branches under adequate light conditions.

Heating Performance of Hot Water Supplying System in Greenhouse (온수배관을 이용한 온실의 난방성능)

  • Yoon, Yong-Cheol;Shin, Yik-Soo;Kim, Hyeon-Tae;Bae, Seoung-Beom;Choi, Jin-Sik;Suh, Won-Myung
    • Journal of Bio-Environment Control
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    • v.21 no.2
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    • pp.79-87
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    • 2012
  • This research was conducted to obtain basic data with regard to the heating performance that would be produced by installing an aluminum hot water pipe inside the greenhouse with the goal of reducing the heating energy in greenhouse. The research results are summarized as follows. The degree of difference in relation to the temperature by height within the greenhouse during the entire experiment was significant - within the range of 4.0~$7.0^{\circ}C$. The temperature difference between incoming and outgoing water was about $3.3^{\circ}C$ greater when FCU was activated compared to when it was not activated. Meanwhile, the amount of energy consumed increased about 36.2~40.1%. The amount of pyrexia per hour also increased by 44.6~52.0%. During the experiment period, circulated flux was within the range of 0.48~$0.49L{\cdot}s^{-1}$ while average fluid speed was 1.53~$1.56m{\cdot}s^{-1}$. The average temperature difference between incoming and outgoing water was 6.24~$11.50^{\circ}C$. The amount of heating value by each set temperature within the minimum outdoor temperature range of -14.0~$-0.6^{\circ}C$ was 135,930~307,150 kcal, and the range was within the 9,610~$19,630kcal{\cdot}h^{-1}$ per hour. This demonstrated that about 23~53% heating energy of the maximum heating load could be supplied. Total radiating value and amount of energy consumed were 2,548,306 kcal and 3,075.7 kWh, respectively. When heating takes place using oil, which is a fossil fuel, the total amount of light oil consumed was 281.6 L while the cost was 321,000 won. When the electricity cost for farms is applied, the total cost was about 110,730 won, which is about 33.5% of the cost required compared to oil consumption. The temperature at in the experiment area was about 8.3~$14.6^{\circ}C$ higher compared to that of the control area.

Growth Characteristics of Lettuce under Different Frequency of Pulse Lighting and RGB Ratio of LEDs (LED의 간헐조명과 RGB 비율에 따른 상추의 품종별 생육 특성)

  • Kim, Sungjin;Bok, Gwonjeong;Lee, Gongin;Park, Jongseok
    • Journal of Bio-Environment Control
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    • v.26 no.2
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    • pp.123-132
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    • 2017
  • This study was aimed to investigate the effect of 1)irradiation with several different ratios using red, green, and blue LEDs and 2)various pulsed light irradiation with 50% duty ratio using red and blue LEDs on the growth and morphogenesis of three lettuce cultivars (Lactuca sativar L. cv. 'Jukchukmeon', 'Lolo Rosa', and 'Grand Rapid') in hydroponics culture system for 4 weeks after transplanting. Seeds were sown in rock-wool plug trays and they were placed in a culture room which was controlled at $23{\pm}1^{\circ}C/18{\pm}1^{\circ}C$ temperature and 50-60/70-85% for day and night, respectively, during cultivation period. Irradiated RGB ratios with LEDs were 6:3:1, 5:2.5:2.5, 3:3:4, 2:2:6, and 1:1:8 with $110{\pm}3{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ PPFD on the surface of cultivation bed. The frequencies of pulsed lighting was 50, 100, 500, 1,000, 5,000, 10,000, 25,000Hz (20, 10, 0.1, 0.04 ms) with red and blue LEDs and 50% duty ratio. At the RGB ratio of 6:3:1, the average fresh weight of 'Jukchukmeon' was significantly higher than that of other RGB treatments, but no significant difference compared to the fluorescent treatment. The average fresh weight at 1:1:8 RGB ratio in 'Lolo Rosa' was significantly lower than that of other RGB treatments. Leaf number and fresh weight of 'Grand Rapid' were significantly lower in the control and 1:1:8 RGB treatments, compared to the other RGB treatments. As the ratio of blue light increased, leaf length decreased and leaf shape became round in three lettuces. Although there is little change in growth, it could not be found any tendency to affect the growth and morphogenesis of three lettuces caused by increasing or decreasing frequency of pulsed lighting with 50% duty ratio at the $72{\mu}mol{\cdot}m^{-2}{\cdot}s^{-1}$ PPFD.

GIS Spatial Analysis of Vulnerability of Protected Cultivation Area to Meteorological Disaster : A Case Study of Jeollanambuk Province, South Korea (GIS를 이용한 시설재배의 기상재해 취약지역 해석 - 전라남북도의 사례를 중심으로 -)

  • Kim, Dong Hyeon;Kang, Dong Hyeon;Lee, Si Young;Son, Jin Kwan;Park, Min Jung;Yoon, Yong-Cheol;Yun, Sung-Wook
    • Journal of Bio-Environment Control
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    • v.26 no.2
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    • pp.87-99
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    • 2017
  • Recently the increase in an abnormal climate events and meteorological disasters which causes a great damage to greenhouse facilities. To minimize and evaluate the expected damages it is necessary to prepare countermeasures and a management system in advance. For this purpose, a quantitative analysis of weather and abnormal climate are needed to investigate protected cultivation areas which are vulnerable to natural disasters. This study focused on protected cultivation areas in Jeolla province, South Korea. Surrogate variables were calculated to analyze the vulnerable areas to meteorological disasters, and spatial distribution analysis was also performed by using GIS to present vulnerable areas on map. The map thus created and was compared with actual data of damages by meteorological disasters which occurred in target areas. The result of the comparison is as follows: About 50% of the target areas showed an agreement between the map created in this study and the actual data, these areas includes Gwangju metropolitan city, Naju city, Yeongam County, Jangseong County, Hampyeong County, and Haenam County. On the other hand, other areas, including Gunsan city, Mokpo city, and Muan County, suffered low damage in spite of high levels of vulnerability to meteorological disasters. This result was considered to be affected by such variables as different structural designs and management systems of greenhouses by region. This study carried out an analysis of meteorological data to find out more detailed vulnerability to protected cultivation area and to create a map of vulnerable protected cultivation areas. In addition, the map was compared with the record of natural disasters to identify actual vulnerable areas. In conclusion, this study can be utilized as basic data for preventing and reducing damages by meteorological disasters in terms of design and management of greenhouses.