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Performance of Occupational Health Services by Type of Service : Cost Benefit Analysis (사업장 보건관리 사업의 형태별 수행성과 분석 -비용편익 분석을 중심으로-)

  • Cho, Tong Ran;Kim, Hwa Joong
    • Korean Journal of Occupational Health Nursing
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    • v.4
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    • pp.5-29
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    • 1995
  • Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

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A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism (폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구)

  • Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Hwang, Jung-Hwa;Kim, Dong Hun;Goo, Dong-Erk;Choi, Deuk-Lin
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.473-479
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    • 2005
  • Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

A Study on Fishing Efficiency and By-Catch of Small Fish of Winged Stow Net Fishery (연안 낭장망어업의 어획성능과 소형어 혼획에 관한 연구)

  • Kim, Joo-Seong;Lee, Ju-Hee
    • Journal of Fisheries and Marine Sciences Education
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    • v.8 no.1
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    • pp.92-107
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    • 1996
  • Based on the act.ivity report for the coastal fisheries resources conducted from 1982 to 1989 by West, East Research Institute of Fisheries, some other reports from Korea Rural Economics Institute and etc., and the questionnaire results for the senses of fishermen, the fishing efficiency and conditions of by - catch of small fish in winged stow net were analized, and then some ways to prevent from by - catch of small fishes were suggested in this paper. The nationwide conditions of Permission and Disposal in winged stow net fishery arc that number of cases of coastal winged stow net fishery has dropped to 757 by 1994 while it was 961 in 1991 and that the number of cases of a sectional winged stow net fishery on the contrary has increased to 302 by 1994 while it was 11 in 1991. Regardless of region, catch per net by year in general has been on gradual increase in 1982 through 1989, but that showed decrease in 1994. From the view of region, the proportion of by - catch of shrimps and blenny is higher in Kyonggi, Chungnam with West Sea and that of anchovy and blenny is higher in Chonbuk, Chonnam, Kyongnam with South Sea. The average proportions of by - catch of small fish for 5 years from 1985 to 1989 are 86.9% for sand lance, 69% for anchovy, 63% for big eyed herring, 51% for blenny, 22% for Southern rough shrimp and 19% for akiami paste shrimp, hence sand lance and anchovy are highly by - catch effective while shrimps is not. Ways to prevent the over fishing of small fish in winged stow net fishery includes reduction of fishing frequency during April and August through November, the very season for small fish, use of meshes large enough for small fish to go through and assignment of fishing area to other than habitats of stationary fish.

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Avifauna and Management of Breeding Season in Taeanhaean National Park (태안해안국립공원의 번식기 조류상과 관리)

  • Paik, In-Hwan;Jin, Seon-Deok;Yu, Jae-Pyoung;Paek, Woon-Kee
    • Korean Journal of Environment and Ecology
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    • v.24 no.2
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    • pp.139-146
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    • 2010
  • The survey was done in order to find what kinds of birds visit Taeanhaean National Park during breeding season, where we fixed up 10 coastal areas and islands within the National Park. Three groups concurrently performed the field research from 5th to 9th of July in 2009. Total 58 species and 7,323 individuals were recorded in Taeanhaean National Park. 48 species including 6,187 individuals were observed in coastal areas and 33 species including 1,136 individuals in island areas. The most dominant species in the National Park are Larus crassirostris which accounts for 60% of the birds inhabiting there, and they seem to have been bred in the islands near the National Park. The birds observed only around the coastal areas include Anas poecilorhyncha, Fulica atra, Egretta intermedia and the others which consist of 25 species and amount to 318 individuals, and the birds found exclusively in island areas include Phalacrocorax filamentosus, Apus pacificus¸ Locustella pleskei and other birds, which consist of 10 species and the number of those individuals observed was 308. The inhabited islands areas such as Gauido were characterized by high ratio of waterbird population, which seems to be correlated with the factors such as the extent of island, the richness of water resources, and the diversity of habitats. Based on the data collected during the research and other data from the previous observations, the kinds of dominant species remain nearly unchanged. And in spite of the oil spill accident in 2007, the increase in the number of waterbirds compared to 2004 may be the evidence that the area is recovering from the environmental pollution. At present, the tidal power plants are being built or scheduled to be built and large-scale reclamation is also under way. What is worse, those areas are seeing the increase of pension construction, which is likely to be the potential cause of damage and disturbance against some key habitats for the waterbirds. Therefore, it is a major priority that we build the bird information system to efficiently manage the knowledge-based asset collected from bird-watching groups and to better monitor the areas that need enhanced database through which the National Park can be appropriately administered.

Comparison of Pakistani Ephedra Herba and Chinese Ephedra Herba Containing Gangjihwan in the Improvement Effects of Weight Loss in a High Fat Diet-Fed Obese Mice (고지방식이 비만마우스 모델에서 파키스탄산 및 중국산 마황으로 조성된 강지환(降脂丸)의 체중감량 효과 비교)

  • Kim, Byeong Chul;Seok, Hoa Jun;Yoo, Jae Sang;Ku, Ja Ryong;Yoon, Ki Hyeon;Jo, Ju Heum;Jang, Du Hyon;Jung, Yang Sam;Kim, Jong Hoon;Ahn, Ye Ji;Woo, Sangee;Yoon, Miso;Shin, Soon Shik
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.63-76
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    • 2014
  • Objectives : This study investigated the improvement effects of Pakistani (DF-a) and Chinese Ephedra herba-containing Gangjihwan (DF-b) on obesity in a high fat diet-fed obese mouse model. Methods : Eight-week-old C57BL/6N mice were divided into four groups: a normal lean group given a standard diet, an obese control group given a high fat diet, and DF-a and DF-b groups given a high fat diet with DF-a (80 mg/kg), and DF-b (80 mg/kg), respectively. After 8 weeks of treatment, body weight gain, feeding efficiency ratio, blood lipid markers, fat weight and histology were examined. Results : 1. Body weight gain and fat mass were significantly decreased in DF-a and DF-b groups compared with control. The extent of decreases was eminent in DF-a group. 2. Feeding efficiency ratio and circulating leptin concentration were significantly decreased in DF-a and DF-b groups compared with control, whereas circulating adiponectin concentration was increased in DF-a and DF-b groups compared with control. 3. Consistent with their effects on body weight gain and fat mass, circulating concentrations of triglyceride, glucose and insulin were decreased in DF-a and DF-b groups compared with control. 4. The size of adipocytes were decreased by DF-a and DF-b compared with control, whereas the adipocyte number per unit area was increased by them, suggesting that DF-a and DF-b decreased the number of large adipocytes. 5. Consistent with their effects on body weight gain, liver fibrosis was reduced in DF-a and DF-b groups compared with control. Conclusions : In conclusion, these results suggest that DF-a and DF-b not only decrease feeding efficiency ratio, plasma leptin concentration, and blood anti-obesity biomarkers, but also reduce fat mass, contributing to the improvement of obesity. DF-a and DF-b also inhibit liver fibrosis. In addition, these effects were similar between Pakistani Ephedra herba and Chinese Ephedra herba-containing Gangjihwan.

Comparison of Gangjihwan and Combination of Gangjihwan and Gamisochehwan in the Improvement Effects of Weight Loss in a High Fat Diet-Fed Obese Mice (고지방식이 비만마우스 모델에서 파키스탄산 마황으로 조성된 강지환(降脂丸)의 단독 투여와 강지환합가미소체환(降脂丸合加味消滯丸)의 병용 투여의 체중감량 효과 비교)

  • Seok, Hoa Jun;Yoo, Jae Sang;Ku, Ja Ryong;Yoon, Ki Hyeon;Jo, Ju Heum;Jang, Du Hyon;Jung, Yang Sam;Kim, Jong Hoon;Kim, Byeong Chul;Roh, Jong Seong;Lee, Hye Rim;Lee, Hyunghee;Yoon, Michung;Shin, Soon Shik
    • Herbal Formula Science
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    • v.22 no.2
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    • pp.105-120
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    • 2014
  • Objectives : This study was investigated the improvement effects of Gangjihwan (DF) and combination of Gangjihwan and Gamisochehwan (GSH) on obesity in a high fat diet-fed obese mouse model. Methods : Eight-week-old C57BL/6N mice were divided into four groups: a normal lean group given a standard diet, an obese control group given a high fat diet, and DF and DF+GSH groups given a high fat diet with DF (40 mg/kg), and DF+GSH (80 mg/kg), respectively. After 8 weeks of treatment, body weight gain, feeding efficiency ratio, blood lipid markers, fat weight and histology were examined. Results : 1. Body weight gain and fat mass were significantly decreased in DF and DF+GSH groups compared with control. The extent of decreases was eminent in DF+GSH group. 2. Feeding efficiency ratio and circulating concentration of leptin were decreased in DF and DF+GSH groups compared with control. These decreases were significant in DF+GSH group. 3. Consistent with their effects on body weight gain and fat mass, circulating concentrations of triglyceride, glucose and insulin were decreased in DF and DF+GSH groups compared with control. 4. The size of adipocytes was decreased by DF and DF+GSH compared with control, whereas the adipocyte number per unit area was increased by them, suggesting that DF and DF+GSH decreased the number of large adipocytes. 5. Consistent with their effects on body weight gain, liver fibrosis was also improved in DF and DF+GSH groups compared with control. Conclusions : In conclusion, these results suggest that DF and DF+GSH groups decrease feeding efficiency ratio, plasma leptin concentration, blood anti-obesity biomarkers and fat mass, improves body weight gain contributing to the inhibition of liver fibrosis. In addition, these effects were more effective in DF+GSH combination group than in DF-only group.

Egg and Larval Development of Chelon lauvergnii from Korea (한국산 가숭어, Chelon lauvergnii의 난 및 자치어의 형태발달)

  • Kim, Jin-Koo;Kim, Yong-Uk;Byun, Soon-Gyu
    • Korean Journal of Ichthyology
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    • v.12 no.2
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    • pp.137-145
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    • 2000
  • The embryonic and larval development of Chelon lauvergnii (Eydoux & Souleyet) was surveyed by incubating artificially inseminated eggs with parent fishes obtained at Kang-wha island in the mid-western coastal area of Korea on June, 1997. The fertilized eggs were transparent, spherical in shape, measuring 0.95~1.08 mm in diameter, having a large oil globule, and their perivitelline space narrow, and began to hatch at 40 hrs. in water temperature $22{\pm}1^{\circ}C$. The newly hatched larvae were 2.35~2.68 mm in total length with 23 myomeres, anus opened, mouth closed, preanal length 58.7~61.6% of total length, oil globule located in posterior end of yolk sac. Melanophores, branch in shape, were distributed mainly along the ventro-lateral region of trunk part and a few on the anterior end of caudal part and surface of oil globule. The larvae measuring 3.08~3.36 mm in total length absorbed yolk material completely in 3 days after hatching, in which air bladder began to appear and mouth opened. In 8 days after hatching, the larva was measured 5.09 mm in total length, its posterior end of notochord began to flex upward and the caudal fin rays differentiated as 7, finfold of the second dorsal and anal fins appeared. In this time, melanophores, branch in shape, were concentrated in the anterior half region of the caudal part and a few also distributed on the top of head, snout region, ventral margin of lower jaw and isthmus region. In 12 days after hatching, the larva measuring 8.48 mm in total length completed all the fins (D. IV-9; P1. 16; P2. I, 5; A. II, 9) and reached to the juvenile stage. Melanophores, in this time, were distributed on the mid-lateral region of the caudal part in enlargment than before and a few also found in the dorso-lateral region of the trunk part, and in the cheek region.

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The Research to Correct Overestimation in TOF-MRA for Severity of Cerebrovascular Stenosis (3D-SPACE T2 기법에 의한 TOF-MRA검사 시 발생하는 혈관 내 협착 정도의 측정 오류 개선에 관한 연구)

  • Han, Yong Su;Kim, Ho Chul;Lee, Dong Young;Lee, Su Cheol;Ha, Seung Han;Kim, Min Gi
    • Journal of the Institute of Electronics and Information Engineers
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    • v.51 no.12
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    • pp.180-188
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    • 2014
  • It is very important accurate diagnosis and quick treatment in cerebrovascular disease, i.e. stenosis or occlusion that could be caused by risk factors such as poor dietary habits, insufficient exercise, and obesity. Time-of-flight magnetic resonance angiography (TOF-MRA), it is well known as diagnostic method without using contrast agent for cerebrovascular disease, is the most representative and reliable technique. Nevertheless, it still has measurement errors (also known as overestimation) for length of stenosis and area of occlusion in celebral infarction that is built by accumulation and rupture of plaques generated by hemodynamic turbulence. The purpose of this study is to show clinical trial feasibility for 3D-SPACE T2, which is improved by using signal attenuation effects of fluid velocity, in diagnosis of cerebrovascular disease. To model angiostenosis, strictures of different proportions (40%, 50%, 60%, and 70%) and virtual blood stream (normal saline) of different velocities (0.19 ml/sec, 1.5 ml/sec, 2.1 ml/sec, and 2.6 ml/sec) by using dialysis were made. Cross-examinations were performed for 3D-SPACE T2 and TOF-MRA (16 times each). The accuracy of measurement for length of stenosis was compared in all experimental conditions. 3D-SPACE 2T has superiority in terms of accuracy for measurements of the length of stenosis, compared with TOF-MRA. Also, it is robust in fast blood stream and large stenosis than TOF-MRA. 3D-SPACE 2T will be promising technique to increase diagnosis accuracy in narrow complex lesions as like two cerebral small vessels with stenosis, created by hemodynamic turbulence.

The Generation of Westerly Waves by Sobaek Mountains (소백산맥에 의한 서풍 파동 발생)

  • Kim, Jin wook;Youn, Daeok
    • Journal of the Korean earth science society
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    • v.38 no.1
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    • pp.24-34
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    • 2017
  • The westerly waves generation is described in the advanced earth science textbook used at high school as follows: as westerly wind approaches and blows over large mountains, the air flow shows wave motions in downwind side, which can be explained by the conservation of potential vorticity. However, there has been no case study showing the phenomena of the mesoscale westerly waves with observational data in the area of small mountains in Korea. And thus the wind speed and time persistency of westerly winds along with the width and length of mountains have never been studied to explain the generation of the westerly waves. As a first step, we assured the westerly waves generated in the downwind side of Sobaek mountains based on surface station wind data nearby. Furthermore, the critical or minimum wind velocity of the westerly wind over Sobaek mountains to generate the downwind wave were derived and calcuated tobe about $0.6m\;s^{-1}$ for Sobaek mountains, which means that the westerly waves could be generated in most cases of westerly blowing over the mountains. Using surface station data and 4-dimensional assimilation data of RDAPS (Regional Data Assimilation and Prediction System) provided by Korea Meteorological Agency, we also analyzed cases of westerly waves occurrence and life cycle in the downwind side of Sobaek mountains for a year of 2014. The westerly waves occurred in meso-${\beta}$ or -${\gamma}$ scales. The westerly waves generated by the mountains disappeared gradually with wind speed decreasing. The occurrence frequency of the vorticity with meso-${\beta}$ scale got to be higher when the stronger westerly wind blew. When we extended the spatial range of the analysis, phenomena of westerly waves were also observed in the downwind side of Yensan mountains in Northeastern China. Our current work will be a study material to help students understand the atmospheric phenomena perturbed by mountains.

Sensitivity of NOx Removal on Recycled TiO2 in Cement Mortar (재생 이산화티탄을 혼입한 모르타르의 NOx 저감률 민감도 분석)

  • Rhee, Inkyu;Kim, Jin-Hee;Kim, Jong-Ho;Roh, Young-Sook
    • Journal of the Korean Recycled Construction Resources Institute
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    • v.4 no.4
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    • pp.388-395
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    • 2016
  • This paper explores the photocatalytic sensitivity of cement mortar incorporated with recycled $TiO_2$ from waste water sludge. Basically, $TiO_2$ cluster sank down slowly to the bottom of cement mortar specimen before setting and hardening process. This leads the mismatch of $TiO_2$ concentration on the top and the bottom faces of a specimen. This poorly dispersed $TiO_2$-cement mortar naturally exhibits poor NOx removal efficiency especially on the top of cementitious structure. In architectural engineering application such as building or housing structures, one can simply filp over from the bottom so that more $TiO_2$ concentrated surface can be placed outward into the air. However, in highway pavement case, this could not be applicable due to in-situ installation of concrete pavement. Hence, the dispersion of $TiO_2$ cluster inside the cementitous material is getting important issue onto road construction application. To elaborate this issue, according to our results, silica fume, high-ranged water reducer, viscosity agent, blast furnace slag were not enhanced much of dispersion characteristics of $TiO_2$ cluster. The combination of foaming agent and accelerator of hardening with viscosity agent and small grain size of fine aggregate may help the dispersion of $TiO_2$ inside cementitious materials. Even though the enhanced dispersion were applied to the specimen, NOx removal efficiency doest not change much for the top surface of the specimen. This concurrently affected by the presence of tiny air voids and the dispersion of $TiO_2$ in that these voids could easily adsorbed NOx gas with the aid of large surface area.