Journal of The Korea Institute of Healthcare Architecture
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v.29
no.2
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pp.17-26
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2023
Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.
An, Jiwon;Yang, Young Kwon;Won, An-Na;Hwang, Jung Ha;Park, Jin Chul
Journal of Korean Living Environment System
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v.25
no.1
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pp.90-97
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2018
The purpose of this study is to compare and analyze the air infections in middle and small hospitals with the facilities of large national hospitals that have air-borne infection isolation (AII) wards through actual condition investigation and airflow analysis simulation (CFD) and to provide basic data for prevention. The method and scope of the study are as follows. First, through literature review, data related to prevention of infection spread in domestic medical institutions were investigated. Second, we conducted a survey on the status of isolation facilities to prevent the spread of infectious diseases in large hospitals and small and medium - sized clinics in Korea. Third, airflow analysis simulation (CFD) was carried out using the isolation ward of the nationally designated inpatient ward and the data of the plane and facility system of the small clinic. As a result of the study, it is found that regulations applicable to small and medium-sized clinics are insufficient. In addition, the simulation results show that the infectious disease virus is likely to spread to other patients in the hospital.
Dong-Uk Park;Kyung Ehi Zoh;Eun Kyo Jeong;Dong-Hee Koh;Kyong-Hui Lee;Naroo Lee;Kwonchul Ha
Safety and Health at Work
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v.15
no.1
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pp.87-95
/
2024
Background: This study focuses on assessing occupational risk for the health hazards encountered during maintenance works (MW) in semiconductor fabrication (FAB) facilities. Objectives: The objectives of this study include: 1) identifying the primary health hazards during MW in semiconductor FAB facilities; 2) reviewing the methods used in evaluating the likelihood and severity of health hazards through occupational health risk assessment (OHRA); and 3) suggesting variables for the categorization of likelihood of exposures to health hazards and the severity of health effects associated with MW in FAB facilities. Methods: A literature review was undertaken on OHRA methodology and health hazards resulting from MW in FAB facilities. Based on this review, approaches for categorizing the exposure to health hazards and the severity of health effects related to MW were recommended. Results: Maintenance workers in FAB facilities face exposure to hazards such as debris, machinery entanglement, and airborne particles laden with various chemical components. The level of engineering and administrative control measures is suggested to assess the likelihood of simultaneous chemical and dust exposure. Qualitative key factors for mixed exposure estimation during MW include the presence of safe operational protocols, the use of air-jet machines, the presence and effectiveness of local exhaust ventilation system, chamber post-purge and cooling, and proper respirator use. Using the risk (R) and hazard (H) codes of the Globally Harmonized System alongside carcinogenic, mutagenic, or reprotoxic classifications aid in categorizing health effect severity for OHRA. Conclusion: Further research is needed to apply our proposed variables in OHRA for MW in FAB facilities and subsequently validate the findings.
Kim, Dong Sik;Park, Jae Yong;Kam, Sin;Cha, Byung Jun
Journal of the Korean Society of School Health
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v.10
no.2
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pp.157-167
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1997
This study was conducted to investigate follow up tests and related factors in students who tested positive for in urine tests. For the purpose of this study, the authors analysed a self-administered questionnaire collected from 316 middle school students and 451 high school students who had positive urinalysis results in Kyungpook province during the month of February, 1996. The major findings of this study were as follows : The proportion of follow up tests among students was 39.2% in middle school students and 34.1% in high school students. There was a significant relation among a number of factors : parents' environment, health concern, and knowledge of urinalysis results, existence of nursing teachers, education concerning urinalysis, medical facility visits, and notification methods. In a multiple logistic regression analysis a higher economic level, parents' concern, knowledge of urinalysis results, medical facility visits, anti direct notification of parents were all significantly related with the follow up tests. On consideration of the above findings, in order to perform practical and effective follow-up management of students who have a positive result in urine test, direct notification of urine test result to parents as well as active health guidance in school are required.
This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year$(1994.4.13\sim1995.4.12)$ at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows ; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8 % of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.
As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.
A computed tomography (CT) is a powerful system for the effectively fast and accurate diagnosis. The CT system, therefore, has used substantially and developed for improving the performance over the past decade, resulting in growing concerns over the radiation dose from the CT. Advanced CT techniques, such as a multidetector row CT scanner and dual energy or dual source CT, have led to new clinical applications that could result in further increases of radiation does for both patients and workers. The objective of this study was to review the international guidelines of the shielding requirements for a CT facility required for a new installation or when modifying an existing one. We used Google Search Engine to search the following keywords: computed tomography, CT regulation or shield or protection, dual energy or dual source CT, multidetector CT, CT radiation protection, and regulatory or legislation or regulation CT. In addition, we searched some special websites, that were provided for sources of radiation protection, shielding, and regulation, RSNA, AAPM, FDA, NIH, RCR, ICRP, IRPA, ICRP, IAEA, WHO (See in Table 1 for full explanations of the abbreviations). We finally summarized results of the investigated materials for each country. The shielding requirement of the CT room design was very well documented in the countries of Canada, United States of America, and United Kingdom. The wall thickness of the CT room could be obtained by the iso-exposure contour or the point source method. Most of documents provided by international organizations were explained in importance of radiation reduction in patients and workers. However, there were no directly-related documents of shielding and patient exposure dose for the dual energy CT system. Based international guidelines, the guideline of the CT room shielding and radiation reduction in patients and workers should be specified for all kinds of CT systems, included in the dual energy CT. We proposed some possible strategies in this paper.
Kim Dae-Sup;Kim Jeong-Man;Lee Hee-Seok;Lim Ra-Seung;Kim You-Hyun
The Journal of Korean Society for Radiation Therapy
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v.17
no.2
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pp.141-145
/
2005
Purpose : It is known that the neutron is generally generated from the photon, its energy is larger than 10 MV. The neutron is leaked in the container inspection system installed at the customs though its energy is below 9 MV. It is needed that the spacial effect of the neutrons released from radiation treatment machine, linac, installed in the medical canter. Materials and Methods : The medical linear accelerator(Clinac 1800, varian, USA) was used in the experiment. Measuring neutron was used bubble detector(Bubble detector, BDPND type, BTI, Canada) which was created bubble by neutron. The bubble detector is located on the medical linear accelerator outskirt in three different distance, 30, 50, 120 cm and upper, lower four point from the iso-center. In addition, for effect on protect material we have measured eight points which are 50 cm distance from iso-center. The SAD(source-axis-distance), distance from photon source to iso-center, is adjusted to 100 cm and the field size is adjusted to $15{\times}15cm^2$. Irradiate 20 MU and calculate the dose rate in mrem/MU by measuring the number of bubble. Results : The neutron is more detected at 5 position in 30, 50 cm, 7 position in 120 cm and with wedge, and 2 position without mount. Conclusion : Though detection position is laid in the same distance in neutron measurement, the different value is shown in measuring results. Also, neutron dose is affected by the additional structure, the different value is obtained in each measurement positions. So, it is needed to measure and evaluate the neutron dose in the whole space considering the effect of the distance, angular distribution and additional structure.
The purpose of the Monte Carlo simulation study was to provide the optimized nozzle design to satisfy the beam conditions for biomedical researches in the Korean heavy-ion accelerator, RAON. The nozzle design was required to produce $C^{12}$ beam satisfying the three conditions; the maximum field size, the dose uniformity and the beam contamination. We employed the GEANT4 toolkit in Monte Carlo simulation to optimize the nozzle design. The beams for biomedical researches were required that the maximum field size should be more than $15{\times}15cm^2$, the dose uniformity was to be less than 3% and the level of beam contamination due to the scattered radiation from collimation systems was less than 5% of total dose. For the field size, we optimized the tilting angle of the circularly rotating beam controlled by a pair of dipole magnets at the most upstream of the user beam line unit and the thickness of the scatter plate located downstream of the dipole magnets. The values of beam scanning angle and the thickness of the scatter plate could be successfully optimized to be $0.5^{\circ}$ and 0.05 cm via this Monte Carlo simulation analysis. For the dose uniformity and the beam contamination, we introduced the new beam configuration technique by the combination of scanning and static beams. With the combination of a central static beam and a circularly rotating beam with the tilting angle of $0.5^{\circ}$ to beam axis, the dose uniformity could be established to be 1.1% in $15{\times}15cm^2$ sized maximum field. For the beam contamination, it was determined by the ratio of the absorbed doses delivered by $C^{12}$ ion and other particles. The level of the beam contamination could be achieved to be less than 2.5% of total dose in the region from 5 cm to 17 cm water equivalent depth in the combined beam configuration. Based on the results, we could establish the optimized nozzle design satisfying the beam conditions which were required for biomedical researches.
This study analyzed the impact of direct and indirect subsidies on profitability in general hospitals in Korea. The data were collected from medical institution accounting information disclosure system of 270 general hospitals from 2016 to 2018. The analysis index used the ratio of net profit to business revenue for profitability, and Subsidies index the ratio of subsidies to business revenue(state subsidies for facility investment purposes, Fund related to essential business, research revenue and contribution revenue). According to the study, the ratio of state subsidies, which are direct subsidies, was very high at 57.30 percent for public institution hospitals. ratio of Fund related to essential business, which is a tax reduction effect with indirect subsidies, had the highest at 6.69 percent for Private University Hospitals. which are Indirect subsidies for deficit or operational assistance, research revenue ratio had the highest 2.8 percent for National University Hospitals, contribution revenue ratio had the highest 36.4 percent for public institutions. As a result of looking at the impact of subsidies on profitability, Nation University Hospitals had the lower the ratio of Fund related to essential business and the ratio of research revenue, the higher the net profit ratio of Business revenue. Medical Corporation Hospitals and Foundation Hospitals had the higher the ratio of Fund related to essential business to business revenues, the higher the net profit ratio of business revenue. These results mean that profitability may fluctuate depending on the utilization of funds related to essential business.
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