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Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Impact of a 'Proactive Self-Audit Program of Fraudulent Claims' on Healthcare Providers' Claims Patterns: Intravenous Injections (KK020) (부당청구 예방형 자율점검제가 의료기관의 청구행태에 미치는 영향: 정맥 내 일시주사(KK020)를 중심으로)

  • Hee-Hwa Lee;Young-Joo Won;Kwang-Soo Lee;Ki-Bong Yoo
    • Health Policy and Management
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    • v.34 no.2
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    • pp.163-177
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    • 2024
  • Background: This study aims to examine changes in fraudulent claim counts and total reimbursements before and after enhancements in counterfeit claim controls and monitoring of provider claim patterns under the "Proactive self-audit pilot program of fraudulent claims." Methods: This study used the claims data and hospital information (July 2021-February 2022) of the Health Insurance Review and Assessment Service. The data was collected from 1,129 hospitals assigned to the pilot program, selected from the providers who filed a claim for reimbursement for intravenous injections. Paired and independent t-tests, along with regression analysis, were utilized to analyze changing patterns and factors influencing claim behaviors. Results: This program led to a reduction in the number of fraudulent claims and the total amount of reimbursements across all levels of hospitals in the experimental groups (except for physicians below 40 years old). In the control group, general hospitals and hospitals demonstrated some significant decreases based on the duration since opening, while clinics showed significant reductions in specified subjects. Additionally, a notable increase was observed among male physicians over the age of 50 years. Overall, claims and reimbursements significantly declined after the intervention. Furthermore, a positive correlation was found between hospital opening duration and claim numbers, suggesting longer-established hospitals were more likely to file claims. Conclusion: The results indicate that the pilot program successfully encouraged providers to autonomously minimize fraudulent claims. Therefore, it is advised to extend further support, including promotional activities, training, seminars, and continuous monitoring, to nonparticipating hospitals to facilitate independent improvements in their claim practices.

Development of a Model of Brain-based Evolutionary Scientific Teaching for Learning (뇌기반 진화적 과학 교수학습 모형의 개발)

  • Lim, Chae-Seong
    • Journal of The Korean Association For Science Education
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    • v.29 no.8
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    • pp.990-1010
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    • 2009
  • To derive brain-based evolutionary educational principles, this study examined the studies on the structural and functional characteristics of human brain, the biological evolution occurring between- and within-organism, and the evolutionary attributes embedded in science itself and individual scientist's scientific activities. On the basis of the core characteristics of human brain and the framework of universal Darwinism or universal selectionism consisted of generation-test-retention (g-t-r) processes, a Model of Brain-based Evolutionary Scientific Teaching for Learning (BEST-L) was developed. The model consists of three components, three steps, and assessment part. The three components are the affective (A), behavioral (B), and cognitive (C) components. Each component consists of three steps of Diversifying $\rightarrow$ Emulating (Executing, Estimating, Evaluating) $\rightarrow$ Furthering (ABC-DEF). The model is 'brain-based' in the aspect of consecutive incorporation of the affective component which is based on limbic system of human brain associated with emotions, the behavioral component which is associated with the occipital lobes performing visual processing, temporal lobes performing functions of language generation and understanding, and parietal lobes, which receive and process sensory information and execute motor activities of the body, and the cognitive component which is based on the prefrontal lobes involved in thinking, planning, judging, and problem solving. On the other hand, the model is 'evolutionary' in the aspect of proceeding according to the processes of the diversifying step to generate variants in each component, the emulating step to test and select useful or valuable things among the variants, and the furthering step to extend or apply the selected things. For three components of ABC, to reflect the importance of emotional factors as a starting point in scientific activity as well as the dominant role of limbic system relative to cortex of brain, the model emphasizes the DARWIN (Driving Affective Realm for Whole Intellectual Network) approach.

Distribution Patterns of Carbon and Nitrogen Contents in the Sediments of the Northeast Equatorial Pacific Ocean (북동 적도태평양해역 퇴적물의 탄소 및 질소함량 분포특성)

  • Kim, Kyeong-Hong;Hyun, Jung-Ho;Son, Ju-Won;Son, Seung-Jyu
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.13 no.3
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    • pp.210-221
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    • 2008
  • The mesoscale environmental surveys were conducted between $5^{\circ}N\;and\;17^{\circ}N$ mainly along the $131.5^{\circ}W$ meridian from 1997 to 2002 to investigate controlling factors of carbon and nitrogen contents in bottom sediments. Sediments of the study area showed zonal distribution pattern depending on latitudinal position and can be classified into four types; calcareous ooze($5{\sim}6^{\circ}N$), siliceous sediments($8{\sim}12^{\circ}N$), pelagic red clay($16{\sim}17^{\circ}N$), and mixed sediments($7^{\circ}N$). Inorganic carbon(IC) contents varied depending on water depth and carbonate compensation depth(CCD). Carbonate materials were well preserved in the low latitude region, where water depths are shallower than CCD. In contrast, the higher latitude region dominated by siliceous sediment and pelagic red clays has low productivity in water column as well as the water depths deeper than CCD. Thus, most of carbonate materials were dissolved, which resulted in IC contents of less than 0.05% in the sediments. Organic carbon(OC) and total nitrogen contents(TN) in siliceous sediments were higher than in pelagic red clay sediments simply because of higher primary productivity in the siliceous sediment dominated area. The contents of OC and TN were lower in the calcareous ooze than in the siliceous sediments. It is attributed to the high input of calcareous material to the bottom due to relatively shallow water depth of the area, which diluted organic matter contents in the sediment. Overall results indicated that water depth relative to CCD, primary production in water column, and sedimentation rate largely controls the large-scale distribution of carbon and nitrogen contents in the study area.

Structure of the Phytoplanktonic communities in Jeju Strait and Northern East China Sea and Dinoflagellate Blooms in Spring 2004: Analysis of Photosynthetic Pigments (봄철 제주해협과 동중국해 북부해역에서 식물플랑크톤의 광합성 색소분석을 이용한 군집 분포 특성과 dinoflagellate 적조)

  • Park, Mi-Ok;Kang, Sung-Won;Lee, Chung-Il;Choi, Tae-Seob;Lantoine, Francois
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.13 no.1
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    • pp.27-41
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    • 2008
  • Distribution characteristics of phytoplankton community were investigated by HPLC and flow cytometry in Jeju Strait and the Northern East China Sea (NECS) in May 2004, in order to understand the relationship between physical environmental factors and distribution pattern of phytoplankton communities. Based on temperature and salinity data, three distinct water masses were identified; warm and saline Tsushima Warm Current (TWC), which is flowing from northwest of Jeju Island, warm and low saline water at the center of Jeju Strait, which is originated from China Coastal Water (CCW) and relatively cold and high saline water originated from Yellow Sea at the bottom of the Jeju Strait. At Jeju Strait, less saline water (<33 psu) of 15 km width occupied surface layer up to 20 m which located at 20 km offshore and strong thermal front between warm and saline water and cold and less saline water was found in the middle of the Jeju Strait. Vertical transect of temperature and salinity at the NECS also showed that low saline (<33 psu) water occupied the upper 20 m layer and cold and saline water was present at the eastern part. Chl a was measured as $0.06{\sim}3.07\;{\mu}g/L$. Spring bloom of phytoplankton was recognized by the high concentrations of Chl a at the low saline water masses influenced by the CCW and subsurface chlorophyll maximum layer appeared between $20{\sim}30\;m$ depth, which was at thermocline depth or below. Abundances of Synechococcus and picoeukaryote were $0.2{\sim}9.5{\times}10^4\;cells/mL$ and $0.43{\sim}4.3{\times}10^4\;cells/mL$, respectively. Dinoflagellate, diatom and prymnesiophyte were major groups and minor groups were chlorophyte+prasinophyte, chrysophyte, cryptophyte and cyanophyte. Especially high abundance of dinoflagellate was identified by high concentration (>1\;{\mu}g/L$) of peridinin at the bottom of the thermocline, which showed an outbreak of red tide by high density of dinoflagellates. Abundances of picoeukaryote in Jeju Strait were about $5{\sim}10$ times higher than abundance measured in Kuroshio water and showed a good correlation with Chl b (Pras+Viola), which implies the most of population of picoeukaryote was composed of prasinophytes. Prochlorococcus was not detected at all, which suggests that Kuroshio Current did not directly influenced on the study area. Based on the strong negative correlations between biomass of phytoplankton (Chl a) and temperature+salinity, the primary production and biomass of phytoplankton in the study area were controlled by the nutrients supply from CCW.

Impact of Fish Farming on Macrobenthic Polychaete Communities (해상 가두리 양식이 저서 다모류군집에 미치는 영향)

  • Jung, Rae-Hong;Yoon, Sang-Pil;Kwon, Jung-No;Lee, Jae-Seong;Lee, Won-Chan;Koo, Jun-Ho;Kim, Youn-Jung;Oh, Hyun-Taik;Hong, Sok-Jin;Park, Sung-Eun
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.3
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    • pp.159-169
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    • 2007
  • Excessive input of organic matters from fish cage farms to the coastal waters has been considered as one of the major factors disturbing their benthic ecosystem. Sediment samples were taken from around the two fish cage zones (A and B) in Tongyeong coast in June and August 2003, to evaluate the ecological impacts of fish cage farming activity on the macrobenthic polychaete communities. Polychaete accounted for $81{\sim}87%$ of the total macrofauna individuals from each of the sampling stations. The number of species, abundance, diversity and dominant species of polychaete were rapidly changed with the distance from the fish cages. Within 10 m from the fish cages, Capitella capitata, which is a bio-indicator for the highly enriched sediments, was a dominant species and the lowest diversity was recorded. In particular, the maximum density (${\sim}18,410\;ind.m^2$) of C. capitata was found at Farm A where fish cages were more densely established within a semi-enclosed bay system. The sampling zone between 10 m and 15 m showed a rapid decrease of C. capitata with a rapid increase of the numbers of species, implying that this zone may be an ecotone point from a highly to a slightly enriched area. In the sampling zone between 15 m and 60 m, a transitional zone, which represents slightly enriched condition before normal one, was observed with additional increase and maintenance of the number of species and density of polychaete. In addition, the potential bio-indicators of organic enrichment, such as Lumbrineris longifolia and Aphelochaeta monilaris were the predominant species in the sampling zone. Multidimensional scaling (MDS) ordination plots and k-dominance curves confirmed the above results on the gradual changes in the macrobenthic polychaete communities. Our findings suggest that the magnitude of impact of fish cage farming activity on polychaete communities is probably governed by a distance from fish cage, density of fish cage and geomorphological characteristics around fish cage farm.

Change of Blooming Pattern and Population Dynamics of Phytoplankton in Masan Bay, Korea (마산만 식물플랑크톤의 대발생 양상의 변화와 군집 동태)

  • Lee, Ju-Yun;Han, Myung-Soo
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.3
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    • pp.147-158
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    • 2007
  • To clarify the bloom pattern and species succession in phytoplankton community, the population dynamics with the determination of physico-chemical factors have been studies in Masan Bay, the south sea of Korea, for the periods November 2003-October 2004. Concentration of $NH_4-N$ was always higher than that of $NO_3-N$, which was similar level as compared to other costal areas. $PO_4-P$ concentration was lower than those in other coastal areas but similar to oligotrophic environments. Thus, phosphate seems the limiting nutrient rather than nitrogen. $SiO_2-Si$ concentration was also low as compared to other costal areas. Si:P ratio was low from autumn to winter, suggesting silicate and/or phosphate limitation during this period. The cell density of phytoplankton was high in winter 2003 and early autumn 2004. The carbon biomass was high in winter 2003 and summer 2004. And chlorophyll-a concentration was high in late autumn 2003 and summer 2004. Among 78 species of phytoplankton found in the bay during the investigated period, dominant species were two diatoms of Cylindrotheca closterium, Skeletonema costatum, and three dinoflagellates of Heterocapsa triquetra, Prorocentrum minimum, P. triestinum, and one raphidophyte of Heterosigma akashiwo. P. minimum dominated from late autumn to winter, but it was replaced by H. triquetra in late winter. P. triestinum dominated from late spring to early summer. Simultaneously, H. akashiwo cell density steadily increased, and it became dominant with C. closterium in late summer. With decreasing of H. akashiwo and C. closterium, S. costatum became the most dominant species in autumn. The canonical analyses showed that total phytoplankton cell density related to diatom cell density and it was affected by temperature, and concentrations of $NO_3-N\;and\;PO_4-P$. The carbon bio-mass and $chlorophyll-{\alpha}$ concentration related to diatom- and dinoflagellate cell densities and these were affected by flagellate cell density, salinity, and concentrations of $SiO_2-Si\;and\;PO_4-P$. Last six years monitoring data in Masan city obtained from Korean Meteorological Agency indicates gradual increase in air temperature. And the precipitation decreased especially in spring season. The winter bloom found in 2003 may be caused by the increase in the temperature and this bloom subsequently induced the nutrients depletion, which continued until next spring probably due to no precipitation. Therefore, the spring bloom, which had been usually observed in the bay, might disappear in 2004.

The Association of Dual Job on Dental Hygienists' Job Satisfaction (치과위생사의 직무만족도와 동시일자리(부업)의 관련성)

  • Mi-Sook Yoon;Go-eun Kim;Han-A Cho
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.51-64
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    • 2023
  • Background: This study was conducted to determine the association with dual jobbing on dental hygienists' job satisfaction and to identify the factors that lead to dual jobs. Methods: This study was an online survey of 110 currently employed dental hygienists conducted during the month of May 2022. To determine job satisfaction, we used the 20-item Korea-Minnesota Satisfaction Questionnaire (K-MSQ). Survey questions related to dual job were adapted and supplemented from the dual job survey instrument for dental hygienists to identify intention to dual job and future intention to dual job. Descriptive statistics, independent t-test, ANOVA and Scheffe's post hoc analysis, and multiple logistic regression were performed. Results: The dual job rate and future dual job rate of the participants in this study were about 27% and 47%, respectively. The means for Intrinsic job satisfaction, Extrinsic job satisfaction, and job satisfaction were 3.44, 3.15, and 3.36, respectively. It was statistically significant that extrinsic job satisfaction increased with increasing position, and intrinsic job satisfaction, extrinsic job satisfaction, and job satisfaction increased with increasing salary. Those currently working dual jobs cited "self-actualization" as a reason for doing so, and those who intended to work dual jobs in the future cited "not being paid enough in their primary job" as a reason. We found that a one-unit increase in intrinsic job satisfaction and job satisfaction increases the odds of future intention to dual job by about 1.07 and 1.05 times, respectively (p<0.05). Conclusion: This study confirmed the influence of dental hygienists' job satisfaction on intention to dual job and future intention to dual job, and self-actualization was found to be the main factor. Therefore, the consideration of dual jobs in the future will affect the improvement of dental hygienists as professionals and the reduction of turnover through better working conditions.

A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Analysis of Greenhouse Thermal Environment by Model Simulation (시뮬레이션 모형에 의한 온실의 열환경 분석)

  • 서원명;윤용철
    • Journal of Bio-Environment Control
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    • v.5 no.2
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    • pp.215-235
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    • 1996
  • The thermal analysis by mathematical model simulation makes it possible to reasonably predict heating and/or cooling requirements of certain greenhouses located under various geographical and climatic environment. It is another advantages of model simulation technique to be able to make it possible to select appropriate heating system, to set up energy utilization strategy, to schedule seasonal crop pattern, as well as to determine new greenhouse ranges. In this study, the control pattern for greenhouse microclimate is categorized as cooling and heating. Dynamic model was adopted to simulate heating requirements and/or energy conservation effectiveness such as energy saving by night-time thermal curtain, estimation of Heating Degree-Hours(HDH), long time prediction of greenhouse thermal behavior, etc. On the other hand, the cooling effects of ventilation, shading, and pad ||||&|||| fan system were partly analyzed by static model. By the experimental work with small size model greenhouse of 1.2m$\times$2.4m, it was found that cooling the greenhouse by spraying cold water directly on greenhouse cover surface or by recirculating cold water through heat exchangers would be effective in greenhouse summer cooling. The mathematical model developed for greenhouse model simulation is highly applicable because it can reflects various climatic factors like temperature, humidity, beam and diffuse solar radiation, wind velocity, etc. This model was closely verified by various weather data obtained through long period greenhouse experiment. Most of the materials relating with greenhouse heating or cooling components were obtained from model greenhouse simulated mathematically by using typical year(1987) data of Jinju Gyeongnam. But some of the materials relating with greenhouse cooling was obtained by performing model experiments which include analyzing cooling effect of water sprayed directly on greenhouse roof surface. The results are summarized as follows : 1. The heating requirements of model greenhouse were highly related with the minimum temperature set for given greenhouse. The setting temperature at night-time is much more influential on heating energy requirement than that at day-time. Therefore It is highly recommended that night- time setting temperature should be carefully determined and controlled. 2. The HDH data obtained by conventional method were estimated on the basis of considerably long term average weather temperature together with the standard base temperature(usually 18.3$^{\circ}C$). This kind of data can merely be used as a relative comparison criteria about heating load, but is not applicable in the calculation of greenhouse heating requirements because of the limited consideration of climatic factors and inappropriate base temperature. By comparing the HDM data with the results of simulation, it is found that the heating system design by HDH data will probably overshoot the actual heating requirement. 3. The energy saving effect of night-time thermal curtain as well as estimated heating requirement is found to be sensitively related with weather condition: Thermal curtain adopted for simulation showed high effectiveness in energy saving which amounts to more than 50% of annual heating requirement. 4. The ventilation performances doting warm seasons are mainly influenced by air exchange rate even though there are some variations depending on greenhouse structural difference, weather and cropping conditions. For air exchanges above 1 volume per minute, the reduction rate of temperature rise on both types of considered greenhouse becomes modest with the additional increase of ventilation capacity. Therefore the desirable ventilation capacity is assumed to be 1 air change per minute, which is the recommended ventilation rate in common greenhouse. 5. In glass covered greenhouse with full production, under clear weather of 50% RH, and continuous 1 air change per minute, the temperature drop in 50% shaded greenhouse and pad & fan systemed greenhouse is 2.6$^{\circ}C$ and.6.1$^{\circ}C$ respectively. The temperature in control greenhouse under continuous air change at this time was 36.6$^{\circ}C$ which was 5.3$^{\circ}C$ above ambient temperature. As a result the greenhouse temperature can be maintained 3$^{\circ}C$ below ambient temperature. But when RH is 80%, it was impossible to drop greenhouse temperature below ambient temperature because possible temperature reduction by pad ||||&|||| fan system at this time is not more than 2.4$^{\circ}C$. 6. During 3 months of hot summer season if the greenhouse is assumed to be cooled only when greenhouse temperature rise above 27$^{\circ}C$, the relationship between RH of ambient air and greenhouse temperature drop($\Delta$T) was formulated as follows : $\Delta$T= -0.077RH+7.7 7. Time dependent cooling effects performed by operation of each or combination of ventilation, 50% shading, pad & fan of 80% efficiency, were continuously predicted for one typical summer day long. When the greenhouse was cooled only by 1 air change per minute, greenhouse air temperature was 5$^{\circ}C$ above outdoor temperature. Either method alone can not drop greenhouse air temperature below outdoor temperature even under the fully cropped situations. But when both systems were operated together, greenhouse air temperature can be controlled to about 2.0-2.3$^{\circ}C$ below ambient temperature. 8. When the cool water of 6.5-8.5$^{\circ}C$ was sprayed on greenhouse roof surface with the water flow rate of 1.3 liter/min per unit greenhouse floor area, greenhouse air temperature could be dropped down to 16.5-18.$0^{\circ}C$, whlch is about 1$0^{\circ}C$ below the ambient temperature of 26.5-28.$0^{\circ}C$ at that time. The most important thing in cooling greenhouse air effectively with water spray may be obtaining plenty of cool water source like ground water itself or cold water produced by heat-pump. Future work is focused on not only analyzing the feasibility of heat pump operation but also finding the relationships between greenhouse air temperature(T$_{g}$ ), spraying water temperature(T$_{w}$ ), water flow rate(Q), and ambient temperature(T$_{o}$).

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