• 대한소아치과학회지
• /
• 제50권2호
• /
• pp.205-216
• /
• 2023

이 연구의 목적은 3D 프린팅 레진의 연마 방법에 따른 색조 안정성과 표면 조도를 시간에 따라 비교하는 것이다. 3D 프린터와 TC-80DP 레진을 이용하여 3D 프린팅 레진 시편을 제작하였고, 각 시편은 연마하지 않은 군, Enhance^®군, Sof-Lex^TM군으로 분류되었다. 각 군은 연마 직후 기준점을 측정하고, 다시 인공 타액과 오렌지 주스에 나누어 침전시킨 뒤, 침전 1, 7, 30, 60일에 CIE L^*a^*b^* 값의 색차(ΔE^*)와 각 시점의 표면 조도가 측정되었다. 연구 결과, 60일 침전 후 인공 타액에서는 육안으로 확인 가능한 정도의 색조 변화는 일어나지 않았으나 오렌지 주스에서는 육안으로 확인 가능한 색조 변화가 나타났고, 용액에 따른 차이는 유의미했다. 표면 조도는 Sof-Lex^TM군에서만 오렌지 주스가 인공 타액보다 유의하게 높았다. 연마 방법에 따른 색조 변화의 차이는 없었으나 표면 조도는 Sof-Lex^TM군이 연마하지 않은 군과 Enhance^®군보다 유의하게 낮았으며, 모든 군에서 치태 침착 임계 조도보다는 높았지만, 임상적으로 허용 가능한 정도였다. 이번 연구 결과, 유전치 전장관 수복을 위해 영구 수복용 3D 프린팅 레진 사용 시 착색제 섭취에 유의해야 하며, SofLex^TM를 이용하여 연마하는 것이 권장된다.

• 자원환경지질
• /
• 제56권2호
• /
• pp.125-138
• /
• 2023

수계 내 세슘(cesium: Cs)을 제거하기 위하여 개발된 대부분의 기존 Cs 흡착제들은 원재료 값이 고가라는 단점과, 해수와 같이 높은 이온 강도와 낮은 Cs 농도를 가지는 대규모의 오염수를 실질적으로 정화하는데 한계를 가지고 있었다. 본 연구에서는 석탄광산배수를 처리하는 과정에서 생성되는 슬러지(CMDS)에 Na와 S를 첨가하여 친환경적이고 높은 Cs 제거 효율을 가지는 Cs 흡착제를 개발하였다. Fe 및 Ca 함량이 풍부한 CMDS를 1차 소재로 사용하였고, 열처리 과정으로 Na와 S를 첨가하여 새로운 Cs 흡착제를 제조하였다(이하 본 연구에서 개발한 흡착제는 Na-S-CMDS라 명명함). Na-S-CMDS의 Cs 흡착능 및 흡착 기작을 평가하기 위해 실험실 규모의 실험과 흡착 동역학 및 등온 모델링 연구를 수행하였으며, XRF, XRD, SEM/EDS, XPS 등의 분석을 통해 Na-S-CMDS의 물리화학적, 광물학적 특성을 조사함으로써 Cs 흡착 기작을 규명하였다. 흡착 배치 실험 결과, Cs은 빠르게 Na-S-CMDS에 흡착되어 1시간 내 평형에 도달하였으며, 낮은 Cs 농도(0.5 mg/L) 조건에서도 높은 Cs 제거 효율(> 90.0%)을 보였다. 흡착 등온 모델링 결과, 단일 흡착을 가정하는 Langmuir 흡착 등온 모델에 대응되는 경향을 보였으며, 흡착 동역학 모델링 결과 흡착 경향이 유사 2차 속도(pseudo second order kinetic) 모델과 일치하는 경향을 보였고, 이러한 결과는 단순한 물리적 흡착보다 이온 교환과 같은 화학적 흡착이 우세함을 의미한다. 고농도의 Cs 용액으로 반응시킨 Na-S-CMDS의 XRF/XRD 분석 결과, Na-S-CMDS 내 Na 함량은 감소하고 흡착 전 존재하던 erdite (NaFeS₂·2(H₂O))가 관찰되지 않는 것을 통해, Na⁺과 Cs⁺ 사이에서 활발한 이온 교환 반응이 진행되었음을 알 수 있었다. XPS 분석 결과, Na-S-CMDS에서 Cs와 S 사이의 강한 결합 작용이 관찰되었으며, 이러한 Cs와 S(또는 S-복합체)내 결합에너지 감소도 Na-S-CMDS의 Cs 흡착능을 증가시키는 요인으로 판단되었다. 본 연구를 통해 기존에 폐기물로 처리되었던 석탄광산배수슬러지를 개량하여 제조한 Na-S-CMDS는 기존의 Cs 흡착제보다 제조 비용이 저렴하고, 해수 및 지하수와 같이 이온 강도는 높지만 Cs 농도가 낮은 대규모 오염 수계에서도 Cs 흡착능이 높게 유지되어, 현장에서 효과적인 Cs 흡착제로 사용할 수 있을 것으로 기대한다.

• Journal of Preventive Medicine and Public Health
• /
• 제20권1호
• /
• pp.165-203
• /
• 1987

This project was a service-cum-research effort with a quasi-experimental study design to examine the health benefits of an integrated Family Planning (FP)/Maternal & Child health (MCH) Service approach that provides crucial factors missing in the present on-going programs. The specific objectives were: 1) To test the effectiveness of trained nurse/midwives (MW) assigned as change agents in the Health Sub-Center (HSC) to bring about the changes in the eight FP/MCH indicators, namely; (i)FP/MCH contacts between field workers and their clients (ii) the use of effective FP methods, (iii) the inter-birth interval and/or open interval, (iv) prenatal care by medically qualified personnel, (v) medically supervised deliveries, (vi) the rate of induced abortion, (vii) maternal and infant morbidity, and (viii) preinatal & infant mortality. 2) To measure the integrative linkage (contacts) between MW & HSC workers and between HSC and clients. 3) To examine the organizational or administrative factors influencing integrative linkage between health workers. Study design; The above objectives called for quasi-experimental design setting up a study and control area with and without a midwife. An active intervention program (FP/MCH minimum 'package' program) was conducted for a 2 year period from June 1982-July 1984 in Seosan County and 'before and after' surveys were conducted to measure the change. Service input; This study was undertaken by the Soonchunhyang University in collaboration with WHO. After a baseline survery in 1981, trained nurses/midwives were introduced into two health sub-centers in a rural setting (Seosan county) for a 2 year period from 1982 to 1984. A major service input was the establishment of midwifery services in the existing health delivery system with emphasis on nurse/midwife's role as the link between health workers (nurse aids) and village health workers, and the referral of risk patients to the private physician (OBGY specialist). An evaluation survey was made in August 1984 to assess the effectiveness of this alternative integrated approach in the study areas in comparison with the control area which had normal government services. Method of evaluation; a. In this study, the primary objective was first to examine to what extent the FP/MCH package program brought about changes in the pre-determined eight indicators (outcome and impact measures) and the following relationship was first analyzed; b. Nevertheless, this project did not automatically accept the assumption that if two or more activities were integrated, the results would automatically be better than a non-integrated or categorical program. There is a need to assess the 'integration process' itself within the package program. The process of integration was measured in terms of interactive linkages, or the quantity & quality of contacts between workers & clients and among workers. Intergrative linkages were hypothesized to be influenced by organizational factors at the HSC clinic level including HSC goals, sltrurture, authority, leadership style, resources, and personal characteristics of HSC staff. The extent or degree of integration, as measured by the intensity of integrative linkages, was in turn presumed to influence programme performance. Thus as indicated diagrammatically below, organizational factors constituted the independent variables, integration as the intervening variable and programme performance with respect to family planning and health services as the dependent variable: Concerning organizational factors, however, due to the limited number of HSCs (2 in the study area and 3 in the control area), they were studied by participatory observation of an anthropologist who was independent of the project. In this observation, we examined whether the assumed integration process actually occurred or not. If not, what were the constraints in producing an effective integration process. Summary of Findings; A) Program effects and impact 1. Effects on FP use: During this 2 year action period, FP acceptance increased from 58% in 1981 to 78% in 1984 in both the study and control areas. This increase in both areas was mainly due to the new family planning campaign driven by the Government for the same study period. Therefore, there was no increment of FP acceptance rate due to additional input of MW to the on-going FP program. But in the study area, quality aspects of FP were somewhat improved, having a better continuation rate of IUDs & pills and more use of effective Contraceptive methods in comparison with the control area. 2. Effects of use of MCH services: Between the study and control areas, however, there was a significant difference in maternal and child health care. For example, the coverage of prenatal care was increased from 53% for 1981 birth cohort to 75% for 1984 birth cohort in the study area. In the control area, the same increased from 41% (1981) to 65% (1984). It is noteworthy that almost two thirds of the recent birth cohort received prenatal care even in the control area, indicating that there is a growing demand of MCH care as the size of family norm becomes smaller 3. There has been a substantive increase in delivery care by medical professions in the study area, with an annual increase rate of 10% due to midwives input in the study areas. The project had about two times greater effect on postnatal care (68% vs. 33%) at delivery care(45.2% vs. 26.1%). 4. The study area had better reproductive efficiency (wanted pregancies with FP practice & healthy live births survived by one year old) than the control area, especially among women under 30 (14.1% vs. 9.6%). The proportion of women who preferred the 1st trimester for their first prenatal care rose significantly in the study area as compared to the control area (24% vs 13%). B) Effects on Interactive Linkage 1. This project made a contribution in making several useful steps in the direction of service integration, namely; i) The health workers have become familiar with procedures on how to work together with each other (especially with a midwife) in carrying out their work in FP/MCH and, ii) The health workers have gotten a feeling of the usefulness of family health records (statistical integration) in identifying targets in their own work and their usefulness in caring for family health. 2. On the other hand, because of a lack of required organizational factors, complete linkage was not obtained as the project intended. i) In regards to the government health worker's activities in terms of home visiting there was not much difference between the study & control areas though the MW did more home visiting than Government health workers. ii) In assessing the service performance of MW & health workers, the midwives balanced their workload between 40% FP, 40% MCH & 20% other activities (mainly immunization). However, $85{\sim}90%$ of the services provided by the health workers were other than FP/MCH, mainly for immunizations such as the encephalitis campaign. In the control area, a similar pattern was observed. Over 75% of their service was other than FP/MCH. Therefore, the pattern shows the health workers are a long way from becoming multipurpose workers even though the government is pushing in this direction. 3. Villagers were much more likely to visit the health sub-center clinic in the study area than in the control area (58% vs.31%) and for more combined care (45% vs.23%). C) Organization factors (admistrative integrative issues) 1. When MW (new workers with higher qualification) were introduced to HSC, it was noted that there were conflicts between the existing HSC workers (Nurse aids with less qualification than MW) and the MW for the beginning period of the project. The cause of the conflict was studied by an anthropologist and it was pointed out that these functional integration problems stemmed from the structural inadequacies of the health subcenter organization as indicated below; i) There is still no general consensus about the objectives and goals of the project between the project staff and the existing health workers. ii) There is no formal linkage between the responsibility of each member's job in the health sub-center. iii) There is still little chance for midwives to play a catalytic role or to establish communicative networks between workers in order to link various knowledge and skills to provide better FP/MCH services in the health sub-center. 2. Based on the above findings the project recommended to the County Chief (who has power to control the administrative staff and the technical staff in his county) the following ; i) In order to solve the conflicts between the individual roles and functions in performing health care activities, there must be goals agreed upon by both. ii) The health sub·center must function as an autonomous organization to undertake the integration health project. In order to do that, it is necessary to support administrative considerations, and to establish a communication system for supervision and to control of the health sub-centers. iii) The administrative organization, tentatively, must be organized to bind the health worker's midwive's and director's jobs by an organic relationship in order to achieve the integrative system under the leadership of health sub-center director. After submitting this observation report, there has been better understanding from frequent meetings & communication between HW/MW in FP/MCH work as the program developed. Lessons learned from the Seosan Project (on issues of FP/MCH integration in Korea); 1) A majority or about 80% of the couples are now practicing FP. As indicated by the study, there is a growing demand from clients for the health system to provide more MCH services than FP in order to maintain the achieved small size of family through FP practice. It is fortunate to see that the government is now formulating a MCH policy for the year 2,000 and revising MCH laws and regulations to emphasize more MCH care for achieving a small size family through family planning practice. 2) Goal consensus in FP/MCH shouBd be made among the health workers It administrators, especially to emphasize the need of care of 'wanted' child. But there is a long way to go to realize the 'real' integration of FP into MCH in Korea, unless there is a structural integration FP/MCH because a categorical FP is still first priority to reduce the rate of population growth for economic reasons but not yet for health/welfare reasons in practice. 3) There should be more financial allocation: (i) a midwife should be made available to help to promote the MCH program and coordinate services, (in) there should be a health sub·center director who can provide leadership training for managing the integrated program. There is a need for 'organizational support', if the decision of integration is made to obtain benefit from both FP & MCH. In other words, costs should be paid equally to both FP/MCH. The integration slogan itself, without the commitment of paying such costs, is powerless to advocate it. 4) Need of management training for middle level health personnel is more acute as the Government has already constructed 90 MCH centers attached to the County Health Center but without adequate manpower, facilities, and guidelines for integrating the work of both FP and MCH. 5) The local government still considers these MCH centers only as delivery centers to take care only of those visiting maternity cases. The MCH center should be a center for the managment of all pregnancies occurring in the community and the promotion of FP with a systematic and effective linkage of resources available in the county such as i.e. Village Health Worker, Community Health Practitioner, Health Sub-center Physicians & Health workers, Doctors and Midwives in MCH center, OBGY Specialists in clinics & hospitals as practiced by the Seosan project at primary health care level.