발달지연 아동 및 뇌성마비 아동의 평가실태와 물리치료사들의 평가에 대한 인식도 조사

박혜정,이충휘,조상현,권혁철 한국전문물리치료학회 2000 한국전문물리치료학회지 Vol.7 No.1

The purpose of this study were to research the current stat of evaluation of children with delayed development and cerebral palsy and determine pediatric physical therapists's knowledge of assessment tools and their use. The subjects were 130 pediatric physical therapists (general hospitals, university-related hospitals, rehabilitation centers, etc.). Data was obtained form August 24, 1999 to October 18, 1999 by means of a survey questionnaire. The results were as follows: 1. the current state of pediatric physical therapist evaluation of children with delayed development and cerebral palsy. 1) Tools used to assess functional areas of children with cerebral palsy were: subjective description format-128 (47.1%); the GMFM-58 (21.3%); facility-generated tool-51 (18.8%); and DDST-15 (5.5%) 2) Tools used to assess developmentally delayed children were: subjective description format-121 (50.6%); the GMFM-43 (18.0%); facility-generated tool-41 (17.2%); and DDST-14 (5.9%). 3) After their college or university study, therapists who had attended lectures on evaluation were 113 (86.9%); 13 (10.0%) therapists had not attended any lectures on evaluation. 2. Test scores of physical therapists' professional knowledge of evaluation procedures: high (more than 36 points)-74 (56.9%); moderate (18~35 points)-39 (30.0%); and low (below 17 points)-none. 1) For therapists treating cerebral palsied children, 73 (65.2%) were in the high range, 39 (34.8%) were in the moderate rage and none were in the low range. 2) For therapists treating children with delayed development, 71 (65.7%) were in the high range, 37 (34.3%) were in the moderate range and none were in low range. Although the general degree of professional knowledge of evaluation was quite high, there was a lack of variety in the assessment tools used with a large number of therapists depending on subjective description. Possible reasons for the low rate of objective assessment tool use: 1) Poor clinical environment: Too many clients and limited treatment time. 2) Lack of any medical insurance fee category for specific assessment tools. 3) Lack of continuing education opportunities in pediatric evaluation skills during or after either college-based(3 year) or university-based(4 year) education programs. Based on the study results, provision of more extended educational opportunities would promote the use of a greater variety of objective assessment tools by pediatric physical therapists.

Concurrent Scheduling of Machines and Tools without Tool Delay in a Multi Machine FMS using Flower Pollination Algorithm

Padma Lalitha Mareddy,Sivarami Reddy Narapureddy,Venkata Ramamurthy Dwivedula,Sunil V Prayagi 대한산업공학회 2023 Industrial Engineeering & Management Systems Vol.22 No.3

This paper deals with machines and tools joint scheduling in a multi-machine flexible manufacturing system to min-imize makespan with the lowest possible copies of every type of tool without tool delay. The tools are placed in a central tool magazine that shares with and serves several machines. The problem is determining the lowest possible copies of every type of tool, allocation of tool copies to job-operations, and job-operations’ sequencing on machines without tool delay for makespan minimization. This paper proposes a nonlinear mixed integer programming formula-tion to model this simultaneous scheduling problem and flower pollination algorithm based on the flowers’ pollination process for solving this problem. The results have been tabulated, analyzed, and compared.

부적절 재원의 이유

김윤,이건세,김창엽,김용익,신영수,이상일,Kim, Yoon,Lee, Kun-Sei,Kim, Chang-Yup,Kim, Yong-Ik,Shin, Young-Soo,Lee, Sang-Il 대한예방의학회 1993 Journal of Preventive Medicine and Public Health Vol.26 No.4

This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into slx major categories : delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol (AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services ($4.7{\sim}9.2%$), and delay related to surgery in surgical services ($7.3{\sim}15.0%$). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay ($2.9{\sim}6.4%$). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical charateristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.

적절성 평가지침과 이유목록의 적용 가능성 평가

신영수,김용익,김창엽,김윤,김은경,송윤미,이영성 한국의료QA학회 1994 한국의료질향상학회지 Vol.1 No.1

Background: An appropriate use of hospital beds can improve productivity of hospital significanlly. The authors previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropritely used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Oversall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. Thess instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

Process design of high-strength bolt of fully pearlitic high-carbon steel

Lee, H.C.,Jin, Y.G.,Lee, Y.H.,Son, I.H.,Lee, D.L.,Im, Y.T. Elsevier 2010 Journal of materials processing technology Vol.210 No.14

In this study, fully pearlitic high-carbon steel, known as a higher delayed fracture strength material, with an ultimate tensile strength of 1410MPa was used for manufacturing a high-strength M8 bolt. Softening behavior was observed by a compression test of the material. The tensile strength of the material was measured after application of several drawings. On the basis of these test results, two multi-stage manufacturing processes were designed by a knowledge-based expert system in order to develop a high-strength bolt using either the upsetting mode or the extrusion mode for the second preform. The load requirement and possible defect formation during the process were predicted by employing a rigid-viscoplastic finite element analysis. When the second preform was made in a laboratory experiment according to the process design on the basis of the upsetting mode, the specimens cracked at the flange in the final stage of forming. However, the bolt was successfully manufactured using the second preform obtained using the extrusion mode and showed extended tool life in the laboratory test. Finally, the manufactured bolt was confirmed via experiments to have tensile strength of 1600MPa and delayed fracture strength.

상태의존적 시간지연을 고려한 선삭 공정의 안정성 해석

김필기(P. Kim),석종원(J. Seok) 한국정밀공학회 2010 한국정밀공학회 학술발표대회 논문집 Vol.2010 No.5월

환자 및 가족에 의한 입원이용 결정의 양상

안병기 ( Byeung-ki An ) 한국보건경제정책학회(구 한국보건경제학회) 2017 보건경제와 정책연구 Vol.23 No.3

한국은 OECD와 비교하여 1인당 국민소득 증가율 대비 1인당 연간진료비 증가율, 평균재원일, 1,000명당 병상수가 각각 1.9배, 1.9배, 2.4배 높은데, 이에 기인하여 부적절한 입원이 다소 있을 수 있다. 미국을 비롯한 선진국은 부적절한 입원이용을 감소시키고자, 입원 의료이용에 대한 적절성 판단 도구인 AEP(적절성 평가지침)와 Delay Tool(이유목록)를 이용하고 있으나, 우리나라는 입원이용에 대한 객관적 기준이 마련되어 있지 않다. 우리나라에서는 입원이 의사가 아닌 환자나 가족들에 의해 다소 결정(부적절한 입원)되고 있다. 본 연구에서는 2014년 한국의료패널자료를 이용하여 부적절한 입원 결정 양상을 파악하고자, Dutton(1986)의 의료이용 모형을 적용하였다. 연구결과, 총 2,396명의 입원환자 중 15.4%인 369명이 의사가 아닌 환자나 가족의 결정에 의해 입원하였다. 의사가 아닌 환자 및 가족 등에 의하여 입원한 환자들은 15세 이하의 환자보다 31-45세 환자와 46-60세 환자가 각각 2.314배, 2.192배 많았고, 건강보험환자보다 건강보험차상위 계층에 속한 환자, 의료급여 1종 환자, 국가유공자 및 가족 특례 지원 환자가 각각 2.209배, 1.870배, 2.447배 많았으며, 상급종합병원에 입원한 환자보다 병원 및 의원과 노인 및 요양병원에 입원한 환자가 각각 2.155배, 34.175배 많았고, 재원기간에서 1주간 재원한 환자보다 5주 이상 재원한 환자가 1.952배 많았다. 본 연구 결과를 바탕으로 정책입안자들은 환자 및 의료기관대상으로 부적절하게 입원이용을 하고 있는 환자들을 찾아, 의료이용이 적절하게 되도록 방안을 강구해야겠다. Korea is more likely to use the inpatient services than the OECD countries. Higher average hospital length of stays and number of hospital beds per capita in Korea compared to OECD countries support this aspect. Generally, the hospital admissions decided by medical doctors, however, a large number of admissions in Korea are decided by patients or their families. We used the 2014 Korea Health Panel Data. Of the total 2,396 cases of admission, 369 cases(15.4%) of admissions are made by the decision of patients or their families. The multiple logistic regression analysis shows that the admission decision by patients or their families(ADPF) is higher in the 31-45 years age group(OR:2.314) and 46-60 years of age group(OR:2.192) compared with the under 15 years age group. The ADPF rate is higher in the quasi-poor class`s group(OR:2.209), medicaid type 1 recipient`s group(OR:1.870) and national merit reward beneficiaries and their family`s group(OR:2.447) compared with the public health insurance`s group. In addition, the ADPF rate is higher in the patients admitted in hospital or clinics(2.155) and geriatric hospital or convalescent hospital(OR:34.175) than that of admitted in superior general hospitals. the ADPF rate is higher in the patients admitted more than 5 weeks(OR:1.952) than that of admitted one week. Our study demonstrates that the policy makers should devise measures to reduce patients who are using inappropriate admission in accordance with the types of medical institutions. These alternatives must lower the soaring length of stay in hospitals and healthcare cost in Korea.

반도체 클러스터 장비에서 웨이퍼 이동지연을 허용하는 스케줄링 방법

허선(Sun Hur),이현(Hyun Lee),박유진(You-Jin Park),양선호(Sun-Ho Yang) 한국생산관리학회 2011 한국생산관리학회지 Vol.22 No.4

차세대 반도체 생산을 위한 450㎜ 웨이퍼 제조공정의 가장 큰 특징은 모든 제조공정이 완전자동화로 이루어진다는 것이다. 이러한 완전자동화로 인해 작업자의 공정개입이 불가능하게 되고 개별 웨이퍼의 중요도가 증가하므로 완전자동화를 지원할 수 있는 보다 우수한 스케줄링 방법과 시스템이 요구된다. 즉, 450㎜ 웨이퍼 생산을 위한 스케줄링 시스템은 개별 웨이퍼와 클러스터 장비의 공정 상태를 실시간으로 반영하여 생산성을 향상시킬 수 있는 견고한 스케줄링 기법을 적용해야 한다. 본 연구에서는 450㎜ 웨이퍼 생산환경에서 중요하게 사용되는 클러스터 장비와 그 특성들을 소개하고 timetabling 방법에 기반을 둔 효과적인 실시간 스케줄링 기법을 제시하고자 한다. 특히 웨이퍼가 공정완료 이후 chamber에서 일정한 시간동안 대기할 수 있는 웨이퍼 이동지연을 고려하여 FOUP 단위의 사이클 타임(cycle time)과 개별 웨이퍼의 공정 시작시간을 결정할 수 있는 방법을 제시한다. In the next generation fab environment for 450㎜ wafer production, one of the most significant features is the adoption of full automation to the whole manufacturing processes involved. So, it is necessary to construct more robust scheduling system for the entire semiconductor manufacturing processes since the full automation system prevents the process engineers from intervening the manufacturing processes as much as possible and the importance of each individual wafer noticeably increases. The scheduling system for 450㎜ wafer production also should be capable of monitoring the status of each individual wafer and collecting useful fab data in real time. In this study, we first introduce the cluster tool mainly used in 450㎜ wafer production, and then propose an effective real-time scheduling algorithm based on the timetabling method. Especially, our method considers the case that the wafer is assumed to be able to stay at the current chamber prior to proceed to the next chamber for a while, which increases the flexibility to assign the starting times of the processes.

ChatGPT가 한국 공학교육에 던지는 질문: 그 의미와 과제

정한별,한경희 한국공학교육학회 2023 공학교육연구 Vol.26 No.5

Generative AI has arrived and it’s here. Education, research, industry, and labor are all on edge about the changes it will bring. It is noteworthy that while there is a wide range of optimistic and pessimistic predictions about the impact of generative AI, there is more concern than hope when it comes to education. This paper focuses on the lack of discussion on the impact of AI in higher education. First, we reviewed the process of the emergence of generative AI and introduced how the impact of AI is being understood from various perspectives. Second, we classified work areas based on expertise and efficiency and analyzed the impact of AI on work in each area. Finally, the study found that the educational perception of generative AI and the way it is perceived for engineering education purposes can be very different. It also argued that there is a lack of active discussion and debate on areas that need to be specifically discussed around generative AI. This has led to a phenomenon known as professors’ delayed indifference. We emphasized that it is time for a serious and realistic discussion on the connection and integration of AI and education.