• Title/Summary/Keyword: 의무확대

Search Result 285, Processing Time 0.025 seconds

Research on the direction of laws improvement integrated maps of underground space for systematic management (지하공간통합지도의 체계적인 관리를 위한 제도 개선 방향 연구)

  • Jisong RYU;Yonggu JANG;Donghyun PARK
    • Journal of the Korean Association of Geographic Information Studies
    • /
    • v.26 no.4
    • /
    • pp.17-26
    • /
    • 2023
  • The integrated underground space map is a three-dimensional map that integrates 16 types, including 7 types of underground facilities, 6 types of underground structures, and 3 types of ground. In order to systematically construct, manage, and utilize the integrated underground space map, it was institutionalized as the "Special Act on Underground Safety Management," and the "Underground Space Integrated Map Production Work Regulations" was prepared as detailed work regulations. However, there is a lack of institutional mechanisms to develop new technologies such as the completed book submission system for submitting change information and automation technology for updating the integrated underground spatial map and to expand the usability of the integrated underground spatial map. Accordingly, this study examined the current status of the integrated underground space map and attempted to suggest a direction for improving the current system through a revision plan and detailed operation management regulations (draft) of the Special Act on Underground Safety Management.

An Exercise Rehabilitation Field Revitalization Plan for Promoting Elderly Sport for All (노인생활체육 진흥을 위한 운동재활분야 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
    • /
    • v.14 no.4
    • /
    • pp.305-319
    • /
    • 2020
  • A The purpose of this study was to determine the present state of the exercise rehabilitation field, promote elderly sport for all, and present a revitalization program for higher quality of life for the elderly in the coming era of the Fourth Industrial Revolution and aged society. Literature review was performed to analyze the actual conditions of the activities for elderly sport for all and the relevant field of exercise rehabilitation, analyze the elderly health and welfare and elderly sport for all programs, and present a plan for revitalizing the field of exercise rehabilitation to promote elderly sport for all. First, it is necessary to reinforce the awareness and promotion of the need and importance of exercise rehabilitation in inducing seniors to participate in sport for all. Second, it is necessary to make it compulsory to place sport leaders for seniors at such places as elderly leisure and welfare centers and promote expertise in managing elderly health guidance efficiently through cooperation with welfare workers. Third, it is necessary to make it compulsory to take exercise rehabilitation and similar subjects in the curriculums of sport for all, elderly sport welfare, and silver welfare sport as well as the subject of volunteering activities at such places as elderly leisure and welfare centers with the aim of giving opportunities for career choice. Fourth, it is necessary to develop characterized exercise rehabilitation programs at senior welfare centers, community centers for the elderly, and elderly classes and employ experts equipped with exercise event and exercise rehabilitation capabilities as itinerant lecturers to contribute to the government's job creation policies through cooperation between the Ministry of Culture, Sports, and Tourism (MOCST) and the Ministry of Health and Welfare (MOHW). Fifth, it is necessary to make a greater investment in research and development required for elderly sport for all. Sixth, it is necessary to develop and distribute various exercise rehabilitation treatment videos and guidelines that seniors can use for themselves. This is associated with the fifth one; in particular, it is urgent to devise measures against Coronavirus 19. Seventh, it is necessary to reduce inefficiency and budget waste caused by overlapped tasks by establishing a new elderly sports promotion organization through adjustment by MOCST and MOHW; it is also necessary to increase the functions of organization establishment with the aim of reinforcing the education area, which involves post-retirement health care, exercise rehabilitation, safety accident prevention, and virus.

A Plan for Activating Elderly Sports to Promote Health in the COVID-19 Era (코로나19 시대 건강증진을 위한 노인체육 활성화 방안)

  • Cho, Kyoung-Hwan
    • Journal of Korea Entertainment Industry Association
    • /
    • v.14 no.7
    • /
    • pp.141-160
    • /
    • 2020
  • The purpose of this study was to devise a specific plan for activating sports to promote health in old age against the prolonged COVID-19 pandemic. Through literature review, it also analyzed the association between health status and COVID-19 in old age, suggested health promotion policies and projects for elderly people, and presented a plan for activating sport to promote health in old age against COVID-19 era. First, it is necessary to revise the relevant laws, including the Sport Promotion Act and the Elderly Welfare Act, partially or entirely, make developmental and convergent legislations for elderly health and sports, and establish an institutional device as needed. Second, it is necessary to build an integrated digital platform for the elderly and make a supporting system that links facilities, programs, information, and job creation as part of a New Deal program in the field of sports on the basis of the Korean New Deal. Third, it is necessary to train elderly welfare professionals. Efforts should be made to establish more departments related to elderly sports in universities and make it compulsory to place elderly sports instructors at elderly leisure and welfare facilities. Fourth, it is necessary to develop contents related to health in old age. This means performing diverse movements by manipulating them through a virtual reality (VR) simulation. Fifth, it is necessary to make a greater investment in research and development related to elderly sports and relevant fields. This means the need to conduct constant research on healthy and active aging in a systematic and practical way through multidisciplinary cooperation. Sixth, it is necessary to establish and operate an elderly management agency (elderly health agency) under the influence of the Office of the Prime Minister. This means the need to secure independence in implementing the functions related to health promotion in old age and make comprehensive operation, which involves all the issues of health promotion in old age, daily function maintenance and rehabilitation, social adjustment, and long-term care, by establishing an elderly management agency in an effort to give lifelong health management to the elderly and cope with the untact, New Normal age.

Philosophical Stances for Future Nursing Education (미래를 향한 간호교육이념)

  • Hong Yeo Shin
    • The Korean Nurse
    • /
    • v.20 no.4 s.112
    • /
    • pp.27-38
    • /
    • 1981
  • 오늘 저희에게 주어진 주제, 내일에 타당한 간호사업 및 간호교육의 향방을 어떻게 정하여야 하는가의 논의는 오늘날 간호계 주변에 일어나고 있는 변화의 실상을 이해하는 데서 비롯되어져야 한다고 생각하는 입장에서 먼저 세계적으로 건강관리사업이 당면한 딜레마가 어떠한 것이며 이러한 문제해결을 위해 어떠한 새로운 제안들이 나오고 있는가를 개관 하므로서 그 교육적 의미를 정의해 보고 장래 간호교육이 지향해야할 바를 생각해 보려 합니다. 오늘의 사회의 하나의 특징은 세계 모든 나라들이 각기 어떻게 전체 국민에게 고루 미칠 수 있는 건강관리체계를 이룩할 수 있느냐에 관심을 모으고 있는 사실이라고 봅니다. 부강한 나라에 있어서나 가장 빈궁한 나라에 있어서나 그 관심은 마찬가지로 나타나고 있읍니다. 보건진료 문제의 제기는 발달된 현대의학의 지식과 기술이 지닌 건강관리의 방대한 가능성과 건강 관리의 요구를 지닌 사람들에게 미치는 실질적인 혜택간에 점점 더 크게 벌어지는 격차에서 발생한다고 봅니다. David Rogers는 1960년대 초반까지 갖고 있던 의료지식의 축적과 민간인의 구매력 향상이 자동적으로 국민 건강의 향상을 초래할 것이라고 믿었던 순진한 꿈은 이루어지지 않았고 오히려 의료사업의 위기는 의료지식과 의료봉사간에 벌어지는 격차와 의료에 대한 막대한 투자와 그에서 얻는 건강의 혜택간의 격차에서 온다고 말하고 있읍니다. 균등 분배의 견지에서 보면 의료지식과 기술의 향상은 그 단위 투자에 대한 생산성을 낮춤으로서 오히려 장애적 요인으로 작용해온 것도 사실이고 의료의 발달에 따른 일반인의 기대 상승과 더불어 의료를 태성의 권리로 규명하는 의료보호사업의 확대로 야기되는 의료수요의 급증은 모두 기존 시설 자원에 압박을 초래하여 전래적 의료공급체제에 도전을 가해 왔으며 의료의 발달에 건 기대와는 달리 인류의 건강 문제 해결은 더욱 요원한 과제로 남게 되었읍니다. 현시점에서 세계인구의 건강문제는 기아, 영양실조, 안전한 식수 공급 및 위생적 생활환경조성의 문제에서부터 가장 정밀한 의료기술발달에 수반되는 의료사회문제에 이르는 다양한 문제를 지니고 있으며 주로 각개 국가의 경제 사회적 여건이 이 문제의 성격을 결정짓고 있다고 볼수 있읍니다. 그러나 건강 관리에 대한 요구는 영구히, 완전히 충족될 수 없는 요구에 속한다는 의미에서 경제 사회적 발달 수준에 상관없이 모든 국가가 공히 요구에 미치지 못하는 제한된 자원문제로 고심하고 있는 실정입니다. 또 하나의 공통된 관점은 각기 문제의 상황은 달라도 오늘날의 건강 문제는 주로 의료권 밖의 유전적 소인, 사회경제적, 정치문화적인 환경여건과 각기 선택하는 삶의 스타일에 깊이 관련되어 있다는 사실입니다. 따라서 오늘과 내일의 건강관리 문제는 의학적 견지에서 뿐 아니라 널리 경제, 사회, 정치, 문화적 관점에서 포괄적인 접근이 시도되어야 한다는 점과 의료의 고급화, 전문화, 일변도의 과정에서 소외되었던 기본건강관리체계 강화에 역점을 둔 다양하고 탄력성 있는 사업전개가 요구되고 있다는 점입니다. 다양한 건강관리요구에 적절히 대처할 수 있기 위한 그간 세계 각처에서 시도된 새로운 건강관리 접근과 그 제안을 살펴보면 대체로 4가지의 뚜렷한 성격들로 집약할 수 있을 것 같습니다. 그 첫째는 건강관리사업계획 및 그 수행에 있어 지역 사회의 적극적 참여를 유도하는 일, 둘째는 지역단위의 일차보건의료에서 부터 도심지 신예 종합병원, 시설 의료에 이르기까지 건강관리사업을 합리적으로 체계화하는 일. 셋째로 의료인력이용의 효율화 및 비의료인의 훈련과 협조 유발을 포함하는 효과적인 인력관리에 대한 제안과 넷째로 의료보험 및 각양 집단 의료유형을 포함하는 대체 의료재정 운영관리에 관련된 제안들을 들 수 있읍니다. 건강관리사업에 있어 지역사회 참여의 의의는 첫째로 사회 경제적인 제약이 모든 사람에게 가능한 최대한의 의료를 모두 고루 공급하기 어렵게 하고 있다는 점에서 제한된 정부재정과 지역사회가용자원을 보다 효율적으로 이용할 수 있게 하는 자조적이고 자율적인 지역사회건강관리체제의 구현에 있다고 볼 수 있으며 둘때로는 개인과 가족 및 지역민의 건강에 영향하는 많은 요인들은 실질적으로 의료권 외적 요인들로서 위생적인 생활양식, 식사습관, 의료시설이용 등 깊이 지역사회특성과 관련되어 국민보건의 실질적 향상을 위하여는 지역 주민의 자발적인 참여가 필수여건이 된다는 점 입니다. 지역 단위별 체계적인 의료사업의 전개는 제한된 의료자원의 보다 합리적이고 효율적인 이용을 가능하게 하며 요구가 있을때 언제나 가까운 거리에서 경제 사회적 제약을 받지 않고 이용할 수 있는 일차건강관리망을 통하여 건강에 관련된 정보를 얻으며 질병예방, 건강증진 및 기초적인 진료의 도움을 얻을 수 있고 의뢰에 대한 제2차, 제3차 진료에의 길은 건강관리사업의 질과 폭을 동시에 높고 넓게 해 줄 수 있는 길이 된다는 것입니다. 인력 관리에 관련된 두가지 기본 방향으로서는 첫째로 기존보건의료인력의 적정배치 유도이고 둘째는 기존인력의 역할확대, 조정 및 비의료인의 교육훈련과 부분적 업무대체를 들수 있으며 이러한 인력관리의 기본 방향은 부족되는 의료인력의 생산성을 높이고 주민들의 자조적 능력을 강화시킨다는 데에 두고 있음니다. 대체적 의료재정운영안은 대체로 의료공급과 재정관리를 이원화하여 주민의 경제능력이 의료수혜의 장애요소로 작용함을 막고 의료인의 경제적 동기에 의한 과잉치료처치에 의한 낭비를 줄임으로써 의료재정의 투자의 효과를 증대하는 데(cost-effectiveness) 그 기본방향을 두고 있다고 봅니다. 이러한 주변의료 사회적인 동향이 간호교육의 미래상에 끼치는 영향은 지대한 것이라 봅니다. 첫째로 장래 세계인구의 건강문제는 정치, 사회, 경제, 환경적인 의료권 밖의 요인들에 의해 더욱 크게 영향 받는다고 전제한다면 건강문제해결에 있어서도 전통적인 의료사업의 접근에서 더나아가 문제발생의 근원이 되는 생활개선이라는 차원에서 포괄적 접근을 생각하여야 하고 이를 위해선 정치, 경제, 사회전반에 걸친 깊이있는 이해과 주민의 생활환경에 직접 영향하는 교통수단, 통신망 mass media, 전력문제, 농업경영방법 및 조직적 사회활동 등 폭넓은 이해가 요구된다고 봅니다. 둘째로, 지역사회참여의 의의를 인정한다면 지역민의 자발적 참여를 효과적으로 유발시킬수 있고 의료집단과 각종 주민조직과 일반주민들 사이에서 협조적으로 일할수 있는 역량을 기르기위한 교육적 준비가 요구된다고 봅니다. 셋째로, 지역주민의 건강관리 자조능력 강화를 하나의 목표로 삼는다면 치료자에서 교육자로, 지도자에서 촉진자로, 제공자에서 지원자료의 역할의 변화 내지 다양화를 요구하게 될 것이므로 그에 대처할 수 있는 준비가 필요하다고 봅니다. 넷째로, 생각되어야 할 점은 지역중심건강관리사업을 지향하는 보건의료의 이념적 방향과 그에 상응하는 구체적 접근방법을 효율적으로 적용하기 위해서는 종횡으로 연결되는 의사소통체계의 정립과 민활한 정보교환이 이루어질 수 있어야 한다는 점에서 의사소통의 구심체로서 역할할 수 있는 역량을 함양해야 할 교육적 과제가 있다고 봅니다. 마지막으로 생각되어야 할 점은 지역중심으로 전개될 건강관리사업은 건강증진 및 질병예방적 측면과 질병진료 및 회복과 재활에 이르는 종합적이고 포괄적인 사업이어야 한다는 점에서 종래 공공 의료부문과 사설의료기관 사이에 나누어져 있던 예방의학과 치료의학의 통합 뿐 아니라 정부주축으로 이루어 지고 있는 지역사회개발사업 및 농촌지도사업과 종교 및 각종 민간인 집단이 벌이고있는 사업들과의 전체적인 통합적 접근이 이루어져야 한다고 생각하는 입장에서 종래 간호교육이 강조하지 않던 진료의 의무와 대외적 조직활동에 대한 보완적인 교육조치가 요구된다고 봅니다. 간호의 학문체계로서의 입장은 오랜 역사를 두고 논의의 대상이 되어왔으나 아직까지 뚜렷이 어떤 것이 간호 특유의 지식체계이며 건강문제에 관련하여 무엇이 간호특유의 결정영역이며 이 결정과 그 결과를 어떠한 방법으로 치료적 행위로 옮길 수 있는가에 대한 확실한 답을 얻지 못하고 있는 실정이라고 봅니다. 다만 근래에 제시된 여러 간호이론들 속에서 공통적으로 이야기되어지고 있는 개념들로선 우선 간호학문을 건강과 질병에 관련된 인간의 전인적이고 전체적인 상황을 다루는 학제적 과학으로서보는 입장이 있고 따라서 생물신체적인 면 외에 정신심리적, 사회경제적, 정치문화적 환경과의 상호작용 속에서 인간의 건강과 질병문제를 생각한다는 지향을 갖고 있다고 말할 수 있겠읍니다. 간호교육은 간호계 내적인 학문적, 이론적 체계화의 요구에 못지않게 대민봉사하는 전문직으로서의 사회적 책임을 감당해야하는 중요과제를 안고있어 변화하는 사회요구에 효과적으로 대처해 나가야 할 당면문제를 안고 있읍니다. 간효역할 확대, 보건진료원훈련 등 이러한 사회적 요구에 대응하려는 조치가 되겠읍니다. 이러한 시점에서 간호계가 분명히 짚고 넘어가야 할 사실은 이러한 움직임들이 종래의 의사들의 외업무공급을 연장 확대하는 입장에 서서 간호의 특수전문직 명목을 흐리게 할수있는 위험을 감수할 것인지 아니면 가능한 대체방안을 갖고 간호전문직의 독자적인 진로를 개척하면서 다각적인 도전을 받아들일 준비를 갖추든지 그 방향을 뚜렷이 해야할 일이라 생각합니다. 저로서는 이미 잘 훈련된 간호원들과 조산원들의 교육적, 경험적 배경을 기반으로 지역사회 최일선 건강관리요원으로 사회적 효능을 다 할수 있는 일차건강관리간호조직의 구현을 대체방안으로 제시하고 싶습니다. 간호원과 조산원들의 훈련된 역량과 건강관리체제의 구조적 변화를 효과적으로 조화시킨다면 대부분의 세계인구의 건강문제는 해결가능하다고 보는 입장입니다. 물론 정책과 의료와 행정적지원이 활성화되어지는 환경속에서만 그 기대하는 결과가 확대되리라는 점 부언하는 바입니다. 마지막으로 언급하고 싶은 점은 바로 오늘의 주제 ''교육의 동역자-선생과 학생''이라는 개념입니다. 특히 상회정의적 입장에서 보는 의료사업전개에 지역민 내지 의료소비자의 참여를 강조하는 현시점에 있어 교육자와 학생이 교육의 현장에서 서로 동역자로서 학습의 책임을 나누는 경험은 아주 시기적으로 적합하여 교육적으로 지대한 의미를 갖는 것이라고 생각합니다. 이에 수반되어져야 할 역할의 변화에 수용적인 자세를 갖고 적극 실제적용하려 노력하는 선생앞에서 자주적 결정을 행사해본 학생이야말로 건강관리대상자로 하여금 같은 결정권을 행사할수 있도록 촉구하여 주민의 자조적 역량을 기르고 의료사업의 민주화, 인간화를 이룩할 수 있는 길잡이가 될 수 있으리라 믿는 바입니다.

  • PDF

A Study on Modernization of International Conventions Relating to Aviation Security and Implementation of National Legislation (항공보안 관련 국제협약의 현대화와 국내입법의 이행 연구)

  • Lee, Kang-Bin
    • The Korean Journal of Air & Space Law and Policy
    • /
    • v.30 no.2
    • /
    • pp.201-248
    • /
    • 2015
  • In Korea the number of unlawful interference act on board aircrafts has been increased continuously according to the growth of aviation demand, and there were 55 incidents in 2000, followed by 354 incidents in 2014, and an average of 211 incidents a year over the past five years. In 1963, a number of states adopted the Convention on Offences and Certain Other Acts Committed on Board Aircraft (the Tokyo Convention 1963) as the first worldwide international legal instrument on aviation security. The Tokyo Convention took effect in 1969 and, shortly afterward, in 1970 the Convention for the Suppression of Unlawful Seizure of Aircraft(the Hague Convention 1970) was adopted, and the Convention for the Suppression of Unlawful Acts Against the Safety of Civil Aviation(the Montreal Convention 1971) was adopted in 1971. After 9/11 incidents in 2001, to amend and supplement the Montreal Convention 1971, the Convention on the Suppression of Unlawful Acts Relating to International Civil Aviation(the Beijing Convention 2010) was adopted in 2010, and to supplement the Hague Convention 1970, the Protocol Supplementary to the Convention for the Suppression of Unlawful Seizure of Aircraft(the Beijing Protocol 2010) was adopted in 2010. Since then, in response to increased cases of unruly behavior on board aircrafts which escalated in both severity and frequency,, the Montreal Protocol which is seen as an amendment to the Convention on Offences and Certain Other Acts Committed on Board Aircraft(the Tokyo Convention 1963) was adopted in 2014. Korea ratified the Tokyo Convention 1963, the Hague Convention 1970, the Montreal Convention 1971, the Montreal Supplementary Protocol 1988, and the Convention on the Marking of Plastic Explosive 1991 which have proven to be effective. Under the Tokyo Convention ratified in 1970, Korea further enacted the Aircraft Navigation Safety Act in 1974, as well as the Aviation Safety and Security Act that replaced the Aircraft Navigation Safety Act in August 2002. Meanwhile, the title of the Aviation Safety and Security Act was changed to the Aviation Security Act in April 2014. The Aviation Security Act is essentially an implementing legislation of the Tokyo Convention and Hague Convention. Also the language of the Aviation Security Act is generally broader than the unruly and disruptive behavior in Sections 1-3 of the model legislation in ICAO Circular 288. The Aviation Security Act has reflected the considerable parts of the implementation of national legislation under the Beijing Convention and Beijing Protocol 2010, and the Montreal Protocol 2014 that are the modernized international conventions relating to aviation security. However, in future, when these international conventions would come into effect and Korea would ratify them, the national legislation that should be amended or provided newly in the Aviation Security Act are as followings : The jurisdiction, the definition of 'in flight', the immunity from the actions against the aircraft commander, etc., the compulsory delivery of the offender by the aircraft commander, etc., the strengthening of penalty on the person breaking the law, the enlargement of application to the accomplice, and the observance of international convention. Among them, particularly the Korean legislation is silent on the scope of the jurisdiction. Therefore, in order for jurisdiction to be extended to the extra-territorial cases of unruly and disruptive offences, it is desirable that either the Aviation Security Act or the general Crime Codes should be revised. In conclusion, in order to meet the intelligent and diverse aviation threats, the Korean government should review closely the contents of international conventions relating to aviation security and the current ratification status of international conventions by each state, and make effort to improve the legislation relating to aviation security and the aviation security system for the ratification of international conventions and the implementation of national legislation under international conventions.

A comparison study of the characteristics of private and public security service of Koryo dynasty and modern security service (고려시대 공적·사적경호의 특성과 현대경호와의 비교연구)

  • Lee, Sung-Jin
    • Korean Security Journal
    • /
    • no.36
    • /
    • pp.417-442
    • /
    • 2013
  • This study considers the characteristics of the separation of public and private security service during Koryo dynasty, and compares it with the modern security service. Modern day security service's definition of private and public security service was used to distinguish them. Given the different historical settings, it's difficult to argue that the distinction between public and private service during Koryo dynasty was clear, but it can be said that public security service was centered around palace guard and concerns the activities of protest, and military made for the relationship, and private security service was centered around power of DoBang and includes the activities of malingering, and Byolchogun. During the early days of Koryo, protest, district military and soldiers who stay in the palace were all parts of a palace revolt and this institutional improvement of soldiers who stay in the palace was accomplished during King Seongjong's rule. The tradition of a palace revolt can find its roots in the middle military, and after the unification, a palace revolt was reformed into the king's palace revolt of second and the 6th along the course of establishing the nation's system. All of the changes stem from the reformation for consolidating the royal authority. Gyung Dae Seoung wanted to protect himself and he slept with his army night and days and because of that, group of soldiers was created and it was called DOBANG. Some members were from dobang gyeonryong, The forced were powerful because it was gathered with a warriors with extraordinaire martial arts and competent management. Most of the soldiers followed gyeong dae seung because they believed that he has a strong leadership and loves his people, and had a strong faith in him. However, the general gyeong jang had a belief that politics must be reverted to the previous so the relationships between jungbang wasn't smooth. Because of the economic operational problems, due to fraud committed by the mens under his command failed to maintain integrity and was criticised.The misconception also fed up with the emperor and the deepening relationships between the soldiers, his dobang was dismantled. After he took over the dobang, for his personal safety and to strengthen his position he compensated gyeon dae seong's dobang and developed the organization. In the process of extending the dobang Choi chung heon recruited many talented people to strengthen the military base, and also accepted the advice and expanded the power of Dobang. Choi Chung Heon thus consolidated his political gains by weakening the power of the king's army and adjusting the myth, which could've threatened his regime, and this was called Dobang number 6th. Dobang number six got even more powerful by his son named Choi woo, and after ruling, he expanded into a room, and a substantial reorganization of Dobang was developed. And then the creation of yabyeolcho also showed the effect to prevent the crisis. Although the palace guards who were public security service of Koryo Dynasty was still maintained during the military rule era when the royal authority was incapacitated, it was only maintained to have a symbolic meaning as the actual authority including military power was with Choi, the master of Dobang, private security service group. Likewise, during the rule of Choi, private securty service could reign over public security service, and the noteworthy characteristic of Dobang is that it assisted the private soldier groups to seize the military power by reorganizing and modifying military system. Although both differences and similarities can be found when comparing the guards of Koryo Dynasty with those of contemporary society, they have a similarity in terms of the essence of guards that they guarantee the safety of their clients. As for differences, the royalty of Koryo Dynasty and the pursuit of profit of contemporary society are in contrast, and contemporary guards can be seen as the fulfillment of responsibility and duty by free will, whereas guards of Koryo Dynasty were ruled with military coercion.

  • PDF

The Role of Intra-Aortic Balloon Pump in Coronary Artery Bypass Surgery (관상동맥 우회술에서의 대동맥내 풍선 펌프의 역할)

  • 박성식;김기봉
    • Journal of Chest Surgery
    • /
    • v.30 no.3
    • /
    • pp.282-286
    • /
    • 1997
  • In the era of coronary artery bypass grafting, the intraaortic balloon pump (IABP) is more widely used and its indication has been ex anded. We perf'orbed retrospective clinical analysis on the patients who have received IABP pre andfor postoperatively during the course of CABG. From January 1981 to June 1995, total 322 patients have received CABG at the Seoul National University Hospital and among them 50 patients (15.5%) were supported by IABP during the course of the operation. The mean age at the time. of the operation was 57.2 years (39∼ 75 years) and the male to female ratio was 33 : 17. The preoperative diagnosis was unstable angina in 33 (66%), stable angina in 7 (14%) and postinfarct angina in 8 patients(16%). As for the indications of the IABP, there were 13 cases(26%) with left main disease, 13 (26%) with class IV angina, 12 (24%) with difficulty in CPB weaning, 6 (12%) with postinfarct angina and 3 (6%) with severe LV dysfunction. In the remaining 3 cases, one patient was operated on after PTCA failure in emergency basis, another was a patient with AMI, and the other was one who had postoperative low c rdiac output syndrome. All IABPS were introduced via femoral artery and among them 45 cases (90%) percutaneously. The mean postoperative assist time was 22.3 hours (0.5 ∼ 168 hours) and IABP could be removed within 48 hours in most of them (44150). The operative mortality was 6.1% (3 cases) and postoperative morbidity was only one with lower extremity ischemia. The more general application of the IABP during the course of the CABG ,especially in patients with high preoperative risk factors or difficulty in CPB weaning is a good measure of protecting and recovering myocardial function with minimal risk.

  • PDF

Acceptance, Modification and Rejection of Paternalism in Korean Medical Law (한국 의료법에서 후견주의 이념의 수용, 변형 그리고 거부 - 치료중단에 대한 법원 판결을 중심으로 -)

  • Kim, Na-Kyoung;Harmon, Shawn H.E.
    • Development and Reproduction
    • /
    • v.14 no.2
    • /
    • pp.143-154
    • /
    • 2010
  • This article analyzes two leading Korean cases which led to opposite conclusions: the Boramae Hospital Case (Korean Supreme Court 2002 Do 995) and the Shinchon Severance Hospital Case (Korean Supreme Court 2009 Da 17471). In doing so, it pays particular attention to the acceptance, modification, and rejection of paternalism, specifically 'physician paternalism' and 'familial paternalism', both of which have long and strongly influenced the Korean medical environment. In Boramae Hospital, the Court emphasized the obligation of the physician in terms of the life of the patient (eg: protecting and preserving the life and welfare of the patient). Its position seemed to be based on the traditional physician paternalism which presupposes the ability of physicians to identify right and wrong choices according to natural laws. However, the Court saw itself as the final arbiter of who identifies and determines the real world content and consequences of that natural law. In short, the Court elevated itself to the supreme guardian of the patient, and held that its decision cannot be overruled by that of the patient's family. So without specifically referring to the importance of the family and the role of familial decisions, both long-observed traditions in medical decision-making in Korea, the Court shifted away from familial paternalism. In Shinchon Severance Hospital, the Court explained the meaning of the patient's powers of self-rulemore concretely, explaining its scope and substance in greater detail. The Court held that one can exercise the right of self-rule, even over issues such as death, in the form of 'previous medical directions'. However, this case does not represent a wholesale acceptance of medical autonomy (ie: it does not accept self-rule unconditionally). Rather, the Court accepted the importance of the opinions and decision of physicians and of the Hospital Ethics Commission, and the Court still retained to itself the authority to review and make alterations to 'material' decision. The Court did not overlook the importance of the decision of the patient's family, but it also did not relinquish its status as supreme guardian, emphasizing the 'objective' nature of a decision from the court.

Standardization of Identification-number for Processed Food in Food-traceability-system (가공식품에 대한 이력추적관리번호 부여체계의 표준화 방안)

  • Choi, Joon-Ho
    • Journal of Food Hygiene and Safety
    • /
    • v.27 no.2
    • /
    • pp.194-201
    • /
    • 2012
  • Facing a number of global food-related accidents, the concept and system for food traceability have been designed and introduced in many countries to manage the food-safety risks. To connect and harmonize the various food traceability-information in food traceability system according to the food supply chain, the coding system of identification-number for food-traceability has to be standardized. The GTIN (Global Trade Item Number) barcode system which has been globally standardized and implemented, is reviewed with the mandatory food-labeling regulation in expiration date of processed foods. The integration of GTIN-13 bar-code system for food-traceability is a crucial factor to expand its function in the food-related industrial areas. In this literature, the standard coding system of identification-number for food-traceability is proposed with 20 digit coding number which is combined with GTIN-13 bar-code (13 digit), expiration date (6 digit), and additional classification code (1 digit). This proposed standard coding system for identification-number has a several advantages in application for prohibiting the sale of hazard goods, food-recall, and inquiring food traceability-information. And also, this proposed coding system could enhance the food traceability system by communicating and harmonizing the information with the national network such as UNI-PASS and electronic Tax-invoice system. For the global application, the identification-number for food-traceability needs to be cooperated with the upcoming global standards such as GTIN-128 bar-code and GS1 DataBar.

Minimized Priming Volume for Open Heart Surgery in Neonates and Infants (신생아와 유아 심장 수술 시 심폐기회로 충진액의 최소화)

  • Kim, Woong-Han;Chang, Hyoung-Woo;Yang, Sung-Won;Cho, Jae-Hee;Lee, Kyung-Hoon;Baek, In-Hyuk;Kwak, Jae-Gun;Park, Chun-Soo;Lee, Jeong-Ryul;Kim, Yong-Jin
    • Journal of Chest Surgery
    • /
    • v.42 no.4
    • /
    • pp.418-425
    • /
    • 2009
  • Background: Cardiopulmonary bypass (CPB) involves use of an initial priming volume which can cause side effects such as hemodilution, transfusion, inflammatory reaction and edema. Hence, there have been efforts made tore-duce the initial priming volume. We compared this traditional method to a CPB method that uses a minimized priming volume (MPV). Material and Method: For 97 patients who underwent congenital cardiac surgery between July 2007 to June 2008, we discussed each case and decided which method to use. We reviewed the medical records and cardiopulmonary bypass sheets of the patients. Result: We used a MPV method for 46 patients, and a traditional method for the other 51. There were no significant differences in preoperative and intraoperative characteristics between the two groups, such as body weight, age, cardiopulmonary bypass time, lowest body temperature, etc. However, the priming volume was much smaller in the MPV group than the traditional group (p<0.001). The volume of initially mixed packed RBC was also much smaller in the MPV group (p<0.001). There were no significant differences in postoperative mortality and neurologic complications. Conclusion: We could significantly reduce the initial priming volume and initially mixed pRBC volume with the revised CPB method. We suggest that this method be used more widely for congenital cardiac surgery.