• Title/Summary/Keyword: 책임과 의무

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Analysis of Complications Associated with the Nuss Procedure: Risk Factors and Preventive Measures (너스수술의 합병증에 대한 고찰: 위험인자 분석과 예방책의 제시)

  • Park, Hyung-Joo;Chang, Won-Ho;Jeon, Cheol-Woo;Park, Han-Gyu;Lee, Seock-Yeol;Lee, Cheol-Sae;Youm, Wook;Lee, Kihl-Roh
    • Journal of Chest Surgery
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    • v.37 no.6
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    • pp.524-529
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    • 2004
  • Background: Since the Nuss procedure for the correction of pectus excavatum is in its early stage, there have been problems that need to be solved. We examined complications in a single-institute experience of the Nuss technique in order to develop possible solutions to prevent them. Material and Method: 335 consecutive patients, who underwent the modified Nuss procedure between August 1999 and October 2002, were studied retrospectively. Median age was 8 years (range 1 to 46). 264 patients (78.8%) were in pediatric group (age$\leq$15) and 71 patients (21.2%) were in adult group (age> 15). 193 patients (57.6%) had symmetric and 142 patients (42.4%) had asymmetric pectus configurations. Risk factors predicting postoperative complications were analyzed using multi-variate logistic regression. Result: Postoperative complication rates were 18.9% (61/335) in total patients. Frequent complications were pneumothorax 24 (7.5%), bar displacement 11 (3.4%), and wound seroma 10 (3.1%) in order. Early complications (within a month, 49 cases, 15.2%) were pneumothorax (n=23, 6.9%), wound seroma (n=12, 3.6%), and bar displacement (n=8, 2.4%). Late complications (after a month, 12 cases, 3.7%) were pericarditis and pericardial effusion (n=5, 1.5%), bar displacement (n=4, 1.2%), and hemothorax (n=3, 0.9%). Techniques were modified to prevent complications especially in bar shaping and fixation, which led to decrease complication rate in later experience (Operation Date 1: 15/51 (29.4%) vs Operation Date 2: 34/284 (12.0%), p=0.004). Grand Canyon type (eccentric long canal type) showed higher complication rate than other types (GC type: 12/30(40%) vs Others: 37/305 (12.1%), p<0.001). Major risk factors are severity of pectus (OR=2.88, p=0.038), Grand Canyon type (OR=2.82, p=0.044), and Op. Date 1 (OR=4.05, p=0.001). Conclusion: Major complications were related to severe eccentric type of pectus configuration (Grand Canyon type) and lack of surgeon's experience (Op. Date 1). Com-plication rate was reduced with accumulation of experience and advancement of surgical techniques. The Nuss procedure can be performed at a low risk of complications with our current technique.

Directions for More Effective County Extension Committees (군 농촌지도위원회의 효율적 운영 방안)

  • Martens, Daniel C.;Kim, Sung-Soo
    • Journal of Agricultural Extension & Community Development
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    • v.6 no.2
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    • pp.75-84
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    • 1999
  • Minnesota state law requires County Extension Committees (CECs). The County Board of Commissioners appoints committee members. Extension Educators are responsible for using CECs to assure the value of Extension work in the County. This paper will explore underlying values, principles and practices that can effect the utilization of CECs in ways that benefit the work of Extension and make the process a good experience for CEC members and Extension Educator. The paper is based primarily on readings in the Journal of Extension, interviews with two Extension Educator, and information provided by the University of Minnesota Extension Service for CEC members.

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Effect of Multidisciplinary Emergency Consultation System for Drug Intoxicated Patients (응급실을 내원한 약물중독 환자에 대한 다학제 응급협진체계의 효과 검증)

  • Kang, Jino;Kim, Hye Ri;Min, Kyungjoon;Kim, Na Ryoung;Heo, Yoon Kyung;Kim, Sun Mi
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.2
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    • pp.130-137
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    • 2019
  • Objectives : When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. Methods : We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. Results : After the ECS, admission to open wards was significantly higher than to the intensive care units (χ2=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ2=4.202, p=0.053), and the time required for consultation response decreased (Z=-2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ2=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=-1.941, p=0.052). Conclusions : After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.

Regulation of Professional Advertising: Focusing on Physician Advertising (전문직 표시·광고규제의 몇 가지 쟁점: 의료광고를 중심으로)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.177-219
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    • 2016
  • A commercial advertisement is not only a way of competition but also a medium of communication. Thus, it is under the constitutional protection of the freedom of business (article 15 of the Constitution) as well as the freedom of press [article 21 (1) of the Constitution]. In terms of the freedom of business or competition, it should be noted that an unfair advertising (false or misleading advertisement) can be regulated as an unfair competition, while any restraint on advertising other than unfair one might be doubted as an unjustifiable restraint of trade. In terms of the freedom of press or communication, it is important that article 21 (2) of the Constitution forbids any kind of (prior) censorship, and the Constitutional Court applies this restriction even to commercial advertising. In this article, the applicability of these schemes to advertising of the so-called learned professions, especially physician, are to be examined, and some proposals for the reformation of the current regulatory regime are to be made. Main arguments of this article can be summarized as follows: First, the current regime which requires advance review of physician advertising as prescribed in article 56 (2) no. 9 of Medical Act should be reformed. It does not mean that the current interpretation of article 21 of the Constitution is agreeable. Though a commercial advertising is a way of communication and can be protected by article 21 (1) of the Constitution, it should not be under the prohibition of censorship prescribed by article 21 (2) of the Constitution. The Constitutional Court adopts the opposite view, however. It is doubtful that physician advertising needs some prior restraint, also. Of course, there exists severe informational asymmetry between physicians and patients and medical treatment might harm the life and health of patients irrevocably, so that medical treatment can be discerned from other services. It is civil and criminal liability for medical malpractice and duty to inform and not regulation on physician advertising, to address these differences or problems. Advance review should be abandoned and repelled, or substituted by more unproblematic way of regulation such as an accreditation of reviewed advertising or a self-regulation preformed by physician association independently from the Ministry of Health and Welfare or any other governmental agencies. Second, the substantive criteria for unfair physician advertising also should correspond that of unfair advertising in general. Some might argue that a learned profession, especially medical practice, is totally different from other businesses. It is performed under the professional ethics and should not persue commercial interest; medical practice in Korea is governed by the National Health Insurance system, the stability of which might be endangered when commercial competition in medical practice be allowed. Medical Act as well as the condition of medical practice market do not exclude competition between physicians. The fact is quite the opposite. Physicians are competing even though under the professional ethics and obligations and all the restrictions provided by the National Health Insurance system. In this situation, regulation on physician advertising might constitute unjustifiable restraint of competition, especially a kind of entry barrier for 'new physicians.'

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A study on factors affecting high school students of school violence - Focusing on personality factors - (고등학생의 학교폭력에 영향을 미치는 요인에 관한 연구 : 인성요인을 중심으로)

  • Lee, Jung-Duk;Chang, Jeong-Hyeon
    • Korean Security Journal
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    • no.42
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    • pp.393-422
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    • 2015
  • The school is committed to the role of public education for the effective development of student academic achievement and intellectual ability. It is also a space to expand the range of care and understanding for others with as a member of the academic community as well. However, the reality of our country schooling has been pointed out that if a lot about the lack of character education related to the attitude of life care for others and feel a sense of responsibility. An individual is not necessarily emotional intelligence There are side out, as well as grow into adults, schools are obliged to teach a variety of methods associated with it. Nevertheless, education is not of the country beyond the formal excessive administrative work or other activities due to the process of character education to neglect, including the work of teachers. Therefore, students brought the expansion of the act that should not, and eventually lead to serious social issues that directly harm others, such as school violence. Therefore, students brought the expansion of the act that should not, and eventually lead to serious social issues that directly harm others, such as school violence. This study is based on an act of juvenile delinquency and criminology education was to refine the concept of toughness and validate the relationship between school violence through empirical research. Accordingly, from July 1, 2013 September 31, 2013 to 277 high schools across the country are attending the third year of the schools available for non-response and analysis of the students who participated in the admission and simulated typical presentation of K University in Gyeonggi-do not judge students in the final analysis, except for the data and data from a total of 1045 patients were utilized. As a result, many schools have experienced violence, male student work can be applied to a lot of rock school violence was experienced. Also, a lot of experience can be applied to a healthy student rock school violence, anger-control and empathy, this is considered a low student showed consciousness experienced school violence exerted.

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A Study on Systematizing Production and Access of the Public Institution's Conference Records -Focused on The Government in the Sunshine Act in USA - (공공기관의 회의록 생산·공개 제도화 연구 -미국의 회의공개법에 대한 분석을 중심으로-)

  • Byon, Ju-yon
    • The Korean Journal of Archival Studies
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    • no.17
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    • pp.203-245
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    • 2008
  • Although a few years have passed since the importance of the public record management became the subject, the management of the minutes which is produced from the deliberation and decision-making process of an important policy relatively was been neglected the while. When institutionally inspecting at present, the minutes production is based upon Record Management Law, and the minutes opening is based upon Freedom of Information Act. Although the minutes must be made out according to Record Management Law, it is not well operated. So, the minutes formally is made out and there was actually the important minutes excepted from the management object. Opening of the minutes made by Article 9 of Freedom of Information Act has the problem that be used as a basis of dividing unfairly into closed opening because the reason of the closed opening is vague. This study analyzes the problem of production and opening of the current minutes. It also considers Sunshine Act in USA and suggests a institutional ways for production and opening of Korean minutes. We can think of two institutional ways for production and opening of the minutes. One is making a separate law like Sunshine Act in USA. The other is revising the existing laws. In reality it's very difficult to make a new law for minute production and opening. Therefore, the purpose of this study is to suggest the way for revising Record Management Law and Freedom of Information Act that include minutes related regulations. The record must be fundamentally produced and opened for a nation and people as public records is the records of the nation and people as well as an authority which produced those records. If the minutes is produced and opened from a institutional change through the revision of Record Management Law and Freedom of Information Act, the minutes can not only help the responsible administration to realize but be utilized to important historical records as a basis data of an important policy decision-making.

Efficient Management and use of Records from the Truth Commissions (과거사위원회 기록의 효율적인 관리와 활용방안)

  • Lim, Hee Yeon
    • The Korean Journal of Archival Studies
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    • no.17
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    • pp.247-292
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    • 2008
  • Investigations have been started to set the modern history and national spirit to rights after Commissions were established. Those Commissions are established and operated with time limit to finish its own missions. They creates three kinds of records as acquired materials which acquired or are donated for investigation; investigation records as investigation reports; and administrative records that created while supporting organization's operation. The Commissions use more past records to do special tasks asnation's slate clean and uncovering the truth than other agencies. In other words, the commissions take the most advantages of well-managed records, however, their record management environment and operation systems are relatively loose than other permanent machineries. It has three reasons that; first, there is no record management regulations and criteria for machineries that have time limit. This affected each commissions 'systems and 6 Truth Commissions' record management systems are built separately and on the different level; Second, members lack responsibility from frequent sending, reinstatement, change, and restructuring and that makes troubles to produce and manage records; Third, central archives pay less attention to machineries that operated limited period as the truth commissions. The Commissions rather need more systematic control because its records have historical value. To solve these problems, record management regulations have to be prepared first with features of organizations running limited time and commissions' records as acquired materials or investigation records. Furthermore, building up standard record management system for the Commissions, standardizing transfer data, imposing professional record personnel, and setting limits frequent personnel changes would finish practical problems. Besides, those records created to reveal the truth should use for education and research because Truth Commissions are established to set unfortunate history right and not to repeat it again. The records would serve as steppingstone for establishment of the Truth Record Center that does education, information work, publication, and research with the records. The record center would help using the records efficiently and improving knowledge for its people. And, the center should devote people to recognize importance of the records.

Methods of Record Management for Head of Local Government (광역자치단체장의 기록 관리 방안 연구)

  • Lee, Young-eun
    • The Korean Journal of Archival Studies
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    • no.27
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    • pp.35-88
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    • 2011
  • This study suggested the methods of record management for the heads of local government, which would be the most valuable among local records. In order to conduct a systematic record management for the heads of local government, this study suggested the methods of establishing a record management system regarding regulation arrangement, production registration, preservation, utilization and services. First of all, in order to estimate the record category of the heads of local government, the study examined the duties of the offices of the deputy heads of local government, secretary's offices and information offices, which have been subsidiary & assistance branches in charge of producing the record. In addition, it investigated the present conditions of record management for the heads of local government through the interviews with secretary offices and information offices belonging to 16 cities and provinces and the claims for information disclosure and found out the following problems. They included incomplete record production, non-registration of produced records, abolition of records and taking them out of designated places with due notice, record preservation period regardless of the term of the heads of local government, varied preservation period for the records of the heads of local government by local self-government, short preservation period of primary records and non-management of home pages after the term of the heads of local government. To solve such problems, the study suggested the regulation arrangement for record management and a record management system. The regulation arrangement could be obtained through the establishment of the administrative organization setup condolence etiquette enforcement regulation and the recorders in local government and the revision of operation rules and through the revision of the reference plan for operation rules enactment of recorders from National Archives of Korea. As for the record management system, the study suggested the establishment of production, registration and preservation system of records for the heads of local government and the utilization and services of their records. In order to produce and register the records, the unit assignments should be founded by department in charge of the duties related to the records of the heads of local government on record management criteria, thus letting the staff surely produce and register the records. In terms of utilization and services of the records, the study suggested the use of websites and drawing up the record list, through which each record viewer would be able to figure out which records have been managed through the list services and which services could be given to the residents, thus letting the residents and the heads of local government who finished their term of duties use the records.

Archival Science and Constitutional Point of View (헌법적 관점의 기록학)

  • Lee, Youngnam
    • The Korean Journal of Archival Studies
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    • no.79
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    • pp.121-168
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    • 2024
  • Record & archives management is at the heart of archival science. We must be faithful to record & archives management. However, isn't there a paradox that arises the more faithful we are to record & archives management? The paradox is that 'being a responsible manager and efficiently managing records' is rather reduces the interest in the social existence of humans who create and use such records. Why do humans produce and use records? It may be because human beings have been living with the concept of records. The concept is 'the same as the design of thoughts'. There is no need to doubt this direction because as record & archives management develops, more valuable records are preserved more systematically, and they are been served with wider scope and appropriateness. However, if we observe this situation from a human point of view rather than record & archives management, we find that humans appearing in record & archives management are limited to the object of using records. If humans are perceived differently based on the hypothesis of reviewing from the ground up, we can encounter a unique context about the relationship between humans and records or between records and humans. If it reaches the norm that human beings have dignity that cannot be transferred to anyone, have the right to pursue happiness, and must live by enjoying freedom, equality, and social basic rights, in short, if human beings are recognized from a constitutional point of view, we can newly recognize the social role and direction of records. The constitution and international human rights norms document basic human rights as the final norm and clarify that it is the duty of the state to guarantee and practice them. The social role of records from a constitutional point of view is the practice of records that proliferate basic human rights. The practice of archiving, which multiplies basic human rights, may also be a civic consciousness required of experts, but on the other hand, it can be a professional way for archival studies. If record management is a two-lane round trip, it can be said that the interaction between record management and record practice, which multiplies basic human rights, is a pioneering four-lane round trip. This article examines the practice of archiving, which has been developed in and out of record & archives management, by clearly grasping the constitutional perspective from the perspective of archival studies, and examines the social role of archival studies in this context. The social role of archival studies is to provide new linguistic rules for archiving.

Analysis and Implication on the International Regulations related to Unmanned Aircraft -with emphasis on ICAO, U.S.A., Germany, Australia- (세계 무인항공기 운용 관련 규제 분석과 시사점 - ICAO, 미국, 독일, 호주를 중심으로 -)

  • Kim, Dong-Uk;Kim, Ji-Hoon;Kim, Sung-Mi;Kwon, Ky-Beom
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.1
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    • pp.225-285
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    • 2017
  • In regard to the regulations related to the RPA(Remotely Piloted Aircraft), which is sometimes called in other countries as UA(Unmanned Aircraft), ICAO stipulates the regulations in the 'RPAS manual (2015)' in detail based on the 'Chicago Convention' in 1944, and enacts provisions for the Rules of UAS or RPAS. Other contries stipulates them such as the Federal Airline Rules (14 CFR), Public Law (112-95) in the United States, the Air Transport Act, Air Transport Order, Air Transport Authorization Order (through revision in "Regulations to operating Rules on unmanned aerial System") based on EASA Regulation (EC) No.216/2008 in the case of unmanned aircaft under 150kg in Germany, and Civil Aviation Act (CAA 1998), Civil Aviation Act 101 (CASR Part 101) in Australia. Commonly, these laws exclude the model aircraft for leisure purpose and require pilots on the ground, not onboard aricraft, capable of controlling RPA. The laws also require that all managements necessary to operate RPA and pilots safely and efficiently under the structure of the unmanned aircraft system within the scope of the regulations. Each country classifies the RPA as an aircraft less than 25kg. Australia and Germany further break down the RPA at a lower weight. ICAO stipulates all general aviation operations, including commercial operation, in accordance with Annex 6 of the Chicago Convention, and it also applies to RPAs operations. However, passenger transportation using RPAs is excluded. If the operational scope of the RPAs includes the airspace of another country, the special permission of the relevant country shall be required 7 days before the flight date with detail flight plan submitted. In accordance with Federal Aviation Regulation 107 in the United States, a small non-leisure RPA may be operated within line-of-sight of a responsible navigator or observer during the day in the speed range up to 161 km/hr (87 knots) and to the height up to 122 m (400 ft) from surface or water. RPA must yield flight path to other aircraft, and is prohibited to load dangerous materials or to operate more than two RPAs at the same time. In Germany, the regulations on UAS except for leisure and sports provide duty to avoidance of airborne collisions and other provisions related to ground safety and individual privacy. Although commercial UAS of 5 kg or less can be freely operated without approval by relaxing the existing regulatory requirements, all the UAS regardless of the weight must be operated below an altitude of 100 meters with continuous monitoring and pilot control. Australia was the first country to regulate unmanned aircraft in 2001, and its regulations have impacts on the unmanned aircraft laws of ICAO, FAA, and EASA. In order to improve the utiliity of unmanned aircraft which is considered to be low risk, the regulation conditions were relaxed through the revision in 2016 by adding the concept "Excluded RPA". In the case of excluded RPA, it can be operated without special permission even for commercial purpose. Furthermore, disscussions on a new standard manual is being conducted for further flexibility of the current regulations.

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