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Standards of Due Diligence and Separation of Responsibilities in the Division of Labor in Medicine (분업적 의료행위에 있어서 주의의무위반 판단기준과 그 제한규칙들)

  • Choi, Hojin
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.41-72
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    • 2018
  • In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

A Meta Analysis of Using Structural Equation Model on the Korean MIS Research (국내 MIS 연구에서 구조방정식모형 활용에 관한 메타분석)

  • Kim, Jong-Ki;Jeon, Jin-Hwan
    • Asia pacific journal of information systems
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    • v.19 no.4
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    • pp.47-75
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    • 2009
  • Recently, researches on Management Information Systems (MIS) have laid out theoretical foundation and academic paradigms by introducing diverse theories, themes, and methodologies. Especially, academic paradigms of MIS encourage a user-friendly approach by developing the technologies from the users' perspectives, which reflects the existence of strong causal relationships between information systems and user's behavior. As in other areas in social science the use of structural equation modeling (SEM) has rapidly increased in recent years especially in the MIS area. The SEM technique is important because it provides powerful ways to address key IS research problems. It also has a unique ability to simultaneously examine a series of casual relationships while analyzing multiple independent and dependent variables all at the same time. In spite of providing many benefits to the MIS researchers, there are some potential pitfalls with the analytical technique. The research objective of this study is to provide some guidelines for an appropriate use of SEM based on the assessment of current practice of using SEM in the MIS research. This study focuses on several statistical issues related to the use of SEM in the MIS research. Selected articles are assessed in three parts through the meta analysis. The first part is related to the initial specification of theoretical model of interest. The second is about data screening prior to model estimation and testing. And the last part concerns estimation and testing of theoretical models based on empirical data. This study reviewed the use of SEM in 164 empirical research articles published in four major MIS journals in Korea (APJIS, ISR, JIS and JITAM) from 1991 to 2007. APJIS, ISR, JIS and JITAM accounted for 73, 17, 58, and 16 of the total number of applications, respectively. The number of published applications has been increased over time. LISREL was the most frequently used SEM software among MIS researchers (97 studies (59.15%)), followed by AMOS (45 studies (27.44%)). In the first part, regarding issues related to the initial specification of theoretical model of interest, all of the studies have used cross-sectional data. The studies that use cross-sectional data may be able to better explain their structural model as a set of relationships. Most of SEM studies, meanwhile, have employed. confirmatory-type analysis (146 articles (89%)). For the model specification issue about model formulation, 159 (96.9%) of the studies were the full structural equation model. For only 5 researches, SEM was used for the measurement model with a set of observed variables. The average sample size for all models was 365.41, with some models retaining a sample as small as 50 and as large as 500. The second part of the issue is related to data screening prior to model estimation and testing. Data screening is important for researchers particularly in defining how they deal with missing values. Overall, discussion of data screening was reported in 118 (71.95%) of the studies while there was no study discussing evidence of multivariate normality for the models. On the third part, issues related to the estimation and testing of theoretical models on empirical data, assessing model fit is one of most important issues because it provides adequate statistical power for research models. There were multiple fit indices used in the SEM applications. The test was reported in the most of studies (146 (89%)), whereas normed-test was reported less frequently (65 studies (39.64%)). It is important that normed- of 3 or lower is required for adequate model fit. The most popular model fit indices were GFI (109 (66.46%)), AGFI (84 (51.22%)), NFI (44 (47.56%)), RMR (42 (25.61%)), CFI (59 (35.98%)), RMSEA (62 (37.80)), and NNFI (48 (29.27%)). Regarding the test of construct validity, convergent validity has been examined in 109 studies (66.46%) and discriminant validity in 98 (59.76%). 81 studies (49.39%) have reported the average variance extracted (AVE). However, there was little discussion of direct (47 (28.66%)), indirect, and total effect in the SEM models. Based on these findings, we suggest general guidelines for the use of SEM and propose some recommendations on concerning issues of latent variables models, raw data, sample size, data screening, reporting parameter estimated, model fit statistics, multivariate normality, confirmatory factor analysis, reliabilities and the decomposition of effects.

Assessing Productivity of Elementary School Lunch Foodservices in Daegu and Gyeongsangbuk-do Area (대구ㆍ경북지역 초등학교 급식소의 급식생산성 분석)

  • 박영숙
    • Korean journal of food and cookery science
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    • v.19 no.3
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    • pp.286-294
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    • 2003
  • The purpose of this study was to analyze the food service management practices and productivity in 49 elementary schools in the Daegu and Gyeongsangbuk-do areas. Survey questionnaires were used to obtain a variety of quantitative and qualitative information, including general food service management and productivity, on elementary school food service systems. Descriptive analysis, $\div$2-test, t-test and one-way ANOVA analysis were used as the statistical methods in this study. Eighteen elementary schools were located in urban areas, 13 in provincial areas and 18 in isolated areas. The average number of meals was 565.1, with a significant difference (p=0.001) between the areas. The average cost per a meal was 1151.0 Won, with a significant difference (p=0.001) between the areas. The productivity Index (meal/hour) was 13.5, with a significant difference (p=0.001) between the areas. There was a significant positive correlation of the productivity Index between the total number of meal, the number of employees, the total food cost, meals per employee and the employee's working period. There was a significant negative correlation between the productivity Index and the number of side dishes, the lost per meal, the labor cost per meal and the employee's job satisfaction degree index (JDI).

Development of NQ-E, Nutrition Quotient for Korean elderly: item selection and validation of factor structure (노인 대상 영양지수 개발 : 평가항목 선정과 구성 타당도 검증)

  • Chung, Min-Jae;Kwak, Tong-Kyung;Kim, Hye-Young;Kang, Myung-Hee;Lee, Jung-Sug;Chung, Hae Rang;Kwon, Sehyug;Hwang, Ji-Yun;Choi, Young-Sun
    • Journal of Nutrition and Health
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    • v.51 no.1
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    • pp.87-102
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    • 2018
  • Purpose: The purpose of this study was to develop a valid instrument for measuring the dietary quality and behaviors of Korean elderly. Methods: The development of the Nutrition Quotient for Elderly (NQ-E) was conducted in three steps: item generation, item reduction, and validation. The 41 items of the NQ-E checklist were derived from a systematic literature review, expert in-depth interviews, statistical analyses of the fifth Korean National Health and Nutrition Examination Survey data, and national nutrition policies and recommendations. Pearson's correlation was used to determine the level of agreement between the questionnaires and nutrient intake level, and 24 items were selected for a nationwide survey. A total of 1,000 nationwide elderly subjects completed the checklist questionnaire. The construct validity of the NQ-E was assessed using confirmatory factor analysis, LISREL. Results: The nineteen checklist items were used as final items for NQ-E. Checklist items were composed of four-factors: food behavior (6 items), balance (4 items), diversity (6 items), and moderation (3 items). The standardized path coefficients were used as the weights of the items. The NQ-E and four-factor scores were calculated according to the obtained weights of the questionnaire items. Conclusion: NQ-E would be a useful tool for assessing the food behavior and dietary quality of the elderly.

A Study on the Evaluation of Food Intake of Middle School Students in Kangneung (강릉지역 중학생의 식품섭취 평가에 관한 연구)

  • 김복란;조영은
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.30 no.5
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    • pp.986-992
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    • 2001
  • To assess the food intake and diet quality of middle school students who live in Kangneung area, a dietary survey using 3-day food record was conducted with 226 subjects. Seventy five percent of total food intake was in the form of plant foods and the rest in the form of animal food. Diet qualify was assessed by food group pattern, dietary diversity score (DDS), and dietary variety score (DVS). When counting the major food groups consumed, 53% of subjects had a DDS of 3 and 35% of subjects had a DDS of 4. When investigating the consumption pattern of the major five food groups, only 10.2% of subjects consumed foods from all five groups. The groups most frequently missed were dairy products (73.0%) and fruits (71.7%). On average, subjects habitually consumed 22.6 different foods daily, with the mean score of diet variety for males (22.1) being significantly lower than for females (22.9). Correlation coefficients between nutrient adequacy ratio (NAR) and DVS ranged from r=0.40 for vitamin B$_1$to r=0.61 for phosphorus. NAR also improved as the number of foods or food groups consumed increased (p<0.001). Associations between the NAR and high level of DVS was more positive than those between the NAR with DDS. When assessing the dietary quality of subjects using DDS and DVS, many people appeared not to have a desirable food intake. Therefore, to lead them to have nutritionally balanced diet, educating students and their parents on nutrients and suggesting guidelines for a desirable diet is considered to be essential so that they can intake from all of major food groups and have various foods in their diet.

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High School Students' Preferences and Food Intake on Menu Items Offered by School Foodservice in Daegu (대구지역 학교급식 식단에 대한 고등학생의 기호도와 섭취율)

  • Kim, So-Hee;Cha, Myeong-Hwa;Kim, Yoo-Kyeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.7
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    • pp.945-954
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    • 2006
  • The purpose of this study is to present basic data for an improvement of school foodservice by indentifying students' preference level for school meal menu and assessing students' nutrition intake. The subjects participated in this study were 544 high school students on 1st grade served by self-operated school foodservice in Daegu. The frequency analysis, t-test analysis, and correlation analysis were carried out for the data analysis using SPSS 12.0 program. Based on the results toward students' preference and serving frequency, the most frequently offered food was soup sorts and then followed by the categories of boiled rice, kimchi, broiled food and hard-boiled food. Boiled rice, rice with assorted vegetables, mandu soup, salad and braised beef rib were highly preferred to the students. Male students scored higher preference to the menu related with meats than female students. However, the students' preference and serving frequency on the menu were not correlated significantly in this study. A substantial correlation was found between the degree of preference and the rate of intake (p<0.01). It would be generalized that preferences to menu items strongly sffected the level of intake by students. The nutrient analysis of food intake revealed that both male and female students were not consuming sufficient level of calorie, calcium and vitamin $B_2$. In conclusion, the results indicate that the students' preference is a very important variable influencing the consumption level of meal as well as balanced nutrient intake by students served in school foodservice. Menu planning should be integrated into school foodservice management for quality control. As limited control of the menu may also negatively influence on the food leftovers and ecological issues, professionals related to the school foodservice including administers, educators and dieticians need to check up the students' preference regularly and reflect their perception on the menu planning to improve the quality of school foodservice. The nutrient intake currently provided through school foodservice should be also assessed more thoroughly. These data could be incorporated into continuous quality improvement and strategic planning in school foodservice.

Changes in Growths of Tomato and Grafted Watermelon Seedlings and Allometric Relationship among Growth Parameters as Affected by Night Temperature (야간온도에 따른 토마토묘와 수박 접목묘의 생육과 생육지표간 상대적 관계)

  • Kang, Yun-Im;Kwon, Joon-Kuk;Park, Kyoung-Sub;Choi, Hyo-Gil;Choi, Gyeong-Lee;Lee, Si-Young;Cho, Myeong-Whan;Kim, Dae-Young;Kang, Nam-Jun
    • Journal of agriculture & life science
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    • v.45 no.6
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    • pp.9-19
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    • 2011
  • This study aimed to investigate the effect of night temperature on tomato and grafted watermelon seedlings, particularly, shoot height, leaf area, stem diameter, and total dry weight and relationship among the growth parameters which are used to evaluate healthy seedling. Plants were grown at 10, 15, and $20^{\circ}C$. Leaf area index (LAI) and total dry weight of tomato seedlings weight deceased more significantly under $10^{\circ}C$ than other night temperature regimes. In grafted watermelon seedlings, shoot height increased shapely and stem diameter decreased under $20^{\circ}C$. Increasing the integral temperature, leaf area of tomato seedlings under $10^{\circ}C$ decreased and shoot height of grafted watermelon seedlings increased although temperature integrals are same. The relationships among the growth parameter were changed upon the night temperature. Stem diameters of tomato seedlings had upward tendency with increase of shoot height, but there were no significant differences among night temperature regimes. Shoot hight of grafted watermelon seedlings had no relationship with shoot height. These results indicate that shoot height and stem diameter of tomato seedlings is not appropriate for assessing seedlings quality but shoot height of grafted watermelon seedlings with stem diameter is available.

The Studies on the Development of Low Irritable Preservative System with Phenoxyethanol in Cosmetics (Phenoxyethanol을 이용한 저자극 방부시스템 개발에 관한 연구)

  • Ahn, Gi-Woong;Lee, Chn-Mong;Kim, Hyeong-Bae;Jeong, Ji-Hen;Jo, Byoung-Kee
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.31 no.1 s.49
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    • pp.43-49
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    • 2005
  • Recently, according as people who have sensitive skin increase, we've been giving more importance to the safety of cosmetics. Especially, preservative is known to be one of the main stimuli which cause side-effects of cosmetics. However, there have been few reports describing cell cytotoxicity, skin penetration, oil-aqueous phase partition, anti-microbial activity of preservatives and their correlation with skin irritation. The study is aimed to develop low irritable preservative system with phenoxyethanol, one of the most commonly used preservatives in cosmetics, considering various factors mentioned above. According to our results of cell cytotoxicity against human normal fibroblasts by means of MTT assay, phenoxyethanol showed the lowest cytotoxicity when compared to other preservatives tested (cytotoxicity: pro-pylparaben > butylparaben > ethylparaben > methylparaben > triclosan > phenoxyethanol), but human patch test for assessing shin primary irritation revealed that phenoxyethanol has higher skin irritation than methylparaben and triclosan. We performed in vitro skin penetration test using horizontal Franz diffusion cells with skin membrane prepared from hairless mouse (5 ${\~}$ 8 weeks, male) to evaluate the rate of skin penetration of preservatives. From the results, we found that the higher irritable property of phenoxyethanol in human skin correlates with its predominant permeability (skin penetration: phenoxyethanol > methylparaben > ethylparaben > propylparaben > butylfaraben > triclosan). Therefore, we made an effort to reduce skin permeability of phenoxyethanol and found that not only the rate of skin penetration of phenoxyethanol but also its skin irritation is dramatically reduced in formulas containing oils with low polarity. In the experiments to investigate the effect of oil polarity on the oil-aqueous phase partition of phenoxyethanol, more than $70\%$ of phenoxyethanol was partitioned in aqueous phase in formulas containing oils with low polarity, while about $70 {\~} 90\%$ of phenoxyethanol was partitioned in oil phase in formulas containing oils with high polarity. Also, in aqueous phase phenoxyethanol showed greater anti-microbial activity. Conclusively, it appears that we can develop less toxic preservative system with reduced use dosage of phenox-yethanol and its skin penetration by changing oil composition in formulas.

A Comparison Study of Alkalinity and Total Carbon Measurements in $CO_2$-rich Water (탄산수의 알칼리도 및 총 탄소 측정방법 비교 연구)

  • Jo, Min-Ki;Chae, Gi-Tak;Koh, Dong-Chan;Yu, Yong-Jae;Choi, Byoung-Young
    • Journal of Soil and Groundwater Environment
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    • v.14 no.3
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    • pp.1-13
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    • 2009
  • Alkalinity and total carbon contents were measured by acid neutralizing titration (ANT), back titration (BT), gravitational weighing (GW), non-dispersive infrared-total carbon (NDIR-TC) methods for assessing precision and accuracy of alkalinity and total carbon concentration in $CO_2$-rich water. Artificial $CO_2$-rich water(ACW: pH 6.3, alkalinity 68.8 meq/L, $HCO_3^-$ 2,235 mg/L) was used for comparing the measurements. When alkalinity measured in 0 hr, percent errors of all measurement were 0~12% and coefficient of variation were less than 4%. As the result of post-hoc analysis after repeated measure analysis of variance (RM-AMOVA), the differences between the pair of methods were not significant (within confidence level of 95%), which indicates that the alkalinity measured by any method could be accurate and precise when it measured just in time of sampling. In addition, alkalinity measured by ANT and NDIR-TC were not change after 24 and 48 hours open to atmosphere, which can be explained by conservative nature of alkalinity although $CO_2$ degas from ACW. On the other hand, alkalinity measured by BT and GW increased after 24 and 48 hours open to atmosphere, which was caused by relatively high concentration of measured total carbon and increasing pH. The comparison between geochemical modeling of $CO_2$ degassing and observed data showed that pH of observed ACW was higher than calculated pH. This can be happen when degassed $CO_2$ does not come out from the solution and/or exist in solution as $CO_{2(g)}$ bubble. In that case, $CO_{2(g)}$ bubble doesn't affect the pH and alkalinity. Thus alkalinity measured by ANT and NDIR-TC could not detect the $CO_2$ bubble although measured alkalinity was similar to the calculated alkalinity. Moreover, total carbon measured by ANT and NDIR-TC could be underestimated. Consequently, it is necessary to compare the alkalinity and total carbon data from various kind of methods and interpret very carefully. This study provide technical information of measurement of dissolve $CO_2$ from $CO_2$-rich water which could be natural analogue of geologic sequestration of $CO_2$.

Nutrient Balance and Vegetable Crop Production as Affected by Different Sources of Organic Fertilizers (유기자원에 따른 양분수지 및 작물생산)

  • Agus, Fahmuddin;Setyorini, Diah;Hartatik, Wiwik;Lee, Sang-Min;Sung, Jwa-Kyung;Shin, Jae-Hoon
    • Korean Journal of Soil Science and Fertilizer
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    • v.42 no.1
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    • pp.1-13
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    • 2009
  • Understanding the net nutrient balance in a farming system is crucial in assessing the system's sustainability. We quantified N, P and K balances under vegetable organic farming in a Eutric Haplud and in West Java, Indonesia in five planting seasons from 2005 to 2007. The ten treatments and three replications, arranged in a completely randomized block design, included single or combined sources of organic fertilizers: barnyard manure, compos ts or green manures. The organic matter rates were adjusted every planting season depending on the previous crop responses. The result sshowed that the application of ${\geq}20$ t $ha^{-1}$ barnyard manure per crop resulted in positive balances of N, P, and K, except in the second crops of 2006 where potassium balance were -25 to -11 kg $ha^{-1}$ under the treatments involving cattle barnyard manure, because of low K content of these treatments and high K uptake by Chinese cabbage. Application of 20 to 25 t $ha^{-1}$ of plant residue or 5 t $ha^{-1}$ of Tithonia compost also resulted in a negative K balance. Soil available P increased significantly under ${\geq}25$ t $ha^{-1}$ barnyard manure and that under chicken manure had the highest available P. Accordingly, chicken barnyard manure gave the highest crop yield because of relatively higher N, P, and K contents. Plant residues gave the lowest yield due to the lowest nutrient content among all sources. Reducing the use of barnyard manure to 12.5 t $ha^{-1}$ and substituting it with Tithonia compost, Tithonia green manure or vegetable plant residue compost gave insignificantly different yield compared to the application of 25 t $ha^{-1}$ barnyard manure singly. In the long run, application of 25 t ha-1 cattle, goat, and horse manure or about 20 t $ha^{-1}$ chicken manure is recommendable for sustaining the fertility of this Andisol for vegetable production.