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Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

Analyzing Career Paths and College Life Plans of Department of Chemistry Education Students in Teacher's College Examined by Their Roadmaps (사범대학 화학교육과 학생들의 로드맵을 통한 진로 목표와 대학 생활 계획 분석)

  • Park, Jongseok;Bae, Sungwoo
    • Journal of the Korean Chemical Society
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    • v.56 no.6
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    • pp.751-758
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    • 2012
  • In this study, we analyzed career paths and college life plans of department of chemistry education students in teacher's college examined by their roadmaps. We let students make their roadmaps and analyzed them using the PASW 18 program. There were significant differences on gender in their career paths, learning English, traveling and volunteer activity. Female students for passing the MEET(Medical Education Eligibility Test) or DEET(Dental Education Eligibility Test) were more interested in learning English and traveling than male students. In addition, female students were more interested in volunteer activity. And the lower year students, the more interested in medical paths, learning English, traveling, getting good grades, exchange student program and scholarship. On the other hand the higher year students, the more interested in group study or E-learning. Then significant differences were in learning English, traveling and getting good grades by students's career paths. Students who wish to pass the MEET or DEET were more interested in learning English and getting good grades. Those two factors were essential in passing the MEET or DEET. Students who did not specified their career paths had more traveling plans than other students for setting their directions of careers. These results show that freshman and female students don't recognize the identity of teacher's college correctly. Because of reduction in the number of teacher recruitment according to decrease of students by birth rate drop, students in teacher's college are expected to continue like this trend that students look for other paths. Therefore, it is required career counseling and guidance for students who give priority practical path choices and college life plans over original characteristics of teacher's college. And it should be reconsidered the direction of chemistry education prepared the identity of teacher's college reflected in this actuality.

Road-map for Environmental Friendly Integrated Pest Management(IPM) of Insect Pests on the Strawberry Vinyl-houses of Farmer's Field (딸기재배 하우스에서 발생하는 해충의 환경친화적 종합적방제를 위한 로드맵)

  • Lee, D.H.;Jo, C.W.;Park, C.R.;Lee, H.J.;Kang, E.J.;Seok, H.B.;Seo, M.J.;Kim, H.Y.;Kim, Y.H.;Yu, Y.M.;Youn, Y.N.
    • Korean journal of applied entomology
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    • v.47 no.3
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    • pp.273-286
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    • 2008
  • Road-map for the environmental friendly integrated pest management(IPM) of insect pests was drawn up on the strawberry vinyl-houses of farmer's field. Major insect pests were occurred Tetranychus urticae and Aphis gossypii during the strawberry plant seeding in the vinyl house and open field. Also, same insect pests were occurred in the vinyl house during harvesting season of strawberry. For the control of T. urticae and A. gossypii, Phytoseiulus persimilis and Aphidius colemani as natural enemies were input to the vinyl house, respectively. However, because these natural enemies could not control insect pest populations, acaricide and insecticide were sprayed. Then natural enemies were input again in the vinyl house. Natural enemies could not endure the intense cold and differences of temperature and relative humidity between day and night during strawberry harvesting season. So, their behavior and control activity of pests were more decrease than pests. Firstly, natural enemies are input in the vinyl house during the early breeding season of strawberry, secondly, acaricides and insecticide are sprayed for the control of mites and aphids, respectively, during the middle breeding season in the hard winter. Finally, natural enemies are re-input in the vinyl house during the middle and late breeding season.

COMORBIDITY AND RISK FACTORS ASSOCIATED WITH CHILDREN WHO HAVE THE SYMPTOMS OF OPPOSITIONAL DEFIANT DISORDER - COMMUNITY BASED STUDY - (반항성 도전 장애 아동과 연관된 공존 증상 및 위험 요인에 관한 연구 - 지역사회 연구 -)

  • Kim Boong-Nyun;Jung Kwang-Mo;Cho Soo Churl;Hong Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.16 no.1
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    • pp.79-89
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    • 2005
  • Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

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A study on the perception of landscape through the selection process of Bandopalgyong - eight beautiful scenary in Korea - within Japanese colonial period (일제강점기 반도팔경 선정과정을 통해 본 경관인식)

  • Kim, Hai-Gyeong;An, Kyung-Jin
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.33 no.2
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    • pp.78-88
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    • 2015
  • In the 1920s, the period of cultural governance ruled by Japan, the diverse media were founded and various events were conducted to boost circulation. Under the Japanese colonial period in 1920s, a number of media - newspapers and magazines - were published and often they carried out entertaining events in order to obtain more subscribers. A hobby magazine, Samchunri, for instace, set up a media event to selecting Korea's eight beautiful scenary (Bandopalgyong) for the first edition in 1929. The paper aims to analyse and understand the perception of landscape in 1929 through the media event carried out by Samchunri. In particular, the selection was made by well-known writers within Japanese colonial period 1910 - 1945). The selection process and views from the writers on landscape were analysed; firstly, the selection of Bandopalgyong was carried out by questionnaires to writers in 1929 where Korea is under Japanese colonial rules. The conditions of the selection were unknown; however, the purpose was enlightening the people specially the youngs and introduction of beautiful places in Korea. As a result, views and opinions on Bandopalgyong by the writers were progressed. Secondly, within the Bandopalgyong, the natural landscape areas include Gumgansan(金剛山), Daedonggang(大洞江), Buyeo(扶餘), Gyongju(慶州), Myongsasipri (明沙十里), Haundae(海雲臺), Baekdusan(白頭山), and Choksukru(矗石樓). Those chosen places were not cohesive nor did not have any consistant reasons to be chosen in terms of size and location; however, some writers claimed that there were other places to match the chosen ones and therefore, the selection process was highly dependent on access (i.e. transport). Thirdly, the travelogue on Baekdusan and Nackwhaam(洛花岩) illustrated interesting views on landscape in particular. Baekdusan landscape were described in overlaping with long history and national soul. In the Nackwhaam travelogue, it described 'Buyeo (夫餘) was an ancient capital of Backjae Dynasty and empty place' as well as denying Chosun Dynasty. It was assumed that the two places weren't visited but rewritten with existing literatures. Fourthly, edited by Kim Dong Whan, a travelogue style book, 'Bandosanha' was published in 1941. It did repeat the selection of Bandopalgyong, but this time, it was classified the eight beautiful landscape into two categories; historic/cultural places and natural landscape. This paper was able to analyse and understand the perception of landscape in 1929 through the travelogue of Samchunri. It is an empirical study on the process and perception on Korea landscape under Japanese colonical period by views of the selected writers.

Minor Stress, Coping Skill and Quality of Life in Patients with Hemodialysis (혈액투석 환자들의 Minor Stress, 대처방식 및 삶의 질)

  • Yang, Jae-Won;Lee, Moon-Soo;Park, Sang-Uk;Oh, So-Young;Ko, Young-Hoon;Kwan, Young-Joo;Joe, Sook-Haeng
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.38-46
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    • 2008
  • Objectives : The purpose of this study is to investigate the minor stress in daily life related to undergoing hemodialysis and the relationship between minor stresses, coping skills, and subjective quality of life among the patients with end stage renal disease. Methods : Seventy seven patients on hemodialysis were enrolled in this study. Minor stress was assessed with daily stress inventory-Korean version(K-DSI), ways of coping checklist identified the use of the following coping strategies:problem-focused, seek social support, emotion-focused coping and wishful thinking. Socio-demographic data were obtained and World Health Organization-Quality of Life Scale(brief form) was also administered to subjects. Results : Participants mean age was $55.92{\pm}13.71$ years. The mean of the event, impact and impact/event (I/E) ratio scores of K-DSI were $29.06{\pm}21.57$, $88.69{\pm}75.88$ and $2.92{\pm}1.11$, respectively. These scores were much higher than normative data of K-DSI. Among the 5 categories of this inventory, the scores of cognitive stressors were highest. 5 categories of the inventory showed positive relationship with way of coping subscales, which showed coefficient of correlation between 0.259(p<.01) and 0.495(p<.001). However, no significant correlation was found between minor stress subscales and quality of life. Hemodialysis patients in our study used more emotional-focused coping methods, which was considered as passive way of cope than problem-orientated coping methods. Conclusion : The main findings of this study indicated that patients on hemodialysis showed higher level of perceived minor stress than normal population. The patients treated with hemodialysis tend to use passive way of coping primarily. For assessing the stress in patients on hemodialysis, clinician has to consider both level of perceived minor stress and the ways of coping the patients primarily use.

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Clonal Variation in Female Flowering of Larix leptolepis (낙엽송 클론의 암꽃 개화량 변이)

  • Kim, In-Sik;Kim, Jong-Han;Kang, Jin-Taek;Lee, Byung-Sil
    • Korean Journal of Plant Resources
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    • v.21 no.1
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    • pp.1-4
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    • 2008
  • The clonal variation in female flowering was studied in Larix leptolepis clone bank, consisting of 116 clones, for three years. The between-year variation was large; i.e. the percentage of flowering grafts and average number of flowering per graft were $28.4{\sim}67.2$ and $9{\sim}176$, respectively. Differences in flowering abundance among clones were large and statistically significant in all the years studied. The variance of flowering abundance among clones was increased when flowering was poor. The average of broad-sense heritability of flowering abundance was 0.52. The genetic gain(%G) was estimated at 57.4% when the upper 30% clones were selected. The clonal stability of flowering abundance was compared using average number of flowering and coefficient of variance value of each clone. The clones such as Gyeonggi 9(29), Kangwon 37(137), Chungnam 6(46), Chungnam 14(414), R11, R8 showed abundant flowering and high stability.

A Study on An Integrated GEO/TES with Geothermal Heat Exchanger and Thermal Ice Storage (지중열 교환기와 빙축열조(Thermal Ice Storage)를 연계시킨 통합 지중열-빙축열조 시스템(Integrated GEO/TES))

  • Lohrenz ED.;Hahn Jeongsang;Han Hyuk Sang;Hahn Chan;Kim Hyoung Soo
    • Economic and Environmental Geology
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    • v.38 no.6 s.175
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    • pp.717-729
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    • 2005
  • Peak cooling load of large buildings is generally greater than their peak heating load. Internal and solar heat gains are used fur selection of adquate equipment in large building in cold winter climate like Canada and even Korea. The cost of geothermal heat exchanger to meet the cooling loads can increase the initial cost of ground source heat pump system to the extend less costly conventional system often chosen. Thermal ice storage system has been used for many years in Korea to reduce chiller capacity and shift Peak electrical time and demand. A distribution system designed to take advantage of heat extracted from the ice, and use of geothermal loop (geothermal heat exchanger) to heat as an alternate heat source and sink is well known to provide many benifits. The use of thermal energy storage (TES) reduces the heat pump capacity and peak cooling load needed in large building by as much as 40 to $60\%$ with less mechanical equipment and less space for mechanical room. Additionally TES can reduce the size and cost of the geothermal loop by 1/3 to 1/4 compared to ground coupled heat pump system that is designed to meet the peak heating and cooling load and also can eliminate difficuties of geothermal loop installation such as space requirements and thermal conditions of soil and rock at the urban area.

How Can Non.Chaebol Companies Thrive in the Chaebol Economy? (비재벌공사여하재재벌경제중생존((非财阀公司如何在财阀经济中生存)? ‐공사층면영소전략적분석(公司层面营销战略的分析)‐)

  • Kim, Nam-Kuk;Sengupta, Sanjit;Kim, Dong-Jae
    • Journal of Global Scholars of Marketing Science
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    • v.19 no.3
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    • pp.28-36
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    • 2009
  • While existing literature has focused extensively on the strengths and weaknesses of the Chaebol and their ownership and governance, there have been few studies of Korean non-Chaebol firms. However, Lee, Lee and Pennings (2001) did not specifically investigate the competitive strategies that non-Chaebol firms use to survive against the Chaebol in the domestic Korean market. The motivation of this paper is to document, through four exploratory case studies, the successful competitive strategies of non-Chaebol Korean companies against the Chaebol and then offer some propositions that may be useful to other entrepreneurial firms as well as public policy makers. Competition and cooperation as conceptualized by product similarity and cooperative inter.firm relationship respectively, are major dimensions of firm.level marketing strategy. From these two dimensions, we develop the following $2{\times}2$ matrix, with 4 types of competitive strategies for non-Chaebol companies against the Chaebol (Fig. 1.). The non-Chaebol firm in Cell 1 has a "me-too" product for the low-end market while conceding the high-end market to a Chaebol. In Cell 2, the non-Chaebol firm partners with a Chaebol company, either as a supplier or complementor. In Cell 3, the non-Chaebol firm engages in direct competition with a Chaebol. In Cell 4, the non-Chaebol firm targets an unserved part of the market with an innovative product or service. The four selected cases such as E.Rae Electronics Industry Company (Co-exister), Intops (Supplier), Pantech (Competitor) and Humax (Niche Player) are analyzed to provide each strategy with richer insights. Following propositions are generated based upon our conceptual framework: Proposition 1: Non-Chaebol firms that have a cooperative relationship with a Chaebol will perform better than firms that do not. Proposition 1a; Co-existers will perform better than Competitors. Proposition 1b: Partners (suppliers or complementors) will perform better than Niche players. Proposition 2: Firms that have no product similarity with a Chaebol will perform better than firms that have product similarity. Proposition 2a: Partners (suppliers or complementors) will perform better than Co.existers. Proposition 2b: Niche players will perform better than Competitors. Proposition 3: Niche players should perform better than Co-existers. Proposition 4: Performance can be rank.ordered in descending order as Partners, Niche Players, Co.existers, Competitors. A team of experts was constituted to categorize each of these 216 non-Chaebol companies into one of the 4 cells in our typology. Simple Analysis of Variance (ANOVA) in SPSS statistical software was used to test our propositions. Overall findings are that it is better to have a cooperative relationship with a Chaebol and to offer products or services differentiated from a Chaebol. It is clear that the only profitable strategy, on average, to compete against the Chaebol is to be a partner (supplier or complementor). Competing head on with a Chaebol company is a costly strategy not likely to pay off for a non-Chaebol firm. Strategies to avoid head on competition with the Chaebol by serving niche markets with differentiated products or by serving the low-end of the market ignored by the Chaebol are better survival strategies. This paper illustrates that there are ways in which small and medium Korean non-Chaebol firms can thrive in a Chaebol environment, though not without risks. Using different combinations of competition and cooperation firms may choose particular positions along the product similarity and cooperative relationship dimensions to develop their competitive strategies-co-exister, competitor, partner, niche player. Based on our exploratory case-study analysis, partner seems to be the best strategy for non-Chaebol firms while competitor appears to be the most risky one. Niche players and co-existers have intermediate performance, though the former do better than the latter. It is often the case with managers of small and medium size companies that they tend to view market leaders, typically the Chaebol, with rather simplistic assumptions of either competition or collaboration. Consequently, many non-Chaebol firms turn out to be either passive collaborators or overwhelmed competitors of the Chaebol. In fact, competition and collaboration are not mutually exclusive, and can be pursued at the same time. As suggested in this paper, non-Chaebol firms can actively choose to compete and collaborate, depending on their environment, internal resources and capabilities.

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The effect of admixture of vitamin $D_3$ and dexamethasone on the activity of osteoblastic cells (Vitamin $D_3$와 Dexamethasone의 복합 투여가 골모세포에 미치는 영향에 관한 연구)

  • Lim, Na-Won;Park, Young Joo;Kim, Sang-Cheol
    • The korean journal of orthodontics
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    • v.29 no.3 s.74
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    • pp.383-397
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    • 1999
  • Bone is a dynamic tissue which is constantly remodelled by subsequent cycles of bone resorption and formation. Glucocorticoid and vitamine $D_3$ are known as regulating substances in bone metabolism. In vitro experiments using bone tissue, it was suggested that glucocorticoid inhibits bone resorption, whereas the effect of glucocorticoid on bone formation are complex- increasing or decreasing effect. The active form of vitamin $D_3$, 1,25-dihydroxycholecalciferol[1.25-$(OH)_2D_3$], has been reported to stimulate osteoblastic activities including the production of ALP, type I collagen, and osteoclacin. The purpose of this study was to evaluate the effect of admixture of vitamin $D_3$ and dexamethasone, one of glucocorticoids, on osteoblastic cell line(MC3T3-E1). Alkaline phosphatase(ALP) and MTT assay were conducted in the cultivated cells with 1, 10, 100nM/ml of 1,25-$(OH)_2D_3$ and/or 10nM/ml, 100nM/ml, $1{\mu}M/ml$ of dexamethasone. The observed results were as follows. 1. The activity of osteoblastic cells with $1{\mu}M/ml$ of dexamethasone was significantly increased at 1-day cultivation with comparison to control group, but was decreased afterwards. But the activity of ALP was greatest in $1{\mu}M/ml$ of dexamethasone and increased with time lapsed. 2. The activity of osteoblastic cells with vitamin $D_3$ was significantly increased dose-dependently at 1-day cultivation, but was significantly decreased in l00nM/.ml at 2-day cultivation, and was a little increased again at 3-day cultivation. The activity of ALP was increased in 10nM/ml or 100nM/ml at 2-day or 3-day cultivation, and was greatest in 100nM/ml at 3-day cultivation. 3. In case of admixture of dexamethasone and vitamin $D_3$, the cellular activity was decreased in any concentration of vitamin $D_3$ at 2-day cultivation, but was increased again at 3-day cultivation, which was greater than that in control or dexamethasone only group. The activity of ALP was decreased at 1-day cultivation, but was increased in the admixture of 10nM/ml or 100nM/ml of dexamethasone with 100nM/ml of vitamin $D_3$ at 2-day cultivation, and was again decreased at 3-day cultivation.

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