• 한국병원경영학회지
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• 제spc호
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• pp.85-95
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• 2016

This study is to introduce a comprehensive framework of a crisis management system developed at a prominent hospital in South Korea. Throughout recent decades, especially in the recent years, the way in which to cope with both internal and external challenges has been one of the most critical issues. Since the incident management system in the U.S. is acknowledged as the most advanced crisis management model in the world, a portion of this study refers to the Hospital Incident Command System(HICS) provided by the California Emergency Medical Services Authority(EMSA). Nevertheless, the framework suggested in this article was designed based on a distinctive Korean hospital setting. The main contents of this study are as follows; categorization of each type of crisis, organization of a crisis management team in a non-crisis or crisis state, crisis assessment by life cycle stage, and establishment of crisis management protocol. Even though many types of crises are unspecified, those can be categorized into external crisis, medical crisis, and utility & activity failure. A crisis management organization should be operated and consisted differently- depending on a crisis or non-crisis situation. From a life-cycle perspective, the range by which the crisis should be managed extends from pre-stage to post-stage of the crisis. It is important to set proper scenarios and manuals by crisis type to develop a crisis management framework of high quality. With continuous efforts, hospitals can prepare for the uncertainty to better concentrate on core business operations.

• Smart Structures and Systems
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• 제16권1호
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• pp.1-26
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• 2015

Minimizing construction cost and reducing seismic damage are two conflicting objectives in the design of any new structure. In the present work, we try to develop a framework in order to solve the optimum performance-based design problem considering the construction cost and the seismic damage of steel moment-frame structures. The Park-Ang damage index is selected as the seismic damage measure because it is one of the most realistic measures of structural damage. The non-dominated sorting genetic algorithm (NSGA-II) is employed as the optimization algorithm to search the Pareto optimal solutions. To improve the time efficiency of the proposed framework, three simplifying strategies are adopted: first, simplified nonlinear modeling investigating minimum level of structural modeling sophistication; second, fitness approximation decreasing the number of fitness function evaluations; third, wavelet decomposition of earthquake record decreasing the number of acceleration points involved in time-history loading. The constraints of the optimization problem are considered in accordance with Federal Emergency Management Agency's (FEMA) recommended seismic design specifications. The results from numerical application of the proposed framework demonstrate the efficiency of the framework in solving the present multi-objective optimization problem.

• Earthquakes and Structures
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• 제7권3호
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• pp.271-294
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• 2014

In recent years, along with the advances made in performance-based design optimization, the need for fast calculation of response parameters in dynamic analysis procedures has become an important issue. The main problem in this field is the extremely high computational demand of time-history analyses which may convert the solution algorithm to illogical ones. Two simplifying strategies have shown to be very effective in tackling this problem; first, simplified nonlinear modeling investigating minimum level of structural modeling sophistication, second, wavelet analysis of earthquake records decreasing the number of acceleration points involved in time-history loading. In this paper, we try to develop an efficient framework, using both strategies, to solve the performance-based multi-objective optimal design problem considering the initial cost and the seismic damage cost of steel moment-frame structures. The non-dominated sorting genetic algorithm (NSGA-II) is employed as the optimization algorithm to search the Pareto optimal solutions. The constraints of the optimization problem are considered in accordance with Federal Emergency Management Agency (FEMA) recommended design specifications. The results from numerical application of the proposed framework demonstrate the capabilities of the framework in solving the present multi-objective optimization problem.

• 한국병원경영학회지
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• 제26권2호
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• pp.1-16
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• 2021

This study aims to examine the effect of integrated health and welfare(IHW) services on medical use and medical expenses in Korean Veteran Hospitals. Data on the volume of medical use and medical expenses were collected from two patient groups of 5 Veterans' Hospitals: the beneficiary group who has received IHW services and the non-beneficiary group who has not. Each group was composed of 265 patients respectively. The results of the study revealed that the volume of home nursing services, home rehabilitation services, ambulatory services have increased significantly, whereas the average length of stay, number of using emergency services, and average medical expenses have decreased after receiving integrated health services in the beneficiary group. In contrast, the non-beneficiary group showed much more increase both in the volume of inpatient and outpatient services, as well as the average medical expenses, compared to those of the beneficiary group. This results imply that the provision of IHW services have positive impacts on the enhancing the effectiveness of the medical resources utilization for the veteran patients.

• 대한정형외과학회지
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• 제54권6호
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• pp.557-561
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• 2019

대부분의 저에너지 외상에 의한 골반환 골절은 합병증 없이 보존적 치료만으로 호전이 되어 혈관손상 등의 합병증에 대한 초기평가를 간과하기 쉽다. 본 증례보고에서는 평소 aspirin을 복용하던 81세 여자환자가 낙상으로 비전위성 치골지 골절이 발생하면서 corona mortis가 손상되어 나타난 대량출혈을 보고하는 바이다. 고령의 골반환 골절 환자에서는 골절의 전위 여부와 관계없이 혈관 손상이 지연되어 발생할 수도 있기 때문에 면밀한 이학적 검사 및 감시가 필요하다.

• 한국임상수의학회지
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• 제41권3호
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• pp.165-169
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• 2024

A 10-year-old, spayed female Maltese dog was tentatively diagnosed with granulomatous meningoencephalitis (GME) on magnetic resonance imaging. The meningoencephalitis was classified as aseptic GME because cerebral fluid analysis did not reveal an infectious aetiology. Two months after leflunomide treatment (Arava; Sanofi; 4 mg/kg/day), the patient developed non-regenerative, macrocytic, and normochromic anemia. As the patient's anaemia began after the administration of leflunomide, and other differentials for anaemia had been ruled out, the leflunomide was determined to be the cause and this treatment ended. After 15 days, the anaemia resolved spontaneously. This is the first report of reversible aplastic anaemia following treatment with leflunomide in a canine patient with GME.

• 한국재난정보학회 논문집
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• 제18권1호
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• pp.91-103
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• 2022

연구목적: 코로나바이러스감염증-19(COVID-19) 이후 교육생태계의 변화가 일어났고 소방학교 역시 대면교육을 비대면 교육으로 전환 되었다. 이로 인해 교육생(소방공무원)의 교육효과는 떨어지고 만족도 역시 낮아지고 있다. 본 연구에서 비대면 실시간 원격교육의 현 실태를 살펴보고 문제점을 보완하여 이에 맞는 교육방법, 교육내용, 교육환경 등을 개선하고자 한다. 연구방법: 본 연구에서는 비대면 실시간 원격교육에 영향을 미치는 독립변수로 시스템 환경운영, 컴퓨터의 자기효능감, 콘텐츠(교육내용, 구조, 설계 등), 적절한 상호작용으로 구성하였고, 종속변수로는 비대면 실시간 원격교육 만족도로 선정하였다. 이러한 독립변수와 종속변수에 사이에 조절변수로 학습동기와 학습태도의 적극성을 추가 구성하였다. 연구결과: 콘텐츠가 좋고 학습동기와 학습태도의 적극적 일수록 비대면 실시간 원격교육의 학습만족도가 높아졌고, 학습동기와 학습태도의 적극성이 높아지면 컴퓨터 자기효능감도 학습만족도에 긍정적 영향을 미칠 수 있다는 결과를 도출하게 되었다. 결론: 코로나바이러스감염증-19(COVID-19)으로 인한 비대면 실시간 교육만족을 높이기 위해 교육설계자 혹은 교수자는 학습동기와 학습태도의 적극성을 높일 수 있는 비대면 교육콘텐츠를 제공해야하고 비대면 교육시스템에 대한 사전교육을 통해 컴퓨터 자기효능감을 높여 학습자의 교육 만족도를 높여야 할 필요가 있다.

• 의료법학
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• 제20권1호
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• pp.163-201
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• 2019

의사에게는 환자와의 법률관계에서 비롯되는 여러 의무들이 존재한다. 그 중 하나가 의사 자신이 속해 있는 의료기관이 치료 및 진료를 위한 인프라나 의료기술이 부족한 것으로 판단하는 경우 환자를 적절한 진단 검사 및 진료가 가능한 의료기관으로 '전원(轉院)'하여야 하는 주의의무인 전원의무(轉院醫務)이다. 의료기관마다 환자의 응급성 정도에 따라 대응할 수 있는 능력이 다르므로 의사의 지시나 권고에 의하여든 환자 본인의 요청에 의하여든 이와 같은 환자의 전원은 불가피한 현상이다. 예를 들어 심각한 뇌손상을 입은 환자가 내원한 경우, 진단, 검사 장비 및 인력을 갖추지 못한 병원의 의사로서는 적절한 시기(이른바 '골든타임')에 진단, 검사 및 진료가 가능한 상급의료기관으로 전원을 고려하여야 한다. 이처럼 전원의무는 의사의 의무 중 하나인 것으로 의사뿐만 아니라 환자들에게도 널리 인식되고 있다. 그러므로 적절한 전원 시점을 놓치게 되어 의료사고가 발생한 상황에서는 전원의무위반 여부와 관련한 의사와 환자 간의 법적 분쟁이 있을 수밖에 없다. 본 연구에서는 이러한 상황과 관련하여 전원의무에 대한 구체적이고도 명확한 판단 기준 정립과 함께 현재 각 의료기관들에 마련되어 있는 가이드라인이 실제 적용에서의 여러 시행착오들을 반영하고 있는지에 대한 검토가 필요하다고 보고, 의사의 전원의무에 대한 판례의 동향 분석을 중심으로 전원의무 관련 판례에서 이미 제시되어 있는 판단 기준 요소들이 적절한지 그리고 현재 실무에서 적용되는 법령 및 가이드라인 등과 부합되는지 여부를 살펴봄으로써 앞으로 응급환자에 대한 의사의 전원의무 관련 분쟁조정 및 소송에서의 해석과 적용에 기여할 수 있도록 하였다.

• 대한전기학회:학술대회논문집
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• 대한전기학회 2004년도 학술대회 논문집 정보 및 제어부문
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• pp.6-8
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• 2004

The objective of this paper is to develop a powered wheelchair controller based on EMG for users with high-level spinal cord injury using a proportional control scheme. An advantage of EMG is relative convenience of acquisition by a surface electrode to users. Direction information can be easily extracted from two EMG channels and force information can be acquired by proportional relationship between the amplitude of EMG and user's power, respectively. Pattern classification algorithm is a threshold method with a supervised learning process. Furthermore, the emergency situation can be avoided using an interrupt function. We evaluated the performance of powered wheelchair controller by navigating a pre-defined path with three non-handicapped people. The results show the feasibility of EMG as an input interface for powered wheelchair and other devices for the seriously disabled.

• 한국지반공학회:학술대회논문집
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• 한국지반공학회 2010년도 추계 학술발표회
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• pp.253-262
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• 2010

In this study, localized heavy rainfall occurred during the collapse of steep slopes adjacent to the construction site and to ensure the safety of residents to build an early warning system was performed. Forecast/Alert range was estimated based on vulnerability landslide map and past disaster history. And established a critical line in consideration of the characteristics of local rainfall and operating a snake line, the study calculated causing and non-causing points. Also, be measured in real-time analysis of rainfall data in conjunction with the system before the steep slope failure occurred forecast/Alert System is presented.