• Title/Summary/Keyword: Time Delay

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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.

An Exploratory Study of Purchasing Decision Making and Adoption on the RFID Purchasing Customer (RFID 구매고객의 구매 의사결정과 수용에 대한 탐색적 연구)

  • Seo, Pil-Su;Jang, Jang-Yi;Shim, Kyeng-Su
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.3 no.4
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    • pp.89-116
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    • 2008
  • RFID (Radio Frequency Identification) is regarded as a core technology of ubiquitous computing. Although it has some technical limitations such as technological standardization of RFID tags as well as economical limitations, many companies around the world have already accepted RFID to improve their management efficiency. In this regard, this study is to meet with results that the adoption of RFID technology willbring opportunities that companies' operational process are improved and customer satisfaction is highly strengthened. This research focuses on providing more understanding for building RFID marketing strategy to suppliers who want to sell their RFID products to customers through analyzing purchasing process. The findings are as follows; First, the study shows that buying center members usually take product reliability and precision of technical specification in the case of new-task buying situation while they put their first purchasing priority on prices in the straight rebuy. Second, the finding presents that in new-task buying situation and the straight rebuy purchasing personnel get information about new products through product performance test, organizational engineers, opinions from other companies' purchasing personnel, and checking out samples. Third, this research demonstrates when it comes to purchasing risk in their first purchasing, the persons who are in charge of material purchasing are inclined to be aware of the risk most in technical problems, followed by financial problems and time delay problems in order. And in addition to those risks are mentioned above, once-again-purchasers take the risk like an opportunity loss for better products into consideration. Fourth, the study shows that the role of concerning departments makes no difference in each purchasing stage. Accordingly marketers need to beef up the differentiated strategy to persuade their customers Fifth, the findings of this study demonstrate that purchasing decision making is much influenced by the final users. So suppliers are supposed to perform the most active marketing strategy at the first stage of purchasing through various resources. Finally, the study presents that the suppliers who will have had close relationships with their customers need to give consistent information to them so that their customers can have lower motive in purchasing products from competitors.

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Quality Evaluation by the Addition of Pine Needle and Artemisia princeps Extracts in Vinegared Kochujang (솔잎, 약쑥추출물을 첨가한 초고추장의 품질평가)

  • Kim, Eun-Lyang;Kang, Sun-Chul
    • Applied Biological Chemistry
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    • v.50 no.3
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    • pp.167-177
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    • 2007
  • This study was carried out to develop natural vinegared kochujang. We first formulated vinegared kochujang containing pine needle (PN) and Artemisia princeps (AP) extracts. A dominant strain was isolated from the vinegared kochujang and identified as Bacillus amyloliquefaciens ER282 based on the 16S rDNA sequence. The plant extracts of PN and AP were also investigated for their antibacterial activity and showed enough good activities to use for vinegared kochujang as a natural preservative. Quality characteristics of vinegared kochujang were evaluated, based on total cell numbers, pH, acidity, sugar content, color and sensory evaluation during storage at $25^{\circ}C$ and $37^{\circ}C$, respectively, for 3 weeks. No significant differences were found in the pHs and acidities of vinegared kochujang added with the plant extracts of PN and AP during their storage compared to starting time; however, total cell numbers were gradually decreased during the storage at $25^{\circ}C$ and $37^{\circ}C$, as the storage period was increased. For sensory evaluation, overall preference continuously declined depending on storage period, but the addition of 3% extracts of PN could delay the quality loss of vinegared kochujang during storage at $25^{\circ}C$ and $37^{\circ}C$ for 3 weeks.

Studies on Selection of Freezing Resistant Clones of Cryptomeria japonica (삼(杉)나무 내한성(耐寒性) 품종(品種) 선발(選拔)에 관한 연구(硏究))

  • Hong, Sung Gak;Cho, Tae Hwan;Hwang, Jeung
    • Journal of Korean Society of Forest Science
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    • v.51 no.1
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    • pp.22-35
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    • 1981
  • This study was designed to know difference in degree of dehardening and rehardening respectively by artificial high and low temperature treatments among different clonal seedlings and seedlings from different seed sources of Cryptomeria japonica which have been grown under the cold areas in Japan and Korea. High temperature treatment was done with 15 to $20^{\circ}C$ under 100% relative humidity for one to nine days and low temperature treatment was carried with $-7^{\circ}C$ for one to three days. Occasionaly, high temperature treatment was combined and followed by low temperature treatment. The ability of stem section to delay dehardening by high temperature treatment and/or to hasten rehardening by low temperature treatment was used as an indicator of adaptability under extreme temperature fluctuation in nature. Clones and seedlings from different seed sources which showed greater freezing resistance than others after artificial high and/or low temperature treatments were selected over two to three time periods: early winter, mid winter and early spring in 1977 to 1980. These were Seoul #7, and #9, Namboo #3, and #4, Sung-Kang #11, Chung-Sam #8 and Huek-Suk #9. These selected seedlings might have survival advantage to withstand early and late frost damage, especially the critical frost damage of the basal stem, since it was known to be induced by lowering freezing resistance of the basal part when exposed to the high temperature near the ground during the day. Large variation in freezing resistance and degree of dehardening and rehardening was found among clonal or seed sources and among individuals within a seed source, but was not related to the difference in climatic conditions where the parent trees was selected. These indicated the possibility of future breeding work for more cold resistant family of Cryptomeria japonica.

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A Study on Purchasing Decision Making and Adoption : Focused on the RFID Purchasing Customer (구매의사 결정과 수용에 대한 연구 : RFID 구매고객 중심으로)

  • Seo, Pil-Su;Jang, Jang-Yi;Shim, Kyeng-Su
    • 한국벤처창업학회:학술대회논문집
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    • 2008.11a
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    • pp.257-282
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    • 2008
  • RFID (Radio Frequency Identification) is regarded as a core technology of ubiquitous computing. Although it has some technical limitations such as technological standardization of RFID tags as well as economical limitations, many companies around the world have already accepted RFID to improve their management efficiency. In this regard, this study is to meet with results that the adoption of RFID technology willbring opportunities that companies' operational process are improved and customer satisfaction is highly strengthened. This research focuses on providing more understanding for building RFID marketing strategy to suppliers who want to sell their RFID products to customers through analyzing purchasing process. The findings are as follows; First, the study shows that buying center members usually take product reliability and precision of technical specification in the case of new-task buying situation while they put their first purchasing priority on prices in the straight rebuy. Second, the finding presents that in new-task buying situation and the straight rebuy purchasing personnel get information about new products through product performance test, organizational engineers, opinions from other companies' purchasing personnel, and checking out samples. Third, this research demonstrates when it comes to purchasing risk in their first purchasing, the persons who are in charge of material purchasing are inclined to be aware of the risk most in technical problems, followed by financial problems and time delay problems in order. And in addition to those risks are mentioned above, once-again-purchasers take the risk like an opportunity loss for better products into consideration. Fourth, the study shows that the role of concerning departments makes no difference in each purchasing stage. Accordingly marketers need to beef up the differentiated strategy to persuade their customers. Fifth, the findings of this study demonstrate that purchasing decision making is much influenced by the final users. So suppliers are supposed to perform the most active marketing strategy at the first stage of purchasing through various resources. Finally, the study presents that the suppliers who will have had close relationships with their customers need to give consistent information to them so that their customers can have lower motive in purchasing products from competitors.

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Clinical characteristics of congenital myotonic dystrophy diagnosed by molecular genetic method (분자 유전학적 방법으로 진단된 선천성 근육긴장성 이영양증 환자의 임상 양상)

  • Nam, Sook Hyun;Son, Young Bae;Lee, Bo Lyun;Lee, Jeehun;Ki, Chang-seok;Lee, Munhyang
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.868-874
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    • 2007
  • Purpose : We performed this study to investigate the perinatal and developmental features of the patients with congenital myotonic dystrophy (CDM) confirmed by the molecular genetic method and the clinical characteristics of their mother, and to identify the relation between the number of CTG repeats and the clinical severity.Methods : A retrospective review of the medical records and the results of the dystrophia myotonica protein kinase (DMPK) gene test was done for the patients who were confirmed as CDM through gene analysis from January 2001 to September 2006. Results : All of the eight patients (male 2, female 6) showed moderate to severe degree of perinatal distress and feeding difficulty associated with profound hypotonia. Three patients had the history of polyhydramnios and two patients had equinovarus deformity. The developmental milestones were delayed in all patients, which improved gradually with age. All of their mothers demonstrated myotonic symptoms and typical myopathic face. The number of CTG repeats in DMPK gene analysis ranged 1,000-2,083, and there was no significant correlation between the number of CTG repeats and the time of walking alone. Conclusion : All patients with CDM presented with severe hypotonia in perinatal period, and developmental delay thereafter, which were improved with age. All of their mothers manifested myotonic symptoms with typical myopathic face, and the identification of such features greatly contributed to the diagnosis of the patients. The number of CTG repeats had no significant influence on the motor development.

Analysis of the Thermal and Structural Stability for the CANDU Spent Fuel Disposal Canister (CANDU 처분용기의 열적-구조적 안정성 평가)

  • Lee, Jong-Youl;Cho, Dong-Geun;Kim, Seong-Gi;Choi, Heui-Joo;Lee, Yang
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.6 no.3
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    • pp.217-224
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    • 2008
  • In deep geological disposal system, the integrity of a disposal canister having spent fuels is very important factor to assure the safety of the repository system. This disposal canister is one element of the engineered barriers to isolate and to delay the radioactivity release from human beings and the environment for a long time so that the toxicity does not affect the environment. The main requirement in designing the deep geological disposal system is to keep the buffer temperature below 100$^{\circ}C$ by the decay heat from the spent fuels in the canister in order to maintain the integrity of the buffer material. Also, the disposal canister can endure the hydraulic pressure in the depth of 500 m and the swelling pressure of the bentonite as a buffer. In this study, new concept of the disposal canister for the CANDU spent fuels which were considered to be disposed without any treatment was developed and the thermal stability and the structural integrity of the canister were analysed. The result of the thermal analysis showed that the temperature of the buffer was 88.9$^{\circ}C$ when 37 years have passed after emplacement of the canister and the spacings of the disposal tunnel and the deposition holes were 40 m and 3 m, respectively. In the case of structural analysis, the result showed that the safety factors of the normal and the extreme environment were 2.9 and 1.33, respectively. So, these results reveal that the canister meets the thermal and the structural requirements in the deep geological disposal system.

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The Synthetic Study of Environmental Contamination at the Seokdae Municipal Waste Landfill in Pusan (부산 석대 생활폐기물 매립장의 환경오염에 대한 종합적 연구)

  • 김병우;정상용;이민희;이병헌
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
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    • 2001.04a
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    • pp.98-103
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    • 2001
  • In order to understand the characteristics of leachate at the Seokdae municipal waste landfill in the Pusan city, the correlation between leachate pollution loading and volume of gas production. concentration of gas and subsidence of ground, the characteristical methos, geochemical analyses and laboratory column tests using samples of gases, leachate and surface soil of Seokdae waste landfill area. Through the analysis of water balance, leachate flow rate and pollution loading were estimated. Geistatistical analysis of four gas components ( $O_2$, C $H_4$, $H_2$S and CO) shows the possibility of ground subsidence around the group of a site with high concentration of gas. From geochemical analyses of leachate, EC and Total-Alkalinity of ground subsidence around the group of a site with high concentration of gas. From geochemical analysis of leachate, Ec and Total-Alkalinity were increased, and Cl, Cr, Mn, Cu, Zn, Cd and Pb were decreassed comparing to the part, and the type of water quality was Na-HC $O_3$ in trilinear diagram. It shows that biodecomposition of municipal wastes continues actively. From the analysis of water balance, the total leachate flow rate is about 465.11㎥/day and pure pollution loading of Cl, Mn and Fe are estimated to 223.8kg/day, 0.2kg/day, 0.3kg/day, respectively. The laboratory column test of residual soil and landfill soil shows 0.206cm and 0.019cm for linear velocity(equation omitted), 0.234 $\textrm{cm}^2$/min and 0.018$\textrm{cm}^2$/min for diffusion coefficient ( $D_{ι}$), and 1.136cm and 0.095cm longitudinal dispersion index ($\alpha$$_{ι}$), respective]y. It demonstrates that the delay time of contamination for residual soil is shorter than that of landfill soil.

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Problems on the Arbitral Awards Enforcement in the 2016 Korean Arbitration Act (2016년 개정 중재법의 중재판정 집행에 관한 문제점)

  • Yoon, Jin-Ki
    • Journal of Arbitration Studies
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    • v.26 no.4
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    • pp.3-41
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    • 2016
  • This paper reviews the problems on the arbitral awards enforcement in the 2016 Korean Arbitration Act. In order to get easy and rapid enforcement of the arbitral awards, the new arbitration act changed the enforcement procedure from an enforcement judgement procedure to an enforcement decision procedure. However, like the old arbitration act, the new act is still not arbitration friendly. First of all, there are various problems in the new act because it does not approve that an arbitral award can be a schuldtitel (title of enforcement) of which the arbitral award can be enforced. In this paper, several problems of the new act are discussed: effect of arbitral award, approval to res judicata of enforcement decision, different trial process and result for same ground, possibility of abuse of litigation for setting aside arbitral awards and delay of enforcement caused by setting aside, infringement of arbitration customer's right to be informed, and non-internationality of enforcement of interim measures of protection, inter alia. The new arbitration act added a proviso on article 35 (Effect of Arbitral Awards). According to article 35 of the old arbitration act, arbitral awards shall have the same effect on the parties as the final and conclusive judgement of the court. The proviso of article 35 in the new act can be interpret two ways: if arbitral awards have any ground of refusal of recognition or enforcement according to article 38, the arbitral awards do not have the same effect on the parties as the final and conclusive judgement of the court; if arbitral awards have not recognised or been enforced according to article 38, the arbitral awards do not have the same effect on the parties as the final and conclusive judgement of the court. In the case of the former, the parties cannot file action for setting aside arbitral awards in article 36 to the court, and this is one of the important problems of the new act. In the new act, same ground of setting aside arbitral awards can be tried in different trial process with or without plead according to article 35 and 37. Therefore, progress of enforcement decision of arbitral awards can be blocked by the action of setting aside arbitral awards. If so, parties have to spend their time and money to go on unexpected litigation. In order to simplify enforcement procedure of arbitral awards, the new act changed enforcement judgement procedure to enforcement decision procedure. However, there is still room for the court to hear a case in the same way of enforcement judgement procedure. Although the new act simplifies enforcement procedure by changing enforcement judgement procedure to enforcement decision procedure, there still remains action of setting aside arbitral awards, so that enforcement of arbitral awards still can be delayed by it. Moreover, another problem exists in that the parties could have to wait until a seventh trial (maximum) for a final decision. This result in not good for the arbitration system itself in the respect of confidence as well as cost. If the arbitration institution promotes to use arbitration by emphasizing single-trial system of arbitration without enough improvement of enforcement procedure in the arbitration system, it would infringe the arbitration customer's right to be informed, and further raise a problem of legal responsibility of arbitration institution. With reference to enforcement procedure of interim measures of protection, the new act did not provide preliminary orders, and moreover limit the court not to recognize interim measures of protection done in a foreign country. These have a bad effect on the internationalization of the Korean arbitration system.

A Clinical Study of Child Abuse (아동학대로 진단된 환아의 임상적 고찰)

  • Choi, Yoon Jin;Kim, Shin Mi;Sim, Eun Jung;Cho, Do Jun;Kim, Dug Ha;Min, Ki Sik;Yoo, Ki Yang
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.436-442
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    • 2007
  • Purpose : To promote awareness and efforts by pediatricians to identity and prevent child abuse by investigation of characteristics of victim and types of injury caused by abuse. Methods : A retrospective study was performed with 20 patients who had been diagnosed or suspected as child abuse at Hallym University Hospital from January 1999 to December 2005. The medical records, radiologic documents, and social worker's notes were reviewed to investigate age, sex, visiting time, form of abuse, perpetrator, risk factor, and type of injury. Results : The mean age of the subjects was 2.8 years. Fourteen patients were between 0-1 years old, 2 patients between 1-6 years old, 3 patients between 7-12 years old, and 1 case over 13 years old. The ratio of male to female was 1:1. The majority of these patients (70%) visited via emergency department. Eight five percent of these patients reported with physical abuse, 5% psychological abuse, 5% sexual abuse, and 5% neglect respectively. The suspected perpetrator was the biological father in six cases, the biological mother in three cases, the stepmother in two cases, caregiver in one case, relatives in one case and "unknown" in six cases. Bruise and hematoma (80%) were the most common physical findings. Skull fractures were diagnosed in six cases, long bone fractures in two cases, hemoperitoneum in two cases, subdural hemorrhage in 10 cases, epidural hemorrhages in two cases, subarachnoidal hemorrhages in two cases, and retinal hemorrhages in five cases respectively. Seventeen cases required hospitalization and surgical operations performed were in nine cases. Four patients died and three patients had sequalae such as developmental delay and quadriplegia. Conclusion : Child abuse results in high mortality and morbidity in victims. Therefore early recognition and prevention is very important. Pediatricians should always suspect the possibilities of abuse in cases of fracture, intracranial hemorrhage, abdominal injury, or even any injury to the body. We recommend that the clinical investigation of suspicious children should include a full multidisciplinary social assessment, a skeletal survey and CT or MRI.