• Title/Summary/Keyword: mentality

검색결과 263건 처리시간 0.02초

외상환자의 병원 전 및 병원단계 중증도 평가의 일치도 (Measure of Agreement between Prehospital EMS Personnel and Hospital Staffs using Guidelines for Field Triage of Injured Patients)

  • 김대곤;홍기정;노현;홍원표;김유진;신상도;박주옥
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.126-132
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    • 2014
  • Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

미성년자 대상 임상시험에 관한 법적 문제점 (Legal Issues in Clinical Trial on Minor)

  • 송영민
    • 의료법학
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    • 제17권2호
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    • pp.125-144
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    • 2016
  • 모든 형태의 임상시험은 시험 자체가 불확실하며, 리스크가 다양하므로 피험자를 보호하기 위한 제도가 완비되어 있어야 한다. 그럼에도 불구하고 현행 임상시험에 관한 법률은 약사법과 의료기기법에서 일정한 규정을 두고 있으나 이는 '의약행정'을 원활하게 수행하기 위한 법목적에 비추어 피험자 보호에는 일정한 한계가 있다. 더 나아가 미성년 피험자를 대상으로 하는 임상시험은 약사법 등에서 직접적인 규정을 두지 않고, '소아를 대상으로 하는 임상시험 평가 가이드라인'이나 '의약품임상시험관리기준' 등에서 일정 부분 규율하고 있으나 이는 법적 효력이 없는 권고사항이라는 점에서 일정한 한계가 있다. 미성년자 대상 임상시험에 대한 법흠결 문제는 인체침습의 정도 면에서 통상적인 의료행위의 경우보다 강한 장기이식법상의 미성년자 취급제도와 기타 외국법상의 미성년자 임상시험 제도를 검토함으로서 입법적 해결이 가능하다고 할 것이다. 그러나 근본적으로는 현행법 체계상 약사법, 의료기기법 기타 가이드라인을 중심으로 이루어지고 있는 임상시험 규율체계를 이른바 "피험자보호법"이라는 법률제정을 통해 해결하는 것이 바람직하다고 본다.

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정기신혈과(精氣神血科)의 형상(形象)에 대한 연구 (Study on the Shapes of Jung-kwa, Gi-kwa, Sin-kwa, Hyul-kwa)

  • 최병태;최영현;백근기;이용태
    • 동의생리병리학회지
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    • 제19권5호
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    • pp.1181-1190
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    • 2005
  • After study about the shapes of Jung, Gi, Sin, Hyul-kwa advocated by Master Jisan, the conclusions are drawn as follows. It pursues the rules of universe being changed from formless to concrete objects that the Body Essence, Vital energy, Mentality, and Blood are materialized to Jung, GE, Sin, Hyul-kwa. It can be drawn an inference from the next three theories that Jisan considered Jung, Gi, Sin, Hyul-kwa as round, square, reverse triangle, and triangle or oval shape. First, it was taken to following the shapes of viscera. Namely Jung-kwa was taken as Kidney, Gi-kwa as Lung, Sin-kwa as Heart, Hyul-kwa as Liver. Second, it was adopted from five kinds of constitutions according to the five elements in [Yeongchu Yin and Yang twenty five shapes] that is Jung-kwa is purchased with Water-earth phases, Gi-kwa with metal phase Sin-kwa with fire phase, Hyul-kwa with Wood phase, Third, it is taken in order to eliminate contradictions. Hyul-kwa disliking to move is assumed to round shape to easily move. Gi-kwa tending to disperse is chosen to square in order to be unmoved. Sin-kwa declining to stagnate of seven emotions is pursued to reverse triangle to compose oneself. Hyul-kwa inclining to gather is preferred to acreage phase to harmonize ascending tendency. Among shapes which Jisan was divided Hado, Nakseo, Bokhee pal kwoe, Moonwang pal kwoe, Jung-kwa as round is Hado, Gi-kwa as square is Nakseo, Sin-kwa as reverse triangle is Bokhee pal kwoe order shape, Hyul-kwa as acreage phase or oval shape is accord with Moonwang pal kwoe order shape. The reason being classified into Jung, GE, Sin, Hyul-kwa from the shapes of the face is that the face is the place to reflect the whole conditions of the body connected with all of the viscera and meridian system such as semen of plants. Above contents are drawn an inference from the transcription of Jisan's lectures and his writings. And it is considered that insufficient parts of the Jisan's theory must be demonstrated continuously.

해전 비교연구를 통한 해군의 임무형 지휘 필요성에 관한 연구 - 세인트 빈센트 곶 해전과 유틀란트 해전을 중심으로 - (A Study on the Necessity of Mission Command in Navy Through the Study of Naval Battle Comparison - Focus on Battle of St. Vincent and Battle of Jutland -)

  • 조성진;전윤재
    • Strategy21
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    • 통권46호
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    • pp.205-238
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    • 2020
  • The origin of mission command can be traced to the era of the Prussian military reforms led by General Gerhard von Scharnhorst after defeats in battle of Jena and Auerstadt in 1806 against Napoleon I. Mission Command is the conduct of military operations through decentralized execution based upon mission-type orders. Commanders issue mission-type orders focused on the purpose of the operation rather than details of how to perform assigned tasks. The mission command has become the command philosophy of the German military and recently many countries in the west accept it as a command philosophy. This study compare and analyze the Battle of St. Vincent and the Battle of Jutland to make sure if the army-initiated mission commands were also useful for the navy. From the late 18th century, represented by the era of Nelson, Royal navy changed from the inherited rigid command culture to guaranteeing the disciplined initiative of its subordinate commanders. In the Battle of St. Vincent in 1797, Nelson acted contrary to the commander's orders at the crucial moment, which gave Britain a decisive victory. On the contrary more than 100 years later, the command culture of the Royal navy changed into a centralized command culture. In the Battle of Jutland in 1916, Royal Navy couldn't win because the rigid command culture did not guarantee initiative of subordinate commanders and subordinate commander's passive attitude of waiting for the commander's instructions even at critical moments. Therefore, a mission command that guarantees the initiative of subordinate commanders is a useful concept even in the navy because it makes subordinate commanders to take full advantage of a sudden change in battle. Today's advanced information and communication technologies have raised questions about mission command. But even advanced technology can't completely eliminate the fundamental nature of the war-the fog of war. War is chaotic and unpredictable. In the flood of lots of informations, senior commander's judgement is not always right because he(she) is also human, he(she) can make mistakes. In the age of informatization, mission command is still effective because it involves increasing interaction and synergy between senior and subordinate commanders by ensuring their independence. Therefore ROK navy also needs to activate mission command. ROK navy must dismantle the zero-defect mentality and apply from educations as Prussian did to establish a mission command culture.

약물중독 후 흡인성 폐렴의 발생에 미치는 인자에 대한 고찰 (Evaluation of the Risk Factors for Aspiration Pneumonitis Following Drug Intoxication)

  • 김동희;오주석;경연영;최세민;오영민;최경호;박규남
    • 대한임상독성학회지
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    • 제7권2호
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    • pp.127-136
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    • 2009
  • Purpose: It is known that aspiration pneumonitis is associated with high mortality and morbidity following overdose. However, until now, few domestic studies on this subject have been conducted. The main aim of this study is to investigate the risk factors associated with aspiration pneumonitis in intubated patients following overdose. Methods: Among 654 adult overdosed patients who visited our institution from Jan. 2006 to June 2008, we enrolled 70 intubated patients within 24 hours after their overdose, and we reviewed the medical records to collect the data. This data was processed by univariate analysis, followed by multiple logistic regression analysis. P values <0.05 were deemed statistically significant. Results: In our study, a high incidence of pneumonitis was seen in the patients with an older age, a lower GCS and a high poisoning severity score or a high comorbidity score (p<0.05). Compared with the non-pneumonitis group, the pneumonitis group had a higher incidence of intubation (6% vs 61.8%, respectively, p<0.05). The main cause of intubation was a decreased mentality (68.6%). Older age, a high comorbidity score, irrigation without airway protection, relative hypoxemia and hyperkalemia were the risk factors of aspiration pneumonitis in the intubated overdosed patients (p<0.05). Among these factors, age, a high potassium level and airway protection might be significant predictors of aspiration penumonitis (p<0.05). Conclusion: Older age, a high potassium level and irrigation without proper airway protection may be the significant factors that can predict aspiration pneumonitis in patients who are intubated within 24 hours after overdose, although the further investigations on this are needed.

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한방의료 품질 향상을 위한 신뢰구현 체계구축 연구 (A Research on Trust Realization Strategies for Oriental Medical Quality Improvement)

  • 김현지;김소연;지영승;남승규;김정호;김영일
    • Journal of Acupuncture Research
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    • 제31권1호
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    • pp.75-93
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    • 2014
  • Objectives : This study was designed to establish medical trust realization system by finding factors influential to it using questionnaire. Methods : 277 subjects were participated in this study. After a treatment, we conducted a survey from April 1st to October 31th about medical service perception index, medical trust index, patient satisfaction index, patient reliability index, patient flow degree index, recall intension index, and hospital image index. To evaluate the influence of medical service perception with other 6 indexes, we statistically made regression analysis of the results through the survey. Results : By the results of the analysis, evaluation of hospital image influenced all 6 indexes. The systemicity of treatment process had an effect on 5 indexes except for the flow degree of patients. The humanity of medical team brought out the estimation of 4 indexes except for the patient flow degree and hospital image. The empathic ability of doctor and appropriacy of medical costs hold the next rank influencing 3 indexes. It reached the conclusion that the systemicity of medical team tend to determine the medical trust and patient reliability. The expertise, professional skill of doctor, the fault, commercial application, fame of medical team, the speed of treatment process, the newest and clean medical facility affected each one index. Conclusions : Korean medicine should find a way to consider the mind of patients for improving the medical quality through trust realization system, keeping up with times. As a result of this research, we can find out important causes which influence the trustful medical system. From now on, we should apply this result to actual treatment of psychology customized system. Also, more simple and clear questionnaire was organized through this research, it can be used to forward research to apprehend patient mentality more conveniently.

사서(四書)에 나타난 유교의 사회복지사상 (The Social Welfare Thoughts in 4 Confucian Classics)

  • 박승희
    • 한국사회복지학
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    • 제38권
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    • pp.126-152
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    • 1999
  • 우리가 흔히 말하는 사회복지는 자본주의적 사회복지이다. 이 사회복지는 사회문제에 사후적으로 대처하면서 오히려 새로운 문제를 만들어 내기도 했다. 이러한 한계를 극복하기 위해서는 사회복지에 대한 질적인 재검토가 이루어져야 할 것이다. 이를 위한 기초 작업으로서 우리는 유효의 사회복지 사상을 살펴보고자 한다. 현대적인 사회복지가 국민의 권리인 것과 달리 유교 사상 안의 사회복지는 군주의 시혜이며 그 목적은 지배의 정당성을 확보하는 것이라고 할 수 있다. 그러나 이것은 제도화된 시혜이고, '여민동락'과 같은 철저한 민본사상에서 출발하고 있다는 점에서 오늘날에도 여전히 유용한 의미를 지닌다. 한편 이 유교의 사회복지는 공동체를 통한 사회복지를 추구한다. 유교의 사회복지 사상에서는 공동체의 생산 증진과 공동체적인 연대를 강화시키면 백성의 부양문제는 저절로 해결된다는 전제 아래서 사회문제에 대한 직접 개입보다는 간접 개입을, 사후적인 대응보다는 예방을 더 중요시한다. 한편 유교에서 백성의 부양은 단순한 물질적인 부양만이 아니라 심리적인 부양까지도 포함하고 있다. 이처럼 유교에서는 공동체를 통한 간접 개입을 시회복지의 원칙으로 삼지만, 4궁(窮) 등과 같이 공동체 자체에서 부양되지 못하는 경우에는 국가가 직접 개입할 것을 강조한다. 이것은 일종의 잔여복지이나, 자본주의 사회의 잔여복지에 비하면 더 마지막 조치라고 말할 수 있다.

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스트레스해소법에 따른 한부모가정 부모의 스트레스와 생활만족도와의 관계 연구 - 중부권 소도시를 중심으로 - (A Research on Relationships between Stress Level of Parents in Single Parent Families and Life Satisfaction in accordance with Stress Removing Methods - Centering on Small Towns in Midsection Sphere -)

  • 오승하;조성제
    • 한국정보전자통신기술학회논문지
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    • 제7권1호
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    • pp.26-35
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    • 2014
  • 본 연구는 스트레스해소법에 따른 한부모가정 부모의 스트레스와 생활만족도와의 관계를 파악하고자 한다. 연구대상은 2013년 3월1일부터 7월31일까지 중부권 소도시를 중심으로 한부모가정 부모 260명을 대상으로 설문조사를 실시하였다. 자료분석은 빈도분석, 요인분석, t-test, 일원변량분석, 상관분석, 회귀분석을 실시하였으며, 실증분석은 유의수준 5%에서 검증하였다. 연구결과 스트레스는 경제, 신체, 사회 및 일상, 가족, 심리요인 순으로 높게 나타났고, 스트레스요인의 해소법과 조절효과에 따른 해소정도가 생활만족도에 유의미한 영향을 나타냈다. 그리고 하위요인은 재정, 정서, 인지적 순으로 유의미하게 나타났다. 연구의 시사점은 생활만족도 증진에 스트레스해소법이 유의미함으로, 한부모가정 부모에 대한 기초적인 지원정책수립과 프로그램개발의 자료가 될 것으로 사료된다.

한국 소아청소년 중독 환자의 경향: 국가응급진료정보망을 이용한 후향적 연구 (Trends in Korean Pediatric Poisoning Patients: Retrospective Analysis of National Emergency Department Information System)

  • 이경재;김경환;신동운;박준석;김훈;전우찬;박준민;김현종
    • 대한임상독성학회지
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    • 제15권2호
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    • pp.69-78
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    • 2017
  • Purpose: This study reports the clinical features of infant, child, school aged and adolescent patients treated for acute poisoning in nationwide emergency departments (EDs). Methods: We retrospectively analyzed clinical data pertaining to patients under 19 years of age who were treated for acute poisoning in nationwide EDs from 2013 to 2015. The data were collected by the National Emergency Department Information System (NEDIS). All patients were divided into three groups: 'Infant and child group' (0 to 5 years), 'school age group' (6 to 12 years) and 'adolescent group' (13 to 18 years). General characteristics, Korea Standard Classification of Disease $7^{th}$ (KCD-7) codes and results of care were collected. Results: There were 14,500 pediatric poisoning cases during the study period. The distribution of patient age was bimodal with two peaks among infant, child and adolescent group. The proportion of alert mentality at the ED visit of the infant and child group was 99.3%, while that of the adolescent group was 86.4%. The proportion of intentional intoxication was higher in the adolescent group (40.7%) than other age groups. Among children less than 13 years of age, various poisonous substances and therapeutic drugs were common. Conclusion: There were some clinical differences in acute poisoning patients between age groups. It is necessary to establish a preventive plan considering characteristics by age. Since the KCD-7 code has limitations in analyzing the characteristics of poisoning patients, it is necessary to consider the registration system of poisoning patients.

韓國 煙草載培地域의 地理學的 硏究 (A geographical study of the Korean Tobacoo forming region)

  • 김광자
    • 대한지리학회지
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    • 제21권
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    • pp.16-37
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    • 1980
  • The purpose of this study is to clarify how the Korean tobacco farming region has been geographically formed by natural and cultural environments, and to examine and cultural environments, and to examine whether it can be recognized as a major part of agricultultural regions. The questions asked in this study are associated with the spatial diffusion of tobacco cultivation, the patterns and processes of the farming region from 1900 to 1960, and the regional characteristics of the concentrated farming area since 1960. The study is inductively approached and most data used were collected from old records and field works. The delineation of the tobacco farming region was derived by applying the concept of the uniform region. Tobacco was introduced through Japan during the years of Kwang Hae Kun (1616-1622). According to the old records, three places, Waekwan, Dongrae, and Ulsan, were the first tobacco raising areas. In the 1700's the well-known tobacco farming regions were scattered all around the nation in places like Jinan, Samdeung, Seongcheon, Gangdong, Yeongweol and Yeongyang. This distributon pattern suggests that tobacco farming in Korea developed spatially along main traffic routes before the 1700's. Untill the 1920's the pattern of tobacco regions was relatively static. Since the 1920's, it has shown a pattern of concentration in the Choongbuk province, where the new highly productive yellow tobacco has been introduced. It was not until the 1960's that yellow tobacco instead of the native variety came to be cultivated all over the country. In the 1960's, the tobacco farming region tended to be concentrated and localized in north western Choongnam, northern Cheonbuk, Choongbuk, and Kyeongbuk including Cheongsong, Andong, and Yeongyang. Since 1970, tobacco production has declined in some of the former major areas of cultivation in terms of its density, while there have appeared highly concentrated areas in Cheongsong and Andong, centered around Yeongyand. There has also emerged a secondary major concentrated area along the coast including such places as Kochang, Yeongkwang and Mooan. The appearance of the Yeongyang tobacco area as the most important core region can be described as follows; at first this area has the disadvantage of being in competition with other places for selling cash crops besides tobacco, because it is located in a mountain zone and it is far from the major metropolises of Seoul and Pusan. Thus has been formed the farming mentality that agricultural management makes the most profit on farming tobacco because tobacco is stable in price and selling routes. As a result of this longstanding belief, these areas (Yeongyang, Cheongsong and Andong) have developed into tobacco concentrated regions. Finally, the tobacco concentrated regions of Korea have changed through time. The factors affecting this change have been the kind of tobacco grown, the monopoly system, agricultural techniques and the expansion of arable land through the clearing of slopes. In conclusion, the research indicates that the localized and concentrated patterns of tobacco cultivation are geographically typical. Thus, recognition of tobacco farming region is important to understanding the agricultural region of Korea as a whole.

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