• 한국응급구조학회지
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• 제23권1호
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• pp.35-48
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• 2019

Purpose: This study aimed to explore the rationality for and countermeasures against the use of prehospital patient restraint (PPR) techniques in efforts to limit violent behavior toward 119 emergency medical technicians (EMTs). Methods: Previous countermeasures to limit violent behavior toward 119 EMTs and medical personnel were focused on strict reactive and passive proactive responses. However, those in support of the countermeasures do not believe that violent and criminal behavior can be limited or extinguished by strengthening the punishment unconditionally. Results: When it comes to the far-reaching effects of stigmatization on people who engage in violent and criminal behavior, it is possible that unconditional punishment leads to more crime, increases the costs of imprisonment, and consequently, adds to the financial burden of the government. Conclusion: Thus, we are faced with an urgent need to prepare legal grounds for the use of PPR techniques by 119 EMTs for agitated or combative patients only, with direct medical oversight. Moreover, the legal foundation for the use of PPR techniques also needs to be established for emergency medical personnel. The use of PPR techniques not only ensures the safety of emergency medical services personnel, but also protects patients from injuring themselves and others.

• 대한한방내과학회지
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• 제25권1호
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• pp.28-45
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• 2004

Objectives : The main purpose of this study is to evaluate the effect of Injinchunggan-tang on $TNF-{\alpha}$ signal transmission system. Materials and Methods : We analyzed the following with quantitative RT-PCR method; the effect of Injinchunggan-tang on secretion of $TNF-\alpha$ mRNA/protein and stability, the effect on gene revelation that consists of signal transmission system (TRAIL, NIK, A20, TRADD, RAIDD, RIP TNFR-I, TNFR-II, TRAF1, TRAF2, FADD), the one on activation of p38, Erk1/2 MAPK and the rate of nuclear $NF-{\kappa}B/cytosolic\;NF-{\kappa}B$ in HepG2 cell. We also analyzed the inhibitory effect of Injinchunggan-tang on the apoptosis of HepG2 cell that $TNF-{\alpha}$ induces and the $NF-{\kappa}B$ restraint effected by transfection of $I{\kappa}B{\Delta}N$ through tryphan blue exclusion assay. Results : Injinchunggan-tang prohibits revelation of $TNF-{\alpha}$ mRNA in HepG2 cell and the creation of protein. However, it has no effect on the stability of $TNF-{\alpha}$ mRNA. While it did not have any effect on the generation of TRAIL, NIK, A20, TRADD, RAIDD and RIP genes, Injinchunggan-tang reduces the revelation of TNFR-I, TNFR-II, TRAF1, TRAF2 and FADD genes. It has been confirmed that Injinchunggan-tang restraints the revelation of $TNF-{\alpha}$ mRNA that is promoted by ethanol, acetaldehyde, lipopolysaccharide, in proportion to the treatment density and time. It activated $NF-{\kappa}B$ of HepG2 cell and promoted activation of $NF-{\kappa}B$ that is occurred by $TNF-{\alpha}$. It has been observed that the restraint effect against the $TNF-{\alpha}$ inducing apoptosis is lost when it is intercepted the function of $NF-{\kappa}B$ in HepG2 cell. Conclusion: It has been confirmed that Injinchunggan-tang has restraining effect against the revelation of $TNF-{\alpha}$ and mRNA that is constituent element of TNF-a signal transmission system. It also has been revealed that it restraints the activation of p38, Erk1/2 by $TNF-{\alpha}$. Through this prohibiting effect, it is inferred that it restraints signal transmission among various cells that are related to inflammation reaction. Meanwhile, Injinchunggan-tang protects liver cell from apoptosis that is caused by $TNF-{\alpha}$, by maintaining the activating function for $NF-{\kappa}B$.

• 디지털융복합연구
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• 제15권12호
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• pp.581-590
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• 2017

본 연구는 300병상 미만 중소병원 간호사의 신체 억제대 사용에 대한 인식을 확인하기 위한 서술적 조사 연구이다. SPSS 통계프로그램을 사용하여 서술통계, t-test, ANOVA, factor analysis로 연구 분석을 하였다. 연구결과 간호사의 신체 억제대 사용 인식에 대한 전체 평균은($3.91{\pm}0.54$)으로 높은 인식률을 나타내었다. 요인분석 결과 '문제행동관리($3.81{\pm}0.67$)', '의료적 처치 유지($4.11{\pm}0.60$)', '환자안전($4.13{\pm}0.63$)' 3개의 요인으로 분류되었다. 신체 억제대를 사용하는 이유 중 가장 중요하다고 인식하는 항목은 침대에서 떨어지지 않도록 환자를 보호하기 위해($4.37{\pm}0.68$)로 환자안전이었다. 중소병원에서 근무하는 간호사의 신체 억제대 사용에 대한 특성과 요인을 파악하고, 신체 억제대 사용에 대한 정확한 이해를 바탕으로 최소한의 신체적 억제대 사용 및 환자의 안전과 권리보장에 대한 인식 필요하다. 그러므로 이를 위해 다양한 상황에서 사용하는 신체 억제대에 대한 직무교육이 필요하며, 간호업무 실정에 맞도록 교육 및 중재프로그램 개발이 요구된다.

• 임상간호연구
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• 제19권3호
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• pp.432-442
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• 2013

Purpose: The purpose of this study was to describe restraint use in care of patients with psychiatric disorders in an attempt to avoid unnecessary restraint use and provide information for developing standards regarding restraint use as a therapeutic maneuver. Methods: For this descriptive study, discharge records from N National Mental Hospital in the year 2009 were reviewed by trained nurses during Dec. 24, 2010 and Mar. 31, 2011. There were 596 restrains applied on 232 of 1,322 discharges. Data collected include general characteristic of patients, the frequency of restraint use, time since admission when restraint was applied, time of the day when restraint was applied, duration of restraint application, place of occurrence, reasons for restraint use, and degree of damage to the patent. Work experience of nurses who applied restraints, number of workforce at the time of restraint, and season of the year was also identified. Descriptive statistics, Chi-square test, t-test, ANOVA, $Scheff{\grave{e}}$ and Jonckheere-Terpstra were applied using SPSS 14.0 to analyze the data. Results: There were 596 restraint uses among 232 patients. Restraints were applied most frequently on males in their 40s, patients diagnosed with schizophrenia, and patients repeating admissions more than 6 times. Restraints were frequently applied within first week following admission, between 16:00 and 20:00, and the average duration of restraint was 5 hours. There were significant differences according to diagnoses of patients in the season restraint occured, time, place of occurrence, reason for restraint, and duration of restraint. Patients with alcoholism received longer restraint application. Conclusion: In order to avoid unnecessary restraint use in patients with psychiatric disorders, nurses and other health care team members need to acknowledge a group of patients such as patients with schizophrenia and alcoholism who relatively frequently restrained or receiving longer restraint. Reasonable and careful decision need to be made when applying restraint in the care of patients with alcohol problem.

• Structural Engineering and Mechanics
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• 제45권4호
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• pp.569-594
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• 2013

The free vibration of axially functionally graded tapered arches including shear deformation and rotatory inertia are studied through solving the governing differential equation of motion. Numerical results are presented for circular, parabolic, catenary, elliptic and sinusoidal arches with hinged-hinged, hinged-clamped and clamped-clamped end restraints. In this study Differential Quadrature element of lowest order (DQEL) or Lagrangian Interpolation technique is applied to solve the problems. Three general taper types for rectangular section are considered. The lowest four natural frequencies are calculated and compared with the published results.

• 월간경쟁저널
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• 127호
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• pp.6-19
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• 2006

사적 경쟁제한행위에 대한 효과적인 규제 없는 통상협정은 그 소기의 목적을 달성하기 힘들다. 통상협정은 근본적으로는 협정 당사국에 대한 시장접근(market access)을 높이기 위한 것이다. 그런데 협정을 통하여 공적 장벽을 없앤다고 하더라도 해당국가에 예컨대 고질적인 수직적 거래제한(vertical restraints)이 만연해 있어서 외국기업이 자국의 소비자에게 접근할 수 없다면 통상협정을 통하여 달성하고자 하는 시장접근은 공염불이 될 것이다. 한미 FTA협상에도 통상협정과 경쟁정책과의 이러한 상호보완적인 관계에 대한 깊이 있는 성찰이 있어야 할 것이다.

• Steel and Composite Structures
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• 제8권1호
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• pp.19-34
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• 2008

This paper presents the results of a validation and parametric study for the theory presented in the companion paper. The parameters investigated include the stiffness of axial and rotational restraints, load ratio, depth-span ratio of the beam, the yield strength of steel, load type and the temperature distribution in the crosssection of the beam.

• Tribology and Lubricants
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• 제4권2호
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• pp.52-59
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• 1988

The purpose of this study is to establish a standard for proper selection of water soluble cutting fluids, such as Emulsion type, Semi-Synthetic type and synthetic type, by investigating cutting effects at the normal temperature(26$\circ$C) and cooling temperature(0$\circ$C) from the viewpoint of cooling and lubricant actions. This paper describes a relation among cutting force, surface roughness and cooled water soluble cutting fluids which are considered as effective restraints on Built up edge.

• Journal of Preventive Medicine and Public Health
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• 제50권2호
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• pp.83-90
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• 2017

Objectives: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. Methods: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. Results: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. Conclusions: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

• Steel and Composite Structures
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• 제8권1호
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• pp.1-18
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• 2008

Observations from experiments and real fire indicate that restrained steel beams have better fire-resistant capability than isolated beams. Due to the effects of restraints, a steel beam in fire condition can undergo very large deflections and the run away damage may be avoided. In addition, axial forces will be induced with temperature increasing and play an important role on the behaviour of the restrained beam. The factors influencing the behavior of a restrained beam subjected to fire include the stiffness of axial and rotational restraints, the load type on the beam and the distribution of temperature in the cross-section of the beam, etc. In this paper, a simplified model is proposed to analyze the performance of restrained steel beams in fire condition. Based on an assumption of the deflection curve of the beam, the axial force, together with the strain and stress distributions in the beam, can be determined. By integrating the stress, the combined moment and force in the cross-section of the beam can be obtained. Then, through substituting the moment and axial force into the equilibrium equation, the behavior of the restrained beam in fire condition can be worked out. Furthermore, for the safety evaluation and repair after a fire, the behaviour of restrained beams during cooling should be understood. For a restrained beam experiencing very high temperatures, the strength of the steel will recover when temperature decreases, but the contraction force, which is produced by thermal contraction, will aggravate the tensile stresses in the beam. In this paper, the behaviour of the restrained beam in cooling phase is analyzed, and the effect of the contraction force is discussed.