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Standards of Due Diligence and Separation of Responsibilities in the Division of Labor in Medicine (분업적 의료행위에 있어서 주의의무위반 판단기준과 그 제한규칙들)

  • Choi, Hojin
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.41-72
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    • 2018
  • In the division of labor (or teamwork) in medicine, the responsibility of medical and nursing staff should be separated or distributed to justify negligent criminal offenses. The present work refers to the standards by which the due diligence and responsibility of the individual persons are to be determined and delimited. In this context, it has been proven that objective theory as a measure of due diligence is appropriate. From a moral point of view, when assessing due diligence, it makes sense to impose greater individual or higher performance demands on the perpetrator, but law and order require that due diligence should result from socially relevant human behavior. To give objective measure of negligence and to provide the highest level of personal responsibility, so that man can not be burdened too much responsibility and it is accordingly with an equality theorem. Afterwards some points are presented, which should be considered in a concrete fact in the determination of the medical negligence. Medical action has specific characteristics such as professionalism, discretionary and exclusive, unbalance of information. These characteristics distinguish medical actions from general negligence. The general level of knowledge, the urgency, working condition and working environment of the medical facility, duration of the professional practice, assessment of the medical activity are crucial in this context. As a standard of delineation of due diligence, I have used the permitted risk and the principle of trust. In the horizontal division of labor, the principle of trust applies. The principle of trust applies in principle in cases of division of labor interaction, when doctors in the same hospital exercise their own specific occupational field or everyone works in another hospital. However, this is not true for every case. In the vertical division of labor, the principle of trust does not apply and the senior physician can not trust the assistant doctors. In this case, the principle of trust is converted into a duty of supervision for assistant doctors by the senior physician. This supervision requirement could be used as a random check.

Isolation and Morphological Identification of Fresh Water Green Algae from Organic Farming Habitats in Korea (유기농업 생태계로부터 담수 녹조류 분리 및 형태적 동정)

  • Kim, Min-Jeong;Shim, Chang-Ki;Kim, Yong-Ki;Hong, Sung-Jun;Park, Jong-Ho;Han, Eun-Jung;Jee, Hyeong-Jin;Yun, Jong-Chul;Kim, Suk-Chul
    • Korean Journal of Organic Agriculture
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    • v.22 no.4
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    • pp.743-760
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    • 2014
  • This study aimed to isolate and identify freshwater algae from the organic agricultural ecosystems and investigate its biological characteristics to study the possibility of utilizing a biomass freshwater algae in organic farming. In the survey area, average water temperature was $12.4{\sim}28.2^{\circ}C$ and the pH ranges were from 6.1 to 8.5. The solid culture method is more suitable than liquid culture method for isolation of freshwater algae with lower contamination level and higher isolation frequency. A total of 115 strains were isolated from six freshwater algae habitats in nine regions in Korea. BGMM (BG11 Modified Medium) amended with NaNO3 and $KNO_3$ as a nitrogen, and $Na_2CO_3$ as carbon source was designed to isolate and culture freshwater algae. Absorbance of freshwater algae culture has increased dramatically to four days and decreased after eight days after inoculation. CHK008 of the seven isolates showed the highest absorbance in seven days after culturing in BGMM. The optimal pH of BGMM for culturing freshwater algae was pH 6-7. As light intensity increased, growth of freshwater algae increased. Among the five kinds of carbon sources, glucose and galactose promoted good growth of freshwater algae in BGMM. The colony color of purified 16 green algae isolates showed a separation of green, dark and light green, and of them, eleven algae strains showed a strong fluorescent light under fluorescence microscopy. Cell size of the green algae showed a wide range of variation depending on the species. General morphology of the green algae strains was spherical. Chlamydomonas sp. was elliptical, and Chlorella sorokiniana was ellipsoidal and cylindrical. All strains of the green algae except for Chlamydomonas sp. did not have flagella. One isolate of Chlamydomonas sp. and five isolates of C. sorokiniana secreted mucus. Sixteen isolates of 16 green algae were identified as two family and six species, Chlorella vulgalis, C. sorokiniana, C. pyrenoidosa, C. kessleri, C. emersonii, and Chlamydomonas sp. based on their morphological characteristics.

Development and Effectiveness of the Primary Hospice Education Program for Nurses (간호사를 위한 호스피스 기초 교육 프로그램 및 효과)

  • In, Sook-Jin
    • 한국호스피스완화의료학회:학술대회논문집
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    • 2004.07a
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    • pp.100-102
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    • 2004
  • Under the current medical system, a terminal patient and his/her family who are neglected inevitably face various aspects of crises including not only physical, but also psychological, social, economic, spiritual and legal problems. Nurses often look after many terminal patents with these types of complicated problems. Therefore, educating the nurses who will take care of such patents would greatly reduce stress so the patents end could their lives in peace and without losing their dignity. This research is a quasi experimental study of nonequivalent control group. A pretest-posttest design where a basic education program is developed for nurses, who frequently treat terminal patents, to understand the importance of the role of hospice and to apply their understandings to treat terminal lancer patents. A sample of the nurses were taken from those who were working in general wards at two general hospitals in Seoul during October, 2003${\sim}$December 2003. The study was composed of 46 experimental group and 43 control group. A basic hospice education program was developed by taking emphasized and overlapping parts from advanced practice hospice nurses education course, short-term education course, an extensive literature survey and by consulting three professionals as well. With the group of 5 professors with vast experiences in oncolgy, 5 nursing administrator, 3 nursing practitioner, the tentative first version of the program was developed and reviewed. Afterwards, by utilizing person to person interviews with 2 head nurses experienced with terminal patients, 1 nurse in charge of hospice, 1 nurse on the contents of the program, and a person to person rating on the educating medium by a nurse were performed. The final version of a basic education program was developed after the second revision. The hospice basic education program consists of introduction to hospice, hospice and commucation, management of pain for terminal cancer patients, physical management for terminal cancer patients, socio-psycological caring of terminal cancer patients and management of death and separation. Total education time was four hours organized into 50 minutes of instruction and 10 minutes of break. $Powerpoint^{(R)}$ software was used as the education medium. As research tools, "Knowledge on Hospice" was developed by the author after receiving a review from one expert. "Attitude of Hospice Nursing" was revised Kim(2001)'s attitude measuring tool which was based on Wang(1998), Kwon(1989), Park and Sung(1991)'s tool. "Liability on nursing terminal patients" was used as developed by Zarits(1980) and Mongomory(1985) translated by Lee(1985). For collecting data, preliminary investigation prior to 1 week of the hospice basic education program and post-investigations after 1 week and 4 weeks of the education were carried out for the nurses at a general ward who understood and agreed on the purpose of the program. Collected data were analyzed throughout t-test, $x^2-test$, Manova test and Bonferroni correction in $SAS^{(R)}$ program. The summary of the investigation is as follows: Hypothesis 1: "Educated experimental group would possess more knowledge on hospice compared to the un-educated control group" was supported after 1 (F=12.14, p=.00) and 4 (F=5.3, p=.02) weeks of education. Hypothesis 2: "Educated experimental group would take a positive attitude toward hospice nursing compared to the un-educated control group" was supported after 1(F=3.92, p=.05) and 4(F=5.05, p=.02) weeks of education. Hypothesis 3: "Educated experimental poop would feel less liability compared to the un-educated control group in nursing terminal cancer patients' was rejected. In this study, it was found that knowledge on hospice was significantly important. By applying hospice basic education programs to nurses, the education program helped nurses to take a positive attitude toward terminal patients. It was, however, seen that the education program had no effect on alleviating liability in nursing terminal patients. Therefore, it is expected that this educational program would help hospices and nurses at general wards to understand the concept and the role of hospice so that terminal patents, now neglected under current medical system, would be able to end their lives in peace.

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Simultaneous Determination of Penicillin Antibiotics in Meat using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS를 이용한 육류 중 페니실린계 항생제 8종의 동시분석 및 적용성 검증)

  • Kim, Myeong-Ae;Yoon, Su-Jin;Kim, MeeKyung;Cho, Yoon-Jae;Choi, Sun-Ju;Chang, Moon-Ik;Lee, Sang-Mok;Kim, Hee-Jeong;Jeong, Jiyoon;Rhee, Gyu-Seek;Lee, Sang-Jae
    • Journal of Food Hygiene and Safety
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    • v.29 no.2
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    • pp.131-140
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    • 2014
  • The objective of this study was to develop a simultaneous method of 8 penicillin antibiotics including amoxicillin, ampicillin, cloxacillin, dicloxacillin, nafcillin, oxacillin, penicillin G and penicillin V in meat using LC-MS/MS. The procedure involves solid phase extraction with HLB cartridge and subsequent analysis by LC-MS/MS. To optimize MS analytical condition of 8 compounds, each parameter was established by multiple reaction monitoring in positive ion mode. The chromatographic separation was achieved on a $C_{18}$ column with a mobile phase of 0.05% formic acid and 0.05% formic acid in acetonitrile at a flow rate of 0.2 mL/min for 20 min with a gradient elution. The developed method was validated for specificity, linearity, accuracy and precision in beef, pork and chicken. The recoveries were 71.0~106%, and relative standard deviations (RSD) were 4.0~11.2%. The limit of detection (LOD) and the limit of quantification (LOQ) were 0.003~0.008 mg/kg and 0.01~0.03 mg/kg, respectively, that are below maximum residue limit (MRL) of the penicillins. This study also performed survey of residual penicillin antibiotics for 193 samples of beef, pork and chicken collected from 9 cities in Korea. Penicillins were not found in all the samples except a sample of pork which contained cloxacillin (concentration of 0.08 mg/kg) below the MRL (0.3 mg/kg).

Comparison of Mathematics and Science Teachers' Perception on the Korean Gifted education of Institutes for the Gifted education in the City Office of education and Science High School (시교육청 영재교육원과 과학고 영재교육원 수학, 과학 교사의 영재교육에 대한 인식 비교 연구)

  • Hwang, Jung-Hoon
    • Journal of Gifted/Talented Education
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    • v.20 no.3
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    • pp.809-830
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    • 2010
  • The purposes of this study are to investigate Korean mathematics & science teachers' perception on the special education for the gifted, and to investigate if there are differences on their perception about it among the mathematics & science teachers when their affiliation institutes for the gifted are different. Their affiliation institutes for the gifted education are divided into two groups, which are the city office of education, and science high school. The research problems of this study are as follows. Firstly, are there any differences of their perception according to their affiliation institutes for the gifted education are divided into two groups, which are the city office of education, science high school? Secondly, are there any differences of their perception according to their affiliation institutes for the gifted education are divided into two groups, which are the mathematics teachers, science teachers? For the study, 26 mathematics teachers & 36 science teachers were sampled from the Institutes for the Gifted Education in Busan Metro-city & the Busan Science High School. and then 34-item-questionnaire developed by the author was administered to them. The research results are as follows. Firstly, the question as to participation in special education for the gifted in mathematics & science, the positive answer has been dominant. Teachers who were going to participate in special education for the gifted in mathematics & science have answered affirmatively. Secondly, perception of the organization of a class of the gifted in mathematics & science is very different between the group of institutes for the gifted education in the city office and the group of institutes for the gifted education in the science high school. Thirdly, perception of selection of gifted students for special education for the gifted in mathematics & science is very different between group of the mathematics teachers and group of the science teachers. Fourthly, 46.7% of the total agree with management of the gifted education in the science high school, 46.7% of the total agree with separation of management about mathematics & science.

EFFECT OF ROTATIONAL SPEED OF PROTAPERTM ROTARY FILE ON THE CHANCE OF ROOT CANAL CONFIGURATION (ProTaperTM로 근관성형시 회전 속도 변화가 근관형태에 미치는 영향)

  • Seo, Min-Chul;Jeon, Yoon-Jeong;Kang, In-Chol;Kim, Dong-Jun;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann
    • Restorative Dentistry and Endodontics
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    • v.31 no.3
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    • pp.179-185
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    • 2006
  • This study was conducted to evaluate canal configuration after shaping by $ProTaper^{TM}$ with various rotational speed in J-shaped simulated resin canals. Forty simulated root canals were divided into 4 groups, and instrumented using by $ProTaper^{TM}$ at the rotational speed of 250, 300, 350 and 400 rpm. Pre-instrumented and post-instrumented images were taken by a scanner and those were superimposed. Outer canal width, inner canal width, total canal width, and amount of transportation from original axis were measured at 1, 2, 3, 4, 5, 6, 7 and 8 mm from apex. Instrumentation time, instrument deformation and fracture were recorded. Data were analyzed by means of one-way ANOVA followed by Scheffe's test. The results were as follows 1. Regardless of rotational speed, at the $1{\sim}2mm$ from the apex, axis of canal was transported to outer side of a curvature, and at 3~6 mm from the apex, to inner side of a curvature. Amounts of transportation from original axis were not sienifcantly different among experimental groups except at 5 and 6 mm from the apex. 2. Instrumentation time of 350 and 400 rpm was significantly less than that of 250 and 300 rpm (p<0.01). In conclusion the rotational speed of $ProTaper^{TM}$ files in the range of $250{\sim}400rpm$ does not affect the change of canal configuration, and high rotational speed reduces the instrumentation time. However appearance of separation and distortion of Ni-Ti rotary files can occur in high rotational speed.

Assessment of Growth Conditions and Maintenance of Law-Protected Trees in Je-cheon City (제천시 보호수의 생육환경 및 관리현황 평가)

  • Yoon, Young-Han;Ju, Jin-Hee
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.28 no.2
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    • pp.67-74
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    • 2010
  • Law-protected trees are our precious asset as natural resources with history and tradition and natural heritage which should be protected and maintained well to bequeath next generation. Law-protected trees have not only thremmatologic and genetic meaning but also environmental and emotional meaning for their value to be high. This study investigated location, vitality, wrapping condition of root area and status of maintenance of the trees to figure out their growth environment and status of maintenance in a small-middle city through survey on those of law-protected trees in Je-cheon. There showed 300 more year old trees in Je-cheon mostly and the number of trees located in flat fields was the highest. For location type, village, hill and road types were presented in the order and for degree of development, land for building was found most frequently. The average electric resistance of the formative layer was measured to be $8.4k{\Omega}$ and four trees showed bark separation. Most law-protected trees underwent tree surgery, and complete bareness of root area was observed in a tree. The root area of two trees was covered with concrete. pH of soil was recorded to be 5.0~8.4 with its average of 7.1 and electric conductivity(EC) was less than 0.5 dS/m. For status of maintenance rearing facilities were placed for 16 trees out of totally 48 ones and stone fence was done for three ones. Tree surgery was conducted for 33 trees to prevent and to treat decomposed parts of holes. Direction boards were installed for 23 trees. Based on these results, measures to manage systematically law-protected trees in Jecheon could be suggested as follows. First, a sufficient space for growth of low part of trees should be secured. Second, a voluntary management should be induced by advertising them to residents in a community. Third, rearing facilities and direction boards of law-protected trees should be placed and related education should be conducted. Fourth, through operation of the department for law-protected trees consisting of related professions and cooperation among related departments the trees should be maintained continuously.

Womans experience of Risk Situation on the High-Risk Pregnancy (여성의 고위험 임신에 대한 경험)

  • Kim, Kyung-Won;Lee, Kyung-Hye
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.161-178
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    • 1998
  • In spite of the great progress of the theory and skill of the Nursing Care & Medical area in relation to pregnancy, nurses in clinics face up to many challenges in maternity nursing care areas. The reason is that the mobility and mortality of mothers was sharply decreased and the unknown high-risk diseases of pregnancy woman in the past is made public. That's why it is difficult to meet the pregnancy woman in natural process from pregnancy to delivery in recently. Admission rooms are filled with high-risk pregnancy women. As a matter of fact, we have done nursing care into the surface symptoms and diseases of high-risk pregnancy women so far. We have been indifferent to a long period hospitalization, separation from family, and conflict of repeated examination. Therefore, it is widely spread to understand the emotional conflict experienced by high-risk pregnancy women and to need for nursing intervention to bring up about emotional support and the ability of perception in psychological crisis. Although the pregnancy woman judged in high-risk should carry out normal task of pregnancy, she have to be confronted with secondary risk situation. The health of self & fetus threatened by the risk situation could be decreased through care plan, but psychological stress increases. Therefore, the pregnancy brings into non-control state. It is important to ask that what the hospitalized pregnancy women in high-risk think of themselves status. Because misunderstanding or serious anxiety of themselves status put into mother and fetus in danger. And adaptation mode makes all the difference. I would like to consider how nurses could deal with this high-risk circumstances in the position of pregnancy woman on the basis of the above fact. This study uses phenomenological method to suggest the basis material for nurses to do nursing intervention in view of pregnancy woman. Because this method understands the nature of true life of pregnancy woman throughly. The phenomenological method is the sources to describe or explain affluently the process generated in confirmation areas and environment and is the application for readers to understand and recognize clinic reality and then apply this method to reasoning study place or other places. Specifically, the phenomenon study method, one of the phenomenological method, is applied. The use of that method is to describe and generalize the experience in environment exactly. The study of this study is as follows : Among 187 descriptive stamens from 8 study participants are classified into 42 theme cluster at the stage of the first analysis. Those theme is categorized into 8 sub-subjects such as anxiety of uncertainty, foreknowledge about risk circumstance, will power about overcome, unsettled feeling about hospital, relief, optimistic thought, family support, and indifferences. At the last stage of analysis, those things are categorized into 3 subjects. When high-risk pregnancy woman foretell the situation, they feel unsettlement about uncertainty and untrust feeling about hospital. But they are ease with family support and hospital support. On the other hand, they express indifferent 3-way structure response to the situation having will of overcome and exceeding optimistic thought. In those statements, the experience by pregnancy woman shows 3 respect subjects. 1. They are anxious of this situation and are in desperation and don't recognize their role to be carried out 2. They think of this situation as normal process of pregnancy and are not concerned that this can give themselves and fetus fatal damage. 3. The pregnancy women will never confront this situation. This study shows the pregnancy woman has anxiety and optimistic relief about the situation, and ignores and optimistic relief about the situation, and ignores many things. Therefore, nurses in clinic should give pregnancy woman knowledge and information about the high-risk and help them to deal with the situation spontaneously. High-risk pregnancy woman should have the care plan in respect of the right perception. And the nurse know that their support help out pregnancy woman overcome the crisis in this respect of the special nursing intervention.

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Effect of cooling rate on precipitation hardening of a Pd-Cu-Ga-Zn metal-ceramic alloy during porcelain firing simulation (금속-세라믹용 Pd-Cu-Ga-Zn계 합금의 모의 소성 시 냉각 속도가 석출 경화에 미치는 영향)

  • Kim, Min-Jung;Shin, Hye-Jeong;Kwon, Yong-Hoon;Kim, Hyung-Il;Seol, Hyo-Joung
    • Korean Journal of Dental Materials
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    • v.44 no.3
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    • pp.207-216
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    • 2017
  • The effect of cooling rate on precipitation hardening of a Pd-Cu-Ga-Zn metal-ceramic alloy during porcelain firing simulation was investigated and the following results were obtained. When the cooling rate was fast (Stage 0), the hardness of the alloy increased at each firing step and the high hardness value was maintained. When the cooling rate was slow (Stage 3), the hardness was the highest at the first stage of the firing, but the final hardness of the alloy after complete firing was lower. The increase in hardness of the specimens cooled at the cooling rate of Stage 0 after each firing step was caused by precipitation hardening. The decrease in hardness of the specimens cooled at the cooling rate of Stage 3 after each firing step was attributed to the coarsening of the spot-like precipitates formed in the matrix and plate-like precipitates. The matrix and the plate-like precipitates were composed of the $Pd_2(Cu,Ga,Zn)$ phase of CsCl-type, and the particle-like structure was composed of the Pd-rich ${\alpha}$-phase of face-centered cubic structure. Through the porcelain firing process, Cu, Ga, and Zn, which were dissolved in Pd-rich ${\alpha}$ particles, precipitated with Pd, resulting in the phase separation of the Pd-rich ${\alpha}$ particles into the Pd-rich ${\alpha}^{\prime}$ particles and ${\beta}^{\prime}$ precipitates composed of $Pd_2(Cu,Ga,Zn)$. These results suggested that the durability of the final prosthesis made of the Pd-Cu-Ga-Zn alloy can be improved when the cooling rate is fast during porcelain firing simulation.

Study on Operating System Improvements to the Competitiveness of Busan Port (부산항 경쟁력 강화를 위한 운영체제 개선에 관한 연구)

  • Seo, Su-Wan
    • Journal of Korea Port Economic Association
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    • v.34 no.4
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    • pp.191-208
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    • 2018
  • This paper focuses on the integration aspect of operators to determine an improvement strategy for the operating system to enhance competitiveness of Busan Port. This Study proposes the following alternatives: valuation standards for the integration of operators, the road map for the integration period, the scope and role setting of integrated operators' participation of Busan Port Authority(BPA), and the separation and linkage North Port and the New Port operators. First, the valuation standards for operator integration should be based on international standards. Additionally quantitative factors such as financial situation, business performance and participating companies' profitability, and the qualitative factors such as management ability, technology, and labor relations should be considered. Second, the timing of North Port's operator integration should be prioritized in the short term in conjunction with the commencement of its phase 2-4, 2-5, and 2-6. The integration of New Port operators should provide a road map for a relatively long-term perspective. Third, the participation of BPA' integrated operators should be considered in terms of publicity as a policy coordinator between terminals and by pursuing the profitability of entering into overseas business by fostering Korean global terminal operators. The scope and role of participation ensures that the experience and technology of the terminal operation business is maximized. Fourth, because physically intergrating the North Port' operator into a single corporate form is difficult, initially establishing a special purpose company to maximize the effect of the integrated operation is necessary. Then, the operators decided to convert to a holding company given the termination of the lease term contract with the State or BPA, and ultimately proposed a merger into a single corporation.