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A Comparative Study on Factors Affecting Satisfaction by Travel Purpose for Urban Demand Response Transport Service: Focusing on Sejong Shucle (도심형 수요응답 교통서비스의 통행목적별 만족도 영향요인 비교연구: 세종특별자치시 셔클(Shucle)을 중심으로)

  • Wonchul Kim;Woo Jin Han;Juntae Park
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.23 no.2
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    • pp.132-141
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    • 2024
  • In this study, the differences in user satisfaction and the variables influencing the satisfaction with demand response transport (DRT) by travel purpose were compared. The purpose of DRT travel was divided into commuting/school and shopping/leisure travel. A survey conducted on 'Shucle' users in Sejong City was used for the analysis and the least absolute shrinkage and selection operator (LASSO) regression analysis was applied to minimize the overfitting problems of the multilinear model. The results of the analysis confirmed the possibility that the introduction of the DRT service could eliminate the blind spot in the existing public transportation, reduce the use of private cars, encourage low-carbon and public transportation revitalization policies, and provide optimal transportation services to people who exhibit intermittent travel behaviors (e.g., elderly people, housewives, etc.). In addition, factors such as the waiting time after calling a DRT, travel time after boarding the DRT, convenience of using the DRT app, punctuality of expected departure/arrival time, and location of pickup and drop-off points were the common factors that positively influenced the satisfaction of users of the DRT services during their commuting/school and shopping/leisure travel. Meanwhile, the method of transfer to other transport modes was found to affect satisfaction only in the case of commuting/school travel, but not in the case of shopping/leisure travel. To activate the DRT service, it is necessary to consider the five influencing factors analyzed above. In addition, the differentiating factors between commuting/school and shopping/leisure travel were also identified. In the case of commuting/school travel, people value time and consider it to be important, so it is necessary to promote the convenience of transfer to other transport modes to reduce the total travel time. Regarding shopping/leisure travel, it is necessary to consider ways to create a facility that allows users to easily and conveniently designate the location of the pickup and drop-off point.

A Study on the Operation Plan of the Gangwon-do Disaster Management Resources Integrated Management Center (강원도 재난관리자원 통합관리센터 운영방안에 관한 연구)

  • Hang-Il Jo;Sang-Beom Park;Kye-Won Jun
    • Journal of Korean Society of Disaster and Security
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    • v.17 no.1
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    • pp.9-16
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    • 2024
  • In Korea, as disasters become larger and more complex, there is a trend of shifting from a focus on response and recovery to a focus on prevention and preparedness. In order to prevent and prepare for disasters, each local government manages disaster management resources by stockpiling them. However, although disaster management resources are stored in individual warehouses, they are managed by department rather than by warehouse, resulting in insufficient management of disaster management resources due to the heavy workload of those in charge. In order to intensively manage these disaster management resources, an integrated disaster management resource management center is established and managed at the metropolitan/provincial level. In the case of Gangwon-do, the subject of this study, a warehouse is rented and operated as an integrated disaster management resource management center. When leasing an integrated management center, there is the inconvenience of having to move the location every 1 to 2 years, so it is deemed necessary to build a dedicated facility in an available site. To select a location candidate, network analysis was used to measure access to and use of facilities along interconnected routes of networks such as roads and railways. During network analysis, the Location-Allocation method, which was widely used in the past to determine the location of multiple facilities, was applied. As a result, Hoengseong-gun in Gangwon-do was identified as a suitable candidate site. In addition, if the integrated management center uses our country's logistics system to stockpile disaster management resources, local governments can mobilize disaster management resources in 3 days, and it is said that it takes 3 days to return to normal life after a disaster occurs. Each city's disaster management resource stockpile is 3 days' worth per week, and the integrated management center stores 3 times the maximum of the city's 4-day stockpile.

Studies on a Factor Affecting Composts Maturity During Composting of SWine Manure (돈분 퇴비화 중 부숙도에 미치는 영향인자 구명)

  • Kim, T.I.;Song, J. I.;Yang, C.B.;Kim, M.K.
    • Journal of Animal Science and Technology
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    • v.46 no.2
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    • pp.261-272
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    • 2004
  • This study was conducted to investigate indices affecting composts maturity for swine manure compost produced in a commercial composting facility with air-forced from the bottom. The composting was made of swine manure mixed with puffing rice hull(6: 4) and turned by escalating agitator twice a day. Composting samples were collected periodically during a 45-d composting cycle at that system, showing that indices of Ammonium-N to Nitrate-N ratio were sensitive indicators of composting quality. Pile temperature maintained more than 62$^{\circ}C$ and water contents decreased about 20% for 25days of composting. A great variety and high numbers of aerobic thermophilic heterotropic microbes playing critical roles in stability of composts have been examined in the final composts, sbowing that they were detected $10^8$ to $10^{10}$ $CFUg^{-1}$ in mesophilic bacteria, $10^3$ - $10^4$ in fungi and $10^6$ - $10^8$ in actinomycetes, respectively. The results of this study for detennining a factor affecting compost stability evaluations based on composting steps were as follows; 1. Ammonium-N concentrations were highest at the beginning of composting, reaching approximately 421mg/kg. However Ammonium-N concentrations were lower during curing, reaching approximately l04mg/kg just after 45 day. The ratio between $NH_4-N$ and $NO_3-N$ was above II at the beginning of composting and less than 2 at the final step(45 day). 2. Seed germination Index was dependent upon the compost phytotoxicity and its nutrition. The phytotocity caused the GI to low during the period of active composting(till 25 days of composting time) depending on the value of the undiluted. After 25 days of composting time, the GI was dependent upon compost nutrition. The Gennination index of the final step was calculated at over 80 without regard to treatments. 3. E4: E6 ratio in humic acid of composts was correlatively decreased from 8.86 to 6.76 during the period of active composting. After 25 days of composting time, the E4: E6 was consistently decreased from 6.76 to 4.67($r^2$ of total composting period was 0.95). 4. Water soluble carbon had a tendency to increase from 0.54% to 0.78%during the period of active composting. After 25 days of composting time, it was consistently decreased from 0.78% to 0.42%. Water soluble nitrogen increased from 0.22% to 0.32% during the period of 15 days after initial composting while decreased from 0.32% to 0.21% after 15days of composting. In consequence, the correlation coefficient($r^2$) between water soluble carbon and water soluble nitrogen was 0.12 during the period of active composting mule was 0.50 after 25 days of composting time

Jangdo(Small Ornamental Knives) manufacturing process and restoration research using Odong Inlay application (오동상감(烏銅象嵌)기법을 활용한 장도(粧刀)의 제작기술 및 복원연구)

  • Yun, Yong Hyun;Cho, Nam Chul;Jeong, Yeong Sang;Jang, Chu Nam
    • Korean Journal of Heritage: History & Science
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    • v.49 no.2
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    • pp.172-189
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    • 2016
  • In this research, literature research on the Odong material, mixture ratio, casting method and casting facility was conducted on contemporary documents, such as Cheongong Geamul. Also, a long sword was produced using the Odong inlay technique. The sword reproduction steps were as follows; Odong alloying, silver soldering alloying, Odong plate and Silver plate production, hilt and sheath production, metal frame and decorative elements, such as a Dugup (metal frame), production, Odong inlay assembly and final assembly. For the Odong alloy production, the mixture ratio of the true Odong, which has copper and gold ratio of 20:1, was used. This is traditional ratio for high quality product according to $17^{th}$ century metallurgy instruction manual. The silver soldering alloy was produced with silver and brass(Cu 7 : Zn 3) ratio of 5:1 for inlay purpose and 5:2 ratio for simple welding purpose. The true Odong alloy laminated with silver plate was used to produce hilt and sheath. The alloy went through annealing and forging steps to make it into 0.6 mm thick plate and its backing layer, which is a silver plate, had the matching thickness. After the two plates were adhered, the laminated plate went through annealing, forging, engraving, silver inlaying, shaping, silver welding, finishing and polishing steps. During the Odong colouring process, its red surface turns black by induced corrosion and different hues can be achieved depending on its quality. To accomplish the silver inlay Odong techniques, a Hanji saturated with thirty day old urine is wrapped around a hilt and sheath material, then it is left at warm room temperature for two to three hours. The Odong's surface will turn black when silver inlay remains unchanged. Various scientific analysis were conducted to study composition of recreated Odong panel, silver soldering, silver plate and the colouring agent on Odong's surface. The recreated Odong had average out at Cu 95.57 wt% Au 4.16wt% and Cu 98.04 wt% Au 1.95wt%, when documented ratio in the old record is Cu 95wt% and Au 5wt%. The recreated Odong was prone to surface breakage during manufacturing process unlike material made with composition ratio written in the old record. On the silver plate of the silver and Odong laminate, 100wt% Ag was detected and between the two layers Cu, Ag and Au were detected. This proves that the adhesion between the two layers was successfully achieved. The silver soldering had varied composition of Ag depending on the location. This shows uneven composition of the silver welding. A large quantities of S, that was not initially present, was detected on the surface of the black Odong. This indicates that presence of S has influence on Odong colour. Additional study on the chromaticity, additional chemical compounds and its restoration are needed for the further understanding of the origin of Odong colour. The result of Odong alloy testing and recreation, Odong silver inlay long sword production, scientific analysis of the Odong black colouring agent will form an important foundation of knowledge for conservation of Odong artifact.

An Analysis of Determinants of Health Knowledge, Attitude and Practice of Housewives in Korea (한국부인의 보건지식, 태도 및 실천에 영향을 미치는 제요인분석)

  • 남철현
    • Korean Journal of Health Education and Promotion
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    • v.2 no.1
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    • pp.3-50
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    • 1984
  • The levels of health knowledge, attitude and practice of housewives considerably effect to the health of households, communities and the nation. This study was designed to grasp the levels of health knowledge, attitude and practice of houswives and analyse the various factors effecting to health in order to provide health education services as well as materials for effective formulation and implementation of health policy to improve the health of the nation. This study has been conducted through interviews by trained surveyers for 4,281 housewives selected from 4,500 households throughout the country for 40 days during July 11-August 20, 1983. The results of survey were analysed by stepwise multiple regression and path analysis are summarized as follows; 1. Based on the measurement instrument applied to this study, the levels of health knowledge, attitude and practice of housewives were extremely low with 54.5 points out of 100 points in full. Higher level with 72 points and above was approximately 21 percent and lower level with 39 points and below was approx. 24 percent. The middle level was approx. 55 percent. In order to implement health programs successively, health education should be more strengthened and to improve the level of health knowledge, attitude and practice (KAP) of the nation, political consideration as a part of spiritual reformation must be concentrated on health. 2. The level of health knowledge indicated the highest points with 57.3 the level of attitude was the second with 55.0 points and the practice level was the lowest with 50.0 point. Therefore, planning and implementation of health education program must be based on the persuasion and motivation that health knowledge turn into practice. 3. Housewives who had higher level of health knowledge, showed their practice level was relatively lower and those who had middle or low level of it practice level was the reverse. 4. Correlations among health knowledge, attitude and practice (KAP) were generally higher and statistically significant at 0.1 percent level. Correlation between total health KAP level and health knowledge was the highest with r=.8092. 5. Health KAP levels showed significant differences according to the age, number of children, marital status, self-assessed health status and concern on health of the housewives interviewed (p<0.001) 6. Health KAP levels also showed significant differences according to the education level, economic status, employment before marriage and grown-up area of the housewives interviewed. (p<0.001) 7. Heath KAP levels showed significant differences according to health insurance benificiary and the existence of patients in the family. (p<0.001). 8. Health KAP levels showed significant differences according to distance to government organizations, schools, distance to health facilities, telephone possession rate, television possession rate, newspaper reading rate and activities of Ban meeting and Women's club. (p<0.001) 9. Health KAP levels showed significant differences according to electric mass communication media such as television, radio and village broadcasting etc. and printed media such as newspaper, magazine and booklets etc., IEC variables such as individual consultation and husband-wife communication, however, there was no significance with group training. 10. Health KAP of the housewives showed close correlation with personal characteristics variables, i.e., education level (r=.5302), age (r=-.3694) grown-up area (r=.3357) and employment before marriage. In general, correlation of health knowledge level was higher than the levels of attitude or practice. In case of health concern and health insurance, correlation of practice level was higher than health knowledge level. 11. Health KAP levels showed higher correlation with community environmental characteristics, Ban meeting and activity of Women's club, however, no correlation with New-village movement. 12. Among IEC variables, husband-wife communication showed the highest correlation with health KAP levels and printed media, electric mas communication media and health consultation in order. Therefore, encouragement of husband-wife communication and development of training program for men should be included in health education program. 13. Mass media such as electric mass com. and printed media were effective for knowledge transmission and husband-wife communication and individual consultation were effective for health practice. Group training was significant for knowledge transmission, however, but not significant for attitude formation or turning to health practice. To improve health KAP levels, health knowledge should be transmitted via mass media and health consultation with health professionals and field health workers should be strengthened. 14. Correlation of health KAP levels showed that knowledge level was generally higher than that of practice and recognized that knowledge was not linked with attitude or practice. 15. The twenty-five variables effecting health KAP levels of housewives had 41 per cent explanation variances among which education level had great contribution (β=.2309) and electric mass com. media (β=.1778), husband-wife communication (β=.1482), printed media, grown-up area, and distance to government organizations in order. Variances explained (R²) of health KAP were 31%, 15%, and 30% respectively. 16. Principal variables contributed to health KAP were education level (β=.12320, β=.1465), electric mass comm. media (β=.1762, β=.1839), printed media, (β=.1383, β=.1420) husband-wife communication (β=.1004, β=.1067), grown-up area and distance to government organizations, in order. Since education level contributes greatly to health KAP of the housewives, health education including curriculum development in primary, middle and high schools must be emphasized and health science must be selected as one of the basic liberal arts subject in universities. 17. Variences explained of IEC variables to health KAP were 19% in total, 14% in knowledge, 9% in attitude, and 10% in health practice. Contributions of IEC variables to health KAP levels were printed media (β=.3882), electric mass comm media (β=.3165), husb-band wife com. (β=.2095,) and consultation on health (β=.0841) in order, however, group training showed negative effect (β=-.0402). National fund must be invested for the development of Health Program through mass media such as TV and radio etc. and for printed materials such as newspaper, magazines, phamplet etc. needed for transmission of health knowledge. 18. Variables contributed to health KAP levels through IEC variables with indirect effects were education level (Ind E=0.0410), health concern (Ind E=.0161), newspaper reading rate (Ind E=.0137), TV possession rate and activity of Ban meeting in order, however, health facility showed negative effect (Ind E=-.0232) and other variables showed direct effect but not indirect effect. 19. Among the variables effecting health KAP level, education level showed the highest in total effect (TE=.2693) then IEC (TE=.1972), grown-up city (TE=.1237), newspaper reading rate (TE=.1020), distance to government organization (TE=.095) in order. 20. Variables indicating indirect effects to health KAP levels were; at knowledge level with R²=30%, education level (Ind E=.0344), newspaper reading rate (Ind E=.0112), TV possession rate (Ind E=.0689), activity of Ban meeting (Ind E=.0079) in order and at attitude level with R²=13%, education level (Ind E=. 0338), activity of Ban meeting (Ind E=.0079), and at practice level with R²=29%. education level (Ind E=.0268), health facility (Ind E=.0830) and concern on health (Ind E=.0105). 21. Total effect to health KAP levels and IEC by variable characteristics, personal characteristics variables indicated larger than community characteristics variables. 22. Multiple Correlation Coefficient (MCC) expressed by the Personal Characteristic Variable was .5049 and explained approximately 25% of variances. MCC expressed by total Community environment variable was .4283 and explained approx. 18% of variances. MCC expressed by IEC Variables was .4380 and explained approx. 19% of variances. The most important variable effected to health KAP levels was personal characteristic and then IEC variable, Community Environment variable in order. When the IEC effected with personal characteristic or community characteristic, the MCC or the variances were relatively higher than effecting alone. Therefore it was identified that the IEC was one of the important intermediate variable.

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A Study on the Conservation State and Plans for Stone Cultural Properties in the Unjusa Temple, Korea (운주사 석조문화재의 보존상태와 보존방안에 대한 연구)

  • Sa-Duk, Kim;Chan-Hee, Lee;Seok-Won, Choi;Eun-Jeong, Shin
    • Korean Journal of Heritage: History & Science
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    • v.37
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    • pp.285-307
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    • 2004
  • Synthesize and examine petrological characteristic and geochemical characteristic by weathering formation of rock and progress of weathering laying stress on stone cultural properties of Unjusa temple of Chonnam Hwasun county site in this research. Examine closely weathering element that influence mechanical, chemical, mineralogical and physical weathering of rocks that accomplish stone cultural properties and these do quantification, wish to utilize by a basic knowledge for conservation scientific research of stone cultural properties by these result. Enforced component analysis of rock and mineralogical survey about 18 samples (pyroclastic tuff; 7, ash tuff; 4, granite ; 4, granitic gneiss; 3) all to search petrological characteristic and geochemical characteristic by weathering of Unjusa temple precinct stone cultural properties and recorded deterioration degree about each stone cultural properties observing naked eye. Major rock that constitution Unjusa temple one great geological features has strike of N30-40W and dip of 10-20NE being pyroclastic tuff. This pyroclastic tuff is ranging very extensively laying center on Unjusa temple and stone cultural properties of precinct is modeled by this pyroclastic tuff. Stone cultural propertieses of present Unjusa temple precinct are accomplishing structural imbalance with serious crack, and because weathering of rock with serious biological pollution is gone fairly, rubble break away and weathering and deterioration phenomenon such as fall off of a particle of mineral are appearing extremely. Also, a piece of iron and cement mortar of stone cultural properties everywhere are forming precipitate of reddish brown and light gray being oxidized. About these stone cultural properties, most stone cultural propertieses show SD(severe damage) to MD(moderate damage) as result that record Deterioration degree. X-ray diffraction analysis result samples of each rock are consisted of mineral of quartz, orthoclase,plagioclase, calcite, magnetite etc. Quartz and feldspar alterated extremely in a microscopic analysis, and biotite that show crystalline form of anhedral shows state that become chloritization that is secondary weathering mineral being weathered. Also, see that show iron precipitate of reddish brown to crack zone of tuff everywhere preview rock that weathering is gone deep. Tuffs that accomplish stone cultural properties of study area is illustrated to field of Subalkaline and Peraluminous, $SiO_2$(wt.%) extent of samples pyroclastic tuff 70.08-73.69, ash tuff extent of 70.26-78.42 show. In calculate Chemical Index of Alteration(CIA) and Weathering Potential Index(WPI) about major elements extent of CIA pyroclastic tuff 55.05-60.75, ash tuff 52.10-58.70, granite 49.49-51.06 granitic gneiss shows value of 53.25-67.14 and these have high value gneiss and tuffs. WPI previews that is see as thing which is illustrated being approximated in 0 lines and 0 lines low samples of tuffs and gneiss is receiving esaily weathering process as appear in CIA. As clay mineral of smectite, zeolite that is secondary weathering produce of rock as result that pick powdering of rock and clothing material of stone cultural properties observed by scanning electron micrographs (SEM). And roots of lichen and spore of hyphae that is weathering element are observed together. This rock deep organism being coating to add mechanical weathering process of stone cultural properties do, and is assumed that change the clay mineral is gone fairly in stone cultural properties with these. As the weathering of rocks is under a serious condition, the damage by the natural environment such as rain, wind, trees and the ground is accelerated. As a counter-measure, the first necessary thing is to build the ground environment about protecting water invasion by making the drainage and checking the surrounding environment. The second thing are building hardening and extirpation process that strengthens the rock, dealing biologically by reducing lichens, and sticking crevice part restoration using synthetic resin. Moreover, it is assumed to be desirable to build the protection facility that can block wind, sunlight, and rain which are the cause of the weathering, and that goes well with the surrounding environment.

A Study on The Enhancement of Aviation Safety in Airport Planning & Construction from a Legal Perspective (공항개발계획과 사업에서의 항공안전성 제고에 대한 법률적 소고)

  • Kim, Tae-Han
    • The Korean Journal of Air & Space Law and Policy
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    • v.27 no.2
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    • pp.67-106
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    • 2012
  • Today air traffic at the airport is complicated including a significant increase in the volume of air transport, so aviation accidents are constantly occurring. Therefore, we should newly recognize importance of the Air Traffic Safety, the core values of the Air Traffic. The location of airport that is the basic infrastructure of the air traffic and the security of safety for facilities and equipments are more important than what you can. From this dimension, I analyze the step-by-step safety factors that are taken into account in the airport development projects from the construction or improvement of the airport within the current laws and institutions and give my opinion on the enhancement of safety in the design and construction of airport. The safety of air traffic, as well as airport, depends on location, development, design, construction, inspection and management of the airport including airport facilities because we have to carry out the national responsibility that prevents the risk of large social overhead capital for many and unspecified persons in modern society through legislation regarding intervention of specialists and locational criteria for aviation safety from the planning stage of airport development. In addition, well-defined installation standards of airports and air navigation facilities, the key points of the airport development phase, can ensure the safety of the airport and airport facilities. Of course, the installation standards of airport and air navigation facilities are based on the global standard due to the nature of air traffic. However, to prevent the chaos for the safety standards in design, construction, inspection of them and to ensure the aviation safety, the safety standards must be further subdivided in the course of domestic legislation. The criteria for installation of the Air Navigation facilities is regulated most specifically. However, to ensure the safety of the operation for Air Navigation Facilities, performance system proved suitable for the Safety of Air Navigation Facilities must change over from arbitrary restrictions to mandatory restrictions and be applied for foreign producers as well as domestic producers. Of course, negligence of pilots and defective aircraft maintenance lead to a large portion of the aviation accidents. However, I think that air traffic accidents can be reduced if the airport or airport facility is perfect enough to ensure the safety. Therefore, legal and institutional supplement to prioritize the aviation safety from the stage of airport development may be necessary.

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Microbiological Hazard Analysis for HACCP System Application to Vinegared Pickle Radishes (식초절임 무의 HACCP 시스템 적용을 위한 미생물학적 위해 분석)

  • Kwon, Sang-Chul
    • Journal of Food Hygiene and Safety
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    • v.28 no.1
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    • pp.69-74
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    • 2013
  • This study has been performed for 150 days from February 1 - June 31, 2012 aiming at analyzing biologically hazardous factors in order to develop HACCP system for the vinegared pickle radishes. A process chart was prepared as shown on Fig. 1 by referring to manufacturing process of manufacturer of general vinegared pickle radishes regarding process of raw agricultural products of vinegared pickle radishes, used water, warehousing of additives and packing material, storage, careful selection, washing, peeling off, cutting, sorting out, stuffing (filling), internal packing, metal detection, external packing, storage and consignment (delivery). As a result of measuring Coliform group, Staphylococcus aureus, Salmonella spp., Bacillus cereus, Listeria Monocytogenes, E. coli O157:H7, Clostridium perfringens, Yeast and Mold before and after washing raw radishes, Bacillus cereus was $5.00{\times}10$ CFU/g before washing but it was not detected after washing and Yeast and Mold was $3.80{\times}10^2$ CFU/g before washing but it was reduced to 10 CFU/g after washing and other pathogenic bacteria was not detected. As a result of testing microorganism variation depending on pH (2-5) of seasoning fluid (condiment), pH 3-4 was determined as pH of seasoning fluid as all the bacteria was not detected in pH3-4. As a result of testing air-borne bacteria (number of general bacteria, colon bacillus, fungus) depending on each workplace, number of microorganism of internal packing room, seasoning fluid processing room, washing room and storage room was detected to be 10 CFU/Plate, 2 CFU/Plate, 60 CFU/Plate and 20 CFU/Plate, respectively. As a result of testing palm condition of workers, as number of general bacteria and colon bacillus was represented to be high as 346 $CFU/Cm^2$ and 23 $CFU/Cm^2$, respectively, an education and training for individual sanitation control was considered to be required. As a result of inspecting surface pollution level of manufacturing facility and devices, colon bacillus was not detected in all the specimen but general bacteria was most dominantly detected in PP Packing machine and Siuping machine (PE Bulk) as $4.2{\times}10^3CFU/Cm^2$, $2.6{\times}10^3CFU/Cm^2$, respectively. As a result of analyzing above hazardous factors, processing process of seasoning fluid where pathogenic bacteria may be prevented, reduced or removed is required to be controlled by CCP-B (Biological) and threshold level (critical control point) was set at pH 3-4. Therefore, it is considered that thorough HACCP control plan including control criteria (point) of seasoning fluid processing process, countermeasures in case of its deviation, its verification method, education/training and record control would be required.

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.

호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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