일개 3차병원 응급의료센터의 가임기 여성에 대한 기형유발가능약제 처방현황

차명일,윤재철,오범진,김원,임경수,이재호 대한응급의학회 2008 大韓應急醫學會誌 Vol.19 No.5

Purpose: The purpose of this study is to survey the prescription status of potentially teratogenic drugs to women of childbearing age in an emergency department (ED). In addition, the frequency of documentation of patient’s pregnancy status was also evaluated. Methods: A retrospective study was conducted through the use of warehouse data at a tertiary care center. Women aged 20~39 years who were prescribed drugs that the U.S. Food and Drug Administration (FDA) identifies as class D or X were evaluated. The frequency of prescription of potentially teratogenic drugs and the rate of pregnancy tests performed at the ED were analyzed. Results: Among the 7,742 women of childbearing age with ED visits, 1,962(25.3%) patients received at least one potentially teratogenic drug during 2006, based upon the FDA risk classification system. The most frequently prescribed drugs were non steroidal anti-inflammatory drugs (NSAID) (50.8%), opioid drugs(26.3%), and benzodiazepines( 10.3%). The number of pregnancy tests performed before prescribing potentially teratogenic drugs was 838 (39.0%). Among patients for whom a pregnancy test was not performed, only 87(7.6%) patients were advised by their doctors of drug teratogenecity. Conclusion: The frequency of prescription of potentially teratogenic drugs to women of childbearing age was 1 in every 4 visits at the ED. In addition, the rates of documentation of pregnancy status and explanation of teratogenecity were relatively low. Introducing a pregnancy information system and a pregnancy alerting system, as well as increasing the frequency of pregnancy tests before prescribing are necessary, not only for pregnant women and fetuses but also for emergency medical personnel at the point of care.

전원조정의 필요성과 개선방향 : 취약지와 비취약지 비교

차명일 대한응급의학회 2023 대한응급의학회 학술대회초록집 Vol.2023 No.2

A study on the disaster medical response during the Mauna Ocean Resort gymnasium collapse

차명일,김기운,김주현,좌민홍,최대해,김인병,왕순주,유인술,윤한덕,이강현,조석주,허탁,홍은석 대한응급의학회 2016 Clinical and Experimental Emergency Medicine Vol.3 No.3

Objective To investigate and document the disaster medical response during the Gyeongju Mauna Ocean Resort gymnasium collapse on February 17, 2014. Methods Official records of each institution were verified to select the study population. All the medical records and emergency medical service run sheets were reviewed by an emergency physician. Personal or telephonic interviews were conducted, without a separate questionnaire, if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. Results One hundred fifty-five accident victims treated at 12 hospitals, mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of collapse was disseminated in 4 minutes, dispatch of 4 disaster medical assistance teams took at least 69 minutes to take the decision of dispatch. Four point five percent were treated at the accident site, 56.7% were transferred to 2 hospitals that were nearest to the collapse site, and 42.6% were transferred to hospitals that were poorly prepared to handle disaster victims. Conclusion In the Gyeongju Mauna Ocean Resort gymnasium collapse, the initial triage and distribution of patients was inefficient and medical assistance arrived late. These problems had also been noted in prior mass casualty incidents.

중증응급환자 이송체계의 문제점과 개선방향

차명일 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2

경주 마우나 오션 리조트 내 체육관 붕괴사고의 재난의료대응체계 고찰

차명일,김기운,김주현,좌민홍,최대해,왕순주,유인술,윤한덕,이강현,조석주,허탁,홍은석,김인병 대한응급의학회 2017 대한응급의학회지 Vol.28 No.1

Purpose: To investigate and document a disaster medical response during the collapse of the Gyeongju Mauna Ocean Resort gymnasium, which occurred on February 17, 2014. Methods: The official records of each institution were verified to select the study population. All the medical records and emergency medical service records were reviewed by an emergency physician. Personal or telephonic interviews were conducted without a separate questionnaire if the institutions or agencies crucial to disaster response did not have official records or if information from different institutions was inconsistent. Results: One hundred fifty-five accident victims, who were treated at 12 hospitals mostly for minor wounds, were included in this study. The collapse killed 10 people. Although the news of the collapse was disseminated in 4 minutes, it took at lease 69 minutes for a dispatch of 4 disaster medical assistance teams to take action; 4.5% of patients were treated on-site, 56.7% were transferred to 2 nearest hospitals, and 42.6% were transferred to hospitals with poor preparation to handle disaster victims. Conclusion: In the collapse of the Gyeongju Mauna Ocean Resort gymnasium, the initial triage and distribution of patients were inefficient, with delayed arrival of medical assistance teams. These problems had also been noted in prior mass casualty incidents. Government agencies are implementing improvements, and this study could aid the implementation process.

The development and application of active RFID entrance management system for emergency patient safety

차명일,오범진,민성우,이상욱,김원,임경수,이재호 대한의료정보학회 2008 Healthcare Informatics Research Vol.14 No.3

Objective: Unauthorized exit of emergency patients could cause serious safety problems in the emergency room. If the entry and exit of emergency patients can be monitored by RFID (Radio Frequency Identification) technology, such safety issues may be resolved. Method: We determined the fundamental requirements of the system for emergency patient safety, and chose an active RFID tag to conduct the recognition test. Subsequently, we performed the entrance recognition rate test and safety test using pacemakers. After developing the entrance management programs, we implemented the system in the emergency room and collected data for 6 months. Result: The overall success rate of the entrance recognition test was 99.5%, and during the safety test, pacemaker oversensing due to noise did not occur. We intended to fulfill the fundamental requirements in developing entrance management programs. A total of 508 patients were given RFID tags for the study period, and the recognition failure rate was 4.7%. “Alert” pop‐ups occurred 62 times. Conclusion: An active RFID entrance management system would be very useful for safety management in emergency room because the system enables detection of the unauthorized exit of emergency patients in real‐ time.

경영자의 자기과신 성향과 조세회피

차명기,김수성,황국재 한국회계정보학회 2016 회계정보연구 Vol.34 No.4

We investigate whether managerial overconfidence influences on tax avoidance. Prior researches documented positive association between managerial overconfidence and earnings management. On the extension with the previous studies, we first find the negative association between managerial overconfidence and tax avoidance mainly based on trade-off relation of tax and nontax costs. Using a sample of 6,550 firm-year observations of Korean listed firms from 1999 to 2011, we constructed proxies using four investing and financing activities of firm-level that prior researches have found to be related to managerial overconfidence; 1) excess investment 2) debt-to-equity ratio 3) dividend yield to zero 4) asset growth rate. And as a proxy of tax avoidance, we used measures of Desai and Dharmapala(2006)'s model and its modified model using discretionary accrual instead of total accrual. Managerial overconfidence may overestimate future returns from firms' investments and therefore high debt-to-equity ratio and overinvestment cause higher nontax costs(reporting cost) that result in big BTD. Under the conformity relation between financial income and tax income, managerial overconfidence regarding earnings management as important will not intend to carry out tax avoidance which induce downward earnings. This asymmetric result between tax policy and financial reporting of those choices by firms with overconfident CEOs should be interest to majority shareholders and rule makers , thus advancing the overconfidence, tax avoidance and financial reporting literatures. 본 연구의 목적은 경영자의 특성 중 하나인 자기과신 성향이 조세회피에 미치는 영향에 대하여 실증분석 하였다. 미래성과에 대한 과도한 자신감을 가지고 주요 재무적 의사결정을 하는 경영자는 이익조정과 양(+)의 관계가 있음을 선행연구에서 보여주고 있다. 같은 맥락에서 이익조정을 하는 자기과신성향이 있는 경영자는 조세비용과 비조세비용간의 상충관계 하에서 조세회피 성향과 음(-)의 관계가 있는 것으로 나타났다. 경영자의 특성 중 자기과신 경향과 조세회피와의 관계를 투자와 재무활동의 기업수준 정도로 1999년부터 2011년 사이의 6,550개 상장법인의 기업연도를 대상으로 실증분석을 하였다. 경영자 자기과신 성향의 측정치로는 경영자의 자기과신과 관련된 투자와 재무활동들의 기업년도 수준의 4가지인 1) 투자활동현금흐름 순액이 동종기업보다 많은 경우 2) 배당률이 0 인 기업의 경우 3) 성장(총자산성장률-매출성장률)비율이 성장비율 중위수보다 큰 경우, 4) 부채비율(총부채/자본)이 평균부채비율보다 과도한 경우를 자기과신적 기업년도로 추정하였다. 조세회피의 측정치는 Desai and Dharmapala(2006)의 모형과 Desai and Dharmapala(2006) 모형에서 총발생액 대신에 재량적 발생액을 적용하여 측정을 하였다. 본 연구의 선행연구와의 차이점 및 공헌점은 다음과 같다. 첫째, 경영자의 자기과신성향이 외부보고의 형태인 조세회피에 영향을 미친다는 것을 분석하였다는 점에서 의의가 있다. 둘째, 회계학적 시각에서 경영자의 자기과신성향을 재무제표에 반영된 재무 및 투자의 다양한 측정치 수준으로 판단하였고, 자기과신성향의 주요 요소인 과잉투자의 측정을 선행연구에서 주로 사용하는 투자활동현금흐름 중 유형자산 현금유출액이 아닌 투자활동 현금흐름의 순액을 적용하여 기업의 투자시 직접투자뿐만 아니라 지분인수를 통한 투자도 반영하였다. 셋째, 경영자의 자기과신성향과 조세회피와는 음(-)의 관계가 있음을 분석하여 과거 조세회피의 요인에 대한 접근 시각를 확대하였으며 넷째, 감리지적기업이나 부실기업만을 대상으로 자기과신성향과 외부보고와의 관계를 분석한 선행연구(Schrand and Zechman(2011)과는 달리, 본 연구는 상장된 기업 전체 표본을 대상으로 실증 분석하여 자기과신성향과 외부보고와의 관계에 대한 인과관계를 강화하였다.

방송언어 사용에서의 문제점에 대하여

차명화(Cha Myunghwa) 길림성민족사무위원회 2018 중국조선어문 Vol.213 No.-

정신분석학을 이용한 루이스 칸과 렘 쿨하스의 건축 내부공간 구성 비교연구

차명열(Cha, Myung-Yeol),최효식(Choi, Hyo-Sik) 한국실내디자인학회 2012 한국실내디자인학회논문집 Vol.21 No.5

The purposes of this study were to compare Louis I. Kahn and Rem Koolhaas, both of whom established their architectural theories and granted rationality to them by applying the theory of psychoanalysis, and examine common and different characteristics in the inner space composition of a building between them. The study also set out to confirm a basic premise based on which to develop a metaphysical design concept by applying the theory of psychoanalysis in the inner space composition of contemporary architecture in future from the more developed and integrated perspective of modern psychoanalysis. As a result, Kahn sought after a metaphysical design concept through the combinations of inner unit spaces including servant and served space, which are comparable to the confrontation between consciousness and unconsciousness from the perspective of psychoanalysis. Unlike him, Koolhaas applied the concept of folding to his architectural plans based on the theory of post-structuralism and created a metaphysical design concept by more focusing on connections between unit spaces rather than their combinations. While Kahn worked on his designs with much interest in the combinations of inner unit spaces in horizontal circulation by separating it from vertical circulation, Koolhaas created a new design concept beyond the limitations of Kahn, who had a confronting, dichotomous view of the world between the phenomenal world and the metaphysical world, by making use of inclined slabs to connect upper slabs with lower ones. The findings show that there can be various metaphysical design concepts depending on how to connect and combine two confronting concepts when applying the theory of psychoanalysis to architectural design.

보호관찰 청소년의 교정상담 모형 연구: 학교복귀를 중심으로

차명호,남정아 한국교정학회 2017 矯正硏究 Vol.- No.77

본 연구는 보호관찰 청소년을 대상으로 학교 밖으로 나가게 되는 심리적 상태를 복합적으로 규명하고, 학교 복귀를 어렵게 하는 요인을 분석하여 효과적인 보호관찰 청소년의 교정상담 모형을 제시하고자 하는데 목적이 있다. 이를 위하여 보호관찰 청소년의 심층면접을 통하여 탈학교 과정의 범주모형을 제시하고, 이를 바탕으로 교정상담 모형을 도출하였다. 보호관찰 청소년의 탈학교 과정에서 경험하는 중심 현상은 ‘자신의 모습이 초라하고 창피함’, 인과적 조건으로 ‘학업부진의 어려움, 또래관계의 어려움, 경제적 어려움, 낙인찍힘’, 맥락적 요인으로 ‘비전 및 목표 부재, 가족갈등 및 불화, 교사와 학교제도와 갈등, 시간 개념의 부재’, 중재적 요인으로 ‘개입 및 지지의 부재’, ‘또래 및 유해환경에 의한 비행행동 촉진’, ‘복학의 어려움’, ‘결과적 사고’, 작용/상호작용 전략으로 ‘문제행동 지속하기’를 사용하였다. 그 결과는 ‘학교 밖 청소년으로서의 삶’으로 이어지는 것으로 나타났다. 이러한 연구 결과를 바탕으로 보호관찰 청소년의 교정상담 모형을 제시하였다. 각 단계는 정보제공과 자각을 지칭하는 정보단계(Information Stage), 구체적 개입전략과 유형을 분석하는 개입단계(Intervention Stage), 변화목표와 영역을 실행하는 변화단계(Change Stage), 변화 과정에 도움과 지원을 제공하는 지원단계(Support Stage), 지속적 변화를 돕는 유지단계(Maintainment Stage)로 구성되었다. 본 연구의 결과는 소년범죄자들의 범죄를 위한 효과적인 예방 정책을 수립하고, 교육 및 교정 상담 현장에서의 지원방향 및 내용을 결정하는데 기초자료로 활용 될 수 있다는 점에서 의의가 있다. The purpose of this study is to present a model of effective counseling for adolescents in probation through analyzing the psychological experiences which make them leave the school and exploring the factors that make it difficult to return to school. In this study, the correctional counseling model was derived by analyzing the category model of the off-school experiences among adolescents in probation through in-depth interviews. The results are as follows: The main phenomenon experienced during the off-school periods of the probation adolescents is ‘the appearance of being shabby and shameful’, the difficulty of poor academic performance, economic difficulty, stigmatization, ‘conflict with family and school system, lack of time concept’, ‘absence of intervention and support’ as an interventional factor, ‘promotion of flight behavior by peer and harmful environment’, ‘difficulty in returning’, ‘resultant thinking’, ‘problem behavior’ as a function / interaction strategy to solve the central phenomenon, and ‘life as a youth outside the school’ as a result. Based on the results of this study, we presented a model of corrective counseling for probation adolescents. It has five stages: Information Stage that provides information and awareness, Intervention Stage that analyzes specific intervention strategies and patterns, Change Stage that specifies change goals and areas, Support Stage that provides help and support for the change process, and Maintenance Stage which is the post-support phase. The results of this study are significant in that they can be used as basic data for providing effective preventive policies for crime of juvenile offenders as well as corrective counseling, and determining the direction and content of support in educational and correctional counseling field.