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Factors Influencing Withdrawal of Life-Sustaining Treatment in Tertiary General Hospital Workers -Knowledge and Attitude of Organ Donation and Transplantation, Awareness of Death, Knowledge and Perception of Hospice Palliative Care- (상급종합병원근무자의 연명치료중단에 미치는 영향요인 -장기기증·이식의 지식 및 태도, 죽음에 대한 인식, 호스피스완화의료에 대한 지식 및 인식-)

  • Je, Nam Joo;Hwa, Jeong Seok
    • Journal of Hospice and Palliative Care
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    • v.21 no.3
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    • pp.92-103
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    • 2018
  • Purpose: This descriptive study was conducted to examine factors that affect hospital workers in their decision to withdraw from life-sustaining treatment, such as knowledge, attitude, and perception of organ donation, transplantation, death and hospice palliative care. Methods: A questionnaire was completed by 228 workers of a tertiary general hospital, and data were analyzed using t-test, ANOVA, and Pearson's correlation by using SPSS 21.0. Results: The subjects' knowledge of biomedical ethics awareness differed by age, education level, occupation, affiliated department, and biomedical ethics education. Their knowledge of brain death, organ donation and transplantation was positively correlated with attitudes toward tissue donation and transplantation, knowledge of hospice palliative care, and perception of hospice palliative care. Their attitudes toward tissue donation and transplantation were significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care, and withdrawal of life-sustaining treatment. Their awareness of death was significantly correlated with knowledge of hospice palliative care, perception of hospice palliative care and withdrawal of life-sustaining treatment. The perception of hospice palliative care was significantly correlated with withdrawal of life-sustaining treatment. Factors associated with their withdrawal of life-sustaining treatment were work at the hospice ward (32.5%), attitudes toward tissue donation and transplantation and perception of hospice palliative care. Conclusion: This study has shown that work at the hospice ward, attitudes toward tissue donation and transplantation and perception of hospice palliative care were related to attitudes toward withdrawal of life-sustaining treatment. More research is needed to further develop various curriculums based on biomedical methods.

The Situation and the Tasks of UK Rail Privatization, Focusing on after the Hatfield Accident (영국 철도 민영화의 현황 및 과제 (Hatfield사고 이후의 변화를 중심으로))

  • Lee, Yong-Sang
    • Journal of Korean Society of Transportation
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    • v.24 no.2 s.88
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    • pp.91-100
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    • 2006
  • This paper examines the situation and tasks of UK rail privatization, especially focusing on after the Hatfield rail accident. Earlier research which focused on the UK's Privatization had little knowledge of the explanations for recent changes. Moreover they had difficulty making a direct comparison between national rail and the privatized rail. Therefore we aye left without a good explanation which has a comprehensive perspective. I attempt to show the change in the rail privatization Process and its outcome, focusing on after the Hatfield rail accident. This Paper argues that the UK's vail privatization process has a regulatory framework which is too complicated with overlapping responsibilities that brought about inefficiency, increasing costs and a superficial safety regime. Especially the planning of rail and infrastructure maintenance did not come to play an appropriate role. However after 2000, the government took charge of setting the strategy for railways, and the Office of Rail Regulation covered safety performance and cost. explain that these changes present a good opportunity to solve the problem of passing the buck for poor performance. Through the analysis, I find that the passenger rail network is well-suited to deliver long distance business and commuters and that the subsidy from the government is decreasing. However, performance, for example punctuality and reliability. should be improved. Especially the Hatfield rail accident caused a reduction in the satisfaction of passengers. In future. the problems of rising costs and monopoly franchise system should be addressed.

Comparison of Attitudes toward Death among Nursing Students from South Korea, Japan and Indonesia (한국.일본.인도네시아 간호대학생의 죽음에 대한 태도 비교)

  • Lee, So Woo;Lee, So Young;Lee, Young Whee;Kuwano, Noriko;Ando, Michiyo;Hayashi, Mariko;Wardaningsih, Shanti
    • Journal of Hospice and Palliative Care
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    • v.15 no.4
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    • pp.212-221
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    • 2012
  • Purpose: This study was performed to compare nursing students' attitudes toward death among South Korea, Japan and Indonesia, and to confirm the need for death education in nursing. Methods: A total of 294 nursing students completed a questionnaire titled as the Death Attitude Profile-Revised (Wong, Recker, Gesser. 1994). Participating students were from two nursing schools in South Korea, two in Japan and one in Indonesia. Data were analyzed by using descriptive statistics and inferential statistics including, ${\chi}^2$-test, ANOVA and multiple comparison analysis. Results: The total mean score of the DAP-R for the three countries combined was $3.84{\pm}0.73$. By country, the mean was the highest for Indonesian students ($4.32{\pm}0.71$), followed by Korean ($3.75{\pm}0.57$) and Japanese ($3.56{\pm}0.70$) respectively. In relation to subcategories, Indonesian students showed the highest mean score for death avoidance ($3.67{\pm}1.38$) and approach acceptance ($5.37{\pm}1.00$). Korean students marked the highest ($5.51{\pm}0.91$) in neutral acceptance and Japanese students scored the best ($3.63{\pm}1.46$) in escape acceptance. Nursing students who had an experience of caring terminally ill patients tended to be affirmative in approach acceptance (P=0.047). There were significant differences in each of the four subcategories except fear of death among the three countries (P<0.001). Conclusion: The above results indicate it is necessary to develop education programs based on each country's social and cultural background to help nursing students form desirable attitudes toward death.

Death Recognition, Meaning in Life and Death Attitude of People Who Participated in the Death Education Program (죽음교육 프로그램 참여자의 죽음인식, 생의 의미 및 죽음에 대한 태도)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.169-180
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    • 2010
  • Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

Community Dwellers' Perception of Past Life Recollection and Preparation for Death (서울시 일 지역 주민의 인생회고 및 죽음준비 인식)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.14 no.2
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    • pp.81-90
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    • 2011
  • Purpose: This study is to understand how community members perceive past life recollection and preparation for death. Methods: Using a questionnaire, we surveyed 160 adult residents of one of the districts (gu) in Seoul, Korea. Descriptive statistics were used. Results: Participants chose their 30s and 40s as the most difficult time in their lives. The most painful experience was "an illness of a family member", followed by "trouble with a spouse", and "trouble with children". As for the most difficult social experience, "sense of loss in life" was ranked the highest. Personally, the happiest time was "accomplishment of a goal", while it was "happiness through children" in family relationship and "contribution to society through my career" in social life. As for the most regrettable experience, personally "having lived without purpose" was the highest, "not meeting my parents' expectation more" in family relationship; "not providing sufficient education" in relationship with children; "not having an occupation that I wanted" in work life, and "lack of social skills" in social life. More than 87% of the surveyed showed a positive attitude about the system of the do not resuscitate (DNS) order. For a situation where participants were supposed to have an incurable disease, "I want to be notified of the true condition" and "I want to write a will and advanced directives" ranked high, receiving more than 3.1 points out of 4. Conclusion: These results demonstrate the need for death education to provide people with an opportunity to accept their regrettable experiences in the past as part of their life. Also, this study suggests the importance of writing advanced directives for people to prepare for "death with dignity" how it can help their decision to be better respected.

Trends in Rapid Detection Methods for Marine Organism-derived Toxins (해양 생물 유래 독소의 나노 기술 기반 신속 진단법 개발 동향)

  • Park, Chan Yeong;Kweon, So Yeon;Moon, Sunhee;Kim, Min Woo;Ha, Sang-Do;Park, Jong Pil;Park, Tae Jung
    • Journal of Food Hygiene and Safety
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    • v.35 no.4
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    • pp.291-303
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    • 2020
  • Marine organism-derived toxins have negative effects not only on human health but also in aquaculture, fisheries, and marine ecosystems. However, traditional analytical methods are insufficient in preventing this threat. In this paper, we reviewed new rapid methods of toxin detection, which have been improved by adopting diverse types of nanomaterials and technologies. Moreover, we herein describe the main strategies for toxin detection and their related sensing performance. Notably, to popularize and commercialize these newly developed technologies, simplifying the process of pre-treating real samples real samples is very important. As part of these efforts, numerous studies have reported pretreatment methods based on the antibody-immobilized magnetic nanoparticles, and some cases have applied nanoparticles to enhance the sensing performance by utilizing the intrinsic catalytic activity. Furthermore, some reports have introduced fluorescent nanoparticles, such as quantum dots, to represent the lower detection limits of conventional enzyme-based colorimetric methods and lateral flow assays. Some studies using electrochemical measurements based on aptamer-nanoparticle complexes have also been announced. In addition, as the response to new toxins generated by changes in the marine environment is still lacking, further research on diagnostic and detection is also greatly needed for these kinds of marine toxins and their derivatives.

An assessment of statistical errors of articles in the Journal of Korean Academy of Prosthodontics: Comparison between Korean version and English version (대한치과보철학회지에 게재된 논문의 통계적 오류: 국문논문과 영문논문의 비교)

  • Park, Dong-Gyu;Choi, Yong-Geun;Kim, Young-Su;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.47 no.3
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    • pp.273-285
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    • 2009
  • Statement of problem: The aim of dental research is to advance scientific knowledge and leads to improvement in the treatment and prevention of dental disease. Utilizing an effective research design and adequate statistical methods are essential procedures ensuring that the results of researches are based on evidences. A research should utilize proper statistical methods without statistical errors; Otherwise, it could adversely affect clinical practice and future research. Purpose: This study was made to investigate the statistical methods used in the Journal of Korean Academy of Prosthodontics (JKAP) and then to assess them for the statistical errors. Material and methods: Among the total of 399 articles in the JKAP published from 2000 to 2006, 292 articles using statistics were reviewed. The validity of the statistical methods used in them were assessed using a checklist based on the guideline for statistical reporting in the uniform requirements for manuscripts submitted to biomedical journals by International Committee of Medical Journal Editors. The checklist consisted of three categories of statistical errors: 1) Unspecified computer statistical packages, 2) Inadequate description of statistical methods, 3) Misuse of statistical terms. Then, the results were compared between the Korean version and the English version in the JKAP. Results: Among the 212 articles using statistics in the Korean version, 115 articles (54%) and among the 80 articles using statistics in the English version, 47 articles (59%) were shown to have unspecified computer statistical packages without statistically significant difference (P = .66). Likewise, 101 articles (48%) in the Korean version and 25 articles (31%) in the English version were shown to have the inadequate description of statistical methods without statistically significant difference (P = .09). However, 114 articles (54%) in the Korean version and 19 articles (24%) in the English version were shown to have the misuse of statistical terms with statistically significant difference (P = .01). Conclusion: Some of the articles in the JKAP had inadequate statistical validity, given the statistical errors identified in this assessment. Hence, dental researchers should be more careful when it comes to describing and applying statistical methods.

Psychometric Evaluation of a Six Dimension Scale of Nursing Performance and Student Nurse Stress Index Using an Objective Structured Clinical Examination - Modules for Asthma and Type 1 Diabetes (객관구조화 임상시험을 활용한 간호수행능력의 Six Dimension Scale과 간호학생 스트레스 평가지수의 도구 평가-천식 및 1형 당뇨 모듈을 중심으로)

  • Park, Kyong-Ok;Ahn, Young-Mee;Kang, Na-Rae;Lee, Mi-Jin;Sohn, Min
    • Child Health Nursing Research
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    • v.19 no.2
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    • pp.85-93
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    • 2013
  • Purpose: The study purposes were to describe the process of developing the Korean versions of the Six Dimension Scale of Nursing Performance (Six-D) and Student Nurse Stress Index (SNSI) and psychometric evaluation of the two measurements. Methods: This was a methodology study using a descriptive cross-sectional design with 51 nursing students in 4th year of university. Internal consistency reliability was assessed using Cronbach alphas. Construct validity was determined by exploring correlations among Six-D, SNSI, objective structured clinical examination (OSCE), self-efficacy and grade point average (GPA). Results: Internal consistency reliability of Six-D and SNSI was acceptable with Cronbach's ${\alpha}$ of .95 and .82. Correlation analysis to determine construct validity revealed that Six-D presented positive correlations with OSCE (r=.109~.272) and self-efficacy (r=.005~.161) and negative correlation with GPA (r=-.246~-.394), although all were not statistically significant. SNSI presented all negative correlations with OSCE (r= -.007~-.238), self-efficacy (r=-.246~-.394), and GPA (r=-.092~-.426) and were mostly statistically significant except OSCE. Conclusion: Six-D needs more evidence to confirm validity to predict observed clinical competency and theoretical relationships with self-efficacy and GPA. However, SNSI presented trends of expected relationships with relevant variables. Therefore, further research is recommended in testing validity of Six-D with other student populations.

The Development and Acceptance of Knowledge Information in Garden of Joseon Dynasty - Focusing on the Garden and Flowering Books Compiled from the 15th and 19th Centuries - (조선시대 정원의 지식정보 전개와 수용 - 15~19세기 편찬된 정원 및 화훼 관련서적을 중심으로 -)

  • Kim, Dong-Hyun;Lee, Won-Ho
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.1
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    • pp.10-20
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    • 2020
  • This study aims to analyze the developed characteristics of the knowledge and information of gardens through garden or flowering plant books compiled in the 15th and 19th centuries of Joseon Dynasty. Diachronically analysis of the garden or flowering plant books classified the characteristics in which knowledge and information about gardens are developed by the period, and looked at the factors. The results are as follows; First, the relationship between the authors who compiled the garden or flowering plant books had similar characteristics to the genealogy of Realist School of Confucianism(實學) in the Joseon Dynasty. Kang, Hee-An's practical features influenced later realist school of confucianism scholars. Lee, Su-Gwang has accumulated knowledge of the garden through his experience of traveling the diplomatic envoy to China. Since then, Hong Man-sun's ideology has been related to Charles, a member of the Southerners. Seo Yu-gu was also able to accept Realist School of Confucianism in an integrated way through the Jungnong school's theory and interaction with the Jungsang school. Ryu, Jung-Lim's relationship with the Jungnong school emerged as he added to the 『Jeungbosanrimgyeongje(增補山林經濟)』. Second, the 『Yanghwasorok(養花小錄)』, 『Jibongyuseol(芝峯類說)』 「Hwuimok(卉木)」, 『Hangjeongrok(閑情錄)』, 『Sanrimgyeongje(山林經濟)』 「Yanghwa(養花)」, 『Jeungbosanrimgyeongje(增補山林經濟)』 「Yanghwa(養花)」, 『Hwaamsurok(花庵隨錄)』 and 『Imwongyeongjeji(林園經濟志)』 「Yewonji(藝畹志)」 contain garden plant characteristics, cultivation methods, and management methods. The 『Imwongyeongjeji(林園經濟志)』 「Seomyongji(贍用志)」, 「Iunji(怡雲志)」, 「Sangtaekji(相宅志)」 contain details on the location selection of gardens, the layout of facilities, how to create them and materials. The description of these garden or flowering plant books was found to be the most common introduction with 55 percent, followed by methodologies(42.8%), the Lichi Theory(理氣論, 15.5%), the classification(12.4%), and the convention(1.9%). Third, based on the importance of knowledge and information on gardens, the garden or flowering plant books related to the period were classified as early period, including 『Yanghwasorok(養花小錄)』, 『Jibongyuseol(芝峯類說)』 which were compiled before the 17th century. The 18th-century compiled 『Sanrimgyeongje(山林經濟)』 and 『Jeungbosanrimgyeongje(增補山林經濟)』 were classified as middle period, and the 19th-century compilation of 『Imwongyeongjeji(林園經濟志)』 was classified as late period. The garden or flowering plant books were cited the contents of ancient Chinese books, the author's experiences and opinions contained in the preceding period in later garden books. And the reinforcement of garden knowledge was made to reflect the agricultural technology and expertise developed at the time of writing. Fourth, based on analysis of the development and acceptance of knowledge information in garden by period, In the early period was dealing with floriculture as a way to explore the logic of things. Later, in the 18th century, a vast influx of garden knowledge information came from China. Among scholars, they secured justification for garden creation as part of various knowledge-seeking activities, which expanded their expertise in gardens. In response to the trend of gardening in the 19th century, professional books were written based on knowledge and information on gardens that were collected in the past, and systems were established such as the collection and management of garden plants, construction methods, enjoying methods, and self-realization.

Shadow of War Covering the Steam Punk Animations (스팀펑크 애니메이션에 드리운 전쟁의 그늘 -미야자키 하야오 감독의 작품을 중심으로-)

  • Oh, Jin-hee
    • Cartoon and Animation Studies
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    • s.46
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    • pp.63-84
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    • 2017
  • Overwhelming images of vividly colored aircraft flying across the blue sky and steam gushing from massive machines are reminiscent of Japanese animation films, especially of works by master director Hayao Miyazaki. By presenting together steam engines, which are mechanical devices of the Industrial Age in the past, and aircraft of the future age, the director constructs ambiguous space and time. These special time and space constitute nostalgia for past time, with devices called steam engines as a medium, and a longing for science and the future as represented by aircraft. In addition, the anticipation and disappointment, ideals and regrets of humans who see these two from the perspective of the present are projected on the works. This shares the characteristic of the steam punk genre, which seeks to return to the past rather than to face current problems. A subgenre of science fiction (henceforth "sci-fi"), steam punk reflects fundamental skepticism of science and technology and mechanized civilization, which have developed beyond human control. In addition, as works that clearly display such characteristics, director Miyazaki's and < $Nausica{\ddot{a}}$ of the Valley of Wind> can be examined. With spectacles of steam engines and aircraft, these two works enticingly visualize narratives about nature and humans and about the environment and destruction. Such attractiveness on the part of the master director's works has led to support from fans worldwide. However, often in the backgrounds of director Miyazaki's works, which have depicted ideal worlds of nature, environment, and community as highly concentrated fantasies, lie presuppositions of war and the end of the world. As works that are especially prominent in such characteristics, there are and . These two works betray the expectations of the audience by establishing the actual wartime as the temporal background and proceeding toward narratives of reality. Trapped in the ontological identity of the director himself, the war depicted by him projects a subjective and romantic attitude. Such a problem stems also from the ambiguity of the hybrid space and time, which is basic to the steam punk genre. This is because the basic characteristic of steam punk is to transplant past time, which humans were able to control, in the future from a perspective of optimism and longing via steam engines rather than to face current problems. In this respect, steam punk animation films in themselves can be seen as having significance and limitations at the same time.