• 제목/요약/키워드: 교육과정의 변화

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Hospice and Palliative Care for the Terminal Patients with Colorectal Cancer (말기 대장직장암 환자의 호스피스 완화의료)

  • Hong, Young-Hwa;Lee, Choon-Sub;Lee, Ju-Ri;Lee, Jung-Ho;Kim, You-Jin;Lee, Tae-Kgyu;Moon, Do-Ho
    • Journal of Hospice and Palliative Care
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    • 제10권1호
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    • pp.35-42
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    • 2007
  • Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

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Regional Differentials in Mortality in Korea, 1990-2000 (사망력 수준의 시ㆍ군별 편차 및 그 변화 추이, 1990∼2000)

  • 김두섭;박효준
    • Korea journal of population studies
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    • 제26권1호
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    • pp.1-30
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    • 2003
  • This paper attempts to explore the effects of ecological and socioeconomic factors on the level of mortality and the changing trends of such effects during the period of 1990∼2000. For this purpose the population census data and micro-data from the vital statistics for years 1990, 1995 and 2000 were used. As indicators of mortality, the crude death rate(CDR), the standardized death rate(SDR) and the longevity rate were calculated for 170 'Si' s and 'Gun's. Using GIS, this paper first presents the mortality and longevity maps for years 1990, 1995 and 2000. Then ANOVA and regression analyses are carried out in an effort to generalize the effects of ecological and socioeconomic factors on the CDR, the SDR and the longevity rate. When the mortality and longevity maps are examined, three indices of mortality are found to be markedly high in the southwest coastal regions of Cholla-Nam-Do. By contrast, Seoul and Pusan metropolitan areas show substantially low level of mortality and longevity in these indices. It is also found that the regional differentials in the SDR and the longevity rate show a trend of becoming smaller after 1990. The research, however, does not find any linear relationship between the SDR and the longevity rate. The causal mechanisms of the two indices are found to be different. The results of the ANOVA and the regression analysis reveal that the locational factors of both mountainous and farming regions tend to increase the CDR and SDR while both coastal and farming regions disclose a tendency of increasing the longevity rate. The level of statistical significance of these analytical results is found to be weaker when socioeconomic factors such as education, income, marital status, availability of medical care, and sanitary conditions of the region are taken into account. The regional differentials in the mortality level seem to have a clear relationship not only with the socioeconomic factors but also with the age structure influenced by the age selectivity of migration during the past 40 years.

주거부문 행정자료의 인구주택총조사 활용방안

  • Lee, Geon;Byeon, Mi-Ri;Lee, Myeong-Jin;Seo, U-Seok
    • Proceedings of the Korean Statistical Society Conference
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    • 한국통계학회 2005년도 추계 학술발표회 논문집
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    • pp.117-120
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    • 2005
  • 인구주택총조사는 국가통계의 가장 기본이 되는 자료를 생산하는 조사로 거의 대부분의 나라에서 전수조사방식으로 정기적으로 시행해왔다. 그러나 최근 들어 일부 국가, 특히 선진국에서 응답거부가 늘고, 조사대상을 접촉하기 어려운 등 조사환경이 나빠지고 있다. 아울러 조사비용이 급격하게 증가하고 있다. 이에 각 국의 통계청에서는 이러한 상황을 인구센서스에 대한 '근본적인 도전'으로 간주하고 있다(Jensen, 2000). 심지어 독일이나 네델란드에서는 조사환경의 악화로 1990년대 이후 인구센서스를 중단한 상태이다(Bierau, 2000). 조사환경의 악화는 조사의 포괄성과 신뢰성에 대한 문제를 야기한다. 선진국들과 마찬가지로 우리나라에서도 조사환경이 빠른 속도로 악화되고 있다. 더욱이 우리의 경우 읍면동사무소 기능축소로 말미암아 과거 인구주택총조사에서 실제 조사에 도움을 주었던 행정지원이 없어짐에 따라 앞으로 조사의 어려움은 더욱 커질 것으로 보인다. 이렇듯 악화되는 조사환경변화에 대응하여 선진 국가에서는 다양한 형태의 인구센서스방식들이 모색되고 있다. 많은 나라들이 순환형 센서스보다는 행정자료를 인구주택총조사에 활용하는 방안을 모색하고 있으며, 덴마크나 핀란드 등 일부 국가에서는 이미 전혀 조사를 하지 않고 행정자료로 대부분의 인구센서스 통계를 생산하고 있다(Harala, 1996; Gaasemyr, 1999; Laihonen, 1999), 많은 나라들이 행정자료를 활용한 인구센서스 방식을 선호하는 데는 또 다른 이유가 있다. 자료의 측면에서 보면, 행정자료를 활용할 경우 매년 인구센서스 통계를 생산할 수 있다. 실제로 현재 덴마크와 핀란드는 인구센서스에 준하는 통계를 매년 생산하고 있다. 또한 이러한 자료를 바탕으로 지역통계 수요에 즉각 대처할 수 있다. 더 나아가 이와 같은 통계는 전 국민에 대한 패널자료이기 때문에 통계적 활용의 범위가 방대하다. 특히 개인, 가구, 사업체 등 사회 활동의 주체들이 어떻게 변화하는지를 추적할 수 있는 자료를 생산함으로써 다양한 인과적 통계분석을 할 수 있다. 행정자료를 활용한 인구센서스의 이러한 특징은 국가의 교육정책, 노동정책, 복지정책 등 다양한 정책을 정확한 자료를 근거로 수립할 수 있는 기반을 제공한다(Gaasemyr, 1999). 이와 더불어 행정자료 기반의 인구센서스는 비용이 적게 드는 장점이 있다. 예를 들어 덴마크나 핀란드에서는 조사로 자료를 생산하던 때의 1/20 정도 비용으로 행정자료로 인구센서스의 모든 자료를 생산하고 있다. 특히, 최근 모든 행정자료들이 정보통신기술에 의해 데이터베이스 형태로 바뀌고, 인터넷을 근간으로 한 컴퓨터네트워크가 발달함에 따라 각 부처별로 행정을 위해 축적한 자료를 정보통신기술로 연계${cdot}$통합하면 막대한 조사비용을 들이지 않더라도 인구센서스자료를 적은 비용으로 생산할 수 있는 근간이 마련되었다. 이렇듯 행정자료 기반의 인구센서스가 많은 장점을 가졌지만, 그렇다고 모든 국가가 당장 행정자료로 인구센서스를 대체할 수 있는 것은 아니다. 행정자료로 인구센서스통계를 생산하기 위해서는 각 행정부서별로 사용하는 행정자료들을 연계${cdot}$통합할 수 있도록 국가사회전반에 걸쳐 행정 체제가 갖추어져야 하기 때문이다. 특히 모든 국민 개개인에 관한 기본정보, 개인들이 거주하며 생활하는 단위인 개별 주거단위에 관한 정보가 행정부에 등록되어 있고, 잘 정비되어 있어야 하며, 정보의 형태 또한 서로 연계가 가능하도록 표준화되어있어야 한다. 이와 더불어, 현재 인구센서스에서 표본조사를 통해 부가적으로 생산하는 경제활동통계를 생산하기 위해서는 개인이 속한 사업체를 파악할 수 있도록 모든 사업체가 등록되어 있고, 개인의 경제활동과 관련된 각종 정보들이 사업체에 잘 기록 및 정비되어 있어야 한다. 따라서 행정자료 기반의 인구센서스통계생산은 단지 국가의 통계뿐만 아니라 행정조직과 행정체계를 정비하고, 개인과 사업체의 등록체계를 정비하며, 사업체의 개인에 관한 정보를 정비하여 표준화하는 막대한 작업을 수반한다. 이런 이유에서 대부분의 국가들은 장래에 행정자료 기반의 인구센서스통계생산을 목표로 하되, 당장은 행정자료를 인구센서스에 보조적 수단을 사용하는 데 노력을 기울이고 있다. 우리나라의 경우 행정자료를 인구주택총조사에 활용할 수 있는 몇 가지 중요한 기반을 갖추고 있다. 첫째, 1962년부터 시행한 주민등록제도가 있다. 주민등록제도는 모든 국민 개개인을 파악할 수 있는 주민등록번호를 갖추고 있으며 40년 이상 제도화되어 오류가 거의 없는 편이다. 둘째, 세계 10위권 내에 들 정도로 높은 우리나라의 정보화 수준과 2000년부터 시작된 전자정부사업으로 행정자료를 연계${cdot}$통합할 수 있는 기반이 잘 갖추어져 있다. 반면, 우리나라 행정자료 가운데 주거(생활)단위와 사업체를 파악할 수 있는 자료는 매우불완전하다. 대표적으로 인구센서스통계의 주요한 단위인 가구를 파악할 수 있는 수준으로 주소체계가 정비되어 있지 않으며, 많은 사업체, 특히 소규모 사업 가운데 등록되어 있지 않거나 등록오류가 많은 편이다. 이외에도 과세대장, 토지대장 등 많은 행정자료가 아직은 불완전하여 이들을 직접 연계하기에 어렵다. 행정자료를 연계하기 위해서는 모든 자료를 정비하고 표준화하여 실제 행정에 활용하여야 하기 때문에 행정적으로 많은 노력과 시간이필요하다. 따라서 현재는 손쉬운 부분에서부터 인구주택총조사에 행정자료를 활용하고, 앞으로 활용 과정을 거치면서 행정자료를 정비하고 표준화하는 장기적인 방안을 마련할 필요가 있다.

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A single case study using Contextual Support Model based music therapy intervention for a terminal pediatric patient (말기질환 아동을 위한 환경적 지지모델(The Contextual Support Model of Music Therapy)에 근거한 음악치료사례연구)

  • Jun, Mi Hye
    • Journal of Music and Human Behavior
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    • 제2권2호
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    • pp.15-31
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    • 2005
  • Terminal pediatric patient include congenital metabolic abnormalities, chromosome aberrations, congenital anomalies, neuromuscular diseases and other incurable conditions as well as malignant tumors. One third of these diseases are cancers, and two thirds of cancers are lymphadenoma and leukemia. Terminal pediatric patient may feel fear, anger and frustration against treatment process in hospitals, lose control of themselves and stay in helplessness due to restrictions within controlled hospital environment. This study examined the relationship between hospitalized childrens behavior and music using Contextual Support Model of Music Therapya theory stating therapeutic music environments possess three elements of Structure, Autonomy support and Involvement, and increase childrens active engagement. Focused on these three therapeutic elements, this study analyzed music therapy cases of terminally ill children to examine the relationship between childrens behavior and music as environmental supportive medium in the environment. This study is on a single case case subject, a 10-year-old girl with acute lymphocytic leukemia. Nine sessions of music therapy activities were conducted and analyzed using qualitative method. Focusing on three therapeutic elements of Contextual Support Model, analysis of sessions was made on the basis of activities specifically designed for this study. Main music therapy activities included singing while playing musical instruments, singing while listening to music through CD player, making up songs, and searching for song lines. The findings of this study are as follows: a) in terms of Structure, music therapy suggested a direction for effective musical activities for terminally ill children by providing environments where child can sing, play musical instruments and make up songs; b) in terms of Autonomy support, music therapy encouraged childs voluntary participation by giving her chances to make choice while singing or playing musical instruments; c) in terms of Involvement, child could gain positive approval of the therapist and conduct musical activities in cooperation with the therapist. Music therapy serves as supportive medium in the environment, develops spontaneity and self-reliance in emotionally depressed children, and promotes voluntary attitudes in the restricted hospital environment. Based on the positive effects of music therapy, more studies need to be conducted with an approach to more various terminal pediatric patients.

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South-North Legal System Division: Challenge for the Integration of Legal Systems beyond the Division of Korea (남북 법제분단: 분단을 넘어 법제통합을 위한 과제)

  • Choi, Eun-Suk
    • Journal of Legislation Research
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    • 제53호
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    • pp.61-107
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    • 2017
  • It has been seventy-two years since the Korean Peninsular was divided into South and North Korea. When Korea was liberated from Japanese colonial rule in August 1945, the South and North established a capitalist system and a socialist system (communism) respectively, intensifying the ideological conflict and confrontation. The division of Korea was not confined to political and economical aspects, but extended to legal system, making it difficult to find legislative homogeneity in the two. The long-term situation of the divided nation results in a social phenomenon accompanied by legal division. For instance, shortly after its liberation from Japan's colonial rule, North Korea responded quickly to secure legal stability to govern the northern part while the Soviet army troops were stationed in it. Based on Marx and Engels' historical materialism, the North drove a change in its ideological superstructure by repealing the privatization of land property which was the means of production and finally enforced land nationalization, in common with other socialist states including the former Soviet Union. The North's land reform made under the guise of fulfilling national independence and doing away with anti-seigneurial and anti-feudalistic relations, has led to a wide difference in the systems between the South and Korea. This paper focuses on the legal systems of South and North Korea and is aimed at exploring the legal characteristics and environment of the North which became secluded from the world while engaging in socialist experiments for the past seventy two years against capitalism. Ongoing studies of legal system integration will be briefly discussed. The legal status of South and North Korea as a political entity will be investigated to overcome legal system division; and the characteristics of South-North relationship in legal terms and the limitations of the North's legal system will be also examined. Moreover, the directions for integrating legal systems and the plan for resolving legal system division will be suggested.

Assessing Middle School Students' Understanding of Radiative Equilibrium, the Greenhouse Effect, and Global Warming Through Their Interpretation of Heat Balance Data (열수지 자료 해석에서 드러난 중학생의 복사 평형, 온실 효과, 지구 온난화에 대한 이해)

  • Chung, Sueim;Yu, Eun-Jeong
    • Journal of the Korean earth science society
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    • 제42권6호
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    • pp.770-788
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    • 2021
  • This study aimed to determine whether middle school students could understand global warming and the greenhouse effect, and explain them in terms of global radiative equilibrium. From July 13 to July 24 in 2021, 118 students in the third grade of middle school, who completed a class module on 'atmosphere and weather', participated in an online assessment consisting of multiple-choice and written answers on radiative equilibrium, the greenhouse effect, and global warming; 97 complete responses were obtained. After analysis, it was found that over half the students (61.9%) correctly described the meaning of radiative equilibrium; however, their explanations frequently contained prior knowledge or specific examples outside of the presented data. The majority of the students (92.8%) knew that the greenhouse effect occurs within Earth's atmosphere, but many (32.0%) thought of the greenhouse effect as a state in which the radiative equilibrium is broken. Less than half the students (47.4%) answered correctly that radiative equilibrium occurs on both Earth and the Moon. Most of the students (69.1%) understood that atmospheric re-radiation is the cause of the greenhouse effect, but few (39.2%) answered correctly that the amount of surface radiation emitted is greater than the amount of solar radiation absorbed by the Earth's surface. In addition, about half the students (49.5%) had a good understanding of the relationship between the increase in greenhouse gases and the absorption of atmospheric gases, and the resulting reradiation to the surface. However, when asked about greenhouse gases increases, their thoughts on surface emissions were very diverse; 14.4% said they increased, 9.3% said there was no change, 7.2% said they decreased, and 18.6% gave no response. Radiation equilibrium, the greenhouse effect, and global warming are a large semantic network connected by the balance and interaction of the Earth system. This can thus serve as a conceptual system for students to understand, apply, and interpret climate change caused by global warming. Therefore, with the current climate change crisis facing mankind, sophisticated program development and classroom experiences should be provided to encourage students to think scientifically and establish scientific concepts based on accurate understanding, with follow-up studies conducted to observe the effects.

Qualitative Study on Experiences of Responding to COVID-19 of Therapists in Long-term Care Hospitals (요양병원 치료사의 코로나19 대응 경험에 대한 질적 연구)

  • Bae, Won-Jin;Park, Ju-Young
    • Journal of Korea Entertainment Industry Association
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    • 제15권4호
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    • pp.337-347
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    • 2021
  • This study is a qualitative study conducted to provide basic data for therapists working in long-term care hospitals to improve their countermeasure strategies for new infectious diseases and improvement of the treatment room infection management system, and to help therapists understand their infection management work. Colaizzi's phenomenological research method was applied as the research method. Telephone interviews were conducted with nine occupational therapists and physical therapists working in nursing hospitals. The contents of the interview were recorded with the consent of the study subjects, and additional confirmation was received by email. The recorded content was analyzed after transcription, and the meaning and nature of the experience coping with COVID-19 were described. The content was organized into 6 themes, 17 main meaning and 49 meaning units. In accordance with the COVID-19 situation, the infection control system has been strengthened by reinforcing infection control education in nursing hospitals, practicing infection control, and supervising infection control outside business hours. It was found that the treatment environment was changed due to the restriction of treatment activities by practicing distancing in the treatment room, adjusting rest and meal times during working hours, and strengthening infection control. In addition, the therapist's role has been expanded and the paradigm of treatment has changed, such as considering the untact intervention, and they have experienced cohort quarantine, pre-tested for COVID-19, vaccinations, and side effects from COVID-19. However, due to the infection work, the therapist's work burden is increased, and the person is experiencing fear, depression, and work stress from the spread of COVID-19. They were also aware of the need for nursing hospital care personnel support, such as guaranteeing rest after vaccination and providing infection control tools and equipment. The results of this study are expected to be used as basic data for human and physical support for the development of infectious disease response strategy programs in nursing hospital treatment rooms and for infection control in nursing hospitals.

Perception of Korean Residential Gardens and Gardening in the 1920~30s (1920~30년대 한국 주택정원 인식과 정원가꾸기 양상)

  • Gil, Jihye;Park, Hee-Soung
    • Journal of the Korean Institute of Landscape Architecture
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    • 제50권2호
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    • pp.138-148
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    • 2022
  • The 1920s and 1930s were when new trends became prominent in Korean housing architecture. This study began with a curiosity about the appearance of residential gardens during the transition period, when housing types were changing. Since gardens are constantly evolving and living spaces, it is not easy to give a clear picture of their evolution. However, through popular magazines and newspaper articles published in the 1920-30s, this study investigated how people perceived the gardens socially and how they engaged in gardening. First, the study of Gyeongseong's urbanization process revealed that people perceived gardens as a way to give natural beauty to the urban environment. Therefore, the creation of a residential garden was strongly encouraged. Second, the housing improvement movement, which the architects actively discussed during this period, emphasized that a garden is a factor that can help improve the quality of the residential environment in terms of hygiene and landscape aesthetics. Third, since the media provided information on gardening, it was confirmed that the number of people engaged in gardening as a hobby increased. As designers and gardeners who had received a modern education became more active, the concept of "designed gardens" was formed. Lastly, although the houses were divided into various types, the shapes of the gardens did not show a significant difference according to the architecture type. They tended to embrace the time's ideal garden design and style. Therefore, even in a traditional hanok, Western-style gardens were naturally harmonized into the overall architecture, and exotic plant species could be found. Although the gardens found in media images were limited to those belonging to the homes of the intelligentsia, it can be seen that representativeness was secured, considering the popularity and ripple effect of the media. Therefore, this study contributes to the literature as it confirmed the ideal gardens and gardening methods in the 1920s and 30s.

Comparison of Dietary Patterns, Health, and Blood Parameters of Elderly Women and College Women in the Seoul Area (노화 과정에 따른 노인과 여대생의 식생활, 건강 상태 및 혈액 성상 비교 연구)

  • Shin, Kyung-Ok;Chung, Keun-Hee;Choi, Kyung-Soon
    • Journal of the East Asian Society of Dietary Life
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    • 제19권5호
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    • pp.703-712
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    • 2009
  • The principal objective of this study was to supply basic material determine basic information regarding effective health promotion regimens for elderly women via a comparative survey of health status by aging age between elderly women (=70 y) and college women. The subject groups of elderly women (=70 y) and college women were selected and surveyed from March to October, 2008, in the Seoul area. The average age of the elderly women assessed in this study was $78.64{\pm}7.30$, the average height was $147.07{\pm}5.72$ cm, and the average weight was $50.47{\pm}7.44$ kg. As compared with college women, a higher percentage of elderly women ate breakfast regularly, but the elderly women also experienced difficulties in chewing due to dentures, and therefore ate their meals with large quantities of liquids, and usually ate their meals within 10 minutes. The majority of elderly women suffered from at least one disease, and the most common symptom reported was hypertension (25%). 52.2% of elderly women and 47.8% of college women reported that they exercised 1~2 times per week. They reported that their favorite exercise was light exercise, such as jogging and athletics (73.1%). As compared with college women, the smoking rate was lower among elderly women, but some of the elderly women were long-time smokers or alcoholics. The differences in red blood cells counts, Hb, hematocrit, and MCV of the between elderly women and college women were significant. In addition, but the MCH and MCHC were higher in elderly women compared with college women and the total cholesterol of elderly woman ($175.62{\pm}38.89$ mg/dL) was significantly lower compared with college woman ($186.13{\pm}28.19$ mg/dL). TG ($127.89{\pm}51.25$ mg/dL) and LDL-cholesterol ($120.51{\pm}32.88$ mg/dL) of elderly woman were significantly higher than TG ($79.71{\pm}40.9$ 6mg/dL) and LDL-cholesterol($103.78{\pm}22.94$ mg/dL) of college woman (p<0.05). The levels of HDL-cholesterol ($58.78{\pm}12.90$ mg/dL) in the college women was significantly higher than the HDLcholesterol levels ($48.17{\pm}13.79$ mg/dL) of the elderly women (p<0.05). Serum vitamin C levels in elderly women were significantly higher than those of college women (p<0.05), whereas no significant difference was detected between the two groups. Consequently, it can be concluded that the appropriate education programs for dietary habits and health promotion are necessary for a healthier life. Additionally, it is necessary for individuals to precisely determine precisely their own health status, and develop appropriate dietary programs for themselves.

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Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • 제32권4호
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.