• The Korean Society of Law and Medicine
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• v.15 no.1
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• pp.335-373
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• 2014

According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

• Journal of agricultural medicine and community health
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• v.20 no.1
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• pp.1-13
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• 1995

Based on the questionnaires sent to 270 nurses of public health centers in kyungnam during the period of March 19 to April 11 in 1992, this study was written for the of finding out the grade of satisfaction, obstacles in carrying out duties concerned with nursing services and the change of nurses role needed according to the change of the local public health administration. The first-ranking tasks carried by nurses of public health center are believed to have been family planning activities before the 1970's, nursing services during the 1970's, mother-child health activities during the 1980's, and nursing services during the period of 1990 to 1992. As far as the priority order of all the family planning activities is concerned, the counseling of the insertion of intrauterine contraceptive device, the use of oral pill or the distribution of condom was placed emphasis on before 1970, and publicity activities of family planning after that time. The first priority order of mother-child health activities has been put on the registration of pregnant women since 1970, with prenatal examination and vaccination ranking next to it. The priority order for activities against tuberculosis was laid on finding out and registration of new T.B. patients every year, with patients' control, and medication or injection ranking next to it. As for the priority order of nursing services, traveling medical examination and treatment ranked the first-stressed activity before 1970, with medication and injection ranking next to it. The first priority order management activity of communicable diseases was put on vaccination before 1970, with medication and injection. ranking next. And consultation and education ranked second to it during 1990 to 1992. As for the health services of the aged, traveling examination and treatment ranked the order, with the assistance of medical examination ranking next to it. As far as troubles and obstacles shown in case of family planning, the rate of residents' lack understanding was 28.8%, that of lacking budget 13.6%, and the imperfection of public health administration system 11.9%. In the case of tuberculosis control, residents' lacking understanding was 32.5%, the deficiency of public health administration system 18.2%, over-duty(shortage of hands) 15.6%, and the insufficiency skill and know-how 13.0%. In the case of nursing services, the deficiency of public health administration system was 18.2%, each over-duty(the shortage of hands) and the shortage of facilities and equipment 15.6% respective, and residents' lacking understanding 13.0%. The rate of dissatisfaction with the chance or possibility of promotion for his or her career or capability was shown to be 49.2%, and 65.9% of the health nurses expressed their complaints of the deficiency of the chance of the promotion to a professional or expert. when the public health nurses were asked in the questionably whether they were satisfied or not with current state of equipment and facilities needed for public health service, 49.6% of them answered in the negative. The grade of the satisfaction with the current individual position was shown to be low as much as the status of his or her position was now. 37.6% of those asked in the research answered to have the readiness to switch jobs for the reasons of dissatisfaction and so on with lacking promotion chance as well as bad working condition. Significant correlation between the grade of job satisfaction and the current status of the po as found to be in this research, which showed that the lower the status of position was, the lower the grade of job satisfaction was. But little correlation between the grade of job satisfaction and his or her schooling and career was found. In order to carry out primary health care successfully, it can be said that more education and publicity activities to make public health nurses and residents see it in a new light are requested. In addition to it, it is suggested that the improvement of promotion system for public health nurses and the enlargement of job province should also be taken in consideration of the high dissatisfaction with and complaints of the chance of promotion and the system of position. In order words, it is important that considerations for system improvement enough to make nursing services pleasant and satisfactory should be taken into.

• Reproductive and Developmental Biology
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• v.31 no.3
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• pp.161-167
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• 2007

In this study, we constructed and tested retrovirus vectors designed to express the human thrombopoietin gene under the control of the tetracycline-inducible promoters. To increase the hTPO gene expression at him-on state, WPRE sequence was also introduced into retrovirus vector at downstream region of either the hTPO gene or the sequence encoding reverse tetracycline-controlled transactivator (rtTA). Primary culture cells (PFF, porcine fetal fibroblast; CEF, chicken embryonic fibroblast) infected with the recombinant retrovirus were cultured in the medium supplemented with or without doxycycline for 48hr, and induction efficiency was measured by comparing the hTPO gene expression level using RT-PCR, western blot and ELISA. Higher hPTO expression and tighter expression control were observed from the vector in which the WPRE sequence was placed at downstream of the hTPO (in CEF) or rtTA(in PFF) gene. This resulting tetracycline inducible vector system may be helpful in solving serious physiological disturbance problems which have been a major obstacle in successful production of transgenic animals.

• Journal of Korean Home Economics Education Association
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• v.32 no.4
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• pp.81-101
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• 2020

The purpose of this study is to develop and implement a process-based evaluation program with the theme of school space design in the housing area of the middle school home economics. In order to achieve For thispurpose, a process-based evaluation program based on the theme of school space design was developed following the ADDIE instructional design model, and the program was executed to a total of 93 students. A questionnaire survey and in-depth interview were conducted for the evaluation of the program. The results of this study are as follows. First, based on the results of a 2015-Revised Curriculum analysis, a school space design program evaluation plan was established, and two evaluation tasks were developed. Accordingly, scoring criteria were prepared and 8 evaluation materials for students and 2 evaluation materials for teachers were developed. A total of 9 sessions were developed for teaching and learning activities and evaluation-linked operation procedures to perform evaluation tasks. As a result of an expert validity test for the program, all items were verified to be appropriate in content validity and content composition with an average of 3.6 to 4 points (4 points). Second, after conducting the school space design program, a survey on students were conducted, and as a result, all three areas of school space design class, process-based evaluation, interest scored high in average scores of 4.12 to 4.27 out of 5. According to the survey and interview results, the program provided new learning opportunities for school space design, the students were able to reach the suggested achievement goals, and the self-assessment, peer evaluation and teacher feedback positively affected the students during the learning process so that they could reflect on their learning and actively participate in the subsequent learning activity. This study has a limitation in generalizability in that the program was conducted on a limited number of students, and future studies are expected to expand the scope in terms of research participants, evaluation criteria, and school space design classes. This study laid the foundation for theory and practice by developing and implementing a process-based evaluation program for home economics education, and it has contribution in that it suggested the possibility that teachers and students can take the initiatives in school space design, focusing on the housing content elements of home economics.

• Journal of Korea Port Economic Association
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• v.39 no.1
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• pp.65-100
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• 2023

This study examines the effects of organizational trust of the container terminal operators' employee on organizational citizenship behavior and the moderating effect of organizational support in the relationship between the two variables. In order to efficiently achieve the purpose of this study, an empirical analysis was conducted by distributing a literature review and a questionnaire, and the results of the study are as follows... First, the organizational trust of the container terminal operators' employee was found to have a significant positive (+) effect on organizational citizenship behavior, and trust in the company appeared to be more important than trust in the superior, indicating trust in the institutional aspect. This means that formation has more influence on organizational citizenship behavior... Second, it was confirmed that the organizational support of the container terminal operators' employee can lead to active participation in organizational citizenship behavior through the expansion of educational compensatory support. Third, among the organizational support of container terminal operators, emotional support and educational compensatory support were found to have a partial moderating effect on the relationship between organizational trust and organizational citizenship behavior." Emotional support has a moderating effect on caring and active participation behaviors in the relationship between trust in the company and organizational citizenship behaviors, and a moderating effect on caring, active participation, and non-complaining behaviors in the relationship between trust in superiors and organizational citizenship behaviors. It was analyzed that there is Compensatory educational support has a moderating effect on altruistic, caring, active participation, and non-complaining behavior in the relationship between trust in the company and organizational citizenship behavior. It was analyzed that there was a moderating effect on active participation and non-complaining behavior. These analysis results mean that members' trust in the company further increases through the container terminal operator's emotional support and educational reward support. As uncertainty grows, it is very important to increase the trust of organizational members in the organization. sense of belonging to the organization, Emotional support that can increase immersion, improvement of work environment, provision of educational opportunities, and education-compensatory support such as a fair compensation system will increase organizational trust and induce effective organizational citizenship behavior to realize sustainable growth of the organization.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.503-515
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• 1998

In order to investigate the factors influencing QOL and life satisfaction of the physically disabled, the author interviewed, by using structuralized questionnaire, 440 individuals among the physically disabled who were participated in Health Examination from April to July, 1997. The questionnaire consisted of the general characteristics(sex, age, marital status, family number, etc), the Reintegration to Normal Living Index(RNLI) to assess QOL, and the single item of five-likert scale to evaluate life satifaction. The means of RNLI were $16.2{\pm}4.8$ in total score, $12.2{\pm}3.4$ in daily functioning and $4.0{\pm}2.1$ in perception of self. The respondents were less reintegrated toward social activities and relationships than impairments or disabilities. While the satisfied group was 47.3%, the dissatisfied group was 52.7%. As the results of multiple regression and logistic regression analysis, the significant predictors of QOL were age, education, job, grade of disability and subjective health status. The life satisfaction were related to economic status, job and subjective health status. To improve QOL and life satisfaction of the physically disabled, it is important that we improve their basic socioeconomic status by getting a job through rehabilitation education and induce them to have positive self-assessment by extending the opportunity of social participation.

• Journal of dental hygiene science
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• v.15 no.3
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• pp.361-368
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• 2015

The study was conducted to provide data for the development of effective medical conflict prevention programs for dental hygiene by analyzing the dental experience conflicts. A self-administered questionnaire survey was conducted targeting dental hygienists who were performing dental assistance at university hospital, dental hospital and dental clinic in Busan and Gyeongnam regions from April 1 to 30, 2014. Collected questionnaires of 212 dental hygienists were then analyzed with IBM SPSS Statistics ver. 20.0 program. A total of 59.4% had experienced complaints, discontents and medical disputes and 24% of these had experienced a legal trouble developed from such and 95.3% were anxious and doubtful about a possible future medical dispute to some degree. Patient complaints, complaints of non-medical issues raised by 24.3% was the most common, notices, maps and descriptions in relation to the issues raised by 14.4%, is related to the impression issue was raised in the order of 13.5%. Occurrence of disputes did not show a significant difference by place of work, however, a possibility of development of dispute into a legal proceeding showed a significant difference depending on service career and it was investigated that the experienced group feels more pressures with regard to a medical dispute according to their experience of such. All respondents said that education on a prevention and countermeasures of medical disputes is necessary. Understanding of dental hygienists on medical related laws regarding the scope of duty is required to be enhanced and, in order to do so, opportunities to receive an education with regard to a prevention and countermeasures of medical disputes are to be expanded.

• Journal of Korean Home Economics Education Association
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• v.20 no.1
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• pp.45-62
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• 2008

The purpose of this study was to investigate middle school home economics(HE) teachers' perception and needs on self supervision related to HE subject matter, Using the methods of survey and interview, 177 samples were collected. For collected surveys, mean value, standard deviation, frequency, percentage analysis were performed by using an SPSS/Win (ver10.1) program. The results of this study were as follows. First, the middle school HE teachers recognized that self supervision related to HE subject matter was absolutely needed to expand the improvement of techniques for teaching instructions and the width of knowledge on the studies on textbook. Second, the middle school HE teachers recognized the necessary parts of self supervision related to HE subject matter as HE teaching-learning methods, the studies on textbook contents, and HE education philosophy in order. Third, the middle school HE teachers recognized that it would be helpful in improving their HE class and expertise in order of field survey, participation in various training programs, utilization of mass media, participation in societies for researches and meetings and information sharing with co-teachers among the types of self supervision. Fourth, the middle school HE teachers needed the reduction in miscellaneous duties, less pressure for time, restoration of teachers' desire, support of physical resources (improvement of various environments such as classrooms and special rooms), economic support and various support programs (expanding the opportunities to participate in training and society and establishment of a database for relevant materials, etc.) to facilitate self supervision. As such, the middle school HE teachers' overall recognition on HE-related self supervision became significantly higher. To enhance the HE-related expertise, however, it would be necessary to conduct concrete and active support for HE education, philosophical area and the studies on textbook contents as well as the teaching-learning methods for HE in which teachers' demand was high. In addition, the HE teachers wanted to have an easy and quick access to various HE-related data; therefore, it would be urgent to summarize scattered relevant data and support the HE teachers more systematically.

• Journal of the Korean Wood Science and Technology
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• v.49 no.6
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• pp.616-642
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• 2021

Improving public awareness of wood is essential for achieving the goal of establishing wood culture by expanding the use of wood. This study presents a basic examination of the strategy of revitalizing wood culture and a survey of its current status and requirements. The survey was divided into seven categories: awareness of wood culture; use characteristics of wood culture; preference and demand for wood culture; awareness of sub-fields of wood culture; awareness of the cultural resources of wood; trends of wood utilization; and wood-related living environment. Based on the survey results, the study analyzed four items: awareness of wood and cultural experience; awareness of the cultural resources of wood; wood-related living environment and trends of wood utilization; and preference and demand for wood culture. In this study, the public awareness of wood and cultural experiences, the first of four items, was analyzed using the survey results. Generally, wood and wood culture are viewed as materials and a cultural heritage, respectively. Moreover, wood is ecofriendly. However, no substantial difference was observed between the two perceptions. Forty-five percent of the respondents reported that using wood exerts a positive effect on the body and mind. However, such use also destroys forests. Additionally, the recognition of wood-related workers, such as engineers or skilled workers, was relatively low compared with educators, such as wood education experts. Moreover, less than 50% of the respondents answered that major projects related to wood culture are well-known, whereas 30% participated in wood education, such as woodworking experience, where the majority required hand tools. Furniture, wooden accessories, and wooden buildings were among the objects that individuals intended to make through the wood culture program. Approximately 23% of the respondents were aware about the wood culture experience center, while approximately 50% had visited it. The response rate to woodworking technology was 73%, where the highest response was found for wood education experts. To improve public awareness about wood, the importance of entertainment factors over educational factors should be considered in the experience of individuals. To provide opportunities to experience wood culture for more individuals, developing and actively promoting various contents, including entertainment elements, are necessary.

• Journal of Korean Home Economics Education Association
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• v.24 no.2
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• pp.117-134
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• 2012

The purpose of this study was to identify the stage of concern, the level of use, and the innovation configuration of Home Economics teachers regarding creativity and personality education in Home Economics(HE) classes. The survey questionnaires were sent through mails and e-mails to middle-school HE teachers in the whole country selected by systematic sampling and convenience sampling. Questionnaires of the stages of concern and the levels of use developed by Hall(1987) were used in this study. 187 data were used for the final analysis by using SPSS/window(12.0) program. The results of the study were as following: First, for the stage of concerns of HE teachers on creativity and personality education, the information stage of concerns(85.51) was the one with the highest response rate and the next high in the following order: the management stage of concerns(81.88), the awareness stage of concerns(82.15), the refocusing stage of concerns(68.80), the collaboration stage of concerns(61.97), and the consequence stage of concerns(59.76). Second, the levels of use of HE teachers on creativity and personality education was highest with the mechanical levels(level 3; 21.4%) and the next high in the following order: the orientation levels of use(level 1; 20.9%), the refinement levels(level 5; 17.1%), the non-use levels(level 0; 15.0%), the preparation levels(level 2; 10.2%), the integration levels(level 6; 5.9%), the renewal levels(level 7; 4.8%), the routine levels(level 4; 4.8%). Third, for the innovation configuration of HE teachers on creativity and personality education, more than half of the HE teachers(56.1%) mainly focused on personality education in their HE classes; 31.0% of the HE teachers performed both creativity and personality education; a small number of teachers(6.4%) focused on creativity education; the same number of teachers(6.4%) responded that they do not focus on neither of the two. Examining the level and type of performance HE teachers applied, the average score on the performance of creativity and personality education was 3.76 out of 5.00 and the mean of creativity component was 3.59 and of personality component was 3.94, higher than standard. For the creativity education, openness/sensitivity(3.97) education was performed most and the next most in the following order: problem-solving skill(3.79), curiosity/interest(3.73), critical thinking(3.63), problem-finding skill(3.61), originality(3.57), analogy(3.47), fluency/adaptability(3.46), precision(3.46), imagination(3.37), and focus/sympathy(3.37). For the personality education, the following components were performed in order from most to least: power of execution(4.07), cooperation/consideration/just(4.06), self-management skill(4.04), civic consciousness(4.04), career development ability(4.03), environment adaptability(3.95), responsibility/ownership(3.94), decision making(3.89), trust/honesty/promise(3.88), autonomy(3.86), and global competency(3.55). Regarding what makes performing creativity and personality education difficult, most HE teachers(64.71%) chose the lack of instructional materials and 40.11% of participants chose the lack of seminar and workshop opportunity. 38.5% chose the difficulty of developing an evaluation criteria or an evaluation tool while 25.67% responded that they do not know any means of performing creativity and personality education. Regarding the better way to support for creativity and personality education, the HE teachers chose in order from most to least: 'expansion of hands-on activities for students related to education on creativity and personality'(4.34), 'development of HE classroom culture putting emphasis on creativity and personality'(4.29), 'a proper curriculum on creativity and personality education that goes along with students' developmental stages'(4.27), 'securing enough human resource and number of professors who will conduct creativity and personality education'(4.21), 'establishment of the concept and value of the education on creativity and personality'(4.09), and 'educational promotion on creativity and personality education supported by local communities and companies'(3.94).