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Recognition of Advance Directives by Advanced Cancer Patients and Medical Doctors in Hospice Care Ward (호스피스병동 말기 암 환자 및 내과의사의 사전의료지시(서)에 대한 인식)

  • Sun, Der-Sheng;Chun, Yeon-Joo;Lee, Jeong-Hwa;Gil, Sang-Hyun;Shim, Byoung-Yong;Lee, Ok-Kyung;Jung, In-Soon;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.12 no.1
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    • pp.20-26
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    • 2009
  • Purpose: We undertook this study to find out the recognitions of terminal cancer patients and doctors about advance directives (ADs), of how they would do in non-response medical conditions and whether ADs could be one of medical options for their dying with dignity. Methods: One hundred thirty four cancer patients in the Hospice Unit, St. Vincent's Hospital, and 97 medical doctors in the Department of Internal Medicine, Catholic Medical Center, were asked about ADs, including Do-Not-Resuscitate (DNR), medical power of attorney, living will and medical options. Results: One hundred thirty patients (97%) and 38 doctors (39.2%) were unfamiliar with ADs, however, 128 patients (95.5%), 95 doctors (97.9%) agreed with it. Seventy nine patients (59.0%) and 96 doctors (99.0%) wanted DNR rather then intensive treatments if they were in non-response medical conditions. Eighty four patients (62.7%) and 75 doctors (77.3%) were agreeable to medical power of attorney. One hundred Thirty four patients (100.0%) and 94 doctors (96.9%) did not want medical options to be in terminal conditions, and hoped to die in peace. Conclusion: Most of patients did not know about ADs and how to make it. However, they showed positive attitudes about it. If we advertise it properly, it is highly likely that a large number of cancer patients would make their living wills easily by ADs. Nevertheless, many legal and ethical problems have to be solved. Doctors should engage their patients in an ongoing communication about the end-of-life. Therefore, let the patients have opportunities to plan their own deaths.

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An Analysis on the Current Status of Daily Outdoor Play Parents Recognize (Focused on Gyeonggi-do) (부모가 인식하고 있는 일상적 바깥놀이 실태 분석 (경기도를 중심으로))

  • Kim, Yong-Sook;Yoon, Hee-Bong;Yoo, Ji-Eun
    • The Journal of the Korea Contents Association
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    • v.17 no.12
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    • pp.461-472
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    • 2017
  • The purpose of this study is to analyze the current status and condition of children's playgrounds in K which parents recognize as in Gyeonggi-do and provide basic data for the qualitative environment for daily outdoor play of young Children. To do so, a survey of 269 parents living in Gyeonggi-do was conducted and reconstructed based on the advanced research related to outdoor play. Also it was evaluated and revised after consultation with 3 children education specialists. The repossessed questionaries were frequency-analyzed with SPSS 20.0 program. The result of the analysis on outdoor playgrounds is in the following. First of all, it was analyzed that parents required 1 or 2 hours for their children to play outdoors in a type of "forest playgrounds." Moreover, they said that it was really important for the children to feel "interesting and funny" during the outdoor play, and they recognized that the play would be helpful for the children's socialization. However, they felt that a risk factor of the outdoor play was "a vehicle risk in streets." Secondly, the study suggested that there were outdoor playgrounds around parents' houses, and a type of the outdoor play was "a playground installed in the apartment complex." Furthermore, most of the parents weren't satisfied with the outdoor play because the apartment neglected the management of the playgrounds, and there were no playing facilities that were good enough to derive children's curiosity and adventurous spirit. The result also showed that most of the children played outdoors with "their mothers," and they participated in indoor activities, especially playing a game or watching TV rather than outdoor activities after attending a children educational institute. Lastly, when it comes to areas of outdoor play to be improved, it was necessary to "expand playgrounds that children can use for each season," build "safe playgrounds" for a type of the outdoor play," provide "playing spaces" for a spatial type, and "control vehicles around the playgrounds and deal with dangerous things" to prevent safety accidents. The result can expand the understanding of outdoor play for Young Children and offer discussions about the relevant organizations and studies.

The Problems and Improvement Measures of Protection for Politician (정치인 경호제도의 문제점 및 개선방안)

  • Jo, Sung-Gu;Kim, Tae-Min
    • Korean Security Journal
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    • no.22
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    • pp.169-196
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    • 2010
  • Although more priority is given to politicians from the aspect that they represent people and decide the future of country, the current situation is that politicians are not free from terrorism because of insufficient guard-concerned law, negative social recognition and increased crime and terrorism. The measure for politician terrorism shall be handled from the aspect of national security rather than public peace. For the purpose, basic legal foundation shall be prepared and specialized guard technique considering specialty of politician shall be established. Basic solution shall be established by reinforcing law against politician terrorism and establishing new law from the national viewpoint. The guard for politician has two faces that both of safety of guard target and voting intention of voter shall be met at the same time. Although special guard technique is required for guarding politician, current situation is that it is not researched professionally. In relation to the measure to develop the system of protection for politician, First, the study suggested legal foundation for politician guard. Although the 17th National Assembly proposed revised legal plan to protect politician from terrorism, it is suspended, expired and abolished now. The legal plan presented by members of the National Assembly was simply restricted to the scope of public guard. The study divided establishment of legal foundation into two things. The first one is the dispatch type of effective public guard and the second one is the transfer to private guard. Second, the study suggested environmental development method of politician guard. in the environment of politician guard, the study suggested improvement and development method by analyzing social recognition, politician's mind and voter's mind psychologically. After the beginning of human society, if human race is continued, political activity won't disappear. It is obvious that the safety of political leader is very important issue for human race because he plays the role to decide the future of human. In the future, more specialized, effective law shall be prepared and deeper study of scholar shall be performed.

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U.S. Admiralty Jurisdiction over aviation claims (항공사고에 관한 미국 해사법정관할)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.31 no.2
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    • pp.3-35
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    • 2016
  • The United States Constitution gives power to the federal district courts to hear admiralty cases. 28 U.S.C. §.133, which states that "The district courts shall have original jurisdiction, exclusive of the Courts of the States, of any civil case of admiralty or maritime jurisdiction." However, the determination of whether a case is about admiralty or maritime so that triggers admiralty jurisdiction was not a simple question. Through numerous legal precedents, the courts have drawn a line to clarify the boundary of admiralty cases. This unique jurisdiction is not determined by the mere involvement of a vessel in the case or even by the occurrence of an event on a waterway. As a general rule, a case is within admiralty jurisdiction if it arises from an accident on the navigable waters of the United States (locus test) and involves some aspect of maritime commerce (nexus test). With regarding to the maritime nexus requirement, the US Supreme Court case, Executive Jet Aviation, Inc. v. City of Cleveland, held that federal courts lacked admiralty jurisdiction over an aviation tort claim where a plane during a flight wholly within the US crashed in Lake Erie. Although maritime locus was present, the Court excluded admiralty jurisdiction because the incident was "only fortuitously and incidentally connected to navigable waters" and bore "no relationship to traditional maritime activity." However, this historical case left a milestone question: whether an aircraft disaster occurred on navigable water triggers the admiralty jurisdiction, only for the reason that it was for international transportation? This article is to explore the meaning of admiralty jurisdiction over aviation accidents at US courts. Given that the aircraft engaged in transportation of passenger and goods as the vessels did in the past, the aviation has been linked closely with the traditional maritime activities. From this view, this article reviews a decision delivered by the Seventh Circuit regarding the aviation accident occurred on July 6, 2013 at San Francisco International Airport.

Clinical Features and Management of Multidrug-Resistant Tuberculosis (다제 내성 폐결핵 환자의 임상상 및 치료에 대한 고찰)

  • Lee, Jae-Cheol;Lee, Seung-Jun;Kim, Gye-Soo;Yoo, Chul-Gyu;Cheong, Hee-Soon;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.1
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    • pp.14-21
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    • 1996
  • Objectives: Although outbreak of MDR Tb has been a recent problem in western countries, it has been a longstanding problem in Korea. The poor outcome of MDR Tb is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. Thus, to improve the outcome of MDR Tb, it is crucial to make individualized adequate prescription based on the knowledge of the patterns of resistance to each drugs in the community as well as the natural history. The purpose of present study is to evaluate the clinical features of Korean MDR Tb patients including patterns of drug resistance and success rate of treatment which was prescribed according to the sensitivity tests. Methods: Retroscpective analysis of 71 Korean patients with MDR Tb was made. All strains isolated from patients showed resistence to at least two first line drugs. Patients profile, previous treatment history, patterns of drug resistance, outcome of treatment was analysed. Initial treatment regimen was selected according to the previous treatment history and was modified according to the sensitivity reports. The regimen was composed to include at least 4 sensitive drugs when possible. Results: The patients showed resistance to 4.1 drugs on average. 90% of them were resistant to INH and RFP. Among 71 patients, 35 patients(49%) had cavitary lesions in CXR. Treatment outcome was analysed in 55 patients. 35 patients(67%) were improved after treatment and 18 patients(33%) showed treatment failure. 5 patients showed primary resistance. Treatment outcome could be evaluated in 4 of them and all showed improvement after treatment. 14 patients(20%) had to change their regimens due to drug side effects. The most frequent side effect was elevation of liver enzymes(6 patients). Others included dizziness, hyperuricemia, tinnitus, skin rash, GI troubles. More than 50% of side effects developed within 3 months. In repeated drug sensitivity test, the concordance rate of resistance to INH was 100% and RFP 98%. EMB, PZA showed 80% concordance rate. But in the other drugs, the concordances were less than 50%. Operation was done in 5 patient - 1 patients as a adjunctive means of chemotherapy -. In that case, negative conversion of sputum AFB was done. Conclusion: 2/3 patients of multidrug-resistant tuberculosis were improved by appropriate prescription and regular medication suggesting that more aggressive management and monitoring is indicated in multidrug-resistant tuberculosis.

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Employment Rate of Graduates of Agricultural Science Colleges in the Fields of Agro-industry (농학계열 대학 졸업생의 농산업 분야 취업률)

  • Kim, Jung Tae;Bae, Sung Eui
    • Journal of Agricultural Extension & Community Development
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    • v.21 no.4
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    • pp.1093-1124
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    • 2014
  • Studies on the role of agricultural science colleges are mostly divided into agricultural production, which is the primary function of agriculture, and other functions, which have recently begun to be emphasized as a result of social needs. With the green revolution and the aging of the farming population, there is a strong view that the role of agricultural science colleges should remain as it is. However, agriculture is expanding in terms of concept and content by converging with other industries not traditionally associated with agricultural production. Thus, the fields that now need to form part of agricultural science knowledge are becoming more detailed and expansive. The government's perception remains at the level of merely fostering farmers. This was evident in a survey on the employment rate, a factor used to evaluate colleges, in which the role of agricultural science colleges was limited to fostering farmers. Agro- industry fields, other than agriculturalists, include general industries in which the academic fields of agricultural science are combined with other academic fields. Thus, even when someone is employed in an industry that requires background knowledge of agricultural science, there is often a perception that he or she is employed in a field that is irrelevant to the major. This study examines the role of agricultural science colleges in agriculture and farm villages by focusing on the employment of graduates of these colleges within agro-industry. We categorize academic research on agricultural science into 16 fields, based on the medium level of the National Standard Science and Technology Classification Codes. Then, we categorize the employment fields into 168 fields, based on the small classification level of the inter-industry relations classification. Thus, we investigate 220 departments of 37 colleges, nationwide. Our findings show that the average employment rate of graduates of agricultural science colleges is 69.0%. Furthermore, 33.0% of all employees work in agro-industry fields that require background knowledge in agricultural science, which is one out of three job seekers. Then, 3.6% of employees work in business startups in agro-industry. The aforementioned government survey showed that only 0.1% of all college graduates in Korea were employed as agriculturalists in 2013. However, our results showed that 13.3% of graduates were working as agriculturalists, which is significantly different to the results of the government survey. These results confirm that agricultural science colleges contribute greatly to the employment of graduates, including farmers, agro-industry, and business startups in agro-industry fields.

Evaluation of Project-Based Learning on Community Dental Hygiene Practice Education (지역사회치위생학 실습 교육에서의 프로젝트 기반 학습 효과 평가)

  • Yoo, Sang-Hee;Bae, Soo-Myoung;Shin, Bo-Mi;Shin, Sun-Jung
    • Journal of dental hygiene science
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    • v.17 no.4
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    • pp.368-374
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    • 2017
  • The purpose of this study was to evaluate community dental hygiene practice education, by verifying its effect after applying project-based learning in improving the practical and social skills of learners. A 15-week project-based community dental hygiene practice course was held for 27 senior students, who took community dental hygiene practice course in the Department of Dental Hygiene, Gangneung-Wonju National University. Twenty-seven students were composed of 4 teams. Each team selected a target group for four workplaces for adult workers to apply the oral health promotion project. The project was then planned and conducted based on a survey on the health problems confronting each group, and an evaluation was carried out after 4 weeks. From the results obtained in comparing confidence in problem solving ability, project value, teamwork competency, and community dental hygienist competence before and after course, the improvement in project value and teamwork competence scores was not statistically significant, but all four areas showed positive results. After analyzing the project actuality, learning outcomes, and project satisfaction after course results, the actuality of the project was 19.30 points, the learning achievement was 45.19 points, and the satisfaction was 19.19 points, demonstrating that the aim of achieving actual performance competence and a learning performance exceeding expectations was accomplished. After conducting an interview survey with 8 students, it was found that they had learned social skills involving problem-solving abilities and confidence, and teamwork competence such as cooperation, role responsibility, creative thinking ability, and communication skills. Community dental hygienists should be able to acquire learner-level practical skills and social skills in the community dental hygiene and practical courses, according to their competencies and job needs. It is necessary to develop a project?based systematic learning module to enable the community dental hygiene practice to operate as a subject closely related to fields in other dental hygiene departments.

Effect of Continuous Cultivation Years on Soil Properties, Weed Occurrence, and Rice Yield in No-tillage Machine Transplanting and Direct Dry-seeding Culture of Rice (벼 무경운 기계이앙 및 건답직파 연속재배년수가 토양특성, 잡초발생 및 벼 생육에 미치는 영향)

  • Park, Hong-Kyu;Kim, Sang-Su;Choi, Won-Yong;Lee, Ki-Sang;Lee, Jae-Kil
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.47 no.3
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    • pp.167-173
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    • 2002
  • This experiment was conducted to figure out the change of soil physical properties, rice growth and yield with the years of continuous cultivation in direct dry-seeding and no-tillage machine transplanting. Experiments were conducted at NHAES(National Honam Agricultural Experiment Station, RDA, Iksan, Cheon Buk Province, South Korea) with a rice variety "Dongjinbyeo" from 1995 to 2000. In no-tillage machine transplanting cultivation, organic matter in soil was higher than that on direct dry-seeding and was significantly high in topsoil. Problematic weed species were E. crus-galli B., A. keisak H., and L. japonica M. Plant height and tiller number m-2 were higher in common-tillage during the total growth duration. The highest weedy rice occurrence of 27.5% was observed in live years' continuous direct dry-seeding and followed by 6.2%, in four years', and 3.7%, in three years'. The highest yield reduction of 38% was observed in five years' continuous direct dry-seeding. The reduction may resulted from the competition between weedy rice and cultivated rice.

Causes of Unresectability in Non-Small Cell Lung Cancer Patients Thought to Be Resectable Preoperatively (수술시 절제가 불가능하였던 비소세포폐암 환자에 대한 분석)

  • Oh, Yeon-Mok;Mo, Eun-Kyung;Jung, Man-Pyo;Yoo, Chul-Gyu;Kim, Young-Whan;Han, Sung-Koo;Sim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.97-102
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    • 1994
  • Objectives : Since Mountain proposed the new staging system of non-small cell lung cancer in 1986, the indications for operation of NSCLC have been extended. However, operative mortality is from 3 to 6%. Therefore it is important to reduce unnecessary operation and to evaluate unresectability of tumor correctly, preoperatively. The purpose of this study is to find out the causes of unresectability in patients who were initially thought to be resectable preoperatively. Methods : By retrospective analysis, 64 patients out of 291 NSCLC patients who were undergone operation for curative resection in Seoul National University Hospital from Jan. of 1987 to Dec. of 1991, were found to be unresectable at operating room, were selected for this study. Out of 64 patients, 42 were evaluable. The analysis was focused on the change of pre- & post-operative staging and the causes of unresectability of tumors. Results : Among 42 patients with unresectable tumor who could be evaluated, preoperative CT finding showed resectable tumors in 55%(23 patients) and suspicious for unresectable tumors in 45%(19 patients). The causes of unresectability were technically unresectable T3 lesions in 7%(3 patients), T4 lesions in 62%(26 patients), N2 lesions in 17%(7 patients) and N3 lesions in 14%(6 patients). Conclusion : The major causes of unresectability of NSCLC were pulmonary artery invasions. It is suggested that careful evaluation of mediastinal structure, especially great vessels by additional imaging technique other than CT(like MRI) is indicated in selected NSCLC cases.

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Perspectives on the Landscape Ecological Function of Dangsan Forests and Rural Community Forests as a Stream Landscape (하천경관으로서 당산숲.마을숲의 경관생태학적 기능 고찰)

  • Choi, Jai-Ung;Kim, Dong-Yeob
    • Journal of Environmental Policy
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    • v.4 no.2
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    • pp.31-55
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    • 2005
  • Dangsan forests and Rural Community Forests(RCF) have been historical assets for the rural communities of more than 40,000 in Korea and they have provided an identity through the cultural heritage. The Dangsan forests and the RCF are parts of a unique cultural landscape in the rural areas as components of stream landscape. In many cases, the Dangsan forests and the RCF are located close to stream corridors. The objective of this study was to understand the function of the Dangsan forests and the RCF on stream water quality and to evaluate its ecological landscape values. Through the consideration of international concensus and domestic government policy for close-to-nature stream, we could find out that Dangsan forests and RCF's have close relationship with the close-to-nature streams. The water quality of the streams close to the Dangsan forests and the RCF are maintained with local culture. It is also compared to the streams located where Dangsan forests and the RCF are absent. Eight study sites were selected. Water samples were collected at three different locations at each study site. Water samples were analyzed for temperature, pH, total P, total N, dissolved oxygen, EC, BOD, COD and SS. Aquatic invertebrates were observed as water quality indicator species. The results showed that the number of aquatic invertebrate species, GPI, DO, EC, BOD, and SS were significantly improved in stream water due to the presence of the Dangsan forests and the RCF. The role of Dangsan forests and the RCF was evident in the conservation of stream landscape and rural culture as well as in maintaining stream water quality. The management schemes of the streams with Dangsan forests and the RCF's are also suggested.

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