• Journal of Hospice and Palliative Care
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• v.11 no.3
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• pp.140-146
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• 2008

Purpose: Sooner of later, end-of-life care decision-making will unfold and be settled during the professional lives of medical students. However, there is prevalent ambiguity and uncertainty between the palliative treatment and euthanasia. We conducted this survey to investigate attitudes of medical students towards end-of-life making decisions, and to find out which factors primarily influenced the attitudes. Methods: A study was conducted among medical students at one university, the Republic of Korea. A written questionnaire was sent to all the 1st, 2nd, and 3rd-year medical students. It presented 5 statements on end-of-life decision-making. Students were asked whether they agreed or disagreed with each statement. Results: The response rate was 74.4%, and 267 questionnaires were analyzed. Percentages of agreement with each statements on Voluntary active euthanasia (VAE), Physician assisted suicide (PAS), Withholding life-sustaining management, Withdrawing life-sustaining management, and Terminal sedation (TS) was 37.1%, 21.7%, 58.4%, 60.3%, and 41.6%, respectively. The grade of students, religious activity, and educational experience were determinant factors. Agreement on each statements was higher in the low religious activity group than in the high religious activity group. Agreement on TS was higher among 3rd year students during their clerkship than among 1st and 2nd year students. Age of students and the experience of dying-people care had no significant influence. Conclusion: In end-of-life decision-making, religious and educational factors influenced medical students' attitudes. Especially, the experience of education during clerkship had significant influence on the attitude. Proper teaching on end-of-life decisions should further be considered during medical students' clerkship.

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.106-110
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• 2008

Palliative sedation has been used in patients who undergo intractable suffering at the end of life. Its implementation, however, may be complicated due to resistance of clinicians and barrier of bioethical issues. Here, we present 50-year-old man with stomach cancer and multiple bone metastasis who was treated with palliative chemotherapy and radiotherapy. He suffered from refractory pain on the whole body even after standard analgesics and multidisplinary effort to relieve. Upon shared decision for sedation, he was given midazolam until discharge. Literature reviews reveal cases similar to the present case.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.139-142
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• 2010

• Journal of Hospice and Palliative Care
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• v.11 no.2
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• pp.99-105
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• 2008

Purpose: In terminally ill cancer patients, accurate prediction of survival is necessary for clinical and ethical reasons, especially in helping to avoid harm, discomfort and inappropriate therapies and in planning specific care strategies. The aim of the study was to investigate prognostic factor of dying patients. Methods: We enrolled the terminal cancer patients from Kangnam St. Mary's Hospital from 2004 until their death. We observed symptoms shown in dying patients and assess 17 common symptoms shown in terminally ill cancer patients, performance status, pain and analgesic use. Results: Average period from hospitalization to death was 11.7 days. The most important prognostic factor is performance status (KPS), average KPS at enrollment is 48% and at last 48 hours is 25%. Physical symptoms that have significant prognostic importance are poor oral intake, weakness, constipation, decreased Karnofsky performance status, bed sore, edema, jaundice, dry mouth, dyspnea. Dying patients showed markedly decreased systolic blood pressure, cyanosis, drowsiness, abnormal respiration, death rattle frequently at 48 hours before death. Conclusion: If we assess the symptoms more carefully, we can predict the more accurate prognosis. The communication about the prognostic information will influence the personal therapeutic decision and specific care planning.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.25 no.3
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• pp.9-14
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• 1980

This experiment was carried out to examine the effect of water stress at anthesis on the grain maturation and to interpret the immediate and resulting growth response in barley. The dry weight of root, stem, internode, flag leaf and grain under water stress was remarkably more reduced than that under no-water stress, respectively. Water stressed plants had heavier grain dry weight during 7.14 days after water stress than that under no-water stress, but this early response was reversed significantly in the later period. The relative turgidity of organs except grain under water stress was severely lowered than that under no-water stress. The net photosynthsis by rewatering after water stress had been kept at the lower level than that under no-water stress ti1l the late maturation.

• Journal of Hospice and Palliative Care
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• v.19 no.4
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• pp.283-291
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• 2016

Over the past decade, hospice and palliative care in Japan have progressed rapidly under the national policies supported by the Cancer Control Act. The numbers of palliative care units/inpatient hospices, hospital palliative care teams, and clinics with a home hospice function have been steadily increasing. The increasing numbers of physicians, nurses, and pharmacists have been certified as specialists in palliative care by national associations. Collaborative efforts have been made to standardize and disseminate educational programs and training opportunities in undergraduate, postgraduate, and continuing medical education. Research activities in Japan have markedly contributed to the growing body of evidence, especially in the fields of terminal delirium, terminal dehydration, palliative sedation, care for dying patients, prognostication, communication, psycho-oncology, and regional palliative care programs. This review focuses on major palliative care settings, specialty, national associations, education, and research in palliative care in Japan.

• Journal of Korean Philosophical Society
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• no.94
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• pp.53-87
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• 2011

Leibniz regards a corporeal substance, which is composed of monads, as 'one substance' and tries to prove that it has a true unity. This position seems to be contradictionary to his Monadology. Therefore, many scholars have ignored Leibniz's stand that corporeal substance is 'one substance', or consider this only as a stand from his theory of substance in his early works, which has been discarded afterwards. This Research will show that Leibniz adheres to this position throughout his lifetime; that although Leibniz uses the concepts such as substantial form and substantial bond to explain his stand, but the concept of substancial bond doesn't fit in with his philosophical system; that to explain the unity of the corporeal substance, the concept of substancial form and the theory of preestablished harmony are sufficient; and that nevertheless the stand that the corporeal substance is 'one substance' inconsistent with the position that the monad is 'one substance'; and that if Leibniz abandons that stand, the theory of the corporeal substance is a good foundation of his panorganism.

• The Journal of the Convergence on Culture Technology
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• v.5 no.4
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• pp.243-249
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• 2019

The purpose of this study is to investigate the factors affecting the respect for life of nursing students and to prepare the basic data for developing educational programs to establish proper awareness of the life of nursing students and nurturing it. This is a descriptive research study. A total of 146 nursing students were included in this study. Data analysis was performed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. The results of this study confirmed the meaning of life, spiritual wellbeing, and attitude toward death as factors influencing respect and will for life. The explanatory power of these three factors was 26.3%. Therefore, nursing students will be able to cultivate respect for life by increasing their understanding of the meaning of life, improving their level of spiritual well-being, and reducing their negative attitudes about death. Also, in order to improve the respect for life of nursing students, it will be possible to develop an intervention program to improve life respect including the factors identified in this study. Ultimately, it is expected to grow into a nurse who can provide real help to patients who are at the end of life or who are dying.

• Journal of Hospice and Palliative Care
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• v.22 no.4
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• pp.198-206
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• 2019

Purpose: The Act on Hospice and Palliative Care and Decisions on Life-sustaining Treatment for Patients at the End of Life was enacted in 2016 and has taken effect since 2018 February. The content of this act was based on Physician Orders for Life-Sustaining Treatment (POLST) in the United States and we modified it for terminal cancer patients registering hospice. The object of this study is to investigate preference and implementation rate for modified Korean POLST (MMK-POLST) items in hospice ward. Methods: From February 1, 2017 to April 30, 2019, medical records regarding MMK-POLST were retrospectively analyzed for all patients hospitalized in the hospice ward of Gyeongsang National University Hospital. Results: Of the eligible 387 total cohorts, 295 patients filled out MK-POLST. MK-POLST has been completed in 133 cases (44.1%) by the patient themselves, 84 cases (28.5%) by the spouse, and 75 cases (25.4%) by their children, respectively. While only 13 (4.4%) out of 295 MK-POLST completed patients refused the parenteral nutrition and 5 patients (1.7%) for palliative sedation, the absolute majority of 288 (97.6%) patients did not want cardiopulmonary resuscitation (CPR) and ventilators and 226 people (76.9%) for pressor medications. Kappa values for the matched strength of MK-POLST implementation were poor for all items except CPR, ventilators and palliative sedation. Conclusion: Hospice patients refused to conduct cardiopulmonary resuscitation, ventilators and pressor agents. In contrast, antibiotics, parenteral nutrition and palliative sedation were favored in the majority of patients.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.32 no.1
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• pp.10-21
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• 2014

This study focuses on the landscape of Daegodae(大孤臺), a prominent rock placed at the side of Namgae Stream in Hamyang, and the person who enjoy the landscape. Through the analysis of the letters such as names carved on the rocks based on ancient poetry and stone walls, the study examines the characteristics of the landscape and the space of Daegodae and the phase of hegemony to enjoy the landscape and space. The result of this study is as follow.2) There are 5 Seowon(書院: lecture halls) nearby Daegodae identified in the ancient map has 5 auditoriums nearby, and three-dimensional volume and eccentricity of the Daegodae is impressive. Daegodae, named by Noh Jin(1518~1578) in 16th century, was used in a variety of ways, including viewing, game, recreation, and meeting, by the staff of the lecture halls including Namgae Seowon(南溪書院), as a result of analyzing the ancient document Go-dae-il-Loc(孤臺日錄) written by Jung Kyung-Woon(鄭慶雲: 1556~?). The structure of Daegodae is that there is Chunggeunchung(淸近亭) on the rock face of the top and Sanangjae(山仰齋) to the west around the memorial stone for Yang Hee(梁喜: 1515~1581). The upper part of the foundation of Daegodae with 11m high and $10m^2$ wide to the east and west was widely used for lecturing and poetry reading. To the north and west of the foundation were the writing of Kim Jeong-Hee(金正喜: 1786~1856) with the words 'Seoksong Chusa(石松 秋史)' carved on the rock and the remains of a dead tree that is presumed to have been called as 'Seoksong'. They are the landscapes that further enhance the history and authenticity of this place. The two kinds of letters carved on the rock 'Daegodae Gaeeunseo(大高臺 介隱書)' and 'Mukheon JungGeunSang(鄭近相: 1893~1934)' were recorded each by Jung Jae-Gi(1811~1879) and his grandson Jung Geun-Sang, which are, as the outcome of exclusive space possession and space hegemony, the signatures indicating that they were the persons who enjoyed this place during the late Joseon and Japanese colonial era. In other words, Daegodae had some implied meaning of preoccupancy of the place as Gujolyangseonsengjangguso since the middle of Joseon, and the place was passed down as a buddhism lecturing and memorial venue called "Dungbukganghoiso Cheonryungjaeseonhyunjangguso" after going through the space hegemony of Jung Jae-Gi and Jung Geun-Sang during the late Joseon and Japanese colonial era each, Nevertheless, a number of letters carved on the rock identified also imply that 'Hadong Jung(河東鄭氏)' and 'Pungcheon Noh(豊川盧氏)' were those who enjoyed the landscape of Daegodae and the center of the space hegemony. The "letters carved on the rock of Daegudae" is another case of cultural landscape and traditional gardening space that serves as the representation of the will of enjoying the landscape in this place and the history of space hegemony.