• Clinical and Experimental Pediatrics
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• v.48 no.10
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• pp.1061-1067
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• 2005

Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.

• Journal of the Korean Society of Marine Environment & Safety
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• v.22 no.5
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• pp.410-416
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• 2016

After the Sewol Ferry accident, the importance of maritime safety has been emphasized in Korea. In particular, educational and experience training are not only being conducted for maritime personnel but also in schools and at maritime-related organizations in order to broadly instill maritime safety awareness. Based on SOLAS regulations, safety education for sailors conducted every 10 days passenger boats, and fire-fighting drills and abandon-ship training should be conducted once a month on merchant ships. After the Sewol Ferry accident, the maximum number of trainees was reduced from 40 to 20 in order to improve the effectiveness of these training sessions by requiring all trainees to participate in the actual training. The current training process consists of two steps: textbook-based theoretical training and actual practice. Current training environment provides limited capability from human and facility recourses which limit the numbers of trainee participated and system operation time. By introducing the simulation training, it will improve the trainee skill and performance prior to the on-site training and allow the more effective and rapid progress on actual practice. Therefore, it will be proposed the three-step training method in order to improve the effectiveness on fire-fighting drill in Maritime Safety Education on this study. This study suggests a three step training method that would increase the efficiency of maritime safety education. An image-training step to enhance individual task awareness and equipment usage via simulation techniques after theoretical training has been added. To implement this simulation, a virtual training session will be conducted before actual training, based on knowledge obtained from theoretical training, which is expected to increase the speed with which trainees can adapt during the practical training session. In addition, due to the characteristics of the simulation, repeated training is possible for reaction drills in emergency circumstances and other various scenarios that are difficult to replicate in actual training. The efficiency of training is expected to improve because trainees will have practiced before practical training takes place, which will decrease the time needed for practical training and increase the number of training sessions that can be executed, increasing the efficiency of training overall. This study considers development methods for fire-fighting drill simulations using virtual reality techniques.

• Journal of Hospice and Palliative Care
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• v.14 no.2
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• pp.91-100
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• 2011

Purpose: This study was performed to investigate patients' preferences on receiving life-sustaining treatments (LST) and to analyze the relationship between patients' characteristics and LST selection. We also examined any discrepancy between LST patients' choices regarding medical intervention and actual medical intervention given/not given within 48 hours before death. Methods: This cross-sectional study was performed from March 1, 2008 to August 31, 2008 in the Palliative Care Unit of Korea University Hospital. Electric medical records (EMR) of 102 hospice cancer patients were reviewed, and 74 patients with Glasgow coma scale (GCS) ${\geq}$10 at the time of signing the advance medical directives (AMD) were selected for the first analysis. Then, patients alive at the end of this study, transferred to other hospitals or dead within 48 hours were excluded, and the remaining 42 patients were selected for the second analysis. Results: Preferred LST included antibiotics, total parenteral nutrition, tube feeding, transfusion, and laboratory and imaging studies. The relationship between patients' characteristics and LST could not be analyzed due to skewed preferences. LST chosen at the time of signing the AMD and actual medical intervention given/not given in the last 48 hours showed discrepancy in most cases. Conclusion: When making AMD in hospice cancer patients, it is important to consider the time and possibility of changing the choices. Above all, patients must fully understand the AMD. Thus, LST should always be provided with careful consideration of all possibilities, because legal and social aspects of AMD have not been established yet.

• Journal of agricultural medicine and community health
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• v.26 no.1
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• pp.65-79
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• 2001

Cerebrovascular disease(CVD) is one of the major causes of death in Korea as well as most countries in the world and the disease gives great burden to humans socio-economically due to its high fatality and common occurrence of disability as the sequelae. This study was performed to investigate the utilization of western hospital(WH) or oriental hospital(OH) due to CVD and compare the type and the clinical characteristics of patients with CVD between WH and OH located in Kwangju City, Chonnam Province and Chonbuk Province. We reviewed the medical records of 1,070 patients who were discharged from 12 WIT and 6 OH from January to March, 2000 and confirmed for the diagnosis of CVD. Fifty-one percent of the subjects were treated at WH and forty-nine percent at OH. Females were more prevalent than males. As well, the most common age group among these subjects was found to be 70 years and older. About 92% in W~H and 80% in OH received brain imaging diagnostic procedures such as CT or MRI. The cerebral infarction was the most common type of CVD when compared by the kind of utilized hospitals, sex, age group except patient Group who was treated at WH and whose age was lower than 50 years old. The cerebral hemorrhage was more frequent than cerebral infarction among this group. The proportion of cerebral hemorrhage was decreasing and that of cerebral infarction was increasing with age. The most common clinical manifestations of undetermined type of CVD was paralysis of lower extremity in WIT and paralysis of upper extremity in OH. In cerebral hemorrhage loss of consciousness in WIT and dysarthria in OH were most frequently manifested, while in the case of cerebral infarction hemiplegia in WIT and dysarthria in OH were the most common complaints. The interval from the onset of disease to admission to the hospital was 5.5 days in WH arid 31.4 days in OH and the difference was statistically significant. Average admission duration of patients at OH was longer than WH, but it was not statistically significant. In conclusion these results suggest that the effort for systematic and efficient management of CVD patients was necessary for close co-operation and role arrangement between WH and OH considering the positive and negative points of western and oriental medicines.

• Women's Studies Review
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• v.27 no.1
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• pp.3-36
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• 2010

This paper is based on the certain point that 'the indigenous', which have long been occupied by the Asian patriarchy or the local communities, now calls for the repositioning in the feminist context. 'The indigenous', in one part, generally refer to the matured long-standing traditions and practices of certain regional, or local communities, as a mode of a place specific way of endowing the world with integral meaning. In the narrow definition, it points to the particular form of placed based knowledge for survival, for example, the useful knowledge of a population who have lived experiences of the environment. In the other part, 'the indigenous' could be criticized in the gender perspectives because it has been served as an ideological tool for patriarchy and sexism, which have undermined women's body and subjectivity in the name of the Asian traditional community. That's why the feminists with sensitivity to the discourses of it, may perceive it very differently, still hesitating dealing with the problem. However, even if there are tendencies that the conservatives romanticize local traditions and essentialize 'the indigenous', as it were, it does not exist 'out there'. Then, it could be scrutinized in the contemporary context which, especially, needs to seek the possibility towards the alternatively post - develope mental knowledge system. In the face of global economic crisis which might be resulted from the instrumentalized or fragmented knowledge production system, it's holistic conceptions that human, society, and nature should not be isolated from each other. is able to give an insightful thinking. It will work in the restraint condition that we reconceptualize the indigenous knowledge not as an unchanging artefact of a timeless culture, but as a dynamic, living and culturally meaningful system towards the ecofeminstic indigenous knowledge. And then, indigenous renaissance phenomena which empower non-western culture and knowledge system and generate increased consciousness of cultural membership. Thus, this paper argues that the indigenous knowledges which have been underestimated in the western-centered knowledge-power relations, could be reconstructed as a potential resources of ecological civility transnationally which reconnect individuals and societies with nature.

• Korean Journal of Culture and Social Issue
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• v.12 no.1
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• pp.161-195
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• 2006

The purpose of this study is to examine factors influencing quality of life for individuals in the family, school or workplace, leisure settings, and Korean society using the indigenous psychological analysis. A total of 3,406 participants, consisting of 1,331 elementary, middle, high school students and 2,075 parents and teacher, completed an open-ended questionnaire developed by Kim and Park (2004b). The respondents reported the factors that influence quality of life in Korean society as follows: Economic condition, collective effort, leisure and cultural life, harmonious interpersonal relationships, effective government policy, and educational attainment. The factors that reduce quality of life in Korean society are as follows: Economic uncertainty, political instability, lack of citizenry, ingroup favoritism, corruption, lack of facilities for leisure and social life, and overemphasis on educational achievement. Second, the factors that influence quality of life in the family are as follows: Harmonious family relations and financial security. For students relationship with friends and academic achievement are reported as important factors influencing quality of life at school. For adults, harmonious interpersonal relationship, financial factors and occupational achievement are reported as important factors influencing quality of life at the workplace. For leisure and social leisure life, financial security, leisure time and interpersonal relationships are reported as important factors influencing quality of life. Third, as for generational differences, students reported political instability and adults reported economic uncertainty as the most important factor reducing quality of life in Korean society. For family life, students reported conflicts among family members and adults reported financial constraints as the most important factor reducing quality of life. For leisure and social life, students reported lack of leisure time and adults reported financial constraints as the most important factor reducing quality of life. Fourth, for students the following characteristics were associated with higher quality of life: Higher socio-economic status of the family, younger, and higher academic achievement. For adults, the following characteristics were associated with higher quality of life: Higher socio-economic status of the family and greater achievement their social life. Implications of these results on the quality of life in Korea, focusing on human relationship, financial factors, self-regulation and educational achievement are discussed.

• Journal of the Korean Society of Food Culture
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• v.1 no.3
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• pp.183-196
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• 1986

This study was designed to be link in the chain of the investigation on daily life and consciousness of longevous people in Korea, and to investigate the social life and daily life habit in the past of longevous people. The social life and daily life habit were surveyed on 379 subjects (male 121, female 258) of the aged who were above 80 years of age, from June to November in 1985. 1. 'Generally regular' in the rising time and bedtime between 40 and 60 years of longevous people had the highest figures of 81.8% and 63.1%, respectively. The longevous peoples of 59.4% got up by before 6 a.m., and 61.3% of these aged went to bed from 9 to 11 p.m. But there was no significant difference between male and female. 2. Of the occupation engaged in the longest term of longevous people, the self-management (86.3%) included farming, fishing and household affairs was the highest, whereas administrative position, small-scale management and white-collar worker were only 0.8%, 0.8% and 1.8%, respectively. Therefore, their work involved mainly physical labor (heavy 48.5%, light 47.2%), and mental work was only 2.8% of longevous people. It is believed that this fact was deeply related to the educational degree of them. 3. The longevous people of 58.3% retired from the occupation and household affairs abover 70 years of age, and especially 24.3% of them is including the aged above 80 years of age. 4. The longevous people of 57.2% were shared the role in the home after retirement from the occupation and household affairs, whereas 35.9% of them didn't share. Of the way in killing time in case having no role in the home, 'at home'(50.0%) was the highest, and decreased in the order of 'old people's home' (30.9%), 'ill in bed' (10.3%) and 'asylum for the aged' (8.8%). 5. The acquaintance frequency before retirement from the occupation and household affairs of longevous people showed in the order of 'wide' (38.5%), 'common' (38.0%) and 'narrow' (19.0%), and 56.5% of them had the acquaintance after retirement. 6. Only the longevous people of 38.5% had the hobby and recreation activities of 'more than once' after retirement from the occupation and household affairs, but 53.0% of them was none. Of the kinds of hobby and/or recreation, 'TV-watching' (79.2%) was the highest, and decreased in the order of 'talking with grandchild' (54.2 %), 'working at home' (35.4%), 'religion' (25.0%) and 'chess etc.' (18.1%).

• Journal of Hospice and Palliative Care
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• v.5 no.2
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• pp.111-124
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• 2002

Purpose : Although the average life expectancy has increased due to advances in medicine, mortality due to cancer is on an increasing trend. Consequently, the number of terminally ill cancer patients is also on the rise. Predicting the survival period is an important issue in the treatment of terminally ill cancer patients since the choice of treatment would vary significantly by the patents, their families, and physicians according to the expected survival. Therefore, we investigated the prognostic factors for increased mortality risk in terminally ill cancer patients to help treat these patients by predicting the survival period. Methods : We investigated 31 clinical parameters in 157 terminally ill cancer patients admitted to in the Department of Family Medicine, National Health Insurance Corporation Ilsan Hospital between July 1, 2000 and August 31, 2001. We confirmed the patients' survival as of October 31, 2001 based on medical records and personal data. The survival rates and median survival times were estimated by the Kaplan-Meier method and Log-rank test was used to compare the differences between the survival rates according to each clinical parameter. Cox's proportional hazard model was used to determine the most predictive subset from the prognostic factors among many clinical parameters which affect the risk of death. We predicted the mean, median, the first quartile value and third quartile value of the expected lifetimes by Weibull proportional hazard regression model. Results : Out of 157 patients, 79 were male (50.3%). The mean age was $65.1{\pm}13.0$ years in males and was $64.3{\pm}13.7$ years in females. The most prevalent cancer was gastric cancer (36 patients, 22.9%), followed by lung cancer (27, 17.2%), and cervical cancer (20, 12.7%). The survival time decreased with to the following factors; mental change, anorexia, hypotension, poor performance status, leukocytosis, neutrophilia, elevated serum creatinine level, hypoalbuminemia, hyperbilirubinemia, elevated SGPT, prolonged prothrombin time (PT), prolonged activated partial thromboplastin time (aPTT), hyponatremia, and hyperkalemia. Among these factors, poor performance status, neutrophilia, prolonged PT and aPTT were significant prognostic factors of death risk in these patients according to the results of Cox's proportional hazard model. We predicted that the median life expectancy was 3.0 days when all of the above 4 factors were present, $5.7{\sim}8.2$ days when 3 of these 4 factors were present, $11.4{\sim}20.0$ days when 2 of the 4 were present, and $27.9{\sim}40.0$ when 1 of the 4 was present, and 77 days when none of these 4 factors were present. Conclusions : In terminally ill cancer patients, we found that the prognostic factors related to reduced survival time were poor performance status, neutrophilia, prolonged PT and prolonged am. The four prognostic factors enabled the prediction of life expectancy in terminally ill cancer patients.

• Korean Journal of Psychosomatic Medicine
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• v.4 no.2
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• pp.269-276
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• 1996

A theroretical study was made on the psychodynamism of somatoform disorder. Somatoform disorder is caused by a defense mechanism of somatization. Somatization is the tendency to react to stimuli(drives, defenses, and conflict between them) physically rather than psychically(Moore, 1990). Ford(1983) said it is a way of life, and Dunbar(1954) said it is the shift of psychic energy toward expression in somatic symptoms. As used by Max Shur(1955), somatization links symptom formation to the regression that may occur in response to acute and chronic conflict. In the neurotic individual psychic conflict often provokes regressive phenomena that may include somatic manifestations characteristic of an earlier developmental phase. Schur calls this resomatization. Pain is the most common example of a somatization reaction to conflict. The pain has an unconscious significance derived from childhood experiences. It is used to win love, to punish misdeeds, as well as a means to amend. Among all pains, chest pain has a special meaning. Generally speaking, 'I have pain in my chest' is about the same as 'I have pain in my mind'. The chest represent the mind, and the mind reminds us about the heart. So we have a high tendency to recognize mental pain as cardiac pain. Kellner(1990) said rage and hostility, especially repressed hostility, are important factors in somatization. In 'Psychoanalytic Observation on Cardiac Pain', psychoanalyst Bacon(1953) presented clinical cases of patients who complained of cardiac pain in a psychoanalytic session that spread from the left side of their chests down their left arms. The pain was from rage and fear which came after their desire to be loved was frustrated by the analyet. She said desires related to cardiac pain were dependency needs and aggressions. Empatic relationship and therapeutic alliances are indispensable to psychotherapy in somatoform disorder. The beginning of therapy is to discover a precipitating event from the time their symptoms have started and to help the patient understand a relation between the symptom and precipitating event. Its remedial process is to find and interpret a intrapsychic conflict shown through the symptoms of the patient. Three cases of somatoform disorder patients treated based on this therapeutic method were introduced. The firt patient, Mr. H, had been suffering from hysterical aphasia with repressed rage as ie psychodynamic cause. An interpretation related to the precipitating event was given by written communication, and he recovered from his aphasia after 3 days of the session. The second patient was a dentist in a cardiac neurosis with agitation and hypochondriasis, whose psychodynamism was caused by a fear that he might lose his father's love. His symptom was also interpreted in relation to the precipitating event. It showed the patient a child-within afraid of losing his father's love. His condition improved after getting a didactic interpretation which told him, to be master of himself, The third patient was a lady transferred from the deparment of internal medicine. She had a frequent and violent fit of chest pains, whose psychodynamic cause was separation anxiety and a rage due to the frustration of dependency needs. Her symptom vanished dramatically when she wore a holler EKG monitor and did not occur during monitoring. By this experience she found her symptom was a psychogenic one, and a therapeutic alliance was formed. later in reguar psychotherapy sessions, she was told the relaton between symptoms and precipitating events. Through this she understood that her separation anxiety was connected to the symptom and she became less terrifide when it occurred. Now she can travel abroad and take well part in social activities.

• Korean Journal of Social Welfare
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• v.64 no.1
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• pp.199-223
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• 2012

The purpose of this study is to clarify the mechanism and essence of problems by understanding the whole structure of the complicated problems that exist in the social welfare field with DEMATEL method, one of structural models. This paper consists of (1) What kind of social welfare problems exist in the community that is related to welfare? (2) What kind of thoughts do people who work in social welfare field have related to these problems? (3) Are there any differences in structure of thoughts among social welfare civil servants who take charge of planning and dividing budgets for community welfare, social workers who provide services personally and civic activists who criticize and keep watch on behalf of civilians? In order to achieve the purpose of this study, data were collected in Busan Busanjingu and the survey was conducted from the year of 2005 when community welfare plan was first established up to now. The major structural problems of the community welfare of the Pusan Jin-gu, Korea, are: 1) welfare budget allocation procedure is not logical, 2) the outskirts of the Pusan Jin-gu are isolated as poor areas, 3) geographic imbalance is severe among communities, and 4) the social welfare response system to support future population structure needs to be more developed. All of these problems are the fundamental origin to the social resource disparity within communities. The major problems of the community social welfare in Pusan Jin-gu, Korea were recognized by different perspective in terms of professional career such as social welfare civil servants, social workers, and civic activists. Majority of the social welfare civil servants thought "severe geographic imbalance"; majority of the social workers believed "lack of the social welfare response system to support the structure of the population in the future" and "disparity in social resources within the communities"; and majority of the civic activists said "limitation for understanding various social welfare needs because of short term need assessments" as main issues of the community social welfare. It seems that this paper is able to be used as a framework to establish community welfare plans and individual programs in Busan Busanjingu.