• Title/Summary/Keyword: Burdens

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ELISA of paragonimiasis in cat by crude and purified antigens of Paragonimus westermani (폐흡충(肺吸蟲)의 조(粗)항원과 정제(精製)항원에 의한 폐흡충(肺吸蟲)감염 고양이혈청의 면역효소반응(免疫酵素反應))

  • Lee, Ok-Ran;Chang, Jae-Kyung
    • Parasites, Hosts and Diseases
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    • v.24 no.2
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    • pp.187-193
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    • 1986
  • Enzyme-linked immunosorbent assay(ELISA) using crude and affinity-purified antigens of adult worms of Paragonimus westermani was performed for infected cat sera with different worm burden, from preinfection to 18th week after infection. Crude antigen was used with supernatant of homogenated worms by freezing-thawing method, and the supernate was centrifuged for 1 hour at 10,000 rpm at $4^{\circ}C$. Affinity-purified antigen(antibody-bound antigen) was prepared from fractions(bound and unbound) of crude antigen by affinity chromatography on CNBr-activated sepharose 4B, and IgG as a ligand was prepared from paragonimiasis cat serum(6 months infected) obtained by ammonium sulfate ($40%{\sim}45%$ saturated) precipitation method. By SDS-PAGE, crude antigen showed 22 polypeptide fractions while purified antigen showed 4 fractions: 36, 400, 34, 700, 27, 600 and 11, 500 in molecular weights. All cats were divided into five groups($G_1-G_5$) by different worm burdens. The mean of recovered worms(${\pm}SD$) and the number of cats in each group are as follows: $G_1$, 2 worms(0) and 4 cats; $G_2$, 4.75 (${\pm}0.66$) and eight; $G_3$, 10.75(${\pm}1.92$) and four; $G_4$, 23.20(${\pm}3.43$) and five; $G_5$, 48(${\pm}12.63$) and five cats. The results were summarized as follows: 1. The antibody levels(OD value) increased by worm burden in $G_1$ to $G_4$ generally. However, individual antibody levels were not exactly related with worm burden in all groups, especially there was a wide difference in $G_4$ and $G_5$. These results suggested that the worm burden in $G_4$ (about $20{\sim}30$ worms) is enough to produce antibody maximum in cats of $2{\sim}3kg$ weight. 2. The antibody levels increased significantly(p<0.05) compared to control sera at the 3rd week in $G_1$ and $G_2$, at the 2nd week in $G_3$, and at the 1st week in $G_4$ and $G_5$. Especially in the 4th week, OD value increased more in $G_1$(p<0.01) and in $G_2$ to $G_5$(p<0.001). In the pattern of antibody levels by ELISA in each group, OD in $G_1$ increased to the 18th week continuously, in $G_2$ OD was maintained same after the 16th week, but in $G_3$ it decreased after the 16th week, and it was maintained same in $G_4$ and $G_5$ after the 14th week. 3. The antibody levels by ELISA with the affinity-purified antigen were higher than those with crude antigen in all groups generally. Especially, the difference of OD values between two antigens was larger from the 4th to the 10th week. In $G_1$ and $G_2$ OD with purified antigen was higher than that with crude one to the 18th week. It was also higher in $G_3$ than that with crude antigen to the 16th week and OD of $G_4$ and $G_5$ were higher before the 14th week than that with crude antigen, however became lower at the 16th week. Consequently, the antibody level in ELISA with affinity-purified antigen was more sensitive at the early weeks after infection and in light infection groups than that with crude antigen.

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Risk Analysis of Household Debt in Korea: Using Micro CB Data (개인CB 자료를 이용한 우리나라 가계의 부채상환위험 분석)

  • Hahm, Joon-Ho;Kim, Jung In;Lee, Young Sook
    • KDI Journal of Economic Policy
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    • v.32 no.4
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    • pp.1-34
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    • 2010
  • We conduct a comprehensive risk analysis of household debt in Korea for the first time using the whole sample credit bureau (CB) data of 2.2 million individual debtors. After analysing debt service capacity profiles of debtor groups classified by the borrower characteristics such as income, age, occupation, credit scoring, and the type of creditor business companies, we investigate the impact of interest rate and income changes on debt service-to-income ratios (DTIs) and default rates of respective debtor groups. Empirical results indicate that debt service burdens are relatively high for low income wage earners, high income self-employed, low income capital and card loan holders, and high income mutual savings loan holders. We also find that debtors from multiple financial companies are particularly weak in their debt service capacity. The scenario analysis indicates that financial companies, with the current level of capital buffers, may be able to absorb negative consequences arising from the increase in DTIs and loan default rates if the interest rate and income changes remain modest. However, the negative consequences may fall disproportionately on non-bank financial companies such as capital, credit card, and mutual savings banks, whose debtors' DTIs are already high. We also find that the refinancing risk of household debt is relatively high in Korea as more than half of household mortgage debts are bullet loans. As the DTIs of mortgage loan holders are already high, under the current DTI regulation, mortgage loans may not be readily refinanced especially when the interest rate rises. Disruptions in mortgage loan refinancing may put downward pressure on housing prices, which may in turn magnify refinancing risk under the current loan-to-value (LTV) regulation. Overall our analysis suggests that, for more effective monitoring of household debt risk, it is necessary to combine existing surveillance schemes based on macro aggregate indicators with more comprehensive and detailed risk analyses based on micro individual data.

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Analysis of utilization and profit for CT and MRI after implementation of insurance coverage for CT (CT 보험급여 전후의 CT 및 MRI검사의 이용량과 수익성 변화)

  • Suh, Chong-Rock;Yu, Seung-Hum;Chun, Ki-Hong;Nam, Chung-Mo
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.1-21
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    • 1997
  • In order to analyze the shifts in the volume and profits of Computed Tomography(CT) and Magnetic Resonance Imaging(MRI) utilization for a year before and after the implementation of insurance coverage for CT, this study has been undertaken examining CT and MRI cost data from 'Y' University Hospital situated in Seoul, Korea. Following are the results of this study: 1. The medical insurance payment for CT, implemented on January 1, 1996, increased CT utilization from January 1996 to April 1996 due to low insurance premiums: however, from May 1996 the number of CT cases significantly decreased as a result of strengthened medical cost reviews and the new 'Detailed standards for approval of CT' announced near the end of April 1996 by the insurer. 2. Since the implementation of insurance coverage for CT, CT fee reduction rates for reimbursements by the insurer to the hospital were 50% and 40% for January and February, respectively, and 31% and 15% for March and April. A significant point in the lowering of the reduction rate was reached in May at 11%; furthermore, since June the reduction rate fell below the average reduction rate for reimbursements for all procedures. If the 'Detailed standards for approval of CT' had been announced before the implementation of insurance coverage for CT, CT utilization would not have been so high due to the need to meet those 'standards'. In addition, loss of hospital profits resulting from the reduction for reimbursements would not have occurred. 3. The shifts in MRI utilization showed that there was no particular change with the beginning of insurance coverage for CT, and the introduction of the 'Detailed standards for approval of CT' made MRI utilization increase because MRI is free of restrictions imposed by the insurer. 4. The relationship between CT utilization and MRI utilization showed that they were supplementary to each other before insurance coverage for CT, but that CT was substituted for MRI because of strengthened medical cost reviews after t~e beginning of insurance coverage for CT. 5. The shifts in volume by patient characteristics showed that the number of inappropriate case patients, according to the insurer's "Standards for approval", decreased more than the number of appropriate case patients after the introduction of insurance coverage for CT. Therefore, the health insurance fee schemes for CT have influenced patient care. 6. The shifts in profits from CT utilization showed a net profit decrease of 31.6%. In order to match the pre-coverage profit level, 5,471 more cases would need to be seen and productivity would need to be increased by 32.7%. This profit decrease resulted from a decrease of CT utilization and low reimbursements. With insurance coverage, net profits from CT were 24.4%, and a margin of safety ratio was 39.6%. Because of the net profits and margin of safety ratio, CT utilization fees for insured appropriate cases could not be considered inappropriate. 7. The shifts in profits from MRI utilization before and after the introduction of CT coverage showed that in order to match pre-CT coverage profit levels, 2,011 more cases would need to be seen and productivity would need to be increased by 9.2%. The reasons for needing to increase the number of cases and productivity result from cost burdens created by adding new MRI units. But with CT coverage already begun, MRI utilization increased. Combined with a minor increase in the MRI fee schedule, MRI utilization showed a net profit increase of 18.5%. Net profits of 62.8% and a 'margin of safety ratio' of 43.1% for MRI utilization showed that the hospital relied on this non-covered procedure for profits. 8. The shifts in profits from CT and MRI utilization showed the net profits from CT decreased by 2.33billion Won while the net profits from MRI increased by 815.7million Won. Overall, these two together showed a net profit decrease of 1.51billion Won. The shifts in utilization showed a functional substitutionary relationship, but the shifts in profits did not show a substitutionary relationship. From these results, We can conclude that if insurance is to be expanded to include previously uncovered procedures using expensive medical equipment, detailed standards should be prepared in advance. The decrease in profits from the shifts in coverage and changes in fees is a difficult burden that should be shared, not carried by the hospital alone. Also, a new or improved fee schedule system should include revised standards between items listed and the appropriateness of the fee schedule should constantly be ensured. This study focused on one university hospital in Seoul and is therefore limited in general applicability. But it is valuable for considering current issues and problems, such as the influence of CT coverage on hospital management. Future studies will hopefully expand the scope of the issues considered here.

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Nurse's Attitudes on Organ Donation in Brain Dead Donors (뇌사자 장기기증에 대한 간호사의 태도)

  • Kim, Sang-Hee
    • Journal of Hospice and Palliative Care
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    • v.9 no.1
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    • pp.11-16
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    • 2006
  • Purpose: This study is aimed to confirm nurse's attitudes and to investigate the factor analysis on organ donation in brain dead donors. Methods: This survey were collected from 198 nurses in three university hospitals and four general hospitals in B city with questionnaires developed by the author. The consent for this research was obtained from nursing managers, head nurses, and staff nurses after explaining the purpose of this research. Results: In questionnaires, 45 items about attitudes were included and positive and negative attitude were analyzed. The contents of factors are 'legal permission of brain death', 'one's will of organ donation at the brain death', 'need for educational program about brain dead during college curriculum', 'organ donation is good presents for others', 'connection with professional institutes', 'necessity of brain death', 'convenient to control of brain death' and 'the goods for organ transplantation in brain dead donors' as positive attitudes. Meanwhile, 'contrast to certain religion and dignity to life', 'negative dangers on brain dead permission', 'unbelief to the medical teams', 'burdens to ask organ donation to brain deads/families' and 'economical compensation' are factors as negative attitudes about organ donation in brain dead. The total mean point score of positive attitudes about organ donation in brain dead donors was $3.753{\pm}3.398$. The total mean point score of negative attitudes about organ donation in brain dead donors was $2.915{\pm}0.472$. Conclusion: The results of this study may be of help for the nurses who concern organ sharing and make effective interventions and educations to facilitate the decision making process for organ donation in brain dead donors or families.

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Public Attitudes Toward Dying with Dignity and Hospice.Palliative Care (품위 있는 죽음과 호스피스.완화의료에 대한 일반 국민들의 태도)

  • Yun, Young-Ho;Rhee, Young-Sun;Nm, So-Young;Chae, Yu-Mie;Heo, Dae-Seuk;Lee, So-Woo;Hong, Young-Seon;Kim, Si-Young;Lee, Kyung-Sik
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.17-28
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    • 2004
  • Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.

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Does the Gut Microbiota Regulate a Cognitive Function? (장내미생물과 인지기능은 서로 연관되어 있는가?)

  • Choi, Jeonghyun;Jin, Yunho;Kim, Joo-Heon;Hong, Yonggeun
    • Journal of Life Science
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    • v.29 no.6
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    • pp.747-753
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    • 2019
  • Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

The Effects of a Brief Intervention for Insomnia on Community Dwelling Older Adults (지역 사회 노인을 대상으로 한 불면증 단기 치료 프로그램의 효과)

  • Oh, Eui Sun;Park, Kyung Mee;An, Suk Kyoon;Namkoong, Kee;Shim, Da-hye;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.25 no.2
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    • pp.74-81
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    • 2018
  • Objectives: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. Methods: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. Results: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. Conclusion: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.

Development of Tree Carbon Calculator to Support Landscape Design for the Carbon Reduction (탄소저감설계 지원을 위한 수목 탄소계산기 개발 및 적용)

  • Ha, Jee-Ah;Park, Jae-Min
    • Journal of the Korean Institute of Landscape Architecture
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    • v.51 no.1
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    • pp.42-55
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    • 2023
  • A methodology to predict the carbon performance of newly created urban greening plans is required as policies based on quantifying carbon performance are rapidly being introduced in the face of the climate crisis caused by global warming. This study developed a tree carbon calculator that can be used for carbon reduction designs in landscaping and attempted to verify its effectiveness in landscape design. For practical operability, MS Excel was selected as a format, and carbon absorption and storage by tree type and size were extracted from 93 representative species to reflect plant design characteristics. The database, including tree unit prices, was established to reflect cost limitations. A plantation experimental design to verify the performance of the tree carbon calculator was conducted by simulating the design of parks in the central region for four landscape design, and the causal relationship was analyzed by conducting semi-structured interviews before and after. As a result, carbon absorption and carbon storage in the design using the tree carbon calculator were about 17-82% and about 14-85% higher, respectively, compared to not using it. It was confirmed that the reason for the increase in carbon performance efficiency was that additional planting was actively carried out within a given budget, along with the replacement of excellent carbon performance species. Pre-interviews revealed that designers distrusted data and the burdens caused by new programs before using the arboreal carbon calculator but tended to change positively because of its usefulness and ease of use. In order to implement carbon reduction design in the landscaping field, it is necessary to develop it into a carbon calculator for trees and landscaping performance. This study is expected to present a useful direction for ntroducing carbon reduction designs based on quantitative data in landscape design.

A Study on the Chapter 'Saving Lives' from The Canonical Scripture: Regarding the Power and Wisdom of Kang Jeungsan (『전경(典經)』 「제생(濟生)」편 연구- 강증산의 권능(權能)·지혜(智慧)와 관련하여 -)

  • Ko Nam-sik
    • Journal of the Daesoon Academy of Sciences
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    • v.41
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    • pp.63-131
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    • 2022
  • In the context of Daesoon Jinrihoe's The Canonical Scripture, 'Saving Lives' consists of one 44 verse-long chapter. The content covers Kang Jeungsan's authority and foreknowledge, and most of the passages are about the treatment of diseases. Other passages are about relief from natural disasters, the resolution of conflicts in personnel affairs, and wisdom as applied to saving lives. The treatment of diseases focuses on solving the ailments faced by lower classes during that time period. Kang Jeungsan relieved the damage suffered by the people from natural phenomena as caused by the three disasters which resulted from water, fire, and wind. He also worked to solve other difficulties experienced in human society. In addition, the definition of 'wisdom' here is one of being high-seeing and far-thinking in Saving Lives. That is the foundation upon which wisdom can save oneself and others. After comparing each chapter of The Canonical Scripture with the parallel verses from the 6th edition of Daesoon Jeongyeong, the results of this study can be summarized as follows: first, saving lives as performed by Kang Jeungsan became an unprecedented and absolute act of relieving the common people during a time when they were suffering from great harms, hardships, and difficulties in their daily lives during the late Joseon Dynasty. Second, the verses were distributed into seven parts to achieve the purpose indicated by the titles of each section which related to specific powers exhibited by Kang Jeungsan in his interactions with Heaven, Earth and Humanity. Third, the second chapter of 'Saving Lives' includes not only treatment of disease, natural disasters, and hardships, but also relief meant to lessen the burdens people experienced in their daily lives while living within the boundaries of society. This is different from the respective section from the 6th edition of Daesoon Jeongyeong which, by way of contrast, only contained verses concerning the treatment of disease. The contents of 'Saving Lives' in The Canonical Scripture deals with the relief in a wide range of applications and is thereby different from the chapter on healing from the Daesoon Jeongyeong, which merely dealt with the healing of diseases. Therefore, this broader range of meanings can be taken to be a unique feature of The Canonical Scripture.

The Crisis of AIDS and responses of South African Churches in the task of new national building (새로운 민주주의 국가건설의 과제 속에 직면한 AIDS와 이에 대한 교회의 반응과 과제: 남아프리카 공화국을 중심으로)

  • Kim, Dae-Yoong
    • Journal of the Korean Association of African Studies
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    • v.29
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    • pp.27-53
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    • 2009
  • At the start of the new century, South Africa probably had the largest number of HIV-infected people of any country in the world. The only nation that comes close is India with a population of one billion people compared to South Africa's figure of 57 million. The tragedy is that this did not have to happen. South Africa was aware of the dangers posed by AIDS as early as 1985. In 1991, the national survey of women attending antenatal clinics found that only 0.8percent were infected. In 1994, when the new government took power, the figure was still comparatively low at 7.6 %. The 2004 figure which has been published is 26.5%. This article tracks the epidemic globally, in the region and in South Africa. I explain some of the basic concepts around the disease and look at what may happen with respect to numbers. The situation is bad, and the number of people falling ill, dying and leaving families will rise over next few years. This will impact on South Africa in a number of important ways. This article assesses the demographic, economic and social consequences of the epidemic. It disposes of a number of myths and present the real facts. The AIDS in South Africa is not related to individuals only. It warns that AIDS in Africa is becoming a community and systemic problem. The acuteness of the problem does not stem merely from the fact that communities are affected, or could even be wipe out by the end of this decade, but from the fact that AIDS will place incredible burdens and obligations upon medical services, health care and religious communities such as churches. The facts confront churches' mission with the important question: who is going to take care of all the patients and where? The reality is that people dying of AIDS will have to be cared for at home by relatives and friends. A further question that arises is whether our people are prepared for this. AIDS was considered to be a homo-plague and the hunt was on for a scapegoat in the light of the fatal implication of the disease. At present we are in the strategic phase where we all realize that it will be of no avail to scare people with the ominous threat of AIDS AIDS destroys the optimism of our achievement ethics. This exposure of the culture of optimism is also an exposure of the so-called 'human basic fear which accuses Christianity that their concept of sin is a damper on man's search for liberation and basic need to be freed from all Imitation. AIDS is also a test for our ecclesiastical genuineness and the sincerity of our mission sensibility. It poses the question: How unconditional is Christian love? Is there room for the AIDS sufferer in the community of believers, despite the fact he is an acknowledged homosexual? The question to put to the church is whether the community of believers is an exclusive to put to the koinonia which excludes homosexuals. They may be welcome on principle, but in actual fact are not acceptable to the church community. As South Africa enters the new century, it is clear that the epidemic is not having a measurable impact. However, the impact of AIDS is gradual, subtle and incremental. The author's proposal of what is currently most needed in South Africa is that the little things will make a difference. It's about doing lots of little things better at grassroots level, with the emphasis on doing. There are so many community, churches and NGOs initiatives worth building on and intensifying. One must not underestimate the therapeutic value of working together in small groups to overcome a problem