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A Study on Medical-criminal Problem of Withdrawing Life-Sustaining Treatment (치료중단행위에 대한 의료형법적 고찰 -의학적 충고에 반한 퇴원 사례를 중심으로-)

  • Cho, In-Ho
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.319-382
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    • 2008
  • As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

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Quality Characteristics of Yukwa Prepared with Mugwort Powder Using Different Puffing Process (팽화방법을 달리한 쑥 분말 첨가 유과의 품질 특성)

  • Yang, Sun;Kim, Mun-Yong;Chun, Soon-Sil
    • Korean journal of food and cookery science
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    • v.24 no.3
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    • pp.340-348
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    • 2008
  • The purpose of this study was to develop new method for the manufacture of Yukwa, a Korean oil-puffed rice snack with a soft texture, using a far infrared ray electric roaster. The Yukwa base is traditionally expanded using oil, but the Yukwa base tends to develop unpleasant rancid odors or off-flavors during storage. In this study, the DPPH radical scavenging activity of mugwort powder was evaluated. Baked and fried Yukwa samples were added with 0.5, 1.0, 1.5, and 2.0% of mugwort powder and left untreated as a control, and then tested for moisture content, expansion rate, color, hardness, and sensory evaluations. The samples with higher concentrations of mugwort powder, evidenced a more profound tendency toward DPPH radical scavenging activity. The moisture content of Yukwa dough tended to increase with the addition of mugwort powder. As the mugwort powder content increased, the moisture contents of the Yukwa base and the Baked Yukwa increased. The moisture content and expansion rates of the fried Yukwa did not differ significantly. The samples containing the mugwort power evidenced a lower expansion rate than was observed in the control group. The lightness of the baked and fried Yukwa was reduced with increased mugwort powder content. The greenness of the baked and fried Yukwa was at a minimum upon the addition of 2.0% mugwort powder. The yellowness of the baked Yukwa did not differ significantly between the samples. As the mugwort powder content increased, the yellowness of the fried Yukwa increased. The hardness of the baked and fried Yukwa tended to increase with the addition of mugwort powder. In the sensory evaluations, the baked Yukwa scored higher than the fried Yukwa, and all of the sensory characteristics of baked Yukwa scored highest in the samples without mugwort powder, but also scored fairly well with 1.0 and 1.5% mugwort powder. In conclusion, these results demonstrated that 1.0~1.5% of mugwort powder should be added to Yukwa baked in a far infrared ray electrical roaster in order to optimize physiological functions and keep overall acceptability reasonably high.

The Changes of Depositional Landforms in the Downstream Reach of Cha-Cheon (차천(車川) 하류 구간의 퇴적지형 변화)

  • Yu, Tai-Il
    • Journal of the Korean association of regional geographers
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    • v.12 no.3
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    • pp.352-363
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    • 2006
  • The purpose of this paper is to analyze changes in the depositional landform in the channel of Cha-cheon, a branch stream of Nakdong river(main stream) since the artificial straight channel has been constructed in 1973. The results of analyses are as follow. First, the Cha-cheon has flooded over one time in a year, and flowed backward over three times annually, according to analyze the data of the Hyeonpoong Gauging Station of rainfall and water level during a decade(1993$\sim$2002). Second, the flood plain within the artificial straightened channel has a nearly plain profile between the small dike and last riffle(point A). Deposits thickness of flood plain reduce gradually toward upstream. Third, grain size distribution of the flood plain deposits(0$\sim$20cm) within the artificial straightened channel has a coarsening trend in downstream reach of C point. It implies that the backward flow of Nakdong river(the main stream of Cha-cheon) make effect on the depositional mechanism of lowest reach in Cha-cheon. Finally, the result of analyzing grain size distribution of the flood plain deposits(0$\sim$20cm) within the artificial straightened channel implies that the c-point is the boundary between the vertical deposition of suspended load due to the backward flow of Nakdong river and the deposition of bed load supplied from hillslope of Cha-cheon basin.

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Performance of elderly oral health management and related factors among care workers in long-term-care hospitals (요양병원 요양보호사의 노인 구강건강관리 수행도 관련요인)

  • Choi, Se-Eun;Han, Mi-Ah;Park, Jong;Ryu, So-Yeon
    • Journal of Korean society of Dental Hygiene
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    • v.17 no.5
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    • pp.791-803
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    • 2017
  • Objectives: Oral health management is important to improve the quality of life among the elderly. This study investigated the performance of elderly oral health management among some care workers in long-term-care hospitals. Methods: The study subjects were 174 care workers in 10 long-term-care hospitals. Data on general characteristics of care workers, attitude, recognition and knowledge of elderly health, performance of elderly oral health management were collected by a self-administered questionnaire. Data were analyzed through descriptive analysis, t-test, ANOVA, correlation and multiple regression analysis by using a SPSS version 23.0 statistical program. Results: The performance score of oral health management was $4.34{\pm}0.64$ on the 5-point Likert scale. The subjects who exercised more than 2 times a month were significantly higher in their performance of elderly oral health management compared to subjects who did not exercise (${\beta}=0.232$, p=0.035). And, the subjects who cared 10-19 persons were significantly higher in performance of elderly oral health management compared to subjects who cared more than 20 elderly (${\beta}=0.246$, p=0.020). The oral health behavior of care worker (${\beta}=0.271$, p<0.001) and the knowledge of oral health care (${\beta}=0.055$, p=0.008) were positively related to the performance of elderly oral health management. Conclusions: The educational program designed to improve knowledge of care workers in accordance with the standard textbook for training care workers should be developed, and the long term education program should be reinforced to improve the performance for elderly oral health care. If care workers can care a proper number of old persons, they will give oral health care to them.

Estimation of Willingness to Pay of Rural Tourism (농촌 체험관광에 따른 Willingness to Pay 추정)

  • Park, Jeong-Won;Choi, Young-Wan;Yoon, Yong-Cheol;Kim, Young-Joo
    • Journal of Korean Society of Rural Planning
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    • v.18 no.2
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    • pp.47-56
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    • 2012
  • Recently urban areas have been advanced in the aspects of convenience, traffic, and cultural environments, but they have faced various problems including environmental issues, traffic congestion, and increasing stress. In contrast, rural areas are in charge of various functions, conservations of natural environments and traditional cultures. Rural life style may be beneficial to urbanites. As urbanites are increasingly interested in leisure activities, such as experiences of tradition cultures and education, safe foods and rural tourism are gaining attention as alternative ways of satisfying their desires. In other words, the rural tourism not only provides urbanites with leisure spaces by playing a role in relations between urban and rural areas, but also acts as a nonfarm income to the rural residents. With the changes of time, the number of current rural experience tourism on a nationwide is increasing and competition among locations is getting intensive. Particularly, despite various rural tourism villages in operation, there is not a standard in the dice for experience cost and accommodation costs. Accordingly, the aim of the study was to estimate urbanites' willingness to pay(WTP) for rural experience tourism and to provide basic data for qualitative growth and revitalization with regard to the tours. The estimated WTP for rural experience tourism was found to be 5,600won for experience, 5,600won for food, 42,000won for accommodation, and 13,000won for purchasing farm products, respectively. This trend could be similarly found (there were slight differences in food cost) on all analyses, such as the research of the current situations of rural tourism villages in Gyeongnam province, the pilot survey and the estimation depending on whether or not urbanites experienced the tours. In other words, the WTP for urban hands-on experience tours estimated by this study is considered highly significant in terms with possibility of its application in the sites. It is concluded that the urbanites' WTP for rural experience tourism obtained by this study will contribute to the setup of standard index of rural tourism, the qualitative development of rural hands-on experiences, and the raise of nonfarm income.

The Effects of the Fun Factor and Immersion of marine Sports on Leisure Satisfaction (해양스포츠 참가자의 재미요인과 몰입이 여가만족에 미치는 영향)

  • Jang, Jae-Yong;Kwon, Oh-Ryun;Kang, Shin-Beum
    • Journal of Navigation and Port Research
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    • v.37 no.1
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    • pp.101-111
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    • 2013
  • The following study holds its purpose on verifying primary fun factors of participation and satisfaction on marine sports. The results are: 1)The efficiency, effectiveness of exercise, self-satisfaction, and family support turned out to be higher in the group with longer and higher period, time, and frequency of participation than those of the control group. 2) The period of participation, speculation on engagement according to the frequency, and behavioral factors were shown to be higher in the group with longer and higher period, time, and frequency of participation than those of the control group. 3) Satisfaction on leisure on social, physical, emotional, and educational means were higher in the group with longer and higher period, time, and frequency of participation than those of the control group. 4) The fun factors of marine sports- self-satisfaction, effectiveness of excercise, efficiency, and family support- had a positive effect on increasing satisfaction in leisure. 5) The fun factors of marine sports- effectiveness of excercise, self-satisfaction, and family support- had a positive effect on increasing satisfaction in leisure. 6) The speculation of engagement in sports and the reinforcement of engagement had a positive effect on increasing satisfaction of leisure.

Taxonomical and Ecological Study on the Vegetation of the Seungbong Island (승봉도 식물상에 관한 분류 및 생태학적 연구)

  • Lee, Ho Joon;Seon Choel Choi;Young Hee Lee
    • Journal of environmental and Sanitary engineering
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    • v.5 no.2
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    • pp.105-116
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    • 1990
  • Seungbong Island is situated about 100km away Inchon Port in the western sea of the Korean Peninsula. Field investigations were conducted for two days each from June 30 through July 1, 1981 and from August 20 through 21, 1981. The results obtained are summarized as follows: Plants growing in this island consist of a total of 193 species (70 families, 151 genera, 170 species, 22 varieties and 1 forma). Pinus thunbergii was confirmed to be the dominant species. The natural degree observed in this island was high, as a whole. The coefficient of ferny plants (Pte-Q) is 0.95, lower than grass. Atractylodes japonica Koidz., Miscanthus sinensis Anders. var. purpurascense Rendle, and Rhododendron mucronulatum Turz. are distributed mainly on the forest bed of Pinus thunbergii. The poor distribution of Chenopodium album var. centrorubrum Makino, Setaria viridis (L.) Beauv., Amaranthus mangostanus Linne is considered attributable to the phenomenon of allellopathy caused by a chemical substance secreted from the leaves of Pinus thunbergii. The component ratio of species in this island is lower than that of other islands due probably to the small area of arable land and grassland. The poor growth of plants in the forest of Pinus thunbergii, the dominant species in this island, seems to be attributed to the low relative light intensity of the forest. Seaside plants consisting of a total of 7 species were distributed mainly in the vicinity of sandy beaches. Naturalized plants comprising a total of 11 species were relatively diversified in the number of species.

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A Study on Actual Conditions of Leisure Time and Service Satisfaction of Community-dwelling Elderly -Focused on Buyeo (지역사회거주 노인의 여가시간활용과 바우처사업 서비스 만족도에 관한 연구-부여군을 중심으로)

  • Jeon, Byoung-Jin;Lee, Jae-Shin;Kwon, Mi-Hwa
    • The Journal of Korean society of community based occupational therapy
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    • v.2 no.1
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    • pp.25-35
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    • 2012
  • Objective : This study conducted in rural areas, elderly services voucher business and leisure satisfaction survey based on data from the use of community-dwelling older people considering service needs was to find ways to take advantage of leisure time. Methods : Buyeo county residents in this study 71 patients were elderly, the characteristics of elderly gender, the presence of spouse, health status, education level, monthly living expenses, number of children, occupation, and the variables were included. Subjects' self-esteem, life satisfaction, quality of life, program satisfaction questionnaire for the survey were used, t-test and correlation analysis using the correlation between each factor were analyzed. Results : In a survey of participants in leisure activities, TV watching, meeting friends, such as phone calls to static and time-consuming activities were surveyed about satisfaction of the voucher business, the elderly oral health care services, health screening services, sports massage such as health-related services is relatively high degree of satisfaction. Conclusion : The results of this study of elderly people in rural communities through meaningful leisure time were utilized to determine what is lacking, a strong desire for health-related services that could be confirmed. Therefore, further experience and knowledge about activities by providing opportunities for meaningful leisure time needs to improve, and it based on a variety of programs to meet the needs of the elderly should be provided.

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Oral health behavior and related factors in public health majoring students (보건계열학과 학생들의 구강건강행위와 관련요인)

  • Han, Yeo-Jung;Han, Mi Ah;Ryu, So Yeon;Choi, Seong Woo
    • Journal of Korean society of Dental Hygiene
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    • v.15 no.3
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    • pp.487-495
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    • 2015
  • Objectives: The purpose of the study was to investigate the associated factors with oral health behavior in public health majoring students. Methods: Using convenience sampling method, the subjects were 474 health-related majoring students in Jeollanamdo. A self-reported questionnaire was completed from September 1 to 15, 2014. The questionnaire consisted of general characteristics of the subjects, oral health related characteristics, oral health knowledge and behavior. Data were analyzed using SAS 9.3 version. T-test, ANOVA, correlation and multiple linear regression analyses were performed to evaluate the related factors with oral health behavior. Cronbach's ${\alpha}$ in oral health knowledge in this study was 0.52 and that in oral health behavior was 0.80. Results: The overall score of oral health behavior was $3.38{\pm}0.52$. Of all behaviors, the practice in brush of teeth and tongue had the highest mean score. In multiple regression analysis, oral health knowledge in the nursing and dental hygiene students was positively associated with the oral health behavior(${\beta}=0.04$, p=0.003, ${\beta}=0.23$, p=0.003, and ${\beta}=0.18$, p=0.034, respectively). Necessity of dental care, one of oral symptom, and more than two oral symptoms were negatively associated with oral health behavior(${\beta}=-0.14$, p=0.002, ${\beta}=-0.11$, p=0.037, and ${\beta}=-0.17$, p=0.011, respectively). Conclusions: Higher oral health knowledge showed higher levels of oral health behavior. These results will enhance the quality of oral health behavior by increasing the level of oral health knowledge. The optimal oral health education program would be able to improve oral health behavior by increasing the level of oral health knowledge.

A Study on Characteristics of Medical Expenses and the Hospitalization Period of Hospitalized Patients Using Diem Payment System at Convalescent Hospitals (요양병원 일당정액제 입원환자의 입원일수 및 진료비 특성에 관한 연구)

  • Roh, Ock-Hee;Lee, Chong Hyung;Park, Arma;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.407-414
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    • 2016
  • This study was conducted to provide basic data to evaluate the appropriateness of convalescent hospitalization treatment by investigating the number of hospitalization days and the total treatment expenses of a total of 44,037 monthly billing statements requested from the Health Insurance Review and Assessment Service. Evaluated data consisted of medical care expenses of patients of the diem payment system hospitalized at convalescent hospitals in Daejeon, Chungnam, Chungbuk and Sejong from January through December of 2014. According to the analysis result of the general characteristics of the study objects and the canonical correlation analysis of the top 15 main diagnosis names, 7 canonical functions have been deducted. Among them, six canonical functions were shown to be statistically significant (p<0.001), and canonical function 1 had a chi-squared value of 5955.49 and 98 degrees of freedom at p<0.001 level. Overall, the results indicated that if health and welfare service in the regional society is magnified, social hospitalization can be reduced.