• Science of Emotion and Sensibility
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• v.17 no.3
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• pp.129-142
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• 2014

Due to the increase of the aged population and population of the disabled today, there is a growing demand for rehabilitation medical instruments. Furthermore, there is a growing demand for evaluation indices for services that should be provided for uses of the rehabilitation medical instruments. In order to evaluate rehabilitation medical instrument designs in this study, the basic index for design evaluations shall be identified to search for assessment plans. Through this, new evaluation indices will be deduced through discussions and analysis of rehabilitation medical experts, biomedical engineers, and designers. The results of this study are summarized as follows. First, the existing design evaluation indices were collected and analyzed to construct 10 rehabilitation medical instrument design evaluation indices and 44 sub-evaluation items. These will be important evaluation standards for designing rehabilitation medical instruments in the future. Second, the design evaluation indices that must be taken into consideration when developing health care rehabilitation medical instruments are the 10 design evaluation indices of usability, cognition, safety, learning, motility, durability, economic feasibility, space, aesthetics and environmental aspects. Third, design evaluation indices of environment, space, cognition, usability, economic feasibility and aesthetics are indices that must be taken into consideration for product design, while learning, safety, motility and durability are factors that must be given special consideration for rehabilitation medical instrument design evaluation indices. Fourth, if existing product design evaluation indices placed importance on environment, space, cognition, usability, economic feasibility and aesthetics of products for design evaluation indices, rehabilitation medical instrument design evaluation indices placed importance on learning, safety, motility and durability on top of usability and economic feasibility, which are the differences between the design evaluation indices of rehabilitation medical instrument and other product designs. The 10 rehabilitation medical device design evaluation indices and 44 sub-evaluation items were carried out in this study. This research is only on the overall rehabilitation medical device design evaluation indices. In future research, the evaluation indices will be applied in the actual rehabilitation medical design device through production of prototypes, while making revisions and supplementations where necessary.

• Tuberculosis and Respiratory Diseases
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• v.64 no.6
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• pp.445-450
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• 2008

Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

• Journal of Korean Academy of Nursing
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• v.4 no.1
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• pp.162-178
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• 1974

The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

• Journal of Nutrition and Health
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• v.42 no.7
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• pp.650-663
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• 2009

The purposes of this study were to investigate one portion size of menus served and to evaluate nutrient intake of lunch at three elderly care facility food services located in Seoul. A weighed plate method was employed to measure plate wastes and consumption of the menus served. Yield factors were calculated from cooking experiments based on standardized recipes, and were used to evaluate nutrient intake. One hundred elderly participated in this study for measuring plate waste and were asked to complete questionnaire. Nutrient analyses for the served and consumed meal were performed using CAN program. The yield factors of rice dishes after cooking are 2.4 regardless of rice dish types, 1.58 for thick soups, 0.60 to 0.70 for meat dishes, and 1.0 to 1.25 branched vegetable. Average consumption quantity of dishes were 235.97 g for rice, 248.53 g for soup, 72.83 g for meat dishes, 39.80 g for vegetables and 28.36 g for Kimchi. On average the food waste rate is 14.0%, indicating the second highest plate waste percentage of Kimchi (26.2%), and meat/fish dish (17.3%). The evaluation results of NAR (Nutrition Adequacy Ratio) showed that iron (0.12), calcium (0.64), riboflavin (0.80), and folic acid (0.97) were less than 1.0 in both male and female elderly groups, indicating significant differences of NAR among three facilities. Compared to the 1/3 Dietary Reference Intake (DRIs) for the elderly groups, nutrient intake analysis demonstrated that calcium (100%) and iron (100%), followed by riboflavin, vitamin A, and Vitamin B6 did not met of the 1/3 EAR (Estimated Average Requirement). For the nutritious meal management, a professional dietitian should be placed at the elderly care center to develop standardized recipes in consideration of yield factors and the elderly's health and nutrition status.

• Journal of The Association for Neo Medicine
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• v.2 no.1
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• pp.35-54
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• 1997

We tried to observe the features of ancient medical practice by analysing the records related to medicine in the book, ${\ulcorner}$the Historical Records of the Three Kingdom${\lrcorner}$ of which content includes the features of medicine in mythology, plague, delivery of twins, drugs, medical system, shamanism, constitutional medicine, psychiatry, forensic medicine, deformity, a spa, medical phrase, health and welfare work, religion, death. physiological anatomy, Taoist medicine, acupuncture, the occult af of transformation and etc. Our initial concern was about where to draw line as of medical field and we defined medicine in more broad meaning. The book ${\ulcorner}$the Historical Records of the Three Kingdoms${\lrcorner}$ describes the world of mythology by way of medicine which is not clearly a conventional one. There appears records of birth of multiple offsprings 7 times in which cases are of triplets or more. Delivering multiple offsprings were rare phenomenon though such fertility was highly admired. This shows one aspect of ancient country having more population meant more power of the nation. Of those medical records conveyed in that book includes stories of childbirth such as giving birth to a son after praying, giving birth to Kim Yoo-shin after 20 months after mother's dream of conception, and a song longing for getting a laudable child. Plagues were prevalent throughout winter to spring season and one can observe various symptoms of plagues in the record. Of these epidemic diseases, cold type might have been more common than the heat one. Appearance of epidemic diseases frequently coincided with that of natural disasters that this suggests a linkage between plague and underlying doctrine on five elements' motion and six kinds of natural factors. There exists only a few names of diseases such as epidemic disease, wind disease, and syndrome characterized by dyspnea. Otherwise there appeared only afflictions that were not specified therefore it remains cluless to keep track of certain diseases of prevalence. Since this ${\ulcorner}$Historical Records of the Three Kingdoms'${\lrcorner}$ wasn't any sort of medical book, words and terms used were not technical kind and most were the ones used generally among lay people. Therefore any mechanisms of the diseases were hardly mentioned. Some of medicinal substances such as Calculus Bovis, Radix Ginseng, Gaboderma Luciderm, magnetitum were also in use in those days. 53 kinds of dietary supplies appears in the records and some of these might have been used as medicinal purpose. Records concerning dicipline of one's body includes activities such as hunting, archery, horseback riding etc. In Shilla dynasty there were positions such as professor of medicine, Naekongbong(內供奉), Kongbong's doctor(供奉醫師), Kongbong's diviner(供奉卜師). As an educational facility, medical school was built at the first year of King Hyoso's reign and it's curricula included various subjects as ${\ulcorner}$Shin Nong's Herbal classic${\lrcorner}$, ${\ulcorner}$Kabeul classic of acupuncture and moxbustion${\lrcorner}$, ${\ulcorner}$The Plain Questions of the Yellow Emperor's Classic of Internal Medicine${\lrcorner}$, ${\ulcorner}$Classic of Acupuncturer${\lrcorner}$, ${\ulcorner}$The Pulse Classic${\lrcorner}$, ${\ulcorner}$Classic of Channels and Acupuncture Points${\lrcorner}$ and ${\ulcorner}$Difficult Classic${\lrcorner}$. There were 2 medical professors who were in charge of education. To establish pharmacopoeia, 2 Shaji(舍知), 6 Sha(史), 2 Jongshaji(從舍知) were appointed. In Baekje dynasty, Department of Herb was maintained. Doing praying for the sake of health, doing phrenology also can be extended to medical arena. Those who survived over 100 years of age appear 3 times in the record, while 98 appears once. The earliest psychiatrist Nokjin differentiated symptoms to apply either therapies using acupuncture and drug or psychotherapy. There appears a case of rape, a case of burying alive with the dead, 8 cases of suicide that can characterize a prototype of forensic medicine. Deformity-related records include phrases as follow: 'there seems protrudent bone behind the head', 'a body which has two heads, two trunks, four arms.', 'a body equipped with two heads' In those times spa can be said to be used as a place for he리ing, convalescence, and relaxation seeing the records describing a person pretended illness and went to spa to enjoy with his friends. Priest doctors and millitary surgeons were in charge of the medical sevice in the period of the Three Kingdoms by the record written by Mookhoja(墨胡子) and Hoonkyeom(訓謙). Poor diet and regimen makes people more vulnerable to diseases. So there existed charity services for those poor people who couldn't live with one's own capacity such as single parents, orphans, the aged people no one to take care and those who are ill. The cause of affliction was frequently coined with human relation. There appeared the phenomenon of releasing prisoners and allowing people to become priests at the time of king's suffering. Besides, as a healing procedure, sutra-chanting was peformed. There appears 10 cases of death related records which varies from death by drowning, or by freezing, death from animals, death from war, death from wightloss and killing oneself at the moment of spouse's death and etc. There also exist certain records which suggest the knowledge of physiology and anatomy in those times. Since the taoist books such as ${\ulcorner}$Book of the Way and Its Power(老子道德經)${\lrcorner}$ were introduced in the period of Three Kingdoms, it can be considered that medicine was also influenced by taoism. Records of higher level of acupuncture, records which links the medicine and occult art of transformation existed. Although limited, we could figure out the medical state of ancient society.

• KDI Journal of Economic Policy
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• v.12 no.3
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• pp.27-45
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• 1990

Two opposing views prevail regarding the economic impact of rural out-migration on the rural areas of origin. The optimistic neoclassical view argues that rapid rural out-migration is not detrimental to the income and welfare of the rural areas of origin, whereas Lipton (1980) argues the opposite. We developed our own alternative model for rural to urban migration, appropriate for rapidly developing economies such as Korea's. This model, which adopts international trade theories of nontraded goods and Dutch Disease to rural to urban migration issues, argues that rural to urban migration is caused mainly by two factors: first, the unprofitability of farming, and second, the decrease in demand for rural nontraded goods and the increase in demand for urban nontraded goods. The unprofitability of farming is caused by the increase in rural wages, which is induced by increasing urban wages in booming urban manufacturing sectors, and by the fact that the cost increases in farming cannot be shifted to consumers, because farm prices are fixed worldwide and because the income demand elasticity for farm products is very low. The demand for nontraded goods decreases in rural and increases in urban areas because population density and income in urban areas increase sharply, while those in rural areas decrease sharply, due to rapid rural to urban migration. Given that the market structure for nontraded goods-namely, service sectors including educational and health facilities-is mostly in monopolistically competitive, and that the demand for nontraded goods comes only from local sources, the urban service sector enjoys economies of scale, and can thus offer services at cheaper prices and in greater variety, whereas the rural service sector cannot enjoy the advantages offered by scale economies. Our view concerning the economic impact of rural to urban migration on rural areas of origin agrees with Lipton's pessimistic view that rural out-migration is detrimental to the income and welfare of rural areas. However, our reasons for the reduction of rural income are different from those in Lipton's model. Lipton argued that rural income and welfare deteriorate mainly because of a shortage of human capital, younger workers and talent resulting from selective rural out-migration. Instead, we believe that rural income declines, first, because a rapid rural-urban migration creates a further shortage of farm labor supplies and increases rural wages, and thus reduces further the profitability of farming and, second, because a rapid rural-urban migration causes a further decline of the rural service sectors. Empirical tests of our major hypotheses using Korean census data from 1966, 1970, 1975, 1980 and 1985 support our own model much more than the neoclassical or Lipton's models. A kun (county) with a large out-migration had a smaller proportion of younger working aged people in the population, and a smaller proportion of highly educated workers. But the productivity of farm workers, measured in terms of fall crops (rice) purchased by the government per farmer or per hectare of irrigated land, did not decline despite the loss of these youths and of human capital. The kun having had a large out-migration had a larger proportion of the population in the farm sector and a smaller proportion in the service sector. The kun having had a large out-migration also had a lower income measured in terms of the proportion of households receiving welfare payments or the amount of provincial taxes paid per household. The lower incomes of these kuns might explain why the kuns that experienced a large out-migration had difficulty in mechanizing farming. Our policy suggestions based on the tests of the currently prevailing hypotheses are as follows: 1) The main cause of farming difficulties is not a lack of human capital, but the in­crease in production costs due to rural wage increases combined with depressed farm output prices. Therefore, a more effective way of helping farm economies is by increasing farm output prices. However, we are not sure whether an increase in farm output prices is desirable in terms of efficiency. 2) It might be worthwhile to attempt to increase the size of farmland holdings per farm household so that the mechanization of farming can be achieved more easily. 3) A kun with large out-migration suffers a deterioration in income and welfare. Therefore, the government should provide a form of subsidization similar to the adjustment assistance provided for international trade. This assistance should not be related to the level of farm output. Otherwise, there is a possibility that we might encourage farm production which would not be profitable in the absence of subsidies. 4) Government intervention in agricultural research and its dissemination, and large-scale social overhead projects in rural areas, carried out by the Korean government, might be desirable from both efficiency and equity points of view. Government interventions in research are justified because of the problems associated with the appropriation of knowledge, and government actions on large-scale projects are justified because they required collective action.