• Title/Summary/Keyword: Health policy guideline

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ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

Preferred Timing for Full-Retirement: Who Wants to Retire Early? (50대 남녀의 기대은퇴연령에 관한 연구: 누가 빠른 은퇴를 원하는가?)

  • Cha, Seung-Eun
    • Korea journal of population studies
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    • v.35 no.2
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    • pp.133-157
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    • 2012
  • This study analyzed plans for retirement by focusing on preferred retirement timing(PRT) measure. Current pension program show rather strong guideline about the timing of full-retirement. This study asked whether the middle age group are willing to retire correspond to the policy guidelines or not. Research sample came from 2008 KLOSA data, recruiting 1,367 workers who are residing in cities or in metropolitan area (women: 34.8%). I have analyzed one item question asking "In what age do you want to fully retire?", The results showed that, about two third of respondents declared they do not want to retire unless they have health problems, or would expect to retire no earlier than age 70. However, a third of respondents expected normal retirement coming between 60~64. Second, the determinants of timing for retirement were differ by PRT. Social determinants, such as gender, short work hours, being employed, and higher status in family income were associated with early PRT. While, good health status, positive view on the future economics were highly associated with late PRT. The results reveal that the timing of retirement is getting more diverse and obscure in the individual level.

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Evaluation of Applicability of Food and Nutrition Standards for Child Care Setting in the Seoul Metropolitan Government (서울시 영유아 공공급식 식품영양관리 기준의 적용 가능성 평가)

  • Jeon, Hye-Min;Kim, Kirang;Yi, Hae-Yeon;Hwang, Ji-Yun
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.8
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    • pp.997-1011
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    • 2017
  • This study aimed to evaluate the applicability of "food and nutrition standards for child care setting in the Seoul Metropolitan Government" using quantitative and qualitative surveys and lay the groundwork for future expansion. To evaluate the understanding and applicability of each item of the standards and utilize goodness of fit as an evaluation item to improve practicality of the child care center's health foodservice, we surveyed 82 child care centers, kindergartens, and community children centers in Seoul by e-mail through the Seoul Metropolitan Government in November 2015. Using focus group interviews with directors of child care centers and kindergartens as well as dieticians of child care support centers who had conducted public foodservice in Seoul, the appropriateness of each standard was finally reviewed, and amendments to extend this standard were derived. Results of the survey show an understanding of 86.9% and an applicability of 80.7%. Moreover, the applicability of the evaluation items for assessing improvement of health foodservice practices at the child care center was 82.6%. Qualitative evaluation of the applicability of standards through focus group interviews identified four factors for extended application: necessity of a guideline for separate food ingredient suppliers, conformity of the basis and purpose of the item, consideration of contextual situations, and necessity of establishing a Seoul-level foundation. Therefore, guidelines for the standards should be suggested for those providing public food services for children. Furthermore, separate guidelines categorized by items that food ingredient suppliers need to provide should be mandatory or recommended. Evaluation of the applicability of the standards suggests that revising and supplementing the guidelines in order to extend the standards can contribute to health promotion and a sustainable environment for children using public foodservice. Follow-up studies and supports are needed for sustainable food and nutrition management programs.

Risks Incurred by Release of Animals into the Natural Ecosystem in Korea and Its Risk Management (국내 동물의 야생생태계 방출로 인한 위해성 및 위해성 관리방안)

  • Bang, Sang-Weon;Kim, Ae-Sun
    • Journal of Environmental Policy
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    • v.10 no.1
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    • pp.3-25
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    • 2011
  • Recently, a number of local governments as well as private organizations have spearheaded the release of animals into the natural ecosystem in Korea. In 2002, most of these animals released were mammals and birds, but the parameter was gradually expanded to include fish, amphibians, and invertebrates in addition to mammals and birds in 2007, with an increased overall number of animals released. Such increase has not only posed ecological, economic, and public health risks, but also yielded an increase in damages incurred by releasing animals historically or ecologically alien to a given region without thorough risk assessment. The most significant cause of such risks was a critical lack of risk management and regulatory schemes addressing the release of animals into the natural ecosystem. In stark contrast, developed countries long before established the requisite risk management and regulatory schemes either by complying with the IUCN/SSC's Guidelines for Re-Introductions or devising them independently. In this context, the current study has examined the release of animals into the natural ecosystem in Korea and, based on the investigation, asserted a strong need for proper risk management. Moreover, the study has presented systematic risk management and regulatory schemes suitable for the Korean milieu based on a comparative analysis of those employed in developed countries.

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Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea (한국에 거주하고 있는 북한이탈주민 여성의 골밀도에 따른 식생활과 영양상태)

  • Kim, Su-Hyeon;Lee, Soo-Kyung;Kim, Sin-Gon
    • Journal of Nutrition and Health
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    • v.52 no.5
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    • pp.449-464
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    • 2019
  • Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

Legal and Regulatory Issues in Genetic Information Discrimination - Focusing on Overseas Regulatory Trends and Domestic Implications - (유전정보 차별금지의 법적문제 - 외국의 규율 동향과 그 시사점을 중심으로 -)

  • Yang, Ji Hyun;Kim, So Yoon
    • The Korean Society of Law and Medicine
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    • v.18 no.1
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    • pp.237-264
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    • 2017
  • With the onset of the Human Genome Project, social concerns about 'genetic information discrimination' have been raised, but the problem has not yet been highlighted in Korea. However, non-medical institutions' genetic testing which is related to disease prevention could be partially allowed under the revised "Bioethics and Safety Act" from June 30, 2016. In the case of one domestic insurance company, DTC genetic testing was provided for the new customer of cancer insurance as a complimentary service, which made the social changes related to the recognition of the genetic testing. At a time when precision medicine is becoming a new standard for medical care, discipline on genetic information discrimination has become a problem that can not be delayed anymore. Article 46 and 67 of the Bioethics Act stipulate the prohibition of discrimination on grounds of genetic information and penalties for its violation. However, these broad principles alone can not solve the problems in specific genetic information utilization areas such as insurance and employment. The United States, Canada, the United Kingdom, and Germany have different regulations that prohibit genetic information based discrimination. In the United States, Genetic Information Non-Discrimination Act takes a form that adds to the existing law about the prohibition of genetic information discrimination. In addition, the range of genetic information includes the results of genetic tests of individuals and their families, including "family history". Canada has recently enacted legislation in 2017, expanding coverage to general transactions of goods or services in addition to insurance and employment. The United Kingdom deals only with 'predictive genetic testing results of individuals'. In the case of insurance, the UK government and Association of British Insurers (ABI) agree to abide by a policy framework ('Concordat') for cooperation that provides that insurers' use of genetic information is transparent, fair and subject to regular reviews; and remain committed to the voluntary Moratorium on insurers' use of predictive genetic test results until 1 November 2019, and a review of the Concordat in 2016. In the case of employment, The ICO's 'Employment Practices Code (2011)' is used as a guideline. In Germany, Human Genetic Examination Act(Gesetz ${\ddot{u}}ber$ genetische Untersuchungen bei Menschen) stipulates a principle ban on the demand for genetic testing and the submission of results in employment and insurance. The evaluation of the effectiveness of regulatory framework, as well as the form and scope of the discipline is different from country to country. In light of this, it would be desirable for the issue of genetic information discrimination in Korea to be addressed based on the review of related regulations, the participation of experts, and the cooperation of stakeholders.

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