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How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

Seismic response characteristics of the hypothetical subsea tunnel in the fault zone with various material properties (다양한 물성의 단층대를 통과하는 가상해저터널의 지진 시 응답 특성)

  • Jang, Dong In;Kwak, Chang-Won;Park, Inn-Joon;Kim, Chang-Yong
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.20 no.6
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    • pp.1061-1071
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    • 2018
  • A subsea tunnel, being a super-sized underground structure must ensure safety at the time of earthquake, as well as at ordinary times. At the time of earthquake, in particular, of a subsea tunnel, a variety of response behaviors are induced owing to relative rigidity to the surrounding ground, or difference of displacement, so that the behavior characteristics can be hardly anticipated. The investigation aims to understand the behavior characteristics switched by earthquake of an imaginary subsea tunnel which passes through a fault zone having different physical properties from those of the surrounding ground. In order to achieve the aim, dynamic response behaviors of a subsea tunnel which passes through a fault zone were observed by means of indoor experiments. For the sake of improved earthquake resistance, a shape of subsea tunnel to which flexible segments have been applied was considered. Afterward, it is believed that a D/B can be established through 3-dimensional earthquake resistance interpretation of various grounds, on the basis of verified results from the experiments and interpretations under various conditions. The present investigation performed 1 g shaking table test in order to verify the result of 3-dimensional earthquake resistance interpretation. A model considering the similitude (1:100) of a scale-down model test was manufactured, and tests for three (3) Cases were carried out. Incident seismic wave was introduced by artificial seismic wave having both long-period and short-period earthquake properties in the horizontal direction which is rectangular to the processing direction of the tunnel, so that a fault zone was modeled. For numerical analysis, elastic modulus of the fault zone was assumed 1/5 value of the modulus of individual grounds surround the tunnel, in order to simulate a fault zone. Resultantly, reduced acceleration was confirmed with increase of physical properties of the fault zone, and the result from the shaking table test showed the same tendency as the result from 3-dimensional interpretation.

Shielding Capability Evaluation of Mobile X-ray Generator through the Production assembled Shield (일체형 방어벽 제작을 통한 이동형 엑스선 발생기의 차폐능 평가)

  • Kim, Seung-Uk;Han, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.895-908
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    • 2018
  • As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.

A Study on Smart Accuracy Control System based on Augmented Reality and Portable Measurement Device for Shipbuilding (조선소 블록 정도관리를 위한 경량화 측정 장비 및 증강현실 기반의 스마트 정도관리 시스템 개발)

  • Nam, Byeong-Wook;Lee, Kyung-Ho;Lee, Won-Hyuk;Lee, Jae-Duck;Hwang, Ho-Jin
    • Journal of the Computational Structural Engineering Institute of Korea
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    • v.32 no.1
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    • pp.65-73
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    • 2019
  • In order to increase the production efficiency of the ship and shorten the production cycle, it is important to evaluate the accuracy of the ship components efficiently during the drying cycle. The accuracy control of the block is important for shortening the ship process, reducing the cost, and improving the accuracy of the ship. Some systems have been developed and used mainly in large shipyards, but in some cases, they are measured and managed using conventional measuring instruments such as tape measure and beam, optical instruments as optical equipment, In order to perform accuracy control, these tools and equipment as well as equipment for recording measurement data and paper drawings for measuring the measurement position are inevitably combined. The measured results are managed by the accuracy control system through manual input or recording device. In this case, the measurement result is influenced by the work environment and the skill level of the worker. Also, in the measurement result management side, there are a human error about the lack of the measurement result creation, the lack of the management sheet management, And costs are lost in terms of efficiency due to consumption. The purpose of this study is to improve the working environment in the existing accuracy management process by using the augmented reality technology to visualize the measurement information on the actual block and to obtain the measurement information And a smart management system based on augmented reality that can effectively manage the accuracy management data through interworking with measurement equipment. We confirmed the applicability of the proposed system to the accuracy control through the prototype implementation.

Comparative Analysis of Nitrogen Concentration of Rainfall in South Korea for Nonpoint Source Pollution Model Application (비점오염모델 적용을 위한 우리나라 행정구역별 강수 중 질소농도 비교분석)

  • Choi, Dong Ho;Kim, Min-Kyeong;Hur, Seung-Oh;Hong, Sung-Chang;Choi, Soon-Kun
    • Korean Journal of Environmental Agriculture
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    • v.37 no.3
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    • pp.189-196
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    • 2018
  • BACKGROUND: Water quality management of river requires quantification of pollutant loads and implementation of measures through monitoring study, but it requires labour and costs. Therefore, many researchers are performing nonpoint source pollution analysis using computer models. However, calibration of model parameters needs observed data. Nitrogen concentration in rainfall is one of the factors to be considered when estimating the pollutant loads through application of the nonpoint source pollution model, but the default value provided by the model is used when there are no observed data. Therefore, this study aims to provide the representative nitrogen concentration of the rainfall for the administrative district ensuring rational modeling and reliable results. METHODS AND RESULTS: In this study, rainfall monitoring data from June 2015 to December 2017 were used to determine the nitrogen concentration in rainfall for each administrative district. Range of the NO3 and NH4+ concentrations were 0.41~6.05 mg/L, 0.39~2.27 mg/L, respectively, and T-N concentration was 0.80~7.71 mg/L. Furthermore, the national average of T-N concentration in this study was 2.84±1.42mg/L, which was similar to the national average of T-N 3.03 mg/L presented by the Ministry of Environment in 2015. Therefore, the nitrogen concentrations suggested in this study can be considered to be resonable values. CONCLUSION: The nitrogen concentrations estimated in this study showed regional differences. Therefore, when estimating the pollutant loads through application of the nonpoint source pollution model, resonable parameter estimation of nitrogen concentration in rainfall is possible by reflecting the regional characteristics.

A Study on the Adolescent's Recognition of Science and Technology, Environment, Climate Change in Korea (우리나라 청소년의 과학기술과 환경, 기후변화 관련 인식 연구)

  • Seo, Keum-Young;Kim, Woo Hyun;Kim, Hyun-Ah;Lee, Jae-Hyung
    • Journal of Climate Change Research
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    • v.4 no.4
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    • pp.409-416
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    • 2013
  • Recently, the property damage has been increasing due to climate change in South Korea. While the general public has become more aware of the environmental issues, but the environmental education system has not been able to meet up with the demands of the public. The purpose of this study is to suggest preliminary data which is needed for developing a environmental textbook. A survey was conducted to meet the following requirements. Respondent's level of interest in problems or situations concerning the following eight themes: fundamental science, health and medicine, aerospace engineering, life science, electrical electronics, telecommunication, mineral and energy resources, environment. The data was collected from 139 students in Seoul and Gyeonggi province. The results showed that health and medicine issues interest students the most (49.6%), followed by environment (46.8%). We asked the respondents who were very interested in each question for their reasons, and they answered that environmental issue is related to the improvement of their life quality (53.8%) than their curiosity (38.5%). Students were very interested in the other issues because of just curiosity. Most students (90.6%) said seasonal change was not same each year. 18.0% of respondents replied that they and their friends had experienced climate change. The majority of students (94.2%) thought that they will experience natural disaster blamed on climate change during their life. In other words, climate change is already the day-to-day events of their lives. The majority of their opinions, more then three than ten students(30.9%) said the South Korean government should conduct an energy saving campaign to climate change problems followed by expanding new renewable energy (24.5%), conducting adaptation policies of climate change(22.3 %), introducing of a system as like CO2 emissions trading(20.9%) and so on. There are more Stu- dents (69.1%) who know of new renewable energy than students who don't know it; however, respondents who know the meaning very well were just 18.7% showing that most students dimly know the meaning of new renewable energy.

Establishment and application of standard-RSF for trace inorganic matter mass analysis using GD-MS (GD-MS 분석 장비를 활용한 극미량 무기물 질량 분석을 위한 표준RSF 구축 및 응용)

  • Jang, MinKyung;Yang, JaeYeol;Lee, JongHyeon;Yoon, JaeSik
    • Analytical Science and Technology
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    • v.31 no.6
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    • pp.240-246
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    • 2018
  • The present study analyzed standard samples of three types of aluminum matrix certified reference materials (CRM) using GD-MS. Calibration curves were constructed for 13 elements (Mg, Si, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Ga, Sn, and Pb), with the slope representing the relative sensitivity factor (RSF). The x- and y-axes of the calibration curve represented ion beam ratio (IBR) and the authenticated value of the standard sample, respectively. In order to evaluate precision and linearity of the calibration curve, RSD and the coefficient of determination were calculated. Curve RSD for every element reflected high precision (within 10 %). For most elements, the coefficient of determination was 0.99, indicating excellent linearity. However, vanadium, nickel, and gallium curves exhibited relatively low linearity (0.90~0.95), likely due to their narrow concentration ranges. Standard RSF was calculated using the slope of the curve generated for three types of CRM. Despite vanadium, nickel, and gallium exhibiting low coefficients of determination, their standard RSF resembled that of the three types of CRM. Therefore, the RSF method may be used for element quantitation. Standard iron matrix samples were analyzed to verify the applicability of the aluminum matrix standard RSF, as well as to calculate the RSD-estimated error of the measured value relative to the actual standard value. Six elements (Al, Si, V, Cr, Mn, and Ni) exhibited an RSD of approximately 30 %, while the RSD of Cu was 77 %. In general, Cu isotopes are subject to interference: 63Cu to 54Fe2+36Ar and 65Cu to 56FeAl3+ interference. Thus, the influence of these impurities may have contributed to the high RSD value observed for Cu. To reliably identify copper, the resolution should be set at 8000. However, high resolutions are inappropriate for analyzing trace elements, as it lowers ion permeability. In conclusion, quantitation of even relatively low amounts of six elements (Al, Si, V, Cr, Mn, and Ni) is possible using this method.

Preparation and Measures for Elderly with Dementia in Korea : Focus on National Strategies and Action Plan against Dementia (한국의 치매에 대한 대응과 대책 : 국가 전략과 활동계획)

  • Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.11-27
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    • 2019
  • Dementia is major epidemic disease of the 21st century in the world. Dementia is one of the major issues in public health globally. Also in Korea, the estimated prevalence of dementia was 8.7%(0.47 million) in 2010, the number will reach the 1 million mark in 2024, it will become a 15.1%(2.71 million) by 2050. Among Koreans aged 65 or older, 725,000 are estimated to be suffering from dementia in 2017. Against dementia, Korea developed three National Dementia Plans in 2008, 2012, and 2016. The 1st plan was came into effect in 2008 and focused on prevention, early diagnostic, development and coordination of infrastructures and management, and improving awareness. The 2nd plan was launched in 2012, addressed the same priorities but had a stronger focus on supporting family members. In 2012 the Dementia Management Act established a statutory basis for organization of the National Dementia Plans. Under the Dementia Management Act, the government is required to produce a comprehensive plan for dementia every 5 years. The Act also orders that the government should register the dementia patients and collect statistics on epidemiology and the management of the dementia conditions. The Dementia Management Act of Korea required the operation of the National Institute of Dementia and Metropolitan/Provincial Dementia Centers to make and carry out dementia management plans throughout the nation. The Act also mandate to establish Dementia Counselling Centers in every public health center and the National Dementia Helpline. The 3rd National Dementia Plan of 2016 aims to build a dementia friendly community to ensure people with dementia and their carer live well. This plan focus on community-based prevention and management of dementia, convenient and safe diagnosis, treatment, and care for people with dementia, the reduction of the care burden for family care-givers of people with dementia, and support for dementia research through research, statistics and technology. In 2017, Moon's government will introduce the "National Dementia Responsibility System," which guarantees most of the burden caused by dementia. This plan include that the introduction of a ceiling on self-pay for dementia diseases, expansion of the application of dementia care standards through alleviating the support criteria for long-term care insurance for mild dementia, expansion of dementia support centers, expansion of national and public dementia care facilities. In the meantime, Korea has accomplished many accomplishments by establishing many measures related to dementia and promoting related projects in a short time, but there are still many challenges.

Numerical Analysis of Coupled Thermo-Hydro-Mechanical (THM) Behavior at Korean Reference Disposal System (KRS) Using TOUGH2-MP/FLAC3D Simulator (TOUGH2-MP/FLAC3D를 이용한 한국형 기준 처분시스템에서의 열-수리-역학적 복합거동 특성 평가)

  • Lee, Changsoo;Cho, Won-Jin;Lee, Jaewon;Kim, Geon Young
    • Journal of Nuclear Fuel Cycle and Waste Technology(JNFCWT)
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    • v.17 no.2
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    • pp.183-202
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    • 2019
  • For design and performance assessment of a high-level radioactive waste (HLW) disposal system, it is necessary to understand the characteristics of coupled thermo-hydro-mechanical (THM) behavior. However, in previous studies for the Korean Reference HLW Disposal System (KRS), thermal analysis was performed to determine the spacing of disposal tunnels and interval of disposition holes without consideration of the coupled THM behavior. Therefore, in this study, TOUGH2-MP/FLAC3D is used to conduct THM modeling for performance assessment of the Korean Reference HLW Disposal System (KRS). The peak temperature remains below the temperature limit of 100C for the whole period. A rapid rise of temperature caused by decay heat occurs in the early years, and then temperature begins to decrease as decay heat from the waste decreases. The peak temperature at the bentonite buffer is around 96.2C after about 3 years, and peak temperature at the rockmass is 68.2C after about 17 years. Saturation of the bentonite block near the canister decreases in the early stage, because water evaporation occurs owing to temperature increase. Then, saturation of the bentonite buffer and backfill increases because of water intake from the rockmass, and bentonite buffer and backfill are fully saturated after about 266 years. The stress is calculated to investigate the effect of thermal stress and swelling pressure on the mechanical behavior of the rockmass. The calculated stress is compared to a spalling criterion and the Mohr-Coulumb criterion for investigation of potential failure. The stress at the rockmass remains below the spalling strength and Mohr-Coulumb criterion for the whole period. The methodology of using the TOUGH2-MP/FLAC3D simulator can be applied to predict the long-term behavior of the KRS under various conditions; these methods will be useful for the design and performance assessment of alternative concepts such as multi-layer and multi-canister concepts for geological spent fuel repositories.

An Exploratory Study on Smart Wearable and Game Service Design for U-Silver Generation: U-Hospital Solution for the Induction of Interest to Carry Out Personalized Exercise Prescription (U-실버세대를 위한 스마트 웨어러블 및 연동 게임의 서비스 디자인 방안 탐색: 개인 맞춤형 운동처방 실행을 위한 흥미 유도 목적의 U-Hospital 솔루션)

  • Park, Su Youn;Lee, Joo Hyeon
    • Science of Emotion and Sensibility
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    • v.22 no.1
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    • pp.23-34
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    • 2019
  • The U-Healthcare era has evolved with the development of the Internet of things (IoT) in the early stages of being connected as a society. Already, many changes such as increased well-being and the extension of human life are becoming evident across cultures. Korea entered the growing group of aging societies in 2017, and its silver industry is expected to grow rapidly by adopting the IoT of a super-connected society. In particular, the senior shift phenomenon has resulted in increased interest in the promotion of the health and well-being of the emergent silver generation which, unlike the existing silver generation, is highly active and wields great economic power. This study conducted in-depth interviews to investigate the characteristics of the new silver generation, and to develop the design for a wearable serious game that intends to boost the interest of the elderly in exercise and fitness activities according to their personalized physical training regimes as prescribed by the U-Hospital service. The usage scenario of this wearable serious game for the 'U-silver generation' is derived from social necessity. Medical professionals can utilize this technology to conduct health examinations and to monitor the rehabilitation of senior patients. The elderly can also use this tool to request checkups or to interface with their healthcare providers. The wearable serious game is further aimed at mitigating concerns about the deterioration of the physical functions of the silver generation by applying personalized exercise prescriptions. The present investigation revealed that it is necessary to merge the on / off line community activities to meet the silver generation's daily needs for connection and friendship. Further, the sustainability of the serious game must be enhanced through the inculcation of a sense of accomplishment as a player rises through the levels of the game. The proposed wearable serious game is designed specifically for the silver generation that is inexperienced in using digital devices: simple game rules are applied to a familiar interface grounded on the gourmet travels preferred by the target players to increase usability.