• Title/Summary/Keyword: Involving

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의료인의 호스피스가정간호에 대한 지식과 태도 조사연구

  • Kim, Ok-Gyeom
    • Korean Journal of Hospice Care
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    • v.2 no.2
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    • pp.28-48
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    • 2002
  • The advances of medical technologies have not only prolonged human life span, but also extended suffering period for the patients with incurable medical diseases. Hospice movement was developed to help these patients keep dignity and lives peaceful at the end of their life. Since many patients prefer to spend the last moment of life at home with their family, hospice home care has become very popular worldwide. The purpose of this study for a promotion and development of hospice home care in Korea, and features basic research on medical profession's knowledge and attitudes to hospice home care. This study which was used for the research questionnaires developed by the researcher that were answered by 100 physicians and 127 nurses in a general hospital. Data were collected from April 22, 2002 to May 10, 2002. The SPSS was used to make a comparative analysis of the frequency, percentile, ANOVA, and x2-test. The results of the study were as follows; 1.The medical profession showed high level of knowledge of the definition and philosophy of hospice. However, the physician group of the examinees showed insufficient knowledge of the fact that hospice care includes bereavement care, while the nurse group's response to the same question showed a significant difference(x2=10.752, p=.001). 2.For whom the hospice home care is provided, 95.6% of the respondents showed very high level of knowledge as answering that the incurable terminal illness patients and their families are the beneficiaries of hospice care. The respondents counted nurses, volunteers, pastors, physicians and social workers, consecutively, as hospice care providers. More nurse were positive toward pastors than physicians in regarding as a hospice care provider by a significant difference(x2=11.634, p=.001). 3.For when to referral hospice home care to the patients, only 34.2% answered that patients with less than 6 months of survival time are advised to receive hospice care, reflecting very low level of knowledge. 23.0% of the physicians and 48.0% of the nurses answered that hospice care should be provided when death is imminent, making a significant difference between the two groups(x2=6.413, p=.000). 4.To promote hospice activities, 87.2% pointed out that it is crucial to make general people, including those engaging in the medical field, more aware of hospice. 79.7% answered that a national hospice management should be developed, marking a significant difference between the physician group and nurse group(x2=10.485, p=.001). 5.Advantages of hospice home care are 87.2% responded that patients can have better rest at home receiving hospice home care. Economical merit was brought forward as one of the advantages also, where there was a significant difference between the physicians group and nurse group(x2=7.009, p=.008). 6.The medical professions' attitude to hospice home care are 92.8% of the physicians answered that they would advise incurable terminally ill patients to be discharged from hospital, with 44.3% of them advising the patients to receive hospice home care after leaving the hospital. From the nurses' point of view, 20.9% of the terminally ill patients are being referred to hospice home care after discharge, which makes a significant difference from the physicians' response(x2=19.121, p=.001). 7. 30.6% of physicians have referred terminally ill patients to hospice home care, 75.9% of whom were satisfied with their decision. Those physicians who have never referred their patients to hospice home care either did not know how to do it(66.7%) or were afraid of losing trust by giving the patients an impression of giving up(27.3%). 94.9% of the physicians responded that they would refer their last stage patients to a doctor who is involving palliative care. 8.Only 36.2% of nurses have suggested to physicians that refer the terminally ill patients discharged from the hospital to hospice home care. Once suggested, 95.8% of the physicians have accepted the suggestion. Nurses were reluctant to suggest hospice home care to the physicians, as 48.8% of the nurses said they did not want to. From the result of this study the following conclusion can be drawn, the medical profession's awareness of general hospice care has been increased greatly compared to the results of the previously performed studies. However, this study result also shows that their knowledge of hospice home care is not good enough yet. There is a need for high recommended that medical education institute and develop regular courses on various types of hospice care. Medical field training courses for physicians and nurses will be very helpful as well. It is also important to train hospice experts such as palliative physicians and develop a national hospice management urgently in order to improve the hospice care in Korea.

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Public Interest and Ownership Regulations in the Media Industry in the Era of Convergence Focused on Domestic Daily Newspapers' Ownership of Broadcasting Station (융합시대 미디어산업의 공익성과 소유규제 국내 종합일간지와 방송의 교차소유 문제를 중심으로)

  • Jun, Young-Beom
    • Korean journal of communication and information
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    • v.46
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    • pp.511-555
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    • 2009
  • Media-related regulations can be classified into two categories; regulations of individual media contents and regulations regarding the entry to and withdrawal from a certain field. In this dissertation, ownership regulations are regarded as legal and political measures so as to prevent the monopoly and oligopoly of public opinion, and to secure its diversity. Every country has its own regulation model according to its particular media environment. Korea too is obliged to actively respond to its environmental changes, at the same time vitalizing the media industry and protecting consumers' rights and interests. Strong political intentions to protect the public interest is necessary when it comes to media regulation policies, especially in the circumstances that public interest is an industrial priority. As the convergence of broadcasting and telecommunications is leading to a major shift in the media industry, the regulation of cross-media ownership is an issue involving potential conflicts among media-owners, non-governmental organizations and the authorities concerned, depending on their various viewpoints regarding the media industry. In this paper, an attempt was made to search necessity of redefining 'public interest', which is the logic behind the restriction of cross-media ownership, and to reconceptualize issues on the centralization and diversity of media. First, an examination of the actual conditions of newspaper companies was carried out in order to reinvestigate domestic cross-media ownership issues, which is represented by the cross-ownership issue of newspapers and broadcasting stations. Next, the dilemma of policies stimulated by the fusion of media was discussed based on cross-media ownership restrictions, and the need for efficient conflict control was suggested. Finally, proposals on the independency and public confidence of media-related policy-making authorities, the rationalization of regulation models, an itemized discussion on cross-media ownership regulation issues, the elaboration of measures for a balanced development among media were made. It could be found that a number of foreign countries were still facing challenges to prevent monopoly and oligopoly of the public opinion and the industry. A solution to settle disagreements about the dilemma of the media industry, including the cross-media ownership regulation issues, must be arranged on the grounds of 'mutual respect of public interest and industrial interest', In Korea, an ease on the ownership regulations adapting to the change in the media industry may be considered, however the softening of the cross-media ownership regulations must be approached with the utmost care. Paradoxically Relieving cross-media ownership regulations may be considered the foundation of a richer field of journalism, where there is no need for concern over the monopoly and oligopoly of public opinion.

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Regeneration of Low Heat - Treated Sciatic Nerve of Rabbit (저온 열처리한 가토 좌골 신경의 재생)

  • Kim, Jae-Do;Kim, Sang-Jin;Jung, Cheoul-Yun;Hong, Young-Gi;Kim, Ghi-Chan
    • The Journal of the Korean bone and joint tumor society
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    • v.3 no.2
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    • pp.80-88
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    • 1997
  • Malignant tumors of extremeties involving major neurovascular structures have been treated by amputation. However recent development of diagnostic tools(CT, MRI etc.), surgical techniques, anticancer chemotherapeutic agents, and radiation techniques allow surgeons to treat malignant tumors in the limb without amputation. It has been reported that a local application of low-heat to the tissue with tumor can kill tumor cells. It is, however, not known if the attendant neural and vascular injuries may be recovered. The present study was, therefore, undertakn to address this question in rabbit sciatic nerves. A low-heat injury to the sciatic nerve was induced by perfusing the nerve with $60^{\circ}C$ saline for 30 minutes and the courses of functional and morphological recovery of the nerve were evaluated for 16 weeks. The results are summerized as follows : 1. In the electromyographic nerve conduction test the average amplitude was markedly attenuated at 4 and 8 weeks after the low-heat treatment, but it progressively increased to the level 89.5% of the control at 16 week post-treatment. The average latency in the control group was 0.62 msec. The latency in the experimental group was much longer than this at 4 and 8 week post-treatment, but it progressively reverted to the control level, showing 0.622 msec at 16 weeks. 2. In the needle EMG, many fibrillation potentials and positive sharp waves were appeared until 8 weeks post-treatment. After 16 weeks, however, no fibrillation potential was observed. 3. In the early phase of post-treatment period, the myelinated nerve fibers contained many vacuoles and the number of myelinated nerve fibers appeared to be considerably reduced. However, as time goes myelinated nerve fibers were regenerated, such that after 16 weeks the histologic appearance of the nerve was similar to that of the control group.

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The Effects of Prostaglandin and Dibutyryl cAMP on Osteoblastic Cell Activity and Osteoclast Generation (Prostaglandin과 Dibutyryl cAMP가 조골세포의 활성과 파골세포 형성에 미치는 영향)

  • Mok, Sung-Kyu;You, Hyung-Keun;Shin, Hyung-Shik
    • Journal of Periodontal and Implant Science
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    • v.26 no.2
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    • pp.448-468
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    • 1996
  • To maintain its functional integrity, bone is continuously remodelled by a process involving resorption by osteoeclasts and formation by osteoblasts, In order to respond to changes in the physical environment or to trauma with the relevant action, this process is strictly regulated by locally synthesized or systemic fators, Prostaglandin $E_2(PGE_2$) is perhaps one of the best studied factors, having been known to affect bone cell function for several decades.$PGE_2$ has both anabolic and catabolic activities. Excess of $PGE_2$ has been implicated in a number of pathological states associated with bone loss in a number of chronic inflammatory conditions such as periodontal disease and rheumatoid arthritis. $PGE_2$ and other arachidonic acid metabolites have been shown to be potent stimulators of osteoclastic bone resorption in organ culture. The anabolic effects of $PGE_2$ were first noticed when an increase in periosteal woven bone formation was seen after the infusion of $PGE_2$ into infants in order to prevent closure of the ductus arteriosus. The cellular basis for the catabolic actions of $PGE_2$ has been well characterized. $PGE_2$increases osteoclast recruitment in bone marrow cell cultures. Also $PGE_2$ has a direct action on osteoclast serving to inhibit activity and can also indirectly activate osteoclast via other cells in the vicinity, presumably osteoblast. The cellular mechanisms for the anabolic actions of $PGE_2$ are not nearly so well understood. The purpose of this paper was to study the effects of $PGE_2$ and dibutyl(DB)cAMP on osteoblastic clone MC3T3El cells and on the generation of osteoclasts from their precursor cells. The effect of $PGE_2$ and DBcAMP on the induction of alkaline phoaphatase(AlP) was investigated in osteoblastic clone MC3T3El cells cultured in medium containing 0.4% fetal bovine serum. $PGE_2$ and DBcAMP stimulated ALP activity and MTT assay in the cells in a dose-dependent manner at concentrations of lO-SOOng/ml. Cycloheximide, protein synthesis inhibitor, inhibited the stimulative effect of $PGE_2$ and DBcAMP on ALP activity in the cells. $PGE_2$also increased the intracellular cAMP content in a dose-dependent fashion with a maximal effect at 500ng/ml. The effect of $PGE_2$ on the generation of osteoclasts was investigated in a coculture system of mouse bone marrow cells with primary osteoblastic cells cultured in media containing 10% fetal bovine serum.After cultures, staining for tartrate-resistant acid phosphatase(TRAP)-marker enzyme of osteoclast was performed. The TRAP(+) multinucleated cells(MNCs), which have 3 or more nuclei, were counted. More TRAP(+) MNCs were formed in coculture system than in control group. $PGE_2(10^{-5}10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in culture. $PGE_2(10^{-6}M)$ stimulated the formation of osteoclast cells from mouse bone marrow cells in coculture of osteoblastic clone MC3T3E1 cells This results suggest that $PGE_2$ stimulates the differentiation of osteoblasts and generation of osteoclast, and are involved in bone formation, as well as in bone resorption.

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A Study on the increase of space debris from Chinese Anti-Satellite and breach of the Outer Space Treaty (자국위성(自國衛星)의 파괴(破壞)에 따른 우주잔해의 증가와 우주조약위반(宇宙條約違反) 여부에 관한 소고(小考) - 중국의 자국위성파괴와 관련하여 -)

  • Kim, Sun-Ihee
    • The Korean Journal of Air & Space Law and Policy
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    • v.28 no.2
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    • pp.259-294
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    • 2013
  • After its experiment involving the exploding of a satellite in space in 2007, China proudly aired news on TV and ran articles in newspapers. However, the event was internationally criticized and drew widespread attention. Many countries denounced the explosion by pointing out that it could be part of the nation's plan to expand its military power to space or that it could pose a danger to the peaceful use of space. However, there is no talk of whether the experiment that produced a huge amount of space debris could have violated an international law, namely the Outer Space Treaty. Although space garbage has been said to be a serious problem, the amount is still on the increase. If we continue to launch new space launch vehicles into orbit at this rate, we will not be able to use it anytime soon like we do today. As the commercial use of space is likely to increase, the situation will certainly get worse. The international community is fully aware of the seriousness of the problem and working together to reduce the amount of space garbage. However, despite the fact that the United States and Soviet Union's ASAT(Anti-Satellite) programs have been implemented for a long time, there have been no complaints about them in terms of military expansion or breach of the Outer Space Treaty. Also, the recent Chinese test is largely viewed to be in accordance with international law. A lot of research has been undertaken with regard to the problem of space garbage. Now people's awareness of dangers being posed has been fully raised. Under the circumstances, the dismissing of China's satellite smashing, leaving a big mess in its wake, as nothing more than an experiment, is a red flag to, if not many, at least some people. By means of this thesis, I would like to review whether the Chinese test has violated an international space law. This thesis presents an overview of the issues surrounding the event and examines the possibility of violating the Outer Space Treaty, formally the Treaty on Principle Governing the Activities of States in the Exploration and Use of Outer Space, Including the Moon and Other Celestial Bodies. After the China test, the UN Scientific and Technical Subcommittee first adopted space debris mitigation guidelines, I'll introduce the content of the guidelines and discuss the characteristics of the guidelines and what can be done to address the issue.

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Clinical investigation of lipoid pneumonia in adults (성인에서 발생한 지방성 폐렴의 임상적 고찰)

  • Hyun, Jae Geun;Rhee, Chong H.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.965-975
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    • 1996
  • Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

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Health Improvement; Health Education, Health Promotion and the Settings Approach (건강 향상: 건강 교육, 건강 증진 및 배경적 접근)

  • Green, Jackie
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2004.10a
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    • pp.111-129
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    • 2004
  • This paper develops the argument that the 'Healthy Cities Approach' extends beyond the boundaries of officially designated Healthy Cities and suggests that signs of it are evident much more widely in efforts to promote health in the United Kingdom and in national policy. It draws on examples from Leeds, a major city in the north of England. In particular, it suggests that efforts to improve population health need to focus on the wider determinants and that this requires a collaborative response involving a range of different sectors and the participation of the community. Inequality is recognised as a major issue and the need to identify areas of deprivation and direct resources towards these is emphasised. Childhood poverty is referred to and the importance of breaking cycles of deprivation. The role of the school is seen as important in contributing to health generally and the compatibility between Healthy Cities and Health Promoting Schools is noted. Not only can Health Promoting Schools improve the health of young people themselves they can also develop the skills, awareness and motivation to improve the health of the community. Using child pedestrian injury as an example, the paper argues that problems and their cause should not be conceived narrowly. The Healthy Cities movement has taught us that the response, if it is to be effective, should focus on the wider determinants and be adapted to local circumstances. Instead of simply attempting to change behaviour through traditional health education we need to ensure that the environment is healthy in itself and supports healthy behaviour. To achieve this we need to develop awareness, skills and motivation among policy makers, professionals and the community. The 'New Health' education is proposed as a term to distinguish the type of health education which addresses these issues from more traditional forms.

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Oxidation Reaction of Hydrazobenzene by Activated Catalysts of Oxygen Adducted Tetradentate Schiff Base Cobalt(Ⅱ) Complexes in Methanol Solvent. (Ⅱ) (메탄올 용매에서 산소 첨가된 네자리 Schiff Base Cobalt(II) 착물들의 활성촉매에 의한 Hydrazobenzene의 산화반응 (제 2 보))

  • Ki-Kyung Chjo;Yong-Kook Choi;Sang-Bock Kim;Jong-Ki Park;Dong-Hwa Park
    • Journal of the Korean Chemical Society
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    • v.36 no.6
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    • pp.894-905
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    • 1992
  • Dioxygen binding and homogeneous catalytic oxidation of hydrazobenzene were investigated by employing tetradentate Schiff base Cobalt(II) complexes such as Co(II)(SED)$(Py)_2$, Co(II)(SOPD)$(Py)_2$ and Co(II)(SND)$(Py)_2$ in saturated oxygen methanol solvent. The major product of hydrazobenzene ($H_2$AB) oxidation by catalysts of superoxo type [Co(III)(SED)(Py)$O_2$] and [Co(III)(SOPD)(Py)$O_2$] complexes are trans-azobenzene (t-AB) and rate constants k for oxidation reaction was 7.692 ${\times}$ $10^{-2}$ M/sec for [Co(III)(SED)(Py)$O_2$] and 5.076 ${\times}$ $10^{-2}$ M/sec for [Co(III)(SOPD)(Py)$O_2$]. But cis-azobenzene (c-AB) are obtained as a major product with ${\mu}$-peroxo type [Co(III)(SED)(Py)]$_2O_2$ catalyst, and rate constant k is 1.266 ${\times}$ $10^{-2}$ M/sec. The rate constants of oxidation reaction has been studied spectrophotometrically and the rate law established. A mechanism involving a intermediate activated complexes of catalyst, hydrazobenzene and oxygen has been proposed. $H_2$AB + Co(II)(Schiff base)$(Py)_2$ + $O_2$ ${\rightleftharpoons}_{MeOH}^K$ Co(III)(Schiff base)(Py)$O_2$${\cdot}$$H_2$AB + Py $\longrightarrow^k$ Co(II)(Schiff base)$(Py)_2$ + t-AB + $H_2O_2$(Scchiff base : SED and SOPD). $H_2$AB + 2Co(II)(SND)$(Py)_2$ + $O_2$ ${\rightleftharpoons}_{MeOH}^K$ [Co(III)(SND)(Py)]$_2O_2$${\cdot}$H_2$AB + 2Py ${\longrightarrow}^k$ (Co(II)(SND)$(Py)_2$ + c-AB + $H_2O_2$.

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Analysis of the Efficiency of Gyeonggi-do Senior Welfare Centers by DEA Model (DEA를 이용한 경기도 노인복지관 효율성 분석)

  • Kim, Keum Hwan;Pak, Ae Kyung;Ryu, Seo Hyun;Lee, Nam Sik
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.8 no.3
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    • pp.165-177
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    • 2013
  • The purpose of this study was to examine the efficiency of senior welfare centers and the cause of differences among senior welfare centers in that regard, and to investigate influential factors for the differences in efficiency and the size of the influence of the factors. What methods would be effective at assessing the efficiency of senior welfare centers by taking into account their circumstances was reviewed, andpost-hoc analyses were made by using data envelopment analysis(DEA) and DAE/AP Modified prosthetic which were useful tools to evaluate relative efficiency. After 20 senior welfare centers located in Gyeonggi-do were selected, their yearly operating data of 2009 were utilized. The purpose of this study was to examine the efficiency of senior welfare centers. The evaluation data released by the Gyeonggi Welfare Foundation were analyzed by DEA, which is one of nonparametric statistics, and it was possible to obtain significant results on the regional operating efficiency of social welfare centers in 14 metropolitan cities and provinces, the causes and degree of their inefficiency and what areas one could refer to. As the data for the counties were utilized in this study, it's not quite possible to produce accurate results on the relative efficiency of senior welfare centers, but this study could be said to be of significance in that it suggested how to evaluate the overall operating efficiency of senior welfare centers in the counties involving the degree of their operating inefficiency, what improvements should be made and what reference groups there might be and provided information on the usefulness of the DEA model.

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Langerhans Cell Histiocytosis in the Skull: Comparison of MR Image and Other Images (두개골의 랑게르한스 세포 조직구증: 자기공명영상과 다른 영상과의 비교)

  • Lim, Soo-Jin;Lim, Myung-Kwan;Park, Sun-Won;Kim, Jung-Eun;Kim, Ji-Hye;Kim, Deok-Hwan;Lee, Seok-Lyong;Suh, Chang-Hae
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.1
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    • pp.74-80
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    • 2009
  • Purpose : To evaluate the characteristic MR imaging findings of Langerhans cell histiocytosis (LCH) in the skull and to compare them with those of plain radiography and computed tomography. Materials and Methods : A total of 10 lesions in 9 patients (Age range; 5-42 years, Mean age; 18, all women) with Langerhans cell histiocytosis in the skull were included in our study. Nine lesions in nine patients were histologically confirmed by surgery or fine needle aspiration biopsy. All patients performed with MRI, and plain radiography and CT scan were done in 7 patients (8 lesions). Two experienced neuroradiologists reviewed the radiological examinations independently with attention to location, size, shape and nature of the lesions in the skull and compared the extent and extension of the lesions to adjacent structures. Results : The lesions were distributed in all of the skulls without predilection site. On MRI, the masses were shown as well-enhancing soft tissue masses (10/10) mainly in diploic spaces (8/10) with extension to scalp (9/10) and dura mater (7/10). Dural enhancement (7/10) and thickening (4/10) were seen. The largest diameter of the soft tissue masses ranged 1.1 cm to 6.8 cm, shaped as round (5/10) or oval (5/10). On CT scans, the lesions were presented as soft tissue masses involving diploic space (6/8) and scalp extension (7/8) were also well visualized. Although bony erosion or destruction was more clearly seen on CT rather than those of MRI, enhancement of soft tissue masses and dura were not well visualized on CT. In contrast, all of the lesions in LCH were seen as punched out (4/8), beveled-edge appearance (4/8) osteolytic masses in plain radiography, but scalp and dural extension could not be seen. Conclusion : Characteristic MR findings in patients with LCH are soft tissue mass in diploic space with extension to dura and scalp, and MRI would be better imaging modality than plain radiography or CT.

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