Recently, Environmental and Safety Management is approaching in order to reduce the loss cost of accidents in effect, efficiency, excellency. In the side that is a large production enemy of the industrialization times, Most companies are focused on decreasing the loss that can let their companies grow healthily than a productivity improvement. The this study analyzed a matter asked f3r basic requirements and continuous development of ISO14001, OHSAS18001, PSM, Responsible Care operating in petro-chemical industries basically, and developed a LCMCI(the Loss Control Management system for Continuous Improvement of the Petro-chemical Industries) fer continuous development of petro-chemical companies in order to be able to continuously manage a loss.
Nurses are medical care providers most closely associated with the national health. Their works are subdivided and specialized, and it is such a factor making nurse's role more important, and with the appearance of specialized nurses, they have secured a position as an independent medical care provider. As the domain of nurse's service becomes broader, there are more accidents and disputes related to nurses. However, there are not many studies conducted on such problems, and even when medical disputes take place related to nurses, the court does not make consistent judgments as a matter of fact. Besides, as the ambiguity of nurse's range of service and the lack of nursing workforce work as a factor causing nurse's medical malpractice, more legal discussions and studies are required to seek proper solutions to such problems. Thus, as a plan to clarify legal issues likely to occur due to nurse's medical practice, this study classified nurse's work into medical assistance practice and other jobs based on their own independent judgments, and proposed establishing concrete regulations on the range of their work, while reviewing common problems extracted from precedents related nurse's medical malpractice. Moreover, while examining Japanese precedents related to the Act of Medical Service Personnel, Nurses and Midwives, which is the sole act of nurses in Japan, this study reviewed the necessity of revising the present nurse-related regulations in Medical Service Act, or enacting a sole act of nurses.
Environmental exposure to air pollution is known to have adverse effects on various organs. Air pollution has greater effects on the pulmonary system as the lungs are directly exposed to contaminants in the air. Here, we review the associations of air pollution with the development, morbidity, and mortality of pulmonary diseases. Short-and long-term exposure to air pollution have been shown to increase mortality risk even at concentrations below the current national guidelines. Ambient air pollution has been shown to be associated with lung cancer. Particularly long-term exposure to particulate matter with a diameter <2.5 ㎛ (PM2.5) has been reported to be associated with lung cancer even at low concentrations. In addition, exposure to air pollution has been shown to increase the incidence risk of chronic obstructive pulmonary disease (COPD) and has been correlated with exacerbation and mortality of COPD. Air pollution has also been linked to exacerbation, mortality, and development of asthma. Exposure to nitrogen dioxide (NO2) has been demonstrated to be related to increased mortality in patients with idiopathic pulmonary fibrosis. Additionally, air pollution increases the incidence of infectious diseases, such as pneumonia, bronchitis, and tuberculosis. Furthermore, emerging evidence supports a link between air pollution and coronavirus disease 2019 transmission, susceptibility, severity and mortality. In conclusion, the stringency of air quality guidelines should be increased and further therapeutic trials are required in patients at high risk of adverse health effects of air pollution.
Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.
Objectives As awareness of the public about Korean medicine health care and the social demand about improvement for quality of health care service is constantly rising, the quality evaluation of Korean medicine health care service is needed to improve the quality. Through trial of Delphi method, we tried to set the priority in short, medium, long term among the disease which is the subject of quality assessment. Methods Carrying out the delphi survey to 50 experts of korean medicine who were recommended by the 41 member societies of Korean medicine and related organizations, we selected final candidates for quality assessment. It is composed with total 2 rounds, and we investigated the priority in three aspects; the importance of the matter, possibility quality assessment, potential about if there's any chance of improvement. Results By delphi method, we set the priority of quality assessment. Base on the result of the second round, we classified importance of the questions into above average, average, below average, and categorized items as short, medium, long term according on the final priority. We classified of musculoskeletal diseases and diseases of connective tissues and musculoskeletal injury as short term and cerebrovascular disease and disease of nerve system and malignant neoplasm as medium term, disease of digestive organs and diseases, symptoms and abnormal findings in clinical field or inspections which are not categorized as long term. Conclusions We set the subjects of quality assessment by delphi survey by experts, and classified into short, medium, long term. Further research is necessary for execution the Quality Assessment to each of the candidate. Also, we can send feedback to medical institution base on the result of Quality Assessment. then it would be able to induce the improvement in quality of medical institution by itself.
The purpose of this study was to find educational needs of toddler's mother in child-caring experience. The subject of the study was toddler's mother who visited one health care center in J city for immunization and had a child or children between twelve and thirty six months old. The subjects were 37 mothers. The instrument used for this study was a semi -structured questionnaire developed by researcher and based on Objective Content Test of Garretson(1967). The collected data were analized by two researchers using the method of Content Analysis. The results of this study are summarized as follows : 1) Of the large categories, the need of the highest frequency was 'prevention and management of disease and injury', that of the lowest 'growth and development'. 2) In 'physical care' category, 'care of sleeping' was the highest. In 'nutrition and eating-habitual management' category, 'weaning management' was the highest. In 'prevention and management of disease and injury' category, 'disease management' was the highest. In 'discipline and teaching' category, 'discipline' was the highest. 3) In comparison with preceding references, the educational needs of child-caring which had not been shown in preceding references but had been shown in this study were hair-caring, kind of weaning diet, method of cure and nursing, man agement of deformity, and so on. In conclusion, educational needs of toddler's mother in child-caring experience were matter-of-fact and inclusive. Needs in management of special situation such as disease were higher than usual parenting procedure or method. In addition, there were higher needs in questions happened through child-caring experience or confirmation of procedures practicing now. Then, it is suggested that parent education program should be developed on the basis of educational needs found in this study to be more effective in preparing mother's child-caring.
A law facilitating a family-friendly social environment was legislated in December 2007. According to the law, projects for facilitating a family-friendly social environment consisted of a family-friendly working environment, a community environment, and the promotion of a family-friendly culture. There has been much progress in developing a family-friendly working environment through projects such as those advocating for flexible work hours, an employee support system, and child care and a family care support system. However, in terms of a family-friendly community environment project, there was no noticeable advancement. Hence, this study was conducted to find ways to vitalize the family-friendly village project in terms of the family-friendly community environment project. The major findings of this study were as follows: A family-friendly village could be structured on the three axes of time, space, and relation. The model of the family-friendly village project consists of the following three steps: motivation, systematization, and participating & practicing. In the motivation step, integration, community, and sustainability were needed as basic ideologies for a family-friendly village. In the systematization step, providing systematic educational systems for residents taking on leadership and activist roles was stressed. In the participating & practicing step, many ways to facilitate residents' social relationships were suggested: starting the project from matters of common interests, making the resolution of families' problems a communal task of the residents, accepting the opinions of various groups associated with the matter, and taking a differentiated project process according to the geographic, socio-economic, and demographic characteristics of the groups. It is strongly suggested that the family-friendly village should be taken as a common functional scheme in everyone of eight livable village models because a key factor in a family-friendly village, family care, serves an essential function in any livable village model.
According to the development of medical technology, new medical treatments have been dramatically increased as an inevitable consequence, however, it is not easy for medical workers to learn the knowledge that is necessary for new medical treatments and their additions in the medical services. Therefore, it could not be helped increasing the guidelines for applying new medical treatments, and then, the problem would come out whether to attribute the medical negligence to the doctors who did not follow the guidelines when the patient became worse because of his non-compliance. Nevertheless, there is no document to review the problem mentioned above and also no definite precedents. Thus, the civil lawful character and obligation of guidelines on the lawsuit against the medical default have been examined in this studies. The medical negligence is defined as usual doctors violate the care obligation which is demanded for them to follow when they treat patients under the proper medical standard in those days. It is resonable to assume that the matter of guidelines is to decide the level of the care obligation, that means the care which is required of the rational doctors under same circumstances, and in general, the experts' testimonies should be needed in this case. In addition, the issue comes out whether the guidelines can be the standard of the judgement of the medical negligence. Finally, I suppose, the evaluation of the issue depends on who makes the guidelines, what materials are based on, and also depends on whether there is another guidelines in the same disease, what the purpose of guidelines is to save the medical costs or to realize the appropriate medical services, in addition, it depends on how often renew the guidelines, and how wide is the usage of guidelines.
This study aims to examine primary determinant for medical expenditure depending on different age and income brackets. The age and income brackets are simultaneously taken into account for a forming of structural models, and GARCH methodology is utilized in analyzing the model. Empirical evidence reveals that no matter how general medical care system is appropriately operated, medical expenditure is vulnerable in taking care of potential socially-disadvantaged class and the group of catastrophic medical expenditure as long as the age and income brackets concern, simultaneously. It signifies that more elaborately designed medical-related policy seems to be established to improve its effectiveness. On the contrary, ageing society is comparatively well-treated by public health law and act on long-term care insurance for the aged.
Recently diseases related to personal health habit and lifestyle have become common in modern industrial society. These kinds of diseases can be prevented simply by changing one's lifestyle to be more healthy. As a result of realization our interest in general health has become stronger. The most basic environment for human-being in society is the home. Humans secure their livelihood, physically. mentally, and socially at home. Therefore health care at home is very important. In modern society the responsibility for this task is traditionally given to housewives. The purpose of this study was to measure the degree of the health knowledge, health concern, health behavior and family health care of the married women and to analyze its related factors. The subjects for this study. 1,100 married women who studied at social education institutes and who had children attending an elementary school or a kindergarten, were surveyed with questionnaires. The preliminary survey was carried out from Aug. 7, to Aug. 19, 1995. With complement of questions, the main survey was carried out from Sep. 11, to Sep. 30, 1995. The data was analysed by using the SAS program. The results were as follows. 1. General Characteristics (1) In the individual characteristics of the respondents, the married women aged 30-39 were 54.8%, the average age was 39.8 years old. 33.8% of respondents had 6-10 years of marriage period, and the average marriage period was 14.9 years. Most of them(96.5%) lived with their husband. Those who graduated from college and graduate school were 53.4%. And 68.3% of respondents had no job. (2) In the family characteristics, 69.3% of the married women had 3 or 4 family members and the average family size was 4.1 person. 60.0% of the respondents had 2 children. Most of the respondents(90.9%) had no married children. 84.8% of the respondents lived with their parents. Those who reported that the total family income was more than 2,500,000 won a month were 32.3%. When making the decisions, 68.5% of the married women discussed the family matter with their husband. (3) In the individual characteristics of the respondents, 51.5% answered they were in good health. 61.7% of the married women answered they obtained the health knowledge through mass media. 24.3% of the women answered they had patients in their family in these days. 67.5% of the respondents answered they could generally control their health by themselves. 2. The Health Knowledge, Concern and Behavior. (1) For the health knowledge, the average score was 11.8. The lowest percent of correct answer(27.8%) was in the item about the skin tests for tuberculosis. And the highest percent(97.%) was in the item about taking a rest. (2) For the health concern, the married women had the highest concern about washing hands. But they were indifferent to smoking. (3) For the health behavior, the highest score was in "changing socks and underwear everyday", and the lowest one was in "taking a regular dental examination". 3. The Family Health Care (1) For the family health care, the item of "using a drug with the order of doctor or pharmacist" had the highest grade(4.78), and "consulting with the family physician about the health problem" had the lowest grade(2.03). (2) Older women and the women with a longer period of marriage had the highest level of the family health care(p<0.001). The married women who had 3 children had the highest level of the family health care(p<0.001). Those who had 5 or 6 family member and higher income had the highest level had the high level of the family health care(p<0.01). Women in good health and those who had the health knowledge from health experts had a high level of the family health care. (3) For the correlation of the family health care and other variables, the health behavior showed the highest correlation with family heath care practice(r=0.74) and the second was health concern(r=0.43). The variables which could explain the family health care were health behavior, the health concern and married women's health status(r²=55.87). The most closely associated with family health care was health behavior(r²=54.93)
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