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Communication at the End of Life

  • Onishi, Hideki
    • Journal of Hospice and Palliative Care
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    • v.24 no.3
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    • pp.135-143
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    • 2021
  • End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

A Study on the Process of Policy Change of Hyper-scale Artificial Intelligence: Focusing on the ACF (초거대 인공지능 정책 변동과정에 관한 연구 : 옹호연합모형을 중심으로)

  • Seok Won, Choi;Joo Yeoun, Lee
    • Journal of the Korean Society of Systems Engineering
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    • v.18 no.2
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    • pp.11-23
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    • 2022
  • Although artificial intelligence(AI) is a key technology in the digital transformation among the emerging technologies, there are concerns about the use of AI, so many countries have been trying to set up a proper regulation system. This study analyzes the cases of the regulation policies on AI in USA, EU and Korea with the aim to set up and improve proper AI policies and strategies in Korea. In USA, the establishment of the code of ethics for the use of AI is led by private sector. On the other side, Europe is strengthening competitiveness in the AI industry by consolidating regulations that are dispersed by EU members. Korea has also prepared and promoted policies for AI ethics, copyright and privacy protection at the national level and trying to change to a negative regulation system and improve regulations to close the gap between the leading countries and Korea in AI. Moreover, this study analyzed the course of policy changes of AI regulation policy centered on ACF(Advocacy Coalition Framework) model of Sabatier. Through this study, it proposes hyper-scale AI regulation policy recommendations for improving competitiveness and commercialization in Korea. This study is significant in that it can contribute to increasing the predictability of policy makers who have difficulties due to uncertainty and ambiguity in establishing regulatory policies caused by the emergence of hyper-scale artificial intelligence.

Analysis on the Shear Behavior of Existing Reinforced Concrete Frame Structures Infilled with L-Type Precast Wall Panel (L형 프리캐스트 콘크리트 벽패널로 채운 기존 철근 콘크리트 골조 구조물의 전단 거동 분석)

  • Yu, Sung-Yong;Ju, Ho-Seong;Ha, Soo-Kyoung
    • Journal of the Korean Society for Advanced Composite Structures
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    • v.6 no.2
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    • pp.105-117
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    • 2015
  • The purpose of this study is to develop a new seismic resistant method by using precast concrete wall panels for existing low-rise, reinforced concrete beam-column buildings such as school buildings. Three quasi-static hysteresis loading tests were experimentally performed on one unreinforced beam-column specimen and two reinforced specimens with L-type precast wall panels. The results were analyzed to find that the specimen with anchored connection experienced shear failure, while the other specimen with steel plate connection principally manifested flexural failure. The ultimate strength of the specimens was determined to be the weaker of the shear strength of top connection and flexural strength at the critical section of precast panel. In this setup of L-type panel specimens, if a push loading is applied to the reinforced concrete column on one side and push the precast concrete panel, a pull loading from upper shear connection is to be applied to the other side of the top shear connection of precast panel. Since the composite flexural behavior of the two members govern the total behavior during the push loading process, the ultimate horizontal resistance of this specimen was not directly influenced by shear strength at the top connection of precast panel. However, the RC column and PC wall panel member mainly exhibited non-composite behavior during the pull loading process. The ultimate horizontal resistance was directly influenced by the shear strength of top connection because the pull loading from the beam applied directly to the upper shear connection. The analytical result for the internal shear resistance at the connection pursuant to the anchor shear design of ACI 318M-11 Appendix-D except for the equation to predict the concrete breakout failure strength at the concrete side, principally agreed with the experimental result based on the elastic analysis of Midas-Zen by using the largest loading from experiment.

A Study on the Children's Eating Habits and Food Preference - focused on staple food and side dishes - (유아기, 학동기 및 청소년기 식습관과 식품 기호도에 관한 연구(I) - 주식과 부식을 중심으로 -)

  • Chung, Hea-Jung
    • Journal of the Korean Society of Food Culture
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    • v.24 no.6
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    • pp.631-640
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    • 2009
  • This study aim to identify preference of main and side dishes of 681 children who lived in Seoul and Gyoung-gi (Incheon) in 2007. To accomplish this, we divided the children into three age groups, an infancy group (below 6 years of age), a middle years group (between 7 and 12 years of age) and a juvenile group (above 12 years of age). Specifically, 145 children were in the infancy group (boys 68, girls 77), 300 children were in middle years group (boys 138, girls 162) and 236 children were in juveniles group (boys 131, girls 105). The average body mass index (BMI) of the parents of the respondents appeared to be normal, and the majority of the parents had bachelor degrees. Across all age groups, most fathers were office workers and most mothers were housewives. The preference for staple foods showed that the infancy group and the middle years group preferred rice the most, while the juvenile group preferred stir-fried rice the most out of 5 grain items. Evaluation of the preference for different types of noodles showed that both boys and girls from the infancy group preferred jajangmyun, while those in the middle years group and the juvenile group preferred spaghetti. For breads, both boys and girls from the infancy group had the highest preference for cake, while boys and girls in the middle years group and boys in the juvenile group preferred pizza the most, and girls from juvenile group preferred cake the most. Evaluation of the preference for soups and pot stew revealed that both boys and girls in the infancy group preferred seaweed soup, while boys from middle years group preferred seol-long-tang and girls from middle years group preferred seaweed soup. Boys and girls from the juvenile group preferred seol-long-tang the most. For hard-boiled foods and stir-fried foods, members of all age groups preferred beef boiled in soy sauce the most and hard-boiled peppers the least. Finally, comparison of the preference for roasted foods, seasoned vegetables and kimchi revealed that the infancy group preferred roasted seaweed the most and that both the middle years and juvenile group had the greatest preference for roasted galbi.

Improvement Way for Mobile X-ray Examinations by Rule Revision about Safety Management of Diagnosis Radiation Occurrence System (진단용방사선발생장치의 안전관리에 관한 규칙 개정에 따른 이동형 방사선검사의 개선방안)

  • Choi, Jun-Gu;Kim, Gyeong-Su;Kim, Byeong-Gi;Ahn, Nam-Jun;Kim, Hyeong-Sun;Kim, Sang-Geon;Lim, Si-Eun
    • Journal of radiological science and technology
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    • v.30 no.1
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    • pp.53-59
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    • 2007
  • A safety management rule of the diagnosis radiation system which opened a court 2006 February 10th was promulgated for safety of the radiation worker, patients and patients' family members. The purpose of this study is to minimize injury by radiation that can happen to patients and people around a sick ward when managing mobile X-ray system. This study analyzed sickroom environment of mobile X-ray examination and the statistical data of the Konkuk medical Information System(KIS) and the Picture Archiving Communication System(PACS). This study also investigated patient conditions, infection, relation information and related data, when the sickroom mobile X-ray examination is used. Through data analysis, many problems were expected such as restriction of space side, manpower and expense of business side, satisfaction degree decline of patient and protector of operation side. Therefore, we tried to restrict examination of multi bed sickroom, and to use treatment room in each ward to solve problem mentioned. As a result, the whole sickroom mobile X-ray examination rate decreased to near 50%, and mobile X-ray examination rate for inpatients decreased to more than 85%. This study shows that several attempts we did should be helpful for manpower, patients satisfaction and expenses. Also, they should protect patients in sickroom from unnecessary radiation exposure and could minimize inconvenience of patients and their family members from x-ray examination.

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A Study on the Effect of Corporate Social Responsibility on Organizational Commitment, Organizational Trust, Organizational Citizenship Behavior: Focusing on Incorporation Companies in Business Incubator (기업의 사회적 책임이 조직몰입, 조직신뢰, 조직시민행동에 미치는 영향에 관한 연구: 창업보육센터 입주기업을 중심으로)

  • Lee, In Seong;Kang, In Won
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.2
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    • pp.235-247
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    • 2019
  • In order to achieve the results that are appropriate for the purpose of the enterprise, it is important to comprehensively understand the behaviors within the roles of the members of the organization and actions outside the roles. However, there have been relatively few studies on corporate social responsibility (CSR) among the existing studies that have been conducted to date. In particular, organizational citizenship behavior, a voluntary commitment by organizational members, is perceived as a very effective way of enhancing corporate performance, but studies on organizational citizenship behavior based on corporate social responsibility have rarely been conducted. In recent years, domestic companies have recognized social responsibility as an activity rather than an additional activity. Therefore, it is very meaningful to look at the organizational performance by examining the factors that make up this social responsibility from the perspective of the company. It is considered a task. In order to demonstrate this, this study collected 303 data from a business incubator center operated by universities and public institutions nationwide and used a total of 303 samples. As a result of the verification, the wages received by the members of the organization did not affect the organizational commitment, and the working hours and the working environment affected the organizational commitment. In addition, corporate social responsibility has an effect on organizational trust in the marketing side. Organizational commitment and organizational trust were studied to positively affect organizational citizenship behavior. In addition, this study divides the degree of perception of social responsibility of the organizational members into the high recognition group and the low recognition group and analyzed whether there is a difference in the level of organizational citizenship behavior according to the employment type (regular and irregular workers) The results of this study are as follows.

Research on the prevention of legal dispute over 119 rescue team (119구급대의 법적분쟁 예방에 관한 연구)

  • Lim, Jae-Man
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.1
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    • pp.19-33
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    • 2009
  • Purpose : To check the legal relation between rescue team and patient as well as legal responsibility for patient's damage intentionally or erroneously caused by rescue member, a public official, in the performance of relevant job ; to prevent legal dispute over rescue team and to present program for fair settlement of dispute and equitable and feasible burden of damage. Method : First, the legal principle of Civil Law, Criminal Law and Administrative Law related to the theme of this research will be investigated around research by literature. Second, the case of dispute related to rescue team will be introduced. Result: 1. If 119 rescue members as a public official intentionally or erroneously cause damage to patient in the performance of job, they shall bear civil, criminal and administrative responsibility. They shall bear civil responsibility for indemnity for damage due to default or tort. The typical criminal responsibility includes accidental homicide arising out of duty, preparing falsified official document, dereliction of duty, etc. In the administrative side, the state is responsible for indemnity for peculiar status of the rescue member, public official. 2. Though raising civil petition or legal dispute over unsatisfactory rescue service may be reasonable to guarantee the right of nation, such action may cause stress to rescue member as well as may lead to mental shrinking and defensive attitude only to take the basic first aid treatment which has low possibility of mistake instead of active first aid treatment so as to avoid legal responsibility. 3. The program that may prevent legal dispute over 119 rescue team includes expansion of manpower specialized in first aid treatment, enhancement of education on legal environment, development and application of standard job guideline, formation of mutual trust with patient, detailed explanation, preparing and keeping minute record, improvement of the rescue members' ability of first aid treatment and development of medical instruction mode. Conclusion : The best policy is to prevent legal dispute. If it is impossible to basically exclude the possibility of dispute, however, we need to make effort to minimize the occurrence, settle fairly and divide damage equitably and feasibly. To improve the preventible death rate of our first aid system to the level of advanced country, 119 rescue team which is in charge of the stage before hospital needs to positively enforce special first aid by improving the qualitative level of rescue service and to strive to prevent legal dispute that may occur in the process.

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A Survey of Sedation Practices in the Korean Dentistry (치과 치료 시 진정법 시행에 대한 실태 조사 연구)

  • Bae, Chi-Hoon;Kim, Hyuk;Cho, Kyoung-Ah;Kim, Mi-Seon;Seo, Kwang-Suk;Kim, Hyun-Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.1
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    • pp.29-39
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    • 2014
  • Background: Dental phobia or anxiety of patients is the serious impediment to appropriate and effective dental treatment. Sedative technique helps to mitigate patients' fear and anxiety thus make them more cooperative and familiar to dental practices. With increasing attention to sedative dentistry in dentists, educational requirements and technical qualification also become stricter but actual survey on recent sedative dentistry has not been reported yet. Especially there is insufficient study reporting the survey of sedative dentistry subjected to Korean adults. In this paper, we conducted a survey study on the actual condition and practice related to sedation with a questionnaire to dentists in South Korea. Methods: The survey was done for members of The Korean Dental Society of Anesthesiology (KDSA), who had great interest in sedation and for whom survey-by-mail was convenient. 472 members of The KDSA having dental license and solid address and contact information were subjected to the survey by sending them survey questions about their sedative techniques and knowledge. In order to increase the response rate, small gifts were presented to those who accurately responded to the survey questions and text messages and phone calls were made to encourage their participation. We collected their responses over two months and examined the returned surveys. Statistical analysis was performed using IBM SPSS Statistics 21 for each question. Results: Out of 472 dentists, 181 responded (38.4% response rate). 63.0% (114 dentists; 77 male and 37 female) of respondents had experience on sedative technique and their average age was $39.8{\pm}7.6$ year. 74 of them were private practitioners, 17 of them were professors (14.9%), 11 of them were dentists-in-service (9.6%), 11 of them were residents (specialist training) (9.6%) and 1 of them was military doctors (0.9%). There were 89 dentists (78.1%) who were specialists or receiving trainings to be specialist, most of whom were pediatric dentists (55, 48.2%) and oral surgeon (31, 27.2%). The most popular route for drug medications was orderly oral, inhalational, intravenous medication. Combination of oral and inhalational medications or single use of intravenous medication was the most common. The most preferred sedative drug was pocral in oral sedation and midazolam in intravenous sedation. 48.2% of practitioners responded that they experienced side effects and emergency situations. Airway obstruction was the most frequent. Conclusions: Results from the survey show that the protocol and system for sedative dentistry have been improved compared to the past. Nevertheless, quality of emergency protocol, monitoring devices and preparation of sedative drugs was still insufficient to achieve safe sedative procedure. This study acquires novelty since actual survey on recent sedative dentistry for adult patients has not been reported yet.

Perception of Internet Cyber Community Participants on Reconciliation of Divorced Couple (이혼 후 재결합에 대한 인터넷 사이버공동체 참여자들의 인식)

  • Lim, Choon-Hee
    • The Journal of the Korea Contents Association
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    • v.12 no.10
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    • pp.237-253
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    • 2012
  • The purpose of this study was to examine the perception of cyber community participants on reconciliation of divorced couple and find reasons for pros and cons concerning reconciliation after divorce. The data were collected through searching for website or Internet cafe related to 'reconciliation after divorce' on Internet. The contents of 7 cases for asking for advice on reuniting and opinions of cyber community participants on them were analyzed. Cyber community participants expressed their approval of divorced couple's reuniting for following reasons: 'strong motive for reunion', 'sexual relation with ex-partner', 'parental responsibility', 'regarding reconciliation as a better choice than remarriage', 'regarding as a good choice for child' etc. But cyber community members were opposed to divorced couple's reuniting for following reasons: 'doubt about real intention to reuniting', 'no self-reflection on previous marriage and ex-spouse', 'concern for recurrence of former marital conflict', 'reuniting only for child not for couple', 'no prior settlement of former marital conflict', 'no forgiveness and tolerance for ex-spouse', 'no reflection and change', 'no effort on ex-spouse's side' etc. Though these results were restrictive, this study identified issues surrounding reconciliation after divorce through asking and giving advices by anonymous members on cyberspace. These findings implied that we should take more interest in reconciliation as an realistic alternative marriage pattern after divorce and consider what is important to successful reuniting after divorce.

A Study on the Archetypes of Historical Edification of Daesoonjinrihoe (대순진리회 교화의 역사적 전형(典型)에 관한 연구)

  • Back, Kyung-un
    • Journal of the Daesoon Academy of Sciences
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    • v.22
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    • pp.471-507
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    • 2014
  • Edification in Daesoonjinrihoe is not only a phenomenon that occurs following the differences of religious experience or spiritual development among the community members, which enables the members to share teaching and learning experiences with one another, but also an issue determined as one of the major activities of the religious order and a plan for achieving the purpose of the religious order-Podeokchenha(Wordly Propagation), Gujechansaeng (Salvation of all mankind) and Jisangcheonguk Geonseol(Building of earthly paradise). The purpose of this article is to clarify its concept and provide an example of edification, through considering the historical model for edification to help the cultivators with their work of edification. The archetype of edification of Daesoonjinrihoe was formed and gradually developed in phases by Sangje, Kang Jeungsan, the Supreme God(姜甑山, 1871-1909), Doju, Jo Jeongsan(趙鼎山, 1895-1958) and Dojeon, Park Wudang(朴牛堂, 1917-1995), by the three of whom the Religious Authority was succeeded. Sangje descended to the human world and preached to people to live by the rule of Haewon Sangsaeng(Resolution of grievances for the mutual beneficences of all life) and set an example of abolishing the old customs, living in mutual beneficences and having respect for human being. Doju, in revering the last will of Sangje, established the religious order by setting its creed, rituals and activities, which formed most contents of the archetype of edification. Dojeon set up a religious faith system by firmly establishing the Religious Authority and performed the True Law in accordance with Sangje's program of heaven to educate the cultivators to achieve the goal of self-cultivation following the last will of Doju. Through this, a perfect method to reach the state of Dotong(The Truly Unified State of Dao) is fulfilled. In this way, the archetype of edification was formed in the process of succession of Religious Authority. In conclusion, edification in Daesoonjinrihoe contributes to a 'systematic conveyance and understanding' through the historical archetype of edification, and it can be described as a concept that becomes a model to put into practice the 'True Law' of teachings given by two Sangjes for Dotong. Therefore, edification of Daesoonjinrihoe is drawing attention of its development as an important activity that realizes the ultimate value of the religious order because it solves the problems of immorality(absence of Dao), disorder and disregard of human value generated from the other side of this material civilization, with the truth of Haewon Sangsaeng, and has a function of rebuilding and leading the individuals and the society to the Truly Unified State of Dao through performing of the True Law.