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The Innovation Ecosystem and Implications of the Netherlands. (네덜란드의 혁신클러스터정책과 시사점)

  • Kim, Young-woo
    • Journal of Venture Innovation
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    • v.5 no.1
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    • pp.107-127
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    • 2022
  • Global challenges such as the corona pandemic, climate change and the war-on-tech ensure that the demand who the technologies of the future develops and monitors prominently for will be on the agenda. Development of, and applications in, agrifood, biotech, high-tech, medtech, quantum, AI and photonics are the basis of the future earning capacity of the Netherlands and contribute to solving societal challenges, close to home and worldwide. To be like the Netherlands and Europe a strategic position in the to obtain knowledge and innovation chain, and with it our autonomy in relation to from China and the United States insurance, clear choices are needed. Brainport Eindhoven: Building on Philips' knowledge base, there is create an innovative ecosystem where more than 7,000 companies in the High-tech Systems & Materials (HTSM) collaborate on new technologies, future earning potential and international value chains. Nearly 20,000 private R&D employees work in 5 regional high-end campuses and for companies such as ASML, NXP, DAF, Prodrive Technologies, Lightyear and many others. Brainport Eindhoven has a internationally leading position in the field of system engineering, semicon, micro and nanoelectronics, AI, integrated photonics and additive manufacturing. What is being developed in Brainport leads to the growth of the manufacturing industry far beyond the region thanks to chain cooperation between large companies and SMEs. South-Holland: The South Holland ecosystem includes companies as KPN, Shell, DSM and Janssen Pharmaceutical, large and innovative SMEs and leading educational and knowledge institutions that have more than Invest €3.3 billion in R&D. Bearing Cores are formed by the top campuses of Leiden and Delft, good for more than 40,000 innovative jobs, the port-industrial complex (logistics & energy), the manufacturing industry cluster on maritime and aerospace and the horticultural cluster in the Westland. South Holland trains thematically key technologies such as biotech, quantum technology and AI. Twente: The green, technological top region of Twente has a long tradition of collaboration in triple helix bandage. Technological innovations from Twente offer worldwide solutions for the large social issues. Work is in progress to key technologies such as AI, photonics, robotics and nanotechnology. New technology is applied in sectors such as medtech, the manufacturing industry, agriculture and circular value chains, such as textiles and construction. Being for Twente start-ups and SMEs of great importance to the jobs of tomorrow. Connect these companies technology from Twente with knowledge regions and OEMs, at home and abroad. Wageningen in FoodValley: Wageningen Campus is a global agri-food magnet for startups and corporates by the national accelerator StartLife and student incubator StartHub. FoodvalleyNL also connects with an ambitious 2030 programme, the versatile ecosystem regional, national and international - including through the WEF European food innovation hub. The campus offers guests and the 3,000 private R&D put in an interesting programming science, innovation and social dialogue around the challenges in agro production, food processing, biobased/circular, climate and biodiversity. The Netherlands succeeded in industrializing in logistics countries, but it is striving for sustainable growth by creating an innovative ecosystem through a regional industry-academic research model. In particular, the Brainport Cluster, centered on the high-tech industry, pursues regional innovation and is opening a new horizon for existing industry-academic models. Brainport is a state-of-the-art forward base that leads the innovation ecosystem of Dutch manufacturing. The history of ports in the Netherlands is transforming from a logistics-oriented port symbolized by Rotterdam into a "port of digital knowledge" centered on Brainport. On the basis of this, it can be seen that the industry-academic cluster model linking the central government's vision to create an innovative ecosystem and the specialized industry in the region serves as the biggest stepping stone. The Netherlands' innovation policy is expected to be more faithful to its role as Europe's "digital gateway" through regional development centered on the innovation cluster ecosystem and investment in job creation and new industries.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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A Survey on Patients도 Nursing Needs Following Discharge from Hospital (퇴원시 환자의 간호요구도 조사)

  • 이은옥;이선자;박성애
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.33-54
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    • 1981
  • The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

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Decision Making on the Non surgical, Surgical Treatment on Chronic Adult Periodontitis (만성 성인성 치주염 치료시 비외과적, 외과적 방법에 대한 의사결정)

  • Song, Si-Eun;Li, Seung-Won;Cho, Kyoo-Sung;Chai, Jung-Kiu;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.28 no.4
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    • pp.645-660
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    • 1998
  • The purpose of this study was to make and ascertain a decision making process on the base of patient-oriented utilitarianism in the treatment of patients of chronic adult periodontitis. Fifty subjects were chosen in Yonsei Dental hospital and the other fifty were chosen in Severance dental hospital according to the selection criteria. Fifty four patients agreed in this study. NS group(N=32) was treated with scaling and root planing without any surgical intervention, the other S group(N=22) done with flap operation. During the active treatment and healing time, all patients of both groups were educated about the importance of oral hygiene and controlled every visit to the hospital. When periodontal treatment needed according to the diagnostic results, some patients were subjected to professional tooth cleaning and scaling once every 3 months according to an individually designed oral hygienic protocol. Probing depth was recorded on baseline and 18 months after treatments. A questionnaire composed of 6 kinds(hygienic easiness, hypersensitivity, post treatment comfort, complication, functional comfort, compliance) of questions was delivered to each patient to obtain the subjective evaluation regarding the results of therapy. The decision tree for the treatment of adult periodontal disease was made on the result of 2 kinds of periodontal treatment and patient's ubjective evaluation. The optimal path was calculated by using the success rate of the results as the probability and utility according to relative value and the economic value in the insurance system. The success rate to achieve the diagnostic goal of periodontal treatment as the remaining pocket depth less than 3mm and without BOP was $0.83{\pm}0.12$ by non surgical treatment and $0.82{\pm}0.14$ by surgical treatment without any statistically significant difference. The moderate success rate of more than 4mm probing pocket depth were 0.17 together. The utilities of non-surgical treatment results were 100 for a result with less than 3mm probing pocket depth, 80 for the other results with more than 4mm probing pocket depth, 0 for the extraction. Those of surgical treatment results were the same except 75 for the results with more than 4mm. The pooling results of subjective evaluation by using a questionnaire were 60% for satisfaction level and 40% for no satisfaction level in the patient group receiving nonsurgical treatment and 33% and 67% in the other group receiving surgical treatment. The utilities for 4 satisfaction levels were 100, 75, 60, 50 on the base of that the patient would express the satisfaction level with normal distribution. The optimal path of periodontal treatment was rolled back by timing the utility on terminal node and the success rate, the distributed ratio of patient's satisfaction level. Both results of the calculation was non surgical treatment. Therefore, it can be said that non-surgical treatment may be the optimal path for this decision tree of treatment protocol if the goal of the periodontal treatment is to achieve the remaining probing pocket depth of less than 3mm for adult chronic periodontitis and if the utilitarian philosophy to maximise the expected utility for the patients is advocated.

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Self Production of Radioisotope and Radiopharmaceuticals Divider (방사성동위원소 및 방사성의약품 분주장치의 자체제작)

  • Hong, Sung-Tack;Park, Kwang-Seo;Kim, Seok-Ki;Won, Woo-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.177-180
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    • 2010
  • Purpose: As PET test came to be covered by the pay system of medical insurance (July 1, 2006) and the needs for it becoming increased for laboratory purpose, it became necessary to purchase expensive medical equipments to solve those problems. However, as most of equipments that are operated by cyclotron are very expensive as to amount from tens of millions up to hundreds of millions of won, it is difficult to purchase those equipments from the point of medical organizations. It may be possible to self manufacture those equipments with least costs if their parts functions that meets the operators demands. The Nuclear Medicine department of National Cancer Center (NCC) is trying to manufacture and use equipments that can be made with least costs, including introducing 2 medical equipments that can improves the operator's works. Materials and Methods: Example 1: Self production of radioisotope($^{18}F$) divider was fabricated. The NCC's Nuclear Medicine department acquired one acrylic panel, seven 3-way valve, tubing etc. that can be found in the market to make the main body of divider in cooperation with biomedical engineering, and placed them inside hot cell, and installed switching box outside of hot cell to make it possible to control them from outside. This main body of divider were placed in radioisotope transfer line that are manufactured in the cyclotron. Example 2: Self production of $^{18}F$-FDG automated divider was fabricated. The NCC's Nuclear Medicine department used cavro pump syringe that consists the main body of divider in cooperation with biomedical engineering, biomedical engineering developed programs that divides a certain amount. $^{18}F$-FDG automated divider is placed inside hot cell, and cable chords were used in the equipment, and then it was connected to PC outside hot cell to make it possible to control the $^{18}F$-FDG automated divider. Results: From the NCC's Nuclear Medicine department tests that were carried out from March, 2007 until now, we found out that radioisotope can be sent to radiopharmaceuticals composite module we want, and from the tests that are carried out at NCC's Nuclear Medicine department using $^{18}F$-FDG automated divider since August, 2009 it was possible to distribute radiopharmaceuticals into vial intended. Conclusion: Through the two examples above, we found out that costs can be reduced by self manufacturing expensive equipments from NCC's cyclotron room with least costs. Also, it decreased radiation exposure dose on workers, and set up problem solving processes in cooperation with lots of parties related.

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A Study on the International Carriage of Cargo by Air under the Montreal Convention-With respect to the Air Waybill and the Liability of Air Carrier (몬트리올 협약상 국제항공화물운송에 관한 연구 - 항공화물운송장과 항공운송인의 책임을 중심으로 -)

  • Lee, Kang-Bin
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.49
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    • pp.283-324
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    • 2011
  • The purpose of this paper is to research the air waybill and the carrier's liability in respect of the carriage of cargo by air under the Montreal Convention of 1999. The Warsaw Convention for the unification of certain rules for international carriage by air was adopted in 1929 and modified successively in 1955, 1961, 1971, 1975 and 1999. The Montreal Convention of 1999 modernized and consolidated the Warsaw Convention and related instruments. Under the Montreal Convention, in respect of the carriage of cargo, the air waybill shall be made out by the consignor. If, at the request of the consignor, the carrier makes it out, the carrier shall be deemed to have done so on behalf of the consignor. The air waybill shall be made out in three orignal parts. Under the Montreal Convention, the consignor shall indemnify the carrier against all damages suffered by the carrier or any other person to whom the carrier is liable, by reason of the irregularity, incorrectness or incompleteness of the particulars and statement furnished by the consignor or on its behalf. The air waybill is not a document of title or negotiable instrument. Under the Montreal Convention, the air waybill is prima facie evidence of the conclusion of the contract, of the acceptance of the cargo and of the conditions of carriage. If the carrier carries out the instructions of the consignor for the disposition of the cargo without requiring the production of the part of the air waybill, the carrier will be liable, for any damage which may be accused thereby to any person who is lawfully in possession of the part of the air waybill. Under the Montreal Convention, the carrier is liable by application of principle of strict liability for the damage sustained during the carriage of cargo by air. The carrier is liable for the destruction or loss of, or damage to cargo and delay during the carriage by air. The period of the carriage by air does not extend to any carriage by land, by sea or by inland waterway performed outside an airport. Under the Montreal Convention, the carrier's liability is limited to a sum of 17 Special Drawing Rights per kilogramme. Any provision tending to relieve the carrier of liability or to fix a lower limit than that which is laid down in this Convention shall be and void. Under the Montreal Convention, if the carrier proves that the damage was caused by the negligence or other wrongful act or omission of the person claiming compensation, or the person from whom he derives his rights, the carrier shall be wholly or partly exonerated from ist liability to the claimant to the extent that such negligence or wrongful act or omission caused the damage. Under the Montreal Convention, any action for damages, however founded, whether under this Convention or in contract or in tort or otherwise, can only be brought subject to the conditions and such limits of liability as are set out in this Convention. Under the Montreal Convention, in the case of damage the person entitled to delivery must complain to the carrier forthwith after the discovery of the damage, and at the latest, within fourteen days from the date of receipt of cargo. In the case of delay, the complaint must be made at the latest within twenty-one days from the date on which the cargo has been placed at his disposal. if no complaint is made within the times aforesaid, no action shall lie against the carrier, save in the case of fraud on its part. Under the Montreal Convention, the right to damage shall be extinguished if an action is not brought within a period of two years, reckoned from the date of arrival at the destination, or from the date on which the aircraft ought to have arrived, or from the date on which the carriage stopped. In conclusion, the Montreal Convention has main outstanding issues with respect to the carrier's liability in respect of the carriage of cargo by air as follows : The amounts of limits of the carrier's liability, the duration of the carrier's liability, and the aviation liability insurance. Therefore, the conditions and limits of the carrier's liability under the Montreal Convention should be readjusted and regulated in detail.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Analysis of Safety Education Contents of 『Field of home life』 in Technology·Home Economics Textbook developed by the revised curriculum in 2009 (2009 개정 기술·가정 교과서 『가정생활영역』의 안전교육 내용 분석)

  • Kim, Nam Eun
    • Journal of Korean Home Economics Education Association
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    • v.29 no.2
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    • pp.23-39
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    • 2017
  • The Purpose of this study is to present the basic data for selecting and improving the safety education contents which help practically middle school students through analysis of contents of safety education in 'field of home life' of 2009 revised middle school textbooks. The subjects of analysis are 12 types of middle school textbooks: in total 24 books written by 12 publishers in terms of the revised curriculum in 2009. The analysis criteria is developed by the researcher referring to preceding studies regarding safety education based on the seventh safety education standard presented by the Ministry of Education (2015). With such analysis criteria, all words related to the contents of the safety education of analysis criteria were extracted from each textbook, such as words directly mentioned as 'safety', words mean as 'psychological safety' and 'happy life', words related to 'attention', 'note', 'stability' etc. Under the analytic frame of safety education contents according to a home economics textbook, content analysis method was used for producing the frequency and percent of those words. The textbook analysis shows that the number of pages regarding safety education is 336.3 pages, as 9.8% in total 3,412 pages of 12 types of technology and home economics textbooks. As following the analysis of each textbook volume of the proportion in the contents related to safety education, 224.9 pages are on the first volume and 111.9 pages are on the second volume. As grades increase from year one to year three, the proportion of safety education in home economics textbooks is decreased. The highest number of safety education contents unit is 'Self-management of youth' which includes three parts of safety education. In the case of a unit for emphasizing practice, experience and practical exercise such as 'Life of youth' and 'Practice of eco-living', safety education content in the area of 'life safety' are mostly contained. Safety accidents related to the most student experienced, Household accidents (1.4%) and experiment or practice accidents (0.3%) are presented in a low figure. The contents of universal housing and school violence are duplicated on first and second volume of text. The most presented safety education content in the 12 types of textbooks are proper sexual attitude, dietary problems, family conflict and food choice. The least common contents are dangerous drugs, family welfare, internet addiction and industrial accident compensation insurance. As this study is to analyze 12 textbooks developed in 2009 revision curriculum, it is necessary to compare it with the textbook written by the revised curriculum in 2015 and to clarify the contents system of safety education and to avoid duplication of contents. In addition, it is necessary to develop and distribute a safety education program that can support textbooks.

A Study On The Attitudes Toward Death -For Nursing Care of The Terminally Ill- (죽음의 태도에 관한 조사연구 -임종환자의 간호를 위하여-)

  • 유계주
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.162-178
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    • 1974
  • The present study is purported to provide a basic information to be utilized by nurses to care and attend effectively for patients nearing the moment of death. Therefore, the primary purpose of the study has been placed upon grasping an understanding of the trends of death in general. For this purpose: 1. By utilizing the schneidman questionnaire, the trend of death has been categorized by 6 parts and analyzed. 2. A search has been conducted to find out dying patient's needs, nurse's attitudes viewed by the patient, and nurse attitudes to dying patient. The followings are itemized results of analysis: 1. Analysis by the schneidman questionnaire. (1) In general concepts of death. the first sighting of the occurrence of death was experienced upon strangers, grandfather and great grandfather. The death is openly discussed among people of all ages and sex. Ages in which the death is mostly feared were from 12 to well over 70 yews old that are evenly distributed regardless of difference in age. (2) As to the attitudes toward death the occurrence of death to most closely associated person influenced most upon the attitude of their own termination of lives. Among the reading materials, the maximum influence was effected by the Bible. In terms of religion, the thoughts of death were Influenced by religions education in case of the believers of the western religions (36%), and by their own health and physical conditions in case of the believers in the oriental religions (35%). In case of non-believer, their attitude toward death were largely determined through their own thinking meditation (45%). People aged 20 or thereunder revealed that they wished to know the day of their own death to be occurred (58%). However, the older the less thor wanted to know. (3) As to the choosing the time of death, 57% preferred senility, and 30% preferred the time in mediately following the prime period of their lives in general. In terms of religion, 85% of the believer in the oriental religion preferred senility, and 67% in the western religion, 58% in others, Therefore. the desiring of their lives to be terminated in earlier stage, not by the natural senility. sequenced as follows : Others, western religions and oriental religions. (4) Referring to the disposal of the corpse under the assumption that it had already occurred, majority desired the burial system. There has been seen a slight tendency to consider the importance of holding funeral services for the sake of survivors. Concerning the life insurance policy, it showed that the nurse had less belief in it than the patient (5) Upon the subject of life-after-death. religion wise, 72% of western religion believers preferred to have an existence of life-after-death: Among the believers of oriental regions, 35% desired this category, 30% did not mind either way. and 35% did not desire the existence of such a life-after-death. In others, 53% did not mind whether or not such a life existed. (6) In general, serious thoughts were not being attended to the commitment of suicide. 37% emphasized that such an act should be prevented. However, 30% insisted that such commitment should not be bothered, and that society possesses no right to prevented it. More male wished to commit suicide (13%) than females (9%). 2. Nurse's attitudes toward terminal patients and patient's needs. In the instance where the patient realized that their death is imminent, most of them showed desire to discuses mainly on the problems of life. When faced a situation of this nature, it is revealed that 40% of nurses could not furnish appropriate care for them.

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Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.163-194
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    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

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