• 대한유전성대사질환학회지
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• 제18권2호
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• pp.50-54
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• 2018

Jehovah's Witnesses do not accept blood transfusions, because of their particular interpretation of the Old and New Testaments. When people with such religious convictions are in need of medical care, their faith and belief may become an obstacle for proper treatment, and pose legal, ethical, and medical challenges for the health care providers. We report two inherited metabolic disorder cases in South Korea where the infants died whilst under medical care because of parental refusal of blood transfusions for religious reasons. Case 1 had methylmalonic acidemia, Down syndrome and associated congenital cardiac anomalies requiring surgery. Case 2 had anemia and methylmalonic acidemia requiring dialysis to treat hyperammonemia and metabolic acidosis. For effective medical management, they needed life-saving blood transfusions. As a part of alternative treatment, Erythropoietin was administered in both cases. As a result, two babies died from their extremely low hemoglobin and hematocrit. The hemoglobin concentrations below 2.7 g/dL without cardiac problem and 5.4 g/dL with cardiac anomaly complicated by pulmonary hypertension are considered life-threatening hemoglobin threshold. The medical professional must respect and accommodate religious beliefs of the patients who can make informed decisions. However, when parents or legal guardians oppose medical treatment of their babies and incompetent care receivers on cultural and religious grounds, the duty to assist and save persons exposed to serious danger, particularly life-threatening events must come first.

• 영어영문학
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• 제54권4호
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• pp.561-577
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• 2008

L.M. Montgomery's Anne of Green Gables is not only confidently labelled a Canadian classic but also placed as a national icon along with the moose, the beaver, and the Habs in Canada. Anne's 'Canadianness' is partly due to its location in the rural world of Prince Edward Island. The fictional Avonlea is described as the ideal space where Canadian spirit can interact with the personified surrounding landscapes through Celtic imagination. Additionally, the communal bond of Avonlea fully demonstrates Scottish Canadian identities. The Scottish national character of Avonlea is responsible for clannishness of the Cuthberts and the Lyndes. The disrespect to the French is also due to Scottish heritage in Avonlea. As an outsider Anne wants to be integrated into the community of Avonlea, and successfully adapts herself to the regional shared values. Meanwhile she partly challenges the strictness and rigidness of the born Canadian Avonlea residents. Despite its Canadian origin, Anne of Green Gables is accepted as part of the American canon of children's literature in the Unite States. The configuration of Anne as an American heroine is noticeable among American scholars: by relocating it to the US the female Bildungsroman in the nineteenth century America, a group of literary critics adapt Anne as an American girl for American readers. The heroine of Anne of Green Gables is linked to American novels such as Louisa May Alcott's Little Women, Kate Douglas Wiggin's Rebecca of Sunnybrook Farm and Gene Stratten Porter's A Girl of the Limberlost. Anne is even classified as another Caddie by American literary critics: Anne is placed at the center of Caddie Woodlawn Syndrome as another Wisconsin pioneer child. Canadian identity of Anne is intentionally excluded and Anne was reborn as an American girl in the U.S. In this context, Anne functions as a sign of nation and a site for cross-national identity formation.

• 여성건강간호학회지
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• 제26권4호
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• pp.285-299
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• 2020

Purpose: This systematic review aims to identify factors associated with risk-reducing salpingo-oophorectomy (RRSO), including the uptake rate and decision timing, among women at high risk for hereditary breast and ovarian cancer (HBOC). Methods: We found 4,935 relevant studies using MEDLINE, Embase, CINAHL, and PsycINFO on July 6, 2020. Two authors screened the articles and extracted data. Twenty-four studies met the inclusion criteria. Quality assessment of articles was conducted using the Risk of Bias for Nonrandomized Studies tool. Results: Five types of factors were identified (demographic factors, clinical factors, family history of cancer, psychological factors, and objective cancer risk). The specific significant factors were older age, having child(ren), being a BRCA1/2 carrier, mastectomy history, perceived risk for ovarian cancer, and perceived advantages of RRSO, whereas objective cancer risk was not significant. The uptake rate of RRSO was 23.4% to 87.2% (mean, 45.2%) among high-risk women for HBOC. The mean time to decide whether to undergo RRSO after BRCA testing was 4 to 34 months. Conclusion: RRSO decisions are affected by demographic, clinical, and psychological factors, rather than objective cancer risk. Nonetheless, women seeking RRSO should be offered information about objective cancer risk. Even though decision-making for RRSO is a complex and multifaceted process, the psychosocial factors that may influence decisions have not been comprehensively examined, including family attitudes toward RRSO, cultural norms, social values, and health care providers' attitudes.

• 대한한방부인과학회지
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• 제34권2호
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• pp.16-30
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• 2021

Objectives: The aim of this study was to establish a clear diagnostic definition of Sanhupung using the Delphi method. Methods: This study used the Delphi technique. A panel consisting of 21 experts of Korean medicine, particularly in of gynecologic medicine, participated in the Delphi examination that included answering the 4th round survey. The Delphi examination was carried out through evaluating and correcting the questionnaire by e-mail. Results: Through the Delphi survey, we have reached on an agreement regarding the basic concepts, time, cause, essential symptoms, and accessory symptoms of Sanhupung. They are as follows: 1) Sanhupung is a culture bound syndrome reflecting Korea's cultural specificity. 2) Sanhupung can be diagnosed even after the miscarriage. 3) For the diagnosis of Sanhupung, the main cause of symptoms should not be classified as other disease. 4) Sanhupung can be diagnosed based on essential symptoms and accessory symptoms. 5) Essential symptoms include local symptoms such as joint pain at specific areas, partial sensory impairment and general symptoms including pain of all the joints, whole body sensory impairment, increased sweating, feeling of wind coming into the body, worsened symptoms with the cold, intolerance to cold, and pain of all the muscles. Conclusions: The basic concepts and diagnostic definition of Sanhupung were suggested based on the Delphi survey among experts in the field. Further research is necessary to improve reliability and validity of diagnostic definition of Sanhupung in clinical trials.

• Journal of Preventive Medicine and Public Health
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• 제55권2호
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• pp.134-143
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• 2022

Objectives: Many governments have imposed-and are still imposing-mobility restrictions to contain the coronavirus disease 2019 (COVID-19) pandemic. However, there is no consensus on whether policy-induced reductions of human mobility effectively reduce the effective reproduction number (Rt) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several studies based on country-restricted data reported conflicting trends in the change of the SARS-CoV-2 Rt following mobility restrictions. The objective of this study was to examine, at the global scale, the existence of regional specificities in the correlations between Rt and human mobility. Methods: We computed the Rt of SARS-CoV-2 using data on worldwide infection cases reported by the Johns Hopkins University, and analyzed the correlation between Rt and mobility indicators from the Google COVID-19 Community Mobility Reports in 125 countries, as well as states/regions within the United States, using the Pearson correlation test, linear modeling, and quadratic modeling. Results: The correlation analysis identified countries where Rt negatively correlated with residential mobility, as expected by policymakers, but also countries where Rt positively correlated with residential mobility and countries with more complex correlation patterns. The correlations between Rt and residential mobility were non-linear in many countries, indicating an optimal level above which increasing residential mobility is counterproductive. Conclusions: Our results indicate that, in order to effectively reduce viral circulation, mobility restriction measures must be tailored by region, considering local cultural determinants and social behaviors. We believe that our results have the potential to guide differential refinement of mobility restriction policies at a country/regional resolution.

• 한국콘텐츠학회논문지
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• 제14권4호
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• pp.123-134
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• 2014

최근 문화콘텐츠의 최고 화두는 복고이다. 하루가 다르게 발전하고 있는 스마트미디어 환경은 콘텐츠 시장에 다양성과 창의성이라는 혜택과 과제를 동시에 던져주고 있다. 최근 레트로 문화는 '응답하라' 시리즈물을 통하여 폭발적으로 확장되었으며 '응답하라'시리즈물의 성공은 사용자의 감성적 경험을 불러일으킬 수 있는 콘텐츠의 중요성을 보여주고 있다. 이러한 관점에서 본 연구는 <응답하라 1994>신드롬을 통하여 사용자의 감성적 경험을 이해하고 레트로 콘텐츠가 단순한 과거회상의 역할을 넘어 어떻게 현재에 재서사화 되어 사용자의 감성적 경험을 이끌어 내는지 고찰한다. <응답하라 1994>를 통한 시청자들의 감성적 경험에 대한 요인분석 결과 도출된 5가지 감성적 경험 요인들은 시청자와 레트로 콘텐츠 관계에 정적인 영향을 미친 것으로 분석되었으며 시청자 만족, 레트로 콘텐츠에 대한 신뢰, 레트로 콘텐츠 애착에 유의미한 영향을 미치는 것으로 나타났다. 시청자 만족에 영향을 미치는 요인별 영향력은 음악적 감성경험, 아이템 감성경험, 감각적 경험, 스토리적 감성경험의 순으로 나타났고, 레트로 콘텐츠에 대한 신뢰에 영향을 미치는 감성적 경험의 요인별 영향력은 음악적 감성경험, 감각적 경험, 스토리적 감성경험, 그리고 아이템 감성경험의 순으로 나타났으나 등장배우로 인한 감성적 경험은 유의미한 영향력을 갖지 못했다. 레트로 콘텐츠 애착에 미치는 감성적 경험의 차원별 영향력은 음악적 감성경험, 아이템 감성경험, 등장배우로 인한 감성경험, 감각적 경험, 스토리적 감성경험의 순으로 나타났다. 본 연구는 레트로가 가지고 있는 본질적인 의미를 파악하고 소비자의 감성적 경험에 기반을 둔 문화 콘텐츠의 생산 및 확산이 미디어 콘텐츠 생태계 형성 및 발전에 매우 중요한 요소임을 시사한다.

• 한방비만학회지
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• 제8권1호
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• pp.71-80
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• 2008

Objectives Obesity and climacteric symptom are affected by various cultural, social and psychological factors. This study is performed to recognize the relationship between obesity, climacteric symptom, and other social and psychological factors such as self-esteem, depression, eating attitude, stress response and social readjustment rating. Methods SRRS(social readjustment rating scale), SES(self-esteem scale), SRI(stress response inventory), BDI(Beck depression inventory), KEAT-26 (Korean Eating Attitude Test-26) and Kuperman index were given to 43 peri-menopausal women aged 45-55 and BMI ${\geq}23$. They were given written consent and this study is performed under the permission of institutional review board of Kyung Hee East-west Neo Medical Center. And height, body weight, waist circumference were measured. These variables were treated by correlation and regression analysis for finding effect factors of climacteric symptom. Result BMI and WC were not related to climacteric symptom. There were significant correlation between KEAT-26(r=0.4388, p=0.004), SES (r=-0.4748, p=0.001), SRI(r=0.6941, p<0.001), BDI(r=0.6354, p<0.001) and Kuperman index. In multiple regression, SRI was find to be a prediction factor of Kuperman index.(Kuperman index=19.033+0.7SRI($R^2$=0.490)). Conclusion Climacteric symptom is related to self-esteem, eating attitude, depression and stress response. And the most important prediction factor of climacteric symptom is stress response. So managing of stress response may be essential to treating climacteric syndrome. And it is necessary to study about climacteric symptom with many other effective factors of various peri-menopausal subjects.

• 한국전통조경학회지
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• 제36권3호
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• pp.115-127
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• 2018

천연기념물 제214호 진안 평지리 이팝나무군의 고사(枯死) 및 쇠약(衰弱) 요인의 명확한 진단(診斷)과 처방(處方)을 통한 천연기념물로서의 가치 존속(存續) 방안을 강구하고자 시도된 본 연구의 결과는 다음과 같다. 첫째, 1968년 13그루의 천연기념물 지정 이후, 1973년을 시작으로 근년까지 계속적으로 고사가 진행되어 현재는 3주만 생존하고 있다. 특히 2010년 이후 마령초등학교 담장 후퇴 등 정비과정에서 복토된 토양의 일부 제거에도 불구하고, 계속적으로 고사가 이루어진 것으로 확인된다. 둘째, 지정목 중 1 3번 생존목 또한 고사된 가지가 많고, 잎이 왜소하며, 엽량이 적었다. 1번목은 수세가 '극히 불량'하고 다량의 가지가 이미 고사하였으며, 금년에는 단지 2개 가지에서만 개화가 이루어졌으며 엽량 또한 현저히 적은 상태이다. 2번목 또한 '불량'상태로 잎이 작고 엽밀도도 낮으며 수형의 변형이 이루어지는 등 수세가 쇠약한 상태이다. 현존하는 가장 큰 1번목은 논토양으로 추정되는 점질토가 복토되어 있어 우려를 더하고 있다. 셋째, 평지리 이팝나무군의 토성 분석결과, '미사질양토[微砂質壤土, Silt loam(SiL)]'로 밝혀짐에 따라 미사(Silt)의 성분비가 높음을 알 수 있다. 또한 1번목 북측의 토양산도는 pH 6.6으로 다른 부위의 흙과는 편차가 컸는데 이는 원지반 토양이 아닌 외부에서 반입된 토양으로 복토되었음에 기인한 것으로 판단된다. 더불어 유기물함량은 적정범위보다 높게 나타났는데 이는 보호관리를 위한 시비가 계속적으로 이루어진 결과가 반영된 것이라고 판단된다. 넷째, 진안 평지리 이팝나무군의 고사 및 생육 불량의 근본적 원인으로는 복토(覆土)로 인한 심각한 생리저하의 만성적 증후군으로 판단된다. 이는 신규로 식재된 후계목 또한 일부 고사된 것에서도 그 원인을 찾을 수 있다. 다섯째, 1차적으로 기존 고사의 원인으로 추정되는 복토 부분에 대한 점진적 제거가 시급하다. 무엇보다도 근계부에 복토된 점질토양의 제거를 건의한다. 복토부를 제거한 후 굵은 모래로 치환하고 뿌리의 호흡 개선을 위해 유공관을 설치한다. 그리고 고사한 4번 고사목과 5 6번의 고사흔적인 밑둥은 제근하고, 하층식생은 예초한다. 생존목은 상부 고사지를 제거, 수피 이탈부는 외과수술을 시행하는 한편 생장점 아래에서 전정하여 맹아의 발생을 유도해야 할 것이다. 여섯째, 지하부 뿌리를 확인하여 부패근 절단 및 토양호흡 개선방안을 마련한다. 근계 전반에 대한 추적 굴취 등으로 썩은 뿌리부를 단근하여 새 뿌리의 발생을 유도한다. 일곱째, 이후 잡초 발생과 답압 억제 그리고 토양 보습효과 유지를 위한 멀칭을 시도한다. 또한 지속적 영양공급을 위한 무기양료 엽면시비 및 영양제 나무주사, 무기양료의 토양관주를 고려한다. 향후 모니터링과 예찰방안을 마련하여 계속적으로 변화상을 체크해야 할 것이다.