Social welfare has transformed from a provider-centered welfare into a user-centered welfare. This trend have to increase the right to welfare and convenience for users. If the goal of social welfare guaranteed the respecting man's life and dignity, we had not regarded service users as the weak in the welfare system. The reinforcement of service users as the reconfirmation of welfare user's identity, mistreatment and violation of another's rights, self-determination must have the advocacy system. The advocacy for social welfare is the activity for benefit of individual, group, and community, and, protection, guarantee and maintenance of client's right. However, the client is hard to realization of right. therefore We have to support the activity for advocacy. The advocacy take aim the basic need of life and need the system for life support and safeguard client's rights. The mission of the advocacy for welfare service user is to advance the dignity, equality, self-determination, and expressed choices of individuals. We promote, expand, protect and seek to ensure the human and legal rights of individuals through the provision of information and advocacy. The advocacy system will carry out this mission in partnership with welfare service users. The goals for the advocacy system are organized into the following focus areas, which are not listed in order of priority: the majority guardian system and the support activity for service users, a predicament solution activity, service assessment, informed concent system.
Journal of the korean academy of Pediatric Dentistry
/
v.29
no.3
/
pp.413-417
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2002
Mucocele is a mucous retention phenomenon which is caused by a laceration to the duct of minor salivary glands causing extravasation of mucin into the connective tissue forming a cyst-like space. Sialolithiasis of minor salivary glands and chronic obstruction of salivary glands may also cause such a phenomenon. Mucocele is a smooth, rounded sessile mass with diameters varying from 1 to 15mm of sudden appearance. Mucocele tying directly beneath the mucosa may rupture spontaneously and decrease in size, but frequently recurs. Lower lip is most frequently affected, and the mouth floor and buccal vestibule may also be affected. Enucleation of the cyst is needed and removal of minor salivary glands, marsupialization and cryotherapy may also be done. The mucocele frequently recurs after its removal. A 1-year-old female patient visited the hospital with a complaint of a swelling on the lower lip since 4 months before. She had no pain history but 4 months ago, fell and such symptom appeared since then. On her first visit, a bullous solid, opaque lesion of 5mm in diameter was noted. Treatment choice of surgical approach and nonsurgical approach were explained to the guardian. Considering the patient's age, the guardian agreed to a nonsurgical procedure. Treatment was carried out by tieing 3-0 silk to the base of the lesion. One week later, the tie loosened and was re-tied. A week later, the mucocele disappeared. Mucocele on the lower lip may be usually be treated by surgical removal, but this may traumatize the surrounding minor salivary gland causing it to recur. Also, surgicial removal may induce an ischemic change causing sialometaplasia. In case of young patients or children with management problems, non-surgical methods such as this tie method may be used. This tie method does not need any local anesthesia and has no pain, no secondary infection, and low bleeding tendency.
This study analyzed the change of after-school guardians' absence types during the first 3 school years, and the relations of after-school care, family environment(family income, parental monitoring) to self-regulatory learning ability and emotional-behavioral problems in each gender of early school-age children from dual income families. The data from 526 boys and 483 girls among 3rd graders of Korean Child and Youth Panel Survey(KCYPS) were statistically analyzed by Friedman's test, t-test, correlational coefficient analysis, regression analysis. The results showed that 45% of boys and 50% of girls were with a guardian for their after-school care in each of the first 3 school years and after-school care had changed gradually into the types of temporal or contingent absence of a guardian. Family income and children's self-regulatory learning ability were different from adult-care and self-care in each gender, but there were differences in the parental monitoring of girls and emotional-behavioral problems of boys according to the care types. Both of boys and girls showed that family environment meaningfully related with the ability and the problems, and also showed the relatively different effects of after-school care and family environment on those ability and problems variables. The results suggested some implications for after-school care.
Our purpose is to specify behavior and environmental factors aimed at reducing the exposed dosage caused by PET-CT and to develop radiation safety management guidelines adequate for domestic circumstances. We have used a multistep-multimethod as the methodological approach to design and to carry out the research both in quality and quantity, including an analysis on previous studies, professional consultations and a survey. The survey includes responses from 139 practitioners in charged of 109 PET-CTs installed throughout Korea(reported by the Korean Society of Nuclear Medicine, 2010). The research use 156 questions using Cronbach's ${\alpha}$ (alpha) coefficients which were: 0.818 for "the necessity of setting and installing the radiation protective environment"; 0.916 for "the necessity of radiation protection", "setting and installing the radiation protective environment"; and 0.885 for "radiation protection". The check list, derived from the radiation safety management guidelines focused on behavior and environment, was composed of 20 items for the radiation protective environment: including 5 items for the patient; 4 items for the guardian; 3 items for the radiologist; and 8 items applied to everyone involved; for a total of 26 items for the radiation protective behavior including: 12 items for the patient; 1 item for the guardian, 7 items for the radiologist; and 6 items applied to everyone involved. The specific check list is shown in(Table 5-6). Since our country has no safety management guidelines of its own to reduce the exposed dosage caused by PET-CTs, we believe the guidelines developed through this study means great deal to the field as it is not only appropriate for domestic circumstances, but also contains specific check lists for each target who may be exposed to radiation in regards to behavior and environment.
Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.
The aim of this study was to determine key experiences of homestay guardians of unaccompanied minor Korean adolescents studying abroad in the United States through qualitative research method of grounded theory methodology. This study identified guardianship experiences and the process of adjustment to life with homestay students through in-depth interviews with 12 subjects who are Korean guardians in the United States. The results of this study classified "started with concern" as a category that leads guardians to start providing homestay accommodation, and "other's recommendation," "need for financial support," and "unexpectedly" as subcategories. This study identified "act as a mediator to resolve differences" as a key experience of guardians, and classified subcategories are "parental role" and "calculation of gains and losses" on a personal level; and "feel sorry for own children," "limited leeway of the family," and "formation of relationship between own children and homestay students" on a family level. Developed subcategories are "thirsty for attention," "vulnerability," "task on freedom and control," and "regrettable feeling in the absence of communication" with respect to relationship with students; "grade expectations," "one-way communication," "trapped between parents' and students' demands" in regard to relationship with parents; and "advice from school" in the aspect of school. "Cultural difference," "preparedness of students and parents," "age differences between guardian's children and students," "family support," "similar personalities," "guardian's motivation," and "parent's attitude" are subcategories that affect central phenomenon of guardians.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.32
no.2
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pp.71-78
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2021
Objectives: This study was conducted to investigate the reliability and validity of the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure-inattention [Swanson, Nolan and Pelham, version IV (SNAP-IV)] and anger [Patient-Reported Outcome Measurement Information System (PROMIS) Anger] for parents and guardians of children aged 6-17 years. Methods: We included 104 children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), ADHD with anxiety and depression, depressive disorder, anxiety disorder, and tic disorder with somatic symptoms (ADHD=41, depression=9, anxiety=14, ADHD+anxious depression=11, tic+somatic symptoms=29). Their ages ranged from 8 years to 15 years. The participants' mothers completed the SNAP-IV, PROMIS Anger scale, Korean version of the IOWA Conners Rating Scale (K-IOWA), and Korean ADHD Rating Scale (K-ARS) so that the reliability and validity of the SNAP-IV and PROMIS Anger scales, which are DSM-5 scales for assessing inattention and anger of children and adolescents, could be examined. Results: The reliability coefficient of SNAP-IV (Cronbach's α) was 0.94. The correlation coefficients between SNAP-IV, K-IOWA inattention, and K-ARS inattention scores ranged from 0.73 to 0.86. The mean SNAP-IV scores of the ADHD and the ADHD+anxious depression groups were significantly higher than those of the anxiety and the tic+somatic symptoms groups. The reliability coefficient of the PROMIS Anger was 0.91. The correlation coefficient between PROMIS Anger and K-IOWA oppositional/defiant scores was 0.75. The PROMIS Anger mean score of the ADHD+anxious depression group tended to be higher than that of the other groups. Conclusion: These results suggest that the Korean version of the DSM-5 Level 2 Cross-Cutting Symptom Measure-inattention and anger for parent and guardian of child age 6-17 might be a reliable and valid test and may be useful for screening children and adolescents with ADHD.
As in all other parts in the body, oral tissue also undergoes dramatic changes with increasing age. Since these changes occasionally go beyond physiological scope, which may result in pathological changes, it is essential for dentist to understand changes caused by normal aging process. With increasing age, tooth morphology and occlusion also varies, especially loss of hard tissue, which is taking place in lifelong time, occurs as a result of tooth wear. When this loss of hard tissue is presented rapidly or excessively, functional and esthetical problems are raised, resulting in lowering quality of life of patient as well as making dental treatment for oral rehabilitation even more complex. Therefore, based on understanding of change in occlusion with increasing age, strategic approaches for maintenance of oral health in both functional and esthetic aspect are required as appropriate restoration and maintenance for progressive tooth wear enables desirable occlusal relationship. Carefully planned-restorative treatment in accordance with changed occlusal relationship is also required in the same context. Instead of taking changes in oral tissue as only a consequence of ageing, it is vital to educate patient and his or her guardian, assuring maintenance of oral hygiene and regular dental check-up are of utmost importance for improved oral health.
Objectives : This study developed an iPad-based animation for an electronic informed consent to directly help patients prepare an informed consent. The goal was to raise patients' understanding about the contents contained in a DNR informed consent in the current medical situation in which DNR informed consents are mostly written by a guardian. Methods : The development of a DNR electronic informed consent was done in 3 stages: analysis, design and development. The analysis stage was done with a survey on the real status of preparing a DNR informed consent in a medical institution. The design stage was done with the contents in the DNR electronic informed consent through a primary and secondary Delphi survey. The development stage created a DNR electronic informed consent and evaluated it through a tertiary Delphi survey. Results : After evaluating the appropriateness of the composition of the contents, the understanding of the contents, the convenience of use, the reflection of an expert opinion, and the suitability of the application, all had scores higher than 4 points. Conclusions : The results of this study show that our proposed DNR electronic informed consent can help patients better understanding the contents of a DNR informed consent.
Purpose: The purpose of this study was to describe and understand elementary school health teachers' role perception in their own perspectives. Methods: Data were collected from three focus groups composed of five participants for each group. Each focus group had an interview for two and a half hours on the average. The main question was "What is your perception on the roles of health teachers in elementary schools?" Qualitative data from transcribed notes and field notes were analyzed using qualitative content analysis. Results: Five main roles were identified from the participants. The participants perceived themselves as 'an expert of health education in school and community', 'a health service provider for school members', 'a health guardian for school members, the coordinator of healthcare related works in school, and the leader of school health. Conclusion: The participants have multiple role identities, which are very important for health management of school members. And the roles such as an expert of health education and a leader for school health are recently emphasized. The findings of this study can provide useful information to design orientation programs for newly appointed health teachers and continuing education programs for enhancing role performance of health teachers in elementary schools.
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