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A Survey on the Certification and Curriculum Development for Hospice and Palliative Care Professionals (호스피스.완화의료 전문인력 자격인증방안과 교육과정개발을 위한 설문조사)

  • Kang, Jin-A;Kim, Do-Yeun;Shin, Dong-Wook;Kim, Si-Young;Lee, Soon-Nam
    • Journal of Hospice and Palliative Care
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    • v.13 no.1
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    • pp.32-40
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    • 2010
  • Purpose: The survey was aimed to provide basic data to develop a certification system for hospice and palliative care professionals. Methods: National Cancer Center (NCC) and the Korean Society for Hospice & Palliative Care (KSHPC) conducted the survey for hospice and palliative care professionals who worked at 34 Palliative care units designated by the Ministry of Health, Welfare, and Family Affairs (MW) and the members of the KSHPC. The survey was conducted via e-mail from June 17 to 23, 2009. Total 220 professionals were surveyed. Results: Most of the hospice and palliative care professionals reported a great need for certification system: Physician, 90% (n=51) nurse, 84% (n=134) social worker, 89% (n=35). In regard with the requirement for the certification, a majority of physicians (46%) preferreddiploma course, while social workers (46%) preferred training course for medical social workers. Concerning the certification body, physician (45%) preferred the KSHPC and the MW almost equally, while nurses (50%) and social workers (60%) preferred the MW highly. As for the body to develop and accredit advance training course for each professionals, most of the physicians (51%) preferred the KSHPC, whereas nurses and social workers preferred collaboration of the MW (or NCC) with the professional society, such as the KSHPC (23%), the Korean Hospice & Palliative nurses association for nurses (21%), or the Korean association of (medical) social workers (37%). Lastly, all respondents preferred the course format of once a week, full day, and some field study at weekend. Conclusion: Korean hospice and palliative care professionals identified the great need for the certification system, therefore, the adequate system development must be followed to reflect their voice.

Suitability Assessment of Domestic Natural Waters as a Culture Medium for Daphnia magna (Daphnia magna의 배양배지로서 국내 자연수의 적절성 평가)

  • Yeom, Dong-Hyuk;Jeon, Chan-Sig
    • Korean Journal of Ecology and Environment
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    • v.45 no.3
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    • pp.271-277
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    • 2012
  • The present study was conducted to assess the suitability of domestic natural waters as a Daphnia magna culture medium. In order to assess survival rate and reproductive output, young female daphnids (parent animals), aged less than 24 hours at the start of the test and produced in the Elendt M4 medium, were exposed to Elendt M4 medium, de-chlorinated tap water, and natural mineral water for 21 days. D. magna cultured in Elendt M4 medium (reference medium) and natural mineral water met the criteria of OECD No. 211, Daphnia magna Reproduction Test Guidelines in terms of percent adult survival, first day of reproduction, and average young production. However, the mortalities of adult daphnids observed in de-chlorinated tap water were more than 20% in two reproduction tests for 21 days. Mortality was observed on exposure days 13, 15, and 18 in de-chlorinated water. The use of D. magna is recommended in water of hardness >80 mg $CaCO_3\;L^{-1}$. However, the hardness of de-chlorinated tap water used in the present study was 50~53 mg $CaCO_3\;L^{-1}$. Therefore, it is judged that the delayed mortalities observed in de-chlorinated tap water were caused by a rapid decreased in hardness when the medium was changed from Elendt M4 to de-chlorinated tap water. When D. magna is cultured using domestic natural waters (underground water, surface water, and de-chlorinated water), the quality-control (QC) data should be maintained through a standardization for health assessment method, toxicity test method using reference chemical, test intervals of reference toxicant toxicity test, and data treatment and interpretation. In the long term, national research programs are needed for the development of test species which are representative of domestic aquatic environmental conditions among indigenous daphnids.

A Case Study on Center of Gravity Analysis when Performing Uchimata by Posture and Voluntary Resistance Levels of Uke in Judo[ll] (유도 허벅다리걸기 기술발휘 시 받기의 자세와 저항수준에 따른 중심변인 분석 사례연구[II])

  • Kim, Eui-Hwan;Kim, Sung-Sup;Chung, Chae-Wook
    • Korean Journal of Applied Biomechanics
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    • v.15 no.1
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    • pp.237-257
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    • 2005
  • It was to study as a following-research of "A Case Study on Center of Gravity(COG) Analysis when Performing Uchimata(inner thigh reaping throw) by Posture and Voluntary Resistance Levels(VRL) of Uke in Judo[I]". The purpose of this study was to analyze the COG variables when performing uchimata(inner thigh reaping throw) by two postures and voluntary resistance levels(VRL) of uke(reciver) in Judo. The subjects, who were one male judoka(YH) for 1992 Barcelona Olympic Games Olympian(silver medalist), and one male trainee; Y.I.University representative member (SDK), and were filmed on two S-VHS 16mm video cameras(60fields/sec.) through 3-dimensional motion analysis methods, that postures of uke were shizenhontai (straight natural posture) and jigohontai(straight defensive posture), VRL of uke were 0% and 100%, respectively. The kinematical variable was COG variable, distance of COG, and distance of resultant COG between uke and tori(the thrower), velocity and acceleration of COG. The data of this study collection were digitized by SIMI Motion Program computed the mean values and the standard deviation calculated for each variables. When performing uchinmata according to each posture and VRL of uke and classifying. From the data analysis and discussion, the conclusions were as follows : 1. Displacement of COG Subject YH, COG was the highest in kuzushi(balance -breaking), vertical COG was low when following in tsukuri(positioning; set-up), kake(application; execution), and COG was pattern of same character each postures and resistance, respectively. Subject SDK, COG was low from kumikata(engagement positioning) to kake, and COG was that each postures and resistance were same patterns, respectively. Subject YH, SDK, each individual, postures and resistance, vertical COG was the lowest in kake phase, when performing. 2. Distance of COG between uke and tori The distance of COG between uke and tori when performing, subject YH was $0.64{\sim}0.70cm$ in kumikata, $0.19{\sim}0.28cm$ in kake, and SDK was $0.68{\sim}0.72cm$ in kumikata, $0.30{\sim}0.42\;cm$ in kake. SDK was wider than YH. 3. Distance of resultant COG between uke and tori The distance of resultant COG between uke and tori when performing, subject YH was $0.27{\sim}0.73cm$ from kumikata to kake. and SDK was $0.14{\sim}0.34cm$ in kumikata, $0.28{\sim}0.65cm$ in kake. Jigohontai(YH:$0.43{\sim}0.73cm$,SDK:$0.59{\sim}0.65cm$) was more moved than shizenhontai(YH:$0.27{\sim}0.53cm$, SDK: $0.28{\sim}\;0.34cm$). 4. Velocity of COG The velocity of COG when performing uchimata, subject YH was fast anterior-posterior direction in kuzushi, ant.-post. and vertical direction fast in tsukuri and kake. SDK was lateral, ant.-post. and vertical direction in kuzushi, ant.-post. and vertical direction in tsukuri and ant.-post. direction in take, respectively. 5. Acceleration of COG The acceleration of COG when performing uchimata, The trend of subject YH was showed fast vertical direction in kuzushi and tsukuri, ant.-post. and vertical direction fast in kake. The trends of SDK showed lateral direction in kuzushi, lateral and ant.-post. direction in tsukuri and ant.-post. direction in kake, respectively.

Strategic Direction and Road Map of Expanding Prevention of Winter Disease in the Summer (동병하치 확산을 위한 전략적 방향과 이행방안)

  • Song, Ho-Sueb
    • Journal of Acupuncture Research
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    • v.27 no.3
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    • pp.147-157
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    • 2010
  • Objectives : The purpose of this study was to propose appropriate strategic directions and road maps for successful achievement of programs preventing winter disease in the summer. Methods : Details on programs preventing winter disease in the summer such as clear concept, theoretical basis, current status, intervention or available prescriptions and indication/contraindication/caution were prepared through the related journal review, upon which an observational study was devised and done for simulation to find out even a trivial problem and to guarantee the safety beforehand. The experimental group was divided into 5 groups by the size of pill and the way ginger is treated; 1cm pill with ginger group, 3cm pill group without ginger, 3cm pill group dipped into ginger, 3cm pill group applying ginger to acupoints and 3cm pill group with ginger Results 1. program preventing winter disease in the summer was defined as representative winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis and rheumatoid arthritis, and preventive care in the summer, reinforcing deficient yang qi of five viscera by using exuberant yang qi from summer heat. 2. It was based upon historically established theories which is 'nourishing yang qi in the spring and summer', 'long summer, namely rainy spell in the summer overwhelms the winter, because of earth winning water according to the five phases theory' and 'To replenish yang qi is major principle to treat winter diseases, which can be most appropriately and timely applied to the patient with deficient yang qi of five viscera inherently, especially in the three dog days of the summer, because of exuberant exterior yang qi and deficient interior yang qi in the five viscera'. 3. In the adjacent China and Taiwan, acupoint applying method in the three dog days named 'San Fu Tie' have been stirring a boom throughout the nation, in which Xiaochuan Gao was used as a basic prescription and it mainly was applied at bilateral $BL_{13}$, $_{15}$ and $_{17}$ for about 4 hours. As far as domestic current status, the necessity of adopting the above method prior to Herbal formula was also recognised, because not a few koreans have apprehension for the safety of it including medicinal herbs and are reluctant to take it any more due to negative advertisement of narrow minded doctors' association. 4. Indication of acupoint applying method in the three dog days included most of winter diseases such as common cold, influenza, chronic asthma, chronic bronchitis, allergic rhinitis, emphysema, chronic gastritis. contraindication was pregnant woman and the weak such as infants and the old. More attention was paid to grasp firmly the normal reaction following the treatment for preventing side effect and teasing blister. recommendation was also given to abstain from food inducing phlegm and dampness such as meat, shrimp and crab as well as cold drinks and foods 5. In the simulation observational study based upon the above findings following review the related articles, no blister was shown on the acupoints icluding bilateral $BL_{13}$, $_{15}$ and $_{17}$ in every experimental group during 24hr observation following the acupoint applying treatment with pills made by modified and devised prescription. At 4 hr, the effectiveness of it reached a peak showing redness and mild tenderness and there is little difference between groups 3cm pills groups regardless of the way ginger was treated. abdominal distention and growling was found in all the volunteers during the treatment at CV 8. Strategic directions and road maps : Through successful fulfillment of the program preventing winter disease in the summer, Korean traditional medicine should be integrated into mainstream national health care services. Cultural access was thought to be as important as Scientific EBM approach. First of all, To evoke potential cultural homogeneity from campaigns and press advertisement was needed for promoting public awareness about preventing winter disease in the summer by enhancing immunity via acupoint applying treatment in the three dog days, and then indigenous name as Sambokcheop, protocol, Clinical Research Form for data collection of it should be developed and prepared. Once the first step was taken this summer, through a thorough data collection and scrutinized scientific evaluation, drawbacks should be compensted for and the efficacy and safety should be substantiated.

A survey of eco-foodservice perception and satisfaction of elementary school parents in Jeju (제주지역 초등학생 학부모의 친환경급식에 대한 인식도 및 만족도 조사)

  • Jeong, Mi-Hui;Chae, In-Sook
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.105-112
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    • 2015
  • Purpose: This study analyzed the eco-foodservice perception and satisfaction of 344 elementary school parents in Jeju surveyed from February 1~12, 2010, with the aim of providing basic data for quality improvement of eco-foodservice in Jeju. Methods: The data were analyzed by descriptive analysis, ${\chi}^2$-test, t-test, ANOVA, and Pearson's correlation coefficients, using the SPSS Win program (version 12.0). Results: Regarding awareness of eco-friendly food materials of subjects, average score was 3.52 points (out of 5 scales) and 'difference between eco-friendly and general agricultural products (3.76)' showed the highest score whereas 'assurance standard and label of eco-friendly agricultural products (3.31)' showed the lowest score. In terms of the recognition of eco-foodservice implementation, 75.0% of parents were aware of it. Regarding the eco-foodservice satisfaction of the subjects, average score was 3.88 points (out of 5 scales) and food safety (3.98 points) showed the highest score whereas food taste (3.70 points) showed the lowest score. The eco-foodservice perception of subjects showed positive correlation with their eco-foodservice satisfaction. Conclusion: It is necessary for the government and the local government to provide continuing education for school parents in order to enhance their perception of eco-friendly food materials. In addition, systematic and appropriate government support is needed in order to ensure internal stability of eco-foodservice.

Clinical significance of follow-up laboratory tests, performed at 6 weeks after the onset of Kawasaki disease (가와사끼병에서 발병 6주째에 시행하는 추적검사의 임상적 유용성에 관한 고찰)

  • Oh, Il Ji;Moon, Kyung Hee;Hong, Myung Eun;Kim, Yeon Soon;Lee, Chang Woo;Yoon, Hyang Suk
    • Clinical and Experimental Pediatrics
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    • v.49 no.6
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    • pp.672-676
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    • 2006
  • Purpose : Low dose aspirin is used due to its antiplatelet effect for the subacute phase of Kawasaki disease(KD). It is usually used for 6-8 weeks, then various hematologic laboratory tests and follow up echocardiography for evaluating coronary abnormalities are performed. Our review investigated the usefulness of various follow up laboratory tests performed at 6 weeks after the onset of KD. Methods : Two hundred eighty-two children diagnosed and hospitalized with KD were identified by reviewing patient's charts. Cases which were diagnosed between January 1997 and December 2004 were included in this study. We reviewed laboratory data including leukocytes, platelet counts, antistreptolysin O(ASO), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), aspartate aminotransferase(AST), alanine aminotransferase(ALT), urinalysis, and echocardiograms performed at admission and 6 weeks after the onset of KD. Paired t-test and Fisher's exact test, as well as logistic regression tests, were used for the statistical analysis. Results : At 6th week data, ESR and CRP were still elevated in 35(12.4 percent) and 12(4.3 percent) patients, respectively. Sterile pyuria were all normalized. But, 36 patients(12.8 percent) showed thrombocytosis, 22(7.8 percent) elevated AST, 15(5.3 percent) leukocytosis, and 6(2.1 percent) coronary abnormalities. Coronary abnormalities at the 6th week were only shown in patients with initial abnormalites. Younger age and initial thrombocytosis were risk factors for thrombocytosis at the 6th week. Conclusion : All children with initial coronary abonormalites should have an echocardiogram at 6 weeks after the onset of fever. In view of case-effectiveness, additional echocardiographic studies are justified only if abnormalities are present at admission. ESR, CRP, and urinalysis performed at the 6 weeks after onset of KD is not significant for clinical information of progression. Platelet count should be estimated at 6th week for a judgement of continuous antiplatelet therapy.

Radiation Exposure Dose on Persons Engaged in Radiation-related Industries in Korea (한국에서 방사선 관련 종사자들의 개인피폭선량 실태에 관한 연구)

  • Lim, Bong-Sik
    • Journal of radiological science and technology
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    • v.29 no.3
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    • pp.185-195
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    • 2006
  • Purpose: This study investigated the status of radiation exposure doses since the establishment of the "Regulations on Safety Management of Diagnostic Radiation Generation Device" in January 6, 1995. Method: The level of radiation exposure in people engaged or having been engaged in radiation-related industries of inspection organizations, educational organizations, military units, hospitals, public health centers, businesses, research organizations or clinics over a 5 year period from Jan. 1, 2000 to Dec. 31, 2004 was measured. The 149,205 measurement data of 57,136 workers registered in a measurement organization were analysed in this study. Frequency analysis, a Chi-square test, Chi-square trend test, and ANOVA was used for data analysis. Results: Among 57,136, men were 40,870(71.5%). 50.3% of them were radiologic technologists, otherwise medical doctors(22.7%), nurse(2.9%) and others(24.1%). The average of depth radiation and surface radiation during the 5-year period were found to decrease each year. Both the depth radiation and surface radiation exposure were significantly higher in males, in older age groups, in radiological technologists of occupation. The departments of nuclear medicine had the highest exposure of both depth and surface radiation of the divisions of labor. There were 1.98 and 2.57 per 1,000 person-year were exposed more than 20 mSv(limit recommended by International Commission on Radiological Protection) in depth and surface radiation consequently. Conclusion: The total exposure per worker was siginifcantly decreased by year. But Careful awareness is needed for the workers who exposed over 20 mSv per year. In order to minimize exposure to radiation, each person engaged in a radiation-related industry must adhere to the individual safety management guidelines more thoroughly. In addition, systematic education and continuous guidance aimed at increasing the awareness of safety must be provided.

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Feasibility of Two Dimensional Ion Chamber Array for a Linac Periodic Quality Assurance (선형가속기의 품질관리를 위한 2차원이온전리함배열의 유용성)

  • Lee, Jeong-Woo;Hong, Se-Mie;Park, Byung-Moon;Kang, Min-Young;Kim, You-Hyun;Suh, Tae-Suk
    • Journal of radiological science and technology
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    • v.31 no.2
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    • pp.183-188
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    • 2008
  • Aim of this study is to investigate the feasibility of 2D ion chamber array as a substitute of the water phantom system in a periodic Linac QA. For the feasibility study, a commercial ion chamber matrix was used as a substitute of the water phantom in the measurement for a routine QA beam properties. The device used in this study was the I'm RT MatriXX (Wellhofer Dosimetrie, Germany). The MatriXX consists of a 1,020 vented ion chamber array, arranged in $24{\times}24\;cm^2$ matrix. Each ion chamber has a volume of $0.08\;cm^3$, spacing of 0.762 cm. We investigated dosimetric parameters such as dose symmetry, energy ($TPR_{20,10}$), and absolute dose for comparing with the water phantom data with a Farmer-type ionization chamber (FC65G, Wellhofer Dosimetrie, Germany). For the MatriXX measurements, we used the white polystyrene phantom (${\rho}:\;1.18\;g/cm^3$) and also considered the intrinsic layer (${\rho}:\;1.06\;g/cm^3$, t: 0.36 cm) of MatriXX to be equivalent to water depth. In the preliminary study of geometrical QA using MatriXX, the rotation axis of collimator and half beam junction test were included and compared with film measurements. Regarding the dosimetrical QA, the MatriXX has shown good agreements within ${\pm}1%$ compared to the water phantom measurements. In the geometrical test, the data from MatriXX were comparable with those from the films. In conclusion, the MatriXX is a good substitute for water phantom system and film measurements. In addition, the results indicate that the MatriXX as a cost-effective novel QA tool to reduce time and personnel power.

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The Effect of Welfare Recognition on the Utilization of Social Services and the Satisfaction of Social Welfare Policies for the Elderly (노인의 복지인식이 사회서비스 이용과 사회복지정책 만족도에 미치는 영향)

  • Seo, Bok Hyun;Hwang, Yoon Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.8
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    • pp.583-597
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    • 2020
  • This study analyzed how elderly people's perception of social welfare affects social welfare service and social welfare policy satisfaction by paying attention to the use of social welfare services and satisfaction with social welfare policies. In order to achieve this research goal, 465 people aged 60 or older who completed responses to the additional survey were collected and analyzed as research targets based on data from the Korea Welfare Panel, which is accumulated by the Korea Institute for Health and Social Affairs and Seoul National University's Social Welfare Research Institute. The results of this study are as follows. First, "Awareness of welfare for the elderly (recognition of welfare expenditure, recognition of welfare targets, recognition of welfare tax increases)" was found to have a negative impact on "use of social services." Second, "Awareness of welfare for the elderly (recognition of welfare expenditure, recognition of welfare targets, recognition of welfare tax increases)" was found to have a negative impact on "satisfaction with social welfare policies." Third, the impact of the recognition of welfare for the elderly on the use of social services was found to be different according to the demographic characteristics (education level, income level, educational background, gender). Fourth, according to the "population statistical characteristics (education level, income level, educational background, gender)" the impact of the recognition of welfare for the elderly on the satisfaction of social welfare policy was shown to be different. The implications of this study are that we looked at multi-dimensional welfare awareness and social service use experience together as factors affecting social welfare policy satisfaction. In other words, it is meaningful that the government focused on welfare awareness based on individual values and subjective perceptions as an influence on social welfare policy satisfaction, and sought practical alternatives to welfare policies and welfare sites by examining whether the experience of using social services in relation to welfare awareness and social welfare policy satisfaction among the elderly.

A STUDY OF THE EFFECTIVENESS OF THE BEREAVEMENT PROGRAM OF SEVERANCE HOSPICE (세브란스 호스피스 추후관리 프로그램의 효과에 관한 연구)

  • Wang, Mae-Ryeon
    • The Korean Nurse
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    • v.31 no.2
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    • pp.51-69
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    • 1992
  • Grief that is not acknowledged and worked through may manifest itself in some emotional, mental or physical problem. In recent years much has been learned about coping with grief which the hospice program can utilize to help family members cope with their grief. This study was carried out to determine the helpfulness of the bereavement care of Severance Hospice and to learm more about the grief response of the bereaved. The tools used to collect data were an assessment form used in the bereavement program and the Grief Experience Inventory developed by Sanders and revised and translated 'by the researcher. Data was obtained from bereaved family members(54 for the final grief assessment and 39 for the grief response assessment) receiving bereavement follow-up, from July 1989 to March 1991. Results of the study were as follows: 1. Final Grief Assessment Regarding the resolution of their grief the majority of the bereaved accepted the reality of the death of their family member, while slightly more than three-quarters were able to express their feelings toward their loss. A large majority had returned to activities of daily living well or fairly well and had reinvested their energy in a person other than the deceased. In addition, the physical condition of the majority was good or fairly good. A majority of the bereaved considered the bereavement care to be helpful and almost three-quarters were not considered to be in need of more follow-up. 2. Grief Response Assessment Age was found to have a modoerately positive correlation to appetite disturbance(r=.41, P<.Ol) and loss of vigor(r=.37, P<.Ol) A moderately positive correlation was found between the number of contacts and sleep disturbance(r=2.38, P<.01) Significant differences were found between men and women in regard to guilt(t=2.38, P<.05), social isolation(t=2.44, P<.05) and depersonalization(t=2.07, P<.05) with men having the more intense grief. Significant differences were found in the grief responses of somatization(F=5.82, P<.001), physical symptoms(F=5.87, P<.OOl), appetite disturbance(F=4.40, P<.Ol), despair(3.79, P<,Ol), anger(Fp2.83, P<.05), social isolation(F=3.61, P<.05), guilt(F=3.62, P<.05) and depersonalization (F = 2.58, P <.05). In the first six of these grief responses mothers scored highest, followed by husbands and then wives, In the grief response of guilt, daughters scored highest and on the grief response of depersonalization sons scored highest. Only one grief response, that of sleep disturbance(t= -2.19, P<.05) was found to be statistically significant, with those family members who died at home having the higher scores. Based on the results of this study several suggestions are presented as follows: 1. Since unresolived grief can have a detrimental effect on the bereaved person's mental and phys. ical health it would be good for the nurse, to include questions related to death of family members and the bereaved person's response to the grief, in her nursing assessment. And in the case of unresolved grief the nurse should encourage the person to talk with a trusted friend or counselor and express their fellings of grief. 2. A study to determine the degree of resolution of the grief of those in the bereavement program could be carried out by use of the Grief Experience Inventory early in their bereavement and again 13 months after the death of their family member. 3. A comparison of the grief response of the bereaved in the bereavement program and bereaved not in the program could be carried out using the Grief Experience Inventory. 4. After bereavement programs have been started in other hospice programs it would be good to carry out a joint study of bereavement outcomes of those in the bereavement programs.

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