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How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.

Effect of environmental temperature on respiration rate, rectal temperature and body-surface temperatures in finishing pigs (환경온도가 비육돈의 호흡수, 직장 온도 및 체표면 온도에 미치는 영향)

  • Cheon, Si-Nae;Park, Kyu-Hyun;Choi, Hee-Chul;Kim, Jong-bok;Kwon, Kyeong-Seok;Lee, Jun-Yeob;Woo, Saem-Ee;Yang, Ga-Yeong;Jeon, Jung-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.1
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    • pp.103-110
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    • 2019
  • Recently, Korea has been affected by extreme weather events including extended summers and increased temperatures caused by global warming and climate change. Environmental temperature is especially important to the livestock industry because it is closely related to livestock productivity. This study was conducted to investigate the influence of different environmental temperatures on respiration rate, rectal temperature and body-surface temperature in finishing pigs. Pigs ($98.3{\pm}6.6kg$) were housed in individual cages inside an experimental chamber and exposed continuously to one of five environmental treatments ($22^{\circ}C$, $24^{\circ}C$, $26^{\circ}C$, $28^{\circ}C$, $30^{\circ}C$) for 10 days without providing additional rest time. Feed and water intake, respiration rate, rectal temperature and body-surface (head, ear, neck, back, side) temperature were measured two times daily during the experimental period. A significant increase in respiration rate from $26^{\circ}C$ and in body-surface temperature from $24^{\circ}C$ (p<0.05) was observed. At $30^{\circ}C$, the respiration rate had almost doubled and the body-surface temperature increased by about $5^{\circ}C-7^{\circ}C$. Moreover, ear skin temperature was very sensitive to environmental temperature. However, feed intake, water intake and rectal temperature did not change significantly during the experiment.

Shielding Capability Evaluation of Mobile X-ray Generator through the Production assembled Shield (일체형 방어벽 제작을 통한 이동형 엑스선 발생기의 차폐능 평가)

  • Kim, Seung-Uk;Han, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.12 no.7
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    • pp.895-908
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    • 2018
  • As modern science is developed and advanced, examination and number of times using radiation are increasing daily. General diagnostic X-ray generator is installed on stationary form, But X-ray generator was developed because patient who is in the intensive care unit, operation room, emergency room can not move to general x-ray room. What we examine patient by x-ray generator is certainly necessary, So patient exposure is inevitable. but reducing radiation exposure is highly important matter about radiation technology, guardian, patient in the same hospital room, nurse etc. For this reason, rule regarding safety control of diagnostic x-ray generator revised for radiation worker, patient and protector proclaim that mobile diagnostic x-ray shield must placed in case of examine different location excluding operation room, emergency room, intensive care unit. But, radiogical technologist is having a lot of difficulties to examine with mobile x-ray generator, diagnostic x-ray shield partition, image plate and lead apron. So, when we use x-ray generator, we manufacture shield tools can be attached to the mobile x-ray generator On behalf of x-ray shield partition and conduct analysis and in comparison to part of body and distribution of dose rate and find way to reduce radiation exposure through distribution of dose rate of patient within the radiogical technologist, medical team. Mobile x-ray generator aimed at SHIMADZU inc. R-20, We manufactured equipment for shielding x-ray scattered x-ray by installing shielding wall from side to side based on support beam on the mobile x-ray generator. Shielding wall when moving can be folded and designed to expand when examine. Experiment measured five times in each by an angle for dose rate of eyes, thyroid, breast, abdomen and gonad on exposure condition of upper and lower extremity, chest, abdomen which is examined many times by mobile x-ray generator. We used dosimeter RSM-100 made by IJRAD and measured a horizontal dose rate by body part. The result of an experiment, shielding decreasing rate of the front and the rear showed 77 ~ 98.7%. Therefore using self-production shielding wall reduce scattered x-ray occurrence rate and confirm can decrease exposure dose consequently. Therefore, through this study, reduction result which is used shielding wall of self-production will be a role of shielding optimization and it could be answer about reduction of medical exposure recommended by ICRP 103.

A Study on the Design of the Grid-Cell Assessment System for the Optimal Location of Offshore Wind Farms (해상풍력발전단지의 최적 위치 선정을 위한 Grid-cell 평가 시스템 개념 설계)

  • Lee, Bo-Kyeong;Cho, Ik-Soon;Kim, Dae-Hae
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.24 no.7
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    • pp.848-857
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    • 2018
  • Recently, around the world, active development of new renewable energy sources including solar power, waves, and fuel cells, etc. has taken place. Particularly, floating offshore wind farms have been developed for saving costs through large scale production, using high-quality wind power and minimizing noise damage in the ocean area. The development of floating wind farms requires an evaluation of the Maritime Safety Audit Scheme under the Maritime Safety Act in Korea. Floating wind farms shall be assessed by applying the line and area concept for systematic development, management and utilization of specified sea water. The development of appropriate evaluation methods and standards is also required. In this study, proper standards for marine traffic surveys and assessments were established and a systemic treatment was studied for assessing marine spatial area. First, a marine traffic data collector using AIS or radar was designed to conduct marine traffic surveys. In addition, assessment methods were proposed such as historical tracks, traffic density and marine traffic pattern analysis applying the line and area concept. Marine traffic density can be evaluated by spatial and temporal means, with an adjusted grid-cell scale. Marine traffic pattern analysis was proposed for assessing ship movement patterns for transit or work in sea areas. Finally, conceptual design of a Marine Traffic and Safety Assessment Solution (MaTSAS) was competed that can be analyzed automatically to collect and assess the marine traffic data. It could be possible to minimize inaccurate estimation due to human errors such as data omission or misprints through automated and systematic collection, analysis and retrieval of marine traffic data. This study could provides reliable assessment results, reflecting the line and area concept, according to sea area usage.

Exposure and Risk Assessments of Multimedia of Arsenic in the Environment (환경 중 비소의 매체통합 노출평가 및 위해성평가 연구)

  • Sim, Ki-Tae;Kim, Dong-Hoon;Lee, Jaewoo;Lee, Chae-Hong;Park, Soyeon;Seok, Kwang-Seol;Kim, Younghee
    • Journal of Environmental Impact Assessment
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    • v.28 no.2
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    • pp.152-168
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    • 2019
  • The element arsenic, which is abundant in the Earth's crust, is used for various industrial purposes including materials for disease treatment and household goods. Various human activities, such as the disposal of soil waste, metal mining and smelting, and combustion of fossil fuels, have caused the pollution of the environment with arsenic. Recently, guidelines for arsenic in rice have been adopted by the Korean ministry of food and drug safety to prevent health risks based on rice consumption. Because of the exposure to arsenic and its accumulation in the human body through various channels, such as air inhalation, skin contact, ingestion of drinking water, and food consumption, integrated multimedia risk assessment is required to adopt appropriate risk management policies. Therefore, integrated human health risk assessment was carried out in this study using integrated exposure assessment based on multimedia (e.g., air, water, and soil) and multi-route (e.g., oral, inhalation, and dermal) scenarios. The results show that oral uptake via drinking water is the most common pathway of arsenic into the human body, accounting for 57%-96% of the total arsenic exposure. Among various age groups, the highest exposures to arsenic were observed in infants because the body weight of infants is low and the surface areas of infant bodies are large. Based on the results of the exposure assessment, the cancer and non-cancer risks were calculated. The cancer risk for CTE and RME is in the range of 2.3E-05 to 6.7E-05 and thus is negligible because it does not exceed the cancer probability of 1.0E-04 for all age groups. On the other hand, the cancer risk for RME varies from 6.4E-05 to 1.8E-04 and from 1.3E-04 to 1.8E-04 for infants and preschool children, exceeding the excess cancer risk of 1.0E-04. The non-cancer risks range from 5.4E-02 to 1.9E-01 and from 1.5E-01 to 6.8E-01, respectively. They do not exceed the hazard index 1 for all scenarios and all ages.

Estimation of Baseflow based on Master Recession Curves (MRCs) Considering Seasonality and Flow Condition (계절·유황특성을 고려한 주지하수감수곡선을 활용한 기저유출분리 평가)

  • Yang, Dongseok;Lee, Seoro;Lee, Gwanjae;Kim, Jonggun;Lim, Kyoung Jae;Kim, Ki-Sung
    • Journal of Wetlands Research
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    • v.21 no.1
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    • pp.34-42
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    • 2019
  • Baseflow which is one of the unmeasurable components of streamflow and slowly flows through underground is important for water resource management. Despite various separation methods from researches preceded, it is difficult to find a significant separation method for baseflow separation. This study applied the MRC method and developed the improved approach to separate baseflow from total streamflow hydrograph. Previous researchers utilized the whole streamflow data of study period at once to derive synthetic MRCs causing unreliable results. This study has been proceeded with total nine areas with gauging stations. Each three areas are selected from 3 domestic major watersheds. Tool for drawing MRC had been used to draw MRCs of each area. First, synthetic MRC for whole period and two other MRCs were drawn following two different criteria. Two criteria were set by different conditions, one is flow condition and the other is seasonality. The whole streamflow was classified according to seasonality and flow conditions, and MRCs had been drawn with a specialized program. The MRCs for flow conditions had low R2 and similar trend to recession segments. On the other hand, the seasonal MRCs were eligible for the baseflow separation that properly reflects the seasonal variability of baseflow. Comparing two methods of assuming MRC for baseflow separation, seasonal MRC was more effective for relieving overestimating tendency of synthetic MRC. Flow condition MRCs had a large distribution of the flow and this means accurate MRC could not be found. Baseflow separation using seasonal MRC is showing more reliability than the other one, however if certain technique added up to the flow condition MRC method to stabilize distribution of the streamflow, the flow conditions method could secure reliability as much as seasonal MRC method.

A study of prostate symptom, sleep quality and quality of life in the community-dwelling korean elderly (남성 노인의 전립선 증상, 수면의 질, 삶의 질에 관한 연구)

  • Shin, Kyung-Rim;Kang, Younhee;Shin, Mee-Kyung
    • 한국노년학
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    • v.28 no.4
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    • pp.1041-1054
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    • 2008
  • This study aimed to identify the severity and types of prostate symptom, to identify the relationship of prostate symptom, sleep quality and quality of life of the elderly in korea, so to provide basic data for developing nursing interventions for the elderly's prostate symptom management. This study used a descriptive correlational research design. The subjects of this study were 100 elderly men over 65yr in an urban city. Data were collected through personal interviews using questionnaires from September 2006 to March 2007. The IPPS, PSQI and SF-36-K were administered. The collected data were analyzed by descriptive statistics and Pearson's correlation. The major findings of this study were as follows: 1) 44% of the participants have moderate to severe Prostate symptom(IPSS>7). 2) Prostate symptom has positive relationship with sleep quality(r=.272, p=.006) and negative relationship with health related quality of life(r=-.197, p=.049). The results of this study indicate that prostate symptom is related to sleep quality and quality of life. So it is necessary to give information to the elderly about the effective coping method of prostate symptom and about the life style which have positive effect to prostate symptom.

A Reexamination of the Impact of the Fit of Corporate Social Responsibility on the Brand Attitude: The Perspective of Brand Hierarchy (기업의 사회적 책임(CSR)활동의적합성이 브랜드 태도에 미치는 영향에 관한 재고찰: 브랜드 계층구조 관점에서)

  • YANG, JAEHO;Seo, Hae-Jin;Song, Tae-Ho
    • (The) Korean Journal of Advertising
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    • v.27 no.8
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    • pp.59-90
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    • 2016
  • Consumers demand that corporates fulfill their social responsibility by exerting influence over not only economical values but also social values in markets. Given such a social mood, most corporates are actively engaging in Corporate Social Responsibility(CSR) activities, and marketing scholars continue to study the effects of such CSR activities. Numerous such studies examined the relationship between CSR activity and brand equity. Moreover, virtually, a majority of these studies focused on consumer responses to CSR activity from an individual brand perspective. In a situation in which brand management must consider the spillover effects of brands, firms holding various brands should consider these spillover effects when they establish CSR activity strategies. Therefore, we examine the effects of CSR activity using a comprehensive approach that considers the hierarchy of brands. Additionally, we develop a new perspective on fit that has been used as a major influence on the effects of CSR activity. We argue that the mixed results of the impact of fit regarding the effect of CSR activities is attributed to the influence of connections among brands based on the hierarchy of brands. We then examine the effect of two types of CSR activity strategies that reflect the relativity of fit. The results reveal that there was no difference in impact of the two strategies based on unique roles and traits of corporate brand and effects of low fit. Also, we found that the corporate brand focused strategy creates a greater change in consumers' attitudes than does an individual brand focused strategy in the case of a particular brand. This finding is meaningful because it indicates that a hierarchy of brands may relatively reduce the impact of the role of fit, unlike general arguments from previous related research. Second, the spillover effects from the CSR activities of individual sub-brands belonging to the same corporate brand were confirmed. Therefore, we clearly verified the role of the hierarchy of brands. Although both strategies cause changes in consumer attitude toward brands engaged in CSR activity, overall, a corporate brand focused strategy turned out to be more effective than an individual brand focused strategy because of the spillover effects of brands. Third, this study verified the effect of a corporate brand focused strategy through a moderating effect analysis of the degree of association between individual brands and corporate brand. Given these results, we identified a moderating role in the degree of association and the changes in consumer attitudes toward both main brands engaged in CSR activities and other different individual brands, which were caused by the spillover effects of brands. Finally, this study addresses implications and limitations.

Analysis of Commercial Organic Compost Manufactured with Livestock Manure (국내 유통중인 가축분퇴비의 품질 특성)

  • Kim, Myung-Sook;Kim, Seok-Cheol;Park, Seong-Jin;Lee, Chang-Hoon
    • Journal of the Korea Organic Resources Recycling Association
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    • v.26 no.4
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    • pp.21-29
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    • 2018
  • The contents of total nitrogen(T-N), phosphate($T-P_2O_5$), and potash($T-K_2O$) are important factors to determine the application rate of the livestock compost to prevent nutrients accumulation and maintain their appropriate levels in arable lands. The concentrations of nutrient, organic matter, salt, water content, heavy metal in livestock compost in circulation were investigated with 659 samples from 2016 to 2017. In order to investigate the fluctuation nutrient contents of livestock composts with the same product name, 19 samples were collected and analyzed T-N, and $T-P_2O_5$, and $T-K_2O$ concentration during two years. The mean levels of T-N, $T-P_2O_5$, and $T-K_2O$ in livestock composts of from 2016 to 2017 were 1.73%, 1.88%, and 1.66%, respectively. The average contents of organic matter, water, and salt were 38.9%, 40.9%, and 1.2%, respectively. There were found that the maximum concentrations of Cr, Ni, Cu, and Zn in some livestock composts were exceeded the criteria of the official standard of commercial fertilizer. The maximum variation coefficient of T-N, $T-P_2O_5$ and $T-K_2O$ content of livestock composts was found to be 24%, 27%, and 50% on average, respectively. In order to manage the nutrients in agricultural soils, it will be reasonable that the error range of T-N and $T-P_2O_5$ content in livestock composts should be recommended to be 27% in mean as variation coefficient in case of displaying the nutrient element in liverstock compost.

Study on the osteoporosis knowledge, concern about osteoporosis factors, and health behavior to prevent osteoporosis of women in Jeonbuk area (전북지역 성인여성의 골다공증 지식, 골다공증관련 요인에 대한 관심 및 예방적 건강행동에 관한 연구)

  • Lee, Hyun Ju;Rho, Jeong Ok
    • Journal of Nutrition and Health
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    • v.51 no.6
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    • pp.526-537
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    • 2018
  • Purpose: The purpose of the study was to identify women's osteoporosis knowledge, concerns about osteoporosis factors, and health behavior as well as to examine the relationship between these variables. Methods: The participants were 394 women in the Jeonbuk area. The data were analyzed using a t-test, ANOVA, Duncan test, and hierarchical regression analysis with SPSS v. 24.0. Results: The score for osteoporosis knowledge was 6.21 points out of a possible 12, the score for concern about osteoporosis factors was 26.50 points out of a possible 40. The score for the health behavior was 57.26 points out of a possible 85. The knowledge showed significant differences according age (p < 0.01), income (p < 0.05), education level (p < 0.01), drinking milk in childhood (p < 0.05), health interest (p < 0.05), and osteoporosis information (p < 0.01). The concern showed significant differences according to age (p < 0.001), income (p < 0.05), health interest (p < 0.001), osteoporosis information (p < 0.001), family history of osteoporosis (p < 0.05), and calcium medications (p < 0.001). The health behavior showed significant differences according to age (p < 0.001), income (p < 0.01), drinking milk in childhood (p < 0.05), health interest (p < 0.001), osteoporosis information (p < 0.01), and calcium medications (p < 0.01). Regression analysis showed that the concern about osteoporosis factors was the most influential variable on health behavior, followed by health interest of the subjects, age, and the osteoporosis knowledge. Conclusion: Therefore, it is necessary to consider educational programs on increasing interest in osteoporosis according to the age and health for improving the health behavior to prevent osteoporosis.