• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.85-99
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• 2011

Purpose: The purpose of this study is to examine the EMT student's attitude to the disabled and provide the basic materials of educational program to make them have right awareness and attitude of the disabled. Methods: The subjects of this study were 348 of 339 emergency medical students at three departments of emergency medical in G metropolitan city who gave consent to take part in the research and the data were collected for 10 days from Mar. 2 to 11, 2011. It used DFS (Disability Factor Scale) developed by Siller (1967) and revised and complemented by Lee Jong Nam (1997) after validity and reliability test. Data collected were analyzed with technical statistics, t-test and ANOVA using SPSS/ PC 12.0 Results: The results of this study are summarized as follows. 1. On the question that there are the disabled around the subjects, 74.7% of the respondents answered 'none', and on the question of having concerns on the disabled problems, 61.5% of the respondents answered 'they have no concerns on them'. In addition, on the question of effective methods for improving a negative awareness of the disabled, many of subjects responded the governmental support must be a priority. 2. The subjects' attitude to the disabled scored average 3.13 and they have positive attitude to the disabled. In six sub-areas of attitude to the disabled, tension in contact with the disabled scored 2.90, inferred emotional disorder 2.79, unconditional repulsion 2.78, refusal to friendly relation 2.74, limitation of other functions undamaged 2.66 and distorted identification 2.65. 3. Variable showing a significant difference in the results of analysis according to general characteristics of subjects was age and those who are over '21' showed more positive attitude to the disabled than those who are below '20'. 4. In the results of analysis according to the subjects' disability related characteristics, those who have the disabled in their friends or family and have concerns on the disabled problems have a positive attitude to the disabled. Promotion and education through mass communication for changing the awareness of the disabled into a positive attitude will be most effective. Conclusion: Consequently, positive attitude of EMT student's to the disabled can be fostered by continuous contact with the disabled and their participation in voluntary services in the dimension of individual or school will be important and also the various practical methods such as enlightenment movement and supply of right information through mass communication should be sought.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.2
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• pp.192-201
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• 2000

The purpose of study was to investigate the oral health care status in institutions and special schools for the disabled in Korea. Nurses in 123 institutions and nurse-teachers in 102 special schools were asked to fill questionnaires regarding periodic oral examination, preventive dental programs. and dental treatment. The results of this study were as follow. 1. 56.8% of institutions implemented regular oral examinations and all of special schools did it twice a year. 2. Preventive programs for dental caries were done in 69.1% of the institutions and 86.3% of the special schools. Programs included regular toothbrushing and dental health education. 3. Dental treatment was done in 84.2% of the institutions and 39.2% of the special schools. Institutions utilized private dental clinics(60.2%), public health centers(16.8%), volunteers(15.3%), and dental hospitals. 4. 17.7% of the institutions experienced the refusal to treat the disabled by private dental clinics.

• Journal of Food Hygiene and Safety
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• v.29 no.2
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• pp.85-91
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• 2014

Deoxynivalenol (DON) and related trichothecene mycotoxins are extensively distributed in the cereal-based food and feed stuffs worldwide. Recent climate changes and global grain trade increased chance of exposure to more DON and related toxic metabolites in poorly managed production systems. Monitoring the biological and environmental exposures to the toxins are crucial in protecting human and animals from toxicities of the hazardous contaminants in food or feeds. Exposure biomarkers including urine DON itself are prone to shift to less harmful metabolites by intestinal microbiota and liver metabolic enzymes. De-epoxyfication of DON by gut microbes such as Eubacterium strain BBSH 797 and Eubacterium sp. DSM 11798 leads to more fecal secretion of DOM-1. By contrast, most of plant-derived DON-glucoside is also easily catabolized to free DON by gut microbes, which produces more burden to body. Phase 2 hepatic metabolism also contributes to the glucuronidation of DON, which can be useful urine biomarkers. However, chemical modification could be very typical depending on the anthropologic or genetic background, luminal bacteria, and hepatic metabolic enzyme susceptibility to the toxins in the diet. After toxin exposure, effect biomarkers are also important in estimating the linkage and mechanisms of foodborne diseases in human and animal population. Most prominent adverse effects are demonstrated in the DON-induced immunological and behavioral disorders. For instance, acutely elevated interleukin-8 from insulted gut exposed to dietaty DON is a dominant clinical biomarker in human and animals. Moreover, subchronic exposure to the toxins is associated with high levels of serum IgA, a biological mediator of IgA nephritis. In particular, anorexia monitoring using mouse models are recently developed to monitor the biological activities of DON-induced feed refusal. It is also mechanistically linked to alteration of serotoin and peptide YY, which are promising biomarkers of neurological disorders by the toxins. As animal-alternative biomonitoring, huamn enterocyte-based assay has been developed and more realistic gut mimetic models would be useful in monitoring the effect biomarkers in resposne to toxic contaminants in the future investigations.

• The Korean Journal of Elementary Counseling
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• v.9 no.1
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• pp.41-58
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• 2010

The purpose of this study was to invent anger-inducing automatic thoughts examination for elementary school children based on its investigation for Korean one. I made the anger-inducing Automatic Thoughts Questionnaire(I, II) and made an examination of the contents of the automatic thoughts with it. Based on it, with preliminary questionnaire 90, I did principal component analysis varimax rotation and then final anger-inducting automatic thoughts examination of 40 question in 2 primary factor construction was consisted. I made 300 students carry out it to know its reliability, propriety and made 100 students carry it out at 2-week intervals test-retest. I divided them in three groups as low, middle and high according to its soore regarding anger-inducting automatic thoughts, I confirmed the variation of each group in positive thoughts, self-esteem, life satisfaction, anger, the result is same as follows; First, the content of Anger-inducting Automatic thoughts for elementary school students is revealed as unreasonableness(56.4%), retailation and passive, active offense(16.3%), blame and contempt(11.9%), injured pride and refusal(9.2%), absurd(3.9%), abandonment and avoidance(2.1%), self-abasement in turn. Second, said inventory is consist of 2 notion; first(20 questions) is blame, retaliation and second(20 questions) is injustice. Inner-item consistency of total 40 question is .97, Split-half reliability is .93, Test-retest reliability is .86. Third, criterion validity is revealed fine by reviewing the correlation between existing index related to the inventory of Anger-inducting Automatic thoughts of the elementary school students. Moreover, to find out discriminant validity, I divided three classes(low, middle, high) according to the score of said thoughts. As a result, there is certain variations when I confirmed variations in groups by reviewing the self-esteem, positive way of thinking, life satisfaction, anger.

• The Korean Society of Law and Medicine
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• v.21 no.2
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• pp.105-162
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• 2020

In the pandemic of infectious disease, restrictions of individual liberty have been justified in the name of public health and public interest. In March 2020, the National Assembly of the Republic of Korea passed the revised bill of the 「Infectious Disease Control and Prevention Act.」 The revised bill newly established the legal basis for forced testing and disclosure of the information of confirmed cases, and also raised the penalties for violation of self-isolation and treatment refusal. This paper examines whether and how these individual liberty limiting clauses be justified, and if so on what ethical and philosophical grounds. The authors propose the theories of the philosophy of law related to the justifiability of liberty-limiting measures by the state and conceptualized the dual-aspect of applying the liberty-limiting principle to the infected patient. In COVID-19 pandemic crisis, the infected person became the 'Patient as Victim and Vector (PVV)' that posits itself on the overlapping area of 'harm to self' and 'harm to others.' In order to apply the liberty-limiting principle proposed by Joel Feinberg to a pandemic with uncertainties, it is necessary to extend the harm principle from 'harm' to 'risk'. Under the crisis with many uncertainties like COVID-19 pandemic, this shift from 'harm' to 'risk' justifies the state's preemptive limitation on individual liberty based on the precautionary principle. This, at the same time, raises concerns of overcriminalization, i.e., too much limitation of individual liberty without sufficient grounds. In this article, we aim to propose principles regarding how to balance between the precautionary principle for preemptive restrictions of liberty and the concerns of overcriminalization. Public health crisis such as the COVID-19 pandemic requires a population approach where the 'population' rather than an 'individual' works as a unit of analysis. We propose the second expansion of the harm principle to be applied to 'population' in order to deal with the public interest and public health. The new concept 'risk to population,' derived from the two arguments stated above, should be introduced to explain the public health crisis like COVID-19 pandemic. We theorize 'the extended harm principle' to include the 'risk to population' as a third liberty-limiting principle following 'harm to others' and 'harm to self.' Lastly, we examine whether the restriction of liberty of the revised 「Infectious Disease Control and Prevention Act」 can be justified under the extended harm principle. First, we conclude that forced isolation of the infected patient could be justified in a pandemic situation by satisfying the 'risk to the population.' Secondly, the forced examination of COVID-19 does not violate the extended harm principle either, based on the high infectivity of asymptomatic infected people to others. Thirdly, however, the provision of forced treatment can not be justified, not only under the traditional harm principle but also under the extended harm principle. Therefore it is necessary to include additional clauses in the provision in order to justify the punishment of treatment refusal even in a pandemic.

• Radiation Oncology Journal
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• v.27 no.4
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• pp.210-217
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• 2009

Purpose: To assess the influence of cyclooxygenase-2 (COX-2) expression on the survival of patients with a combination of rectal cancer and lymph node metastasis. Materials and Methods: The study included rectal cancer patients treated by radical surgery and postoperative radiotherapy at the Dong-A university hospital from 1998 to 2004. A retrospective analysis was performed on a subset of patients that also had lymph node metastasis. After excluding eight of 86 patients, due to missing tissue samples in three, malignant melanoma in one, treatment of gastric cancer around one year before diagnosis in one, detection of lung cancer after one year of diagnosis in one, liver metastasis in one, and refusal of radiotherapy after 720 cGy in one, 78 patients were analyzed. The immunohistochemistry for COX-2 was conducted with an autostainer (BenchMark; Ventana, Tucson, AZ, USA). An image analyzer (TissueMine; Bioimagene, Cupertino, CA, USA) was used for analysis after scanning (ScanScope; Aperio, Vista, CA, USA). A survival analysis was performed using the Kaplan Meier method and significance was evaluated using the log rank test. Results: COX-2 was stained positively in 62 patients (79.5%) and negatively in 16 (20.5%). A total of 6 (7.7%), 15 (19.2%), and 41 (52.6%) patients were of grades 1, 2, and 3, respectively for COX-2 expression. No correlation was found between being positive of COX-2 patient characteristics, which include age (<60-year old vs. $\geq$60), sex, operation methods (abdominoperineal resection vs. lower anterior resection), degrees of differentiation, tumor size (<5 cm vs. $\geq$5 cm), T stages, N stages, and stages (IIIa, IIIb, IIIc). The 5-year overall and 5-year disease free survival rates for the entire patient population were 57.0% and 51.6%, respectively. The 5-year overall survival rates for the COX-2 positive and negative patients were 53.0% and 72.9%, respectively (p=0.146). Further, the 5-year disease free survival rates for the COX-2 positive and negative patients were 46.3% and 72.7%, respectively (p=0.118). The 5-year overall survival rates were significantly different (p<0.05) for the degree of differentiation, N stage, and stage, whereas the 5-year disease free survival rates were significant for N stage and stage. Conclusion: Being positive for and the degree of COX-2 expression did not have a significant influence on the survival of rectal cancer patients with lymph node metastasis. However, N stage and stage did significantly influence the rateof survival. Further analysis of a greater sample size is necessary for the verification of the effect of COX-2 expression on the survival of rectal cancer patients with lymph node involvement.

• Journal of agricultural medicine and community health
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• v.26 no.1
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• pp.37-56
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• 2001

This study was conducted to analyze the degree of changes in knowledge and attitude toward smoking and to examine the factors affecting knowledge and attitude for smoking after providing a smoking prevention program based on social influence model for a year to middle school students. Study population consists of 665 subjects of middle school students(aged 14 years) in Gumi city in Kyeongsangbukdo Province. Among them three-hundred sixty-seven students(intervention group) were educated to a smoking prevention program for 1 year from April 1999 to April 2000. School-based four-class program to prevent smoking was developed. The program provides instruction about short and long-term negative physiologic and social consequences of smoking and also discussed the health hazards of smoking, social pressure to smoke, peer norms regarding tobacco use, and refusal skill. A 45-item self-administered structured questionnaire was designed to evaluate the change of knowledge, attitude, smoking rate and the amount of smoking. The instrument was comprised of 11 knowledge items, thirteen attitude item and demographic items. Each scales were created by summing responses to each items within each scales and high scores on the knowledge, attitude, and smoking behavioral intention scales indicated positive responses. Based on the changes before and after the implementation of smoking prevention program between intervention and control group, the change of scores on knowledge were significantly different between the control group and the intervention group(p<0.05) and the change of scores on the attitude toward smoking was significantly different between intervention and control group. The change of smoking rate were not showing a significant difference between two groups but the amount of smoking were significantly reduced in intervention group than control group. In multiple regression analysis on changes of knowledge about smoking, the variables of smoking prevention program education, previous knowledge on smoking and students' school performance were selected the significant variables. In multiple regression to analysis of the factors influencing changes in attitude toward smoking, the variables of smoking prevention program education, previous knowledge on smoking were shown to be significant. The smoking prevention program was effective on change of knowledge and attitude of middle school students. In considering that the policy should be needed to extent of implementation of school-based health education curricula based on social influence model and it would contribute to reduce smoking of students.

• Journal of agricultural medicine and community health
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• v.12 no.1
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• pp.5-27
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• 1987

It is widely recognized that primary health care in the community is one of the most important and effective health measures in these days. However, it is reality that unsatisfactory health care system, ineffective utilization of health care by the community people in the rural area are hampering better understanding for primary health care. Therefore promoting health for the rural people and increasing understanding about primary health care, the baseline survey in the community focused in examination for safe community water supply was carried out. The survey was conducted through August 25-31, 1986 in order to find out health problems and relevant factors and to define the demographic characteristics of $^*$Sanpuk village, Kumsa-Myun, Yuju-Gun, Kyunggi-Do, Korea. Household survey was carried out for every home by trained interviewers. The major results are found out as follows : 1) 84.2%(400 houses) of total households were surveyed because 15.8%(75 houses) were unable to survey due to either refusal against interview or absence of family. These 400 households were composed of 1,697 residents(male:830, female 867). Educational level of respondents showed 34.1% as elementary school graduated. Religion distribution showed Buddism(23.8%) as the most dominant. 50.7% of respondents married in the area. 2) Most households(91.5%) have lived in their own house in Sanpuk area. Average family size showed 4.3. More than half of residents(64.2%) have used public supplied water tap. Only 1.5% of the households had a flush toliet. The rest of households have still used primitive insanitary latrines. 3) 32.5% of residents have used gas burner for cooking and for heating in the house, and the coal briquet were used for boiler. Lack of convenient public transportation was the chief complaint for their day life. 4) Each household occupied 1,990 pyungs of rice paddy and 1,170 pyungs of ordinary field in average. Beside farming products, mushroom was the highest product. 5) Sixth percent of households in the survey area regularly participated in community meeting one hand and on the other hand 39.5% never participated. Most of respondents closely contacted with their neighbours and they seemed very friendly each other. 6) The prevalence rate of illness and injury during recent 15 days showed 48.3 per 1,000. The prevalence rate of chronic illnesses during the past one year showed 74 per 1,000. Injury and accident lead the higher portion(22.0%) in the former and in the latter pain(arthritis, back-pain) showed 27.0% as the dominant sickness. 87.8% of the ill residents in the former received medical treatment. As the most frequently utilized medical facility, the clinic or hospital were counted. Among the residents suffering from chronic illnesses, 77.3% in Sanpuk area get some kind of medical treatments and they rarely utilized the clinic or hospital. The reason why the patient did not receive any medical care was found out the fact that symptoms of illness was light or mild and economic problems was serious. 7) Average age of marriage showed 21.6 years old in the women and the average duration of marital period was shown for 15.1 years. The married woman in reproductive age in Sanpuk area had experienced pregnancies 4 times in the aver-age including 0.7 time of pregnancy in average were interrupted by induced abortion and 0.3 time by spontaneous abortion respectively. The practicing rate of the family planning of the married woman during reproductive ages showed 70.7% and the tuballigation was found out as the most frequently used contraceptives. 8) Among woman who has children under 2 years old, 70.0% had received the prenatal care for the last pregnancy. However, the average number of prenatal care visitis per woman showed 3.3 times. Fifty-two % of woman who received the postnatal care for the last delivery showed only 37.5%. 9) Immunization rate of the children under 2 years old showed relatively high and looked successful. The breast feeding for these children showed dominantly in the most. Most of the mothers in Sanpuk area had started the supplementary diet during weaning period of their infants of 6th and 7th month after birth. * : Sanpuk area is a demstration area for community development which has been supported by the Community Development Foundation during the part 10 years. The village is relatively closer to urban area such as Seoul, However, it has a similar characteristics shown as a remote village because of geographical location and inconvenient transportation at present.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.8
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• pp.3547-3554
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• 2011

The aim of this study is to take hold of the present situation as well as the perspective of the domestic alcohol specialized hospitals. The structured questionnaire was prepared to understand the type of services, manpower and systematic programs. Among eight hospitals that stand for the alcohol addiction specialized hospitals, six hospitals agreed to participate in the survey, which was made from Jun. 17 to July 15, 2010. The average number of beds of the surveyed hospitals was 208. They were mostly private ones(66.7%), located in urban area(50%), and had experiences of alcohol treatment less than five years(50%). While all of them practiced both the inpatient and outpatient services, only 33% provided the systematic outpatient program that was at least 2 or 3 hours per week. All hospitals practiced the physical and individual psychological evaluations, but only 16.1% had the daytime programs. The beds of protective ward were 72% of all beds, and the beds of night and day occupied 7.6% and 2.6% respectively. It was found that although the average number of mental health social worker and mental health nurse was larger than that required in the regulation of mental health law there are significant deviations between hospitals. However, the manpower of psychiatrists and nurses were comparatively large. The first problem indicated by clinical experts was the patient's refusal of care, which results in an inefficiency in the treatment. The next problem was the lack of local health care institutions that can attend on the discharged patients were important issues. Also the low reimbursement and indifferences to the alcohol abuse were considered as important issues.

• Radiation Oncology Journal
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• v.18 no.4
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• pp.293-299
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• 2000

Purpose :We conducted a prospective non-randomized clinical study to evaluate the efficacy and toxic of the preoperative concurrent chemoradiotherapy for locally advanced unresectable rectal cancer. Materials and Methods: Between January 1995 and June 1998, 37 conecutive patients with locally unresectable advanced rectal cancer were entered into the study. With 3- or 4- fields technique, a total of 45 Gy radiation was delivered on whole pelvis, followed by 5.4 Gy boost to the primary tumor in some cases. Chemotherapy was done at the first and fifth week of radiation with bolus i.v. 5-Fluorouracil (FU) 370$\~$450 mg/m$^{2}$, days 1$\~$5, plus Leucovorin 20 mg/m$^{2}$, days 1$\~$5. OF 37 patients, 6 patients did not receive all planned treatment course (refusal in 4, disease progression in 1, metastasis to lung in 1). Surgical resection was undergone 4$\~$6 weeks after preoperative concurrent chemoradiotherapy. Results :Complete resection rate with negative margins was 94$\%$ (29/31). Complete response was seen in 7 patients (23$\%$) clinically and 2 patients (6$\%$) pathologically. Down staging of tumor occured in 21 patients (68$\%$). Treatment related toxicity was minimal except grade III & IV leukopenia in 2 patients, respectively. Conclusion : Preoperative concurrent chemoradiotherapy in locally advanced rectal cancer was effective in inducing down staging and complete resection rate. Treatment related toxicity was minimal. Further follow up is on-going to determine long term survival following this treatment.