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Ethical problems in an emergency department (ED) are much more common than is usually recognized. But these difficult ethical dilemmas have not been dealt with by general medical ethicists. Most medical ethics guidelines tend to concentrate on chronic or at least relatively stable situations rather than on the acute, episodic cases that are typical in the ED. most ethical problems such as abortion, euthanasia, and professionalism can be solved after reflection and deliberation, and after a process of communication that reveals the values and interests of the patient or the patient's family. In contrast, when health care professionals in the ED recognize ethical problems, they often don't have enough time for an ethical consultation such as a Hospital Ethics Committee. Ethical principles such as autonomy, beneficence, nonmaleficence, and justice need to be applied to the unique setting of emergency medicine. Hence, it is necessary to develop ethics guidelines in emergency medicine and ethics education for health care professionals in emergency departments. At first, we collected cases involving ethical problems and reviewed the ethical and legal aspects of those cases. In this article, we summarize the ethical issues in emergency medicine, deal with actions in emergency medical services, and also consider the relationships between ethical issues and act on emergency medical services. We want to present the important factors that should be considered in ethical decision making within an emergency medicine department including patient decision making capacity, legal custody, and ethical principles.
Beneficence ; Decision Making ; Delivery of Health Care ; Emergencies ; Emergency Medical Services ; Emergency Medicine ; Ethicists ; Ethics Committees, Clinical ; Ethics, Medical ; Euthanasia ; Humans ; Jurisprudence ; Social Justice

The purpose of this study was to investigate the effects of a nutrition education and personalized lunch service program in a senior welfare center. A total of 30 elderly (14 males, 16 females) aged 62~89 years participated in this study. Nutrition education lessons (2 hour/lesson/week) were provided for 4 weeks. Also, ten weeks from week 3rd to week 12th, personalized lunch providing 1/3 personal needed energy was served 5 times for a week. After the nutrition intervention program, we compared anthropometric characteristics, blood biochemical characteristics, nutrition knowledge, dietary attitude and dietary intake using 24 hr recall with those before the intervention. The body weight (p < 0.001) and body mass index (BMI) (p < 0.001) were decreased. There were significant increases in score of nutrition knowledge (p < 0.01) and consumption of milk & milk products for snacks. There was a positive effect on fasting blood sugar (FBS) showing significant decreases in portion of impaired fasting glucose and diabetes mellitus (p < 0.05). Also, serum triglyceride (TG) was significantly decreased (p < 0.05). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), riboflavin (p < 0.01), vitamin C (p < 0.001), calcium (p < 0.05) were positively improved. The index of nutritional quality (INQ) and intakes of vitamin C (p < 0.001), riboflavin (p < 0.05), Ca (p < 0.01) and Fe (p < 0.05) were increased. In conclusion, this nutrition education and lunch service program providing 1/3 personal needed energy can be used to develop and implement a tailored nutritional intervention programs in the setting of a community senior welfare center to improve health and nutritional status of Korean elderly.
Aged ; Ascorbic Acid ; Blood Glucose ; Body Mass Index ; Body Weight ; Calcium ; Diabetes Mellitus ; Fasting ; Glucose ; Humans ; Lunch ; Male ; Milk ; Nutritional Status ; Nutritive Value ; Riboflavin ; Snacks

The purpose of this study is to determine the effect of diabetes education program on Glucose Metabolism(blood sugar. HbAlc) and Lipid Metabolism(total cholesterol. triglyceride. low density lipoprotein. high density lipoprotein). Self-efficacy in non-insulin independent diabetes mellitus. The study design was a non equivalent control group pre-test post-test design. Data for the study were collected from March 12 to June 19, 2001. Sixty-two research subjects were assigned to experimental (36) and control (26) groups. The collected data was analyzed using the Chi-Square test. t-test by spsswin program The results are as follows: 1. Experimental group had higher level of glucose metabolism than control group(FBS: t=-3.317. p=.002. HbAlc: t=-4.956. p=.000). 2. Level of lipid metabolism were partly a significant different between experimental group and control group(Triglyceride: t=-2.108. p=.039). 3. Experimental group had higher efficacy score than control group(t=4.651. p=.000). In conclusion. the study supported the effects of diabetes education program to increase metabolism and self-efficacy. Further study with a longitudinal design is suggested to verify the effect of diabetes education program in NIDDM and standardized diabetes education program.
Cholesterol ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Education* ; Glucose* ; Humans ; Lipid Metabolism* ; Lipoproteins ; Metabolism* ; Research Subjects ; Triglycerides

BACKGROUND: We evaluated the effectiveness of isolation measures using cohorting rooms and antimicrobial use in reducing the isolation rate of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Acinetobacter baumannii (MDR-AB). METHODS: Four cohorting rooms (16 beds) for patients colonized or infected with multidrug-resistant organisms (MDRO) have been created in the general wards of our 894-bed hospital since October 2003. We prospectively evaluated the isolation rates of MRSA and MDR-AB, and amount of antimicrobial use during the 8-year study period. We also investigated the relationship between antimicrobial use density (AUD) and the isolation rates of MRSA and MDR-AB. RESULTS: After creating cohorting rooms, the isolation rates of MRSA decreased from 1.56 cases per 1,000 patient-days from 2004-2005 to 1.24 from 2006-2007 (P=0.57). The isolation rates of MDR-AB also decreased from 0.72 from 2004-2005 to 0.36 from 2010-2011 (P<0.01). The mean quarterly AUDs of glycopeptides and carbapenems were 30.17+/-6.80 and 19.5+/-7.10, respectively. There were no significant correlations between AUD values and the isolation rate of MRSA or MDR-AB. CONCLUSION: This study suggests that isolation measures using cohorting rooms to help limit the transmission of MDRO infection and colonization, especially MDR-AB, in resource-limited settings is feasible and efficacious.
Acinetobacter ; Acinetobacter baumannii ; Carbapenems ; Cohort Studies ; Colon ; Drug Resistance ; Glycopeptides ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Patient Isolation ; Patients' Rooms ; Prospective Studies

Recent studies have suggested that natural agents such as isoflavones, resveratrol, and anthocyanin have beneficial effects on metabolic syndrome-related disorders. The objective of this study was to evaluate dietary isoflavone intake, urinary isoflavone level, and their relationship with the risk of metabolic syndrome (MetS) among Korean postmenopausal women. The subjects included 46 MetS and 60 controls. The MetS risk score was determined by adding the number of risk factors such as waist circumference, blood pressure (BP) and levels of triglyceride (TG), HDL-cholesterol, and glucose. Dietary isoflavone intake was not significantly different between the MetS and control groups; however, the urinary daidzein level was significantly higher in the MetS subjects compared to that of the controls. Subjects with high TG had higher urinary daidzein and isoflavone (daidzein + genistein) levels than those without such abnormalities. But, the MetS risk score showed no significant correlation with urinary daidzein, genistein, and isoflavone excretions.
Anthocyanins ; Blood Pressure ; Female ; Genistein ; Glucose ; Humans ; Isoflavones ; Risk Factors ; Triglycerides ; Waist Circumference

It is suggested that evaluation of diet quality may be a great indicator of nutritional assessment. The aim of this study was to evaluate the diet quality of children and adolescents based on nutrient and food group intake and Diet Quality Index-International (DQI-I). This survey was conducted through questionnaires and diet record survey to 477 students (elementary school students; n = 131, middle school students; n = 136, and high school students; n = 210). The results showed that high school students were significantly more often to skip breakfast compared with the other groups. The middle and high school students consumed significantly higher intakes of food and energy compared to the elementary school students. Also the number of nutrients in Index of Nutritional Quality (INQ) < 1.0 of high school students were significantly higher than that of elementary and middle school students. The Korean's dietary diversity score (KDDS) of elementary school, middle school and high school students were 4.1, 4.4 and 4.3 respectively. The average DQI-I of elementary school, middle school and high school students were 66.7, 65.5, and 63.7, respectively and there was significant difference. Also, middle school students showed to have higher score in variety and adequacy category compared with the other groups, and elementary school students appeared to have higher score in moderation category. In conclusion, high school students appeared to have unhealthy dietary habits in terms of high frequency of skipping breakfast and lower INQ and DQI-I score compared to the elementary school and middle school students. Therefore, the proper dietary management should be needed for high school students.
Adolescent ; Breakfast ; Child ; Diet ; Diet Records ; Food Habits ; Humans ; Nutrition Assessment ; Nutritive Value ; Surveys and Questionnaires

The purpose of this study was to analyze the quality of meal and dietary habits of college students according to where they reside. This survey included 260 students and was conducted through questionnaires. The subjects were divided into three groups: first group was composed of students who reside in boarding-houses(BH group, N=72), second was students who reside in self-boarding set up(SB group, N=90), and third was those who lived in the same house with their parents(HWP group, N=98). The average age of the students in the BH, SB, and HWP group were 19.7 yrs, 21.1 yrs, and 21.7 yrs, respectively. There were no significant differences in the weight, height and BMI among the three groups. The BH group had significantly higher frequency of skipping breakfast and smoking than those of the SB and HWP groups. The amount of energy, food, carbohydrates, proteins, fats, vitamins and minerals consumed in the BH group were significantly higher than in the SB and HWP groups. Similarly, the NAR(nutrient adequacy ratio), MAR (mean adequacy ratio), ND(nutrient density) and INQ(index of nutritional quality) of the BH group were significantly higher than those in the SB and HWP groups. There was no significant difference in the KDDS(Korean's Diet Diversity Score) between the three groups. From the data obtained, the SB and HWP students appeared to have more dietary problems than the BH students. These results show that nutrition education for SB and HWP students is needed in order for them to learn proper dietary management and help improve the diet of students living in self-boarding arrangements.
Breakfast ; Carbohydrates ; Diet ; Education ; Fats ; Food Habits ; Gangwon-do* ; Humans ; Meals ; Minerals ; Nutritional Status* ; Surveys and Questionnaires ; Smoke ; Smoking ; Vitamins

PURPOSE: This study was performed to identify the effect of admission type on college adaptation and academic achievement in one nursing school in order to refine the entrance selection system. METHODS: Subjects were 405 nursing students (female : male = 385 : 20, first grade = 155, second grade = 138, third grade = 112). They were given the Student Adaptation to College Questionnaire (SACQ) purchased from Western Psychological Service. SACQ is composed of 67 questions and subdivided into 4 subcategories: academic adjustment, social adjustment, personal-emotional adjustment, and attachment. Student college adaptation scores and academic achievements were analyzed with reference to the entrance selection system (rolling admission vs. regular admission) by SPSS 22.0. The rolling admission system recruited students based on high school records only while the regular admission system was based on both high school records and the College Scholastic Ability Test (CSAT). RESULTS: Total College adaptation score, personal-emotional adjustment score, and academic achievement were higher in regular-admission students than in those admitted through rolling admission. Academic achievement for first-grade students was higher in regular-admission students than for those admitted through rolling admission, But the difference in academic achievement became null as students were promoted to the second and third grades. CONCLUSION: Students recruited using both high school records and the CSAT showed better college adaptation and higher academic achievement.
Humans ; Male ; Surveys and Questionnaires ; Schools, Nursing* ; Social Adjustment ; Students, Nursing

No abstract available.
Diabetes, Gestational* ; Female ; Pregnancy ; Prenatal Diagnosis*