Rapid progress in modern medical technology has made it possible to sustain life and/or delay death using 'heroic' treatments. The availability of life-sustaining treatment brings several issues in end-of-life care such as 'dying with dignity' and an radical increase in health care costs. The use of Advance Directives(AD) have been widely heralded by health care providers, gerontologists, and advocacy groups as means of protecting patients' right to accept or refuse life-sustaining treatment in end-of-life care. The use of AD can not only improve patients' autonomy and quality of life but also bring efficiency in distributing health care resources. The proportion of older persons in Korean population has been increasing. Those 65 years of age or over were about 7 percent of the population. Death and dying is not limited to older persons, but it is more prevalent among them. In conjunction with an aging population and the increasing prevalence of death, the issues of death and dying will become crucial in near future in terms of 'dying with dignity', 'autonomy', and 'self-control'. This paper attempts to explode and establish the concept of advance directives (AD) based on literature review. Data sources are computer searches with the MEDLINE database. Due to the lack of prior study on AD for a Korean cases, studies abroad are reviewed. This paper suggests the need for future study on the possibility of the use of AD in Korea.
Advance Directives* ; Aging ; Surveys and Questionnaires ; Delivery of Health Care ; Health Care Costs ; Health Personnel ; Humans ; Korea ; Patient Rights ; Prevalence ; Quality of Life

No abstract available.
Cytomegalovirus Infections* ; Cytomegalovirus*

PURPOSE: This study was done to identify the mediating effect of emotional dissonance in the relationship between emotional labor and burnout among clinical nurses. METHODS: A cross-sectional survey design was used. The participants were 257 nurses working at three general hospitals located in Seoul and Gyeonggi Province. Data were collected by convenience sampling using self-report questionnaires that consisted of general characteristics, and measures of emotional labor, emotional dissonance and burnout. Data were analyzed with descriptive statistics, t-test, ANOVA, correlation, and multiple regression. RESULTS: The findings of the multiple regression were as follows. First, surface acting of emotional labor showed significant positive effects on emotional dissonance and burnout. Second, when surface acting and emotional dissonance were entered into the regression model at the same time, surface acting showed an insignificant effect on burnout, however, emotional dissonance showed a significant effect. Finally, emotional dissonance had a mediating effect only between surface acting of emotional labor and burnout, not between deep acting and burnout. CONCLUSION: Results of the study suggest that as a way to reduce burnout, nursing administrators should develop educational programs for nurses to perform deep acting of emotional labor instead of surface acting at the moment of truth.
Administrative Personnel ; Cross-Sectional Studies ; Gyeonggi-do ; Hospitals, General ; Humans ; Negotiating* ; Nursing ; Surveys and Questionnaires ; Seoul

This study examined the effectiveness of two commonly used dietary assessment methods (the 24-hour recall and the food frequency questionnaire) in the epidemiological investigations of health-related habits and degenerative diseases. This cross sectional project in the Seoul area was conducted for the purpose of establishing cohort subjects and collecting reliable nutrient intake data for a further large-scale cross sectional study. The subjects were 91 volunteers from the Seoul area with a mean age of 53.5 +/- 9.6 for the males and 52.2 +/- 8.9 for the females. The subjects had a rela-tively high educational background, were from high socioeconomic levels, and were greatly concerned about healthrelated life styles. There was a significantly negative correlation between their smoking and their nutrient intake. Their drinking habits, their self-estimated health status and their concern or stress about being healthy did not have any influence on their nutrient intakes. Skipping meals was the most undesirable dietary habit influencing their nutrient intakes, and the next was their irregularity of eating meals. The subjects who liked legumes and fish had higher intakes of iron and niacin and those who liked milk and dairy products had higher intakes of calcium, vitamin B2 and fat. The subjects who considered themselves not to be healthy consumed higher amounts of fish and shell-fish, and those who considered themselves to be healthy consumed higher amounts of vegetables. The smokers consumed less fruits than non-smokers, but there was no correlation between their drinking and consumption of the food groups. There was no correlation between their food consumption frequency and their skipping meals or meal irregularity. There were positive correlations between their food likes and food consumption frequency for foods such as meat, milk and dairy products, seaweeds and fruits. Therefore, their smoking, skipping meals and meal irregularity appeared to greatly influence their nutrient intakes. Significant correlations were found between their health-related habits and their food group preferences and food frequencies. This implies that simple surveying methods using criteria such as smoking, skipping meals and meal irregularity, food group preferences and eating frequencies can be used as useful tools in the assessment of nutritional statuses.
Calcium ; Cohort Studies ; Dairy Products ; Drinking ; Eating ; Fabaceae ; Female ; Food Habits ; Fruit ; Humans ; Iron ; Life Style ; Male ; Meals ; Meat ; Milk ; Niacin ; Nutritional Status ; Riboflavin ; Seoul* ; Smoke ; Smoking ; Vegetables ; Volunteers

No abstract available.
Acinar Cells* ; Biopsy, Fine-Needle* ; Carcinoma, Acinar Cell* ; Parotid Gland*

Carbapenem resistance is a serious clinical and public health threat. Carbapenemase can confer carbapenem resistance, and most carbapenemase genes are plasmid encoded so resistance can easily spread. In this study, we aimed to develop a novel system based on the TaqMan platform for the rapid detection of 6 clinically prevalent carbapenemase genes: Klebsiella pneumoniae carbapenemase, New Delhi metallo-β-lactamase, oxacillinase, imipenem-hydrolyzing, Verona integron-encoded metallo-β-lactamase, and Guiana extended-spectrum β-lactamase.

Objective: The effectiveness of music therapy programs for the elderly with dementia has been verified through several studies, but there is a limitation in that most of them are compared with a single group, no treatment group or waiting group. In this study, to overcome this problem, the two groups that performed similar interventions were selected and compared retrospectively. Methods: For 37 people who participated in the treatment programs for the elderly with dementia at Dongdaemun Center for De-mentia and its branch center, we retrospectively analyzed the changes in Korean version of Geriatric Depression Scale and GeriatricQuality of Life Scale-Dementia scores measured before and after treatment. Results: Prior to treatment, there is no significant difference between the groups in the demographic variables and the depression and quality of life scores. The difference between pre- and post-scores was not significant in the group at the branch center without a music therapy, but depression was significantly reduced and quality of life had improved in the group at Dongdaemun center with the music therapy program. Conclusion It was confirmed that participation in the structured music therapy program had a positive effect on the improve-ment of depression and quality of life in the elderly with dementia compared to other similar interventions.

Objective: The effectiveness of music therapy programs for the elderly with dementia has been verified through several studies, but there is a limitation in that most of them are compared with a single group, no treatment group or waiting group. In this study, to overcome this problem, the two groups that performed similar interventions were selected and compared retrospectively. Methods: For 37 people who participated in the treatment programs for the elderly with dementia at Dongdaemun Center for De-mentia and its branch center, we retrospectively analyzed the changes in Korean version of Geriatric Depression Scale and GeriatricQuality of Life Scale-Dementia scores measured before and after treatment. Results: Prior to treatment, there is no significant difference between the groups in the demographic variables and the depression and quality of life scores. The difference between pre- and post-scores was not significant in the group at the branch center without a music therapy, but depression was significantly reduced and quality of life had improved in the group at Dongdaemun center with the music therapy program. Conclusion It was confirmed that participation in the structured music therapy program had a positive effect on the improve-ment of depression and quality of life in the elderly with dementia compared to other similar interventions.

This study examined the reproducibility of nutrient intakes estimated by the 24-hour recall method in a prospective cohort study (Longitudinal study of aging and health monitoring of Korean elderly) of middle-aged volunteer subjects (42 males and 49 females) in the Seoul area. The three-day 24-hour recall was administered twice at an interval of approximately 6 months. The first data were collected and a corrective procedure was performed by interviewing of the subjects and a trained dietitian. The second data were collected by mail from the subjects without the performance of any corrective procedure. The mean age of the subjects was 53.5+/-9.6 for the males and 52.2+/-8.9 for the females. The subjects who had above college education were 95% in the case of the males and 60% in the case of the females. The characteristics of the male subjects in this study were that they were highly educated and held professional jobs and were from the middle or upper class. Comparing the first and second 24-hour recall data, the second data showed relatively lower intakes of all nutrients, except vitamin A, vitamin Bi and cholesterol. There was no difference in the nutrients of the first and the second data with respect to vitamin A, vitamin B1 and cholesterol in the males and calcium, iron, sodium, vitamin A, vitamin B1, vitamin B2 and cholesterol in the females. This data may indicate that the 24 hour retail method without a dietitian's help may result in lower reporting of the subject's intakes. The men had a tendency to remember less than the women. Pearson's correlation coefficients with unadjusted nutrient intakes values were ranged from 0.24 to 0.66. When energy intake was adjusted, there was a slight increase (from 0.26 to 0.71). Intra-class correlation coefficients with nutrient-unadjusted values ranged from 0.22 to 0.66, and the energy-adjusted values were ranged from 0.23 to 0.69. The weighted Kappa statistical values ranged from 0.10 to 0.40. On the average,46.3% of the subjects who were found in the lowest quartile of the nutrient intake levels based on the first 24-hour recall, were in the lowest quartile based on the second 24-hour recall. Therefore, there was a low reproducibility between the first and the second 24-hour recall. We should examine the factors influencing low reproducibility. Also, strategies should be developed to maximize the reliability of the assessment, with regard to portion-size training and telephone validation.
Aging ; Calcium ; Cholesterol ; Cohort Studies ; Education ; Energy Intake ; Female ; Humans ; Iron ; Male ; Nutritionists ; Postal Service ; Prospective Studies ; Riboflavin ; Seoul ; Sodium ; Telephone ; Thiamine ; Vitamin A ; Vitamins ; Volunteers

It is reported that a fermented soybean food, Doenjang, has strong antimutagenic and cytotoxic effect on cancer cells. This study investigated the effect of Chungkookjang, another traditional popular Korean soybean fermented food, on growth of cancer cells: HL-60, SNU-638 and MCF-7, and also its in vivo antitumorigenic effect in DMBA-induced mammary tumor rat model. For the in vitro study, Chungkookjang and steamed soybeans were extracted with ethanol and sequentially fractioned with 5 kinds of solvents differing in grades of polarity such as hexane, dichloromethane, ethylacetate, butanol and water. Almost all Chungkookjang extracts significantly inhibited the growth of HL-60 (human leukemic cancer cell), SNU-638 (human gastric cancer cell) and MCF-7 (human breast cancer cell) when compared to steamed soybean extracts. Butanol fraction of Chungkookjang extract especially showed a remarkable inhibitory effect in all the three kinds of cancer cells. To induce a mammary gland tumor, DMBA (50 mg/BW) was administered to 50 day-old female rats and followed by Chungkookjang or steamed soybean supplemented diets. Freezedried Chungkookjang powder (20% of diet in wet weight) was added to AIN-93G based diet for the Chungkookjang group of rats. Likewise, steamed soybean powder containing equal protein content to that of Chungkookjang powder was supplemented to soybean group of rats. At 13 weeks later, the mammary tumor incidence, average tumor number and tumor weight a rat were lower in Chungkookjang group compared to the control or soybean group. In conclusion, Chungkookjang showed a strong inhibitory effect on cancer cell growth in vitro, as well as a more preventive effect against chemically induced mammary tumorigenesis in vivo, while steamed soybeans did not. Therefore, these results suggest that Chungkookjang acquire its anticancer activity through the fermentation process.
9,10-Dimethyl-1,2-benzanthracene ; Animals ; Breast Neoplasms ; Carcinogenesis ; Diet ; Ethanol ; Female ; Fermentation ; Humans* ; Incidence ; Mammary Glands, Human ; Methylene Chloride ; Models, Animal ; Rats* ; Solvents ; Soybeans* ; Steam ; Stomach Neoplasms ; Tumor Burden ; Water