Improvement of additional immunization rate is indicated as an important factor for effective immunization of diseases. In this study, the relationship between retention of mother and child health handbook and additional immunization rate of Japanese encephalitis and tetanus was examined.

A survey via questionnaire was performed against parents of students of middle schools in Gwangmyeong-si, Gyeonggi-do, and elementary schools in Seoul. Among 350 copies of the questionnaire delivered via post mail, 261 copies were collected and used in the analysis. The questionnaire included general features of subjects and their children, retention of the mother and child health handbook, and recognition of additional immunization of the Japanese encephalitis and tetanus vaccine.

It was found that 80.8% of subjects answered affirmative to retaining the mother and child health handbook, and the group retaining the handbook had higher recognition rate of the need for additional immunization than the group that did not, for the Japanese encephalitis vaccine (83.2% vs. 51.2%, P < 0.001) and for the tetanus vaccine (66.5% vs. 31.7%, P < 0.001). Although the group retaining the handbook had a significantly higher additional immunization rate of the tetanus vaccine of 48.6% vs. 17.1% (P = 0.001), the immunization rate of the Japanese encephalitis vaccine did not show a significant difference (P = 0.231). The group recognizing the need for additional immunization of the Japanese encephalitis and tetanus vaccine had a significantly higher additional immunization rate than the counterpart (P < 0.001).

It was considered that retention of the mother and child health handbook was related to recognition and execution of additional immunizations.

It is important to know and decide when to end regimen for the quality of life of the patients. However, there is currently no clear agreement on when to terminate palliative chemotherapy. We investigated the duration between the last chemotherapy and death, and associated factors affecting patients receiving palliative care after the last chemotherapy.

We studied 242 patients who were put into palliative care ward after receiving chemotherapy and died during hospitalization from 2008 to 2009. Electronic medical records were used to gather information on demographic characteristics, types of primary cancer, and palliative chemotherapy. Then we analyzed the relationship between the clinical characteristics of patients and interval between last chemotherapy and death.

The average survival time of patients after referral to palliative care was 17.5 days; survival time after discontinuation of chemotherapy was 103 days. Also, 104 (43.0%) patients died within 3 months and 14 (5.8%) patients died within 1 month of persistent palliative chemotherapy. Chemotherapy on patients within 3 months from their death was not associated with the social characteristics of the population.

The patients who were referred to palliative care were found to have continued to receive chemotherapy within 3 months before death. However, only a small number of patients received chemotherapy within 1 month before death, which confirms that futile chemotherapy that extends to the end of life was less frequent. Doctors should be able to recognize the implications of excessive and aggressive use of chemotherapy and should actively communicate with patients about therapeutic choices.