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Inferring Pedestrian Level of Service for Pathways through Electrodermal Activity Monitoring

  • Lee, Heejung;Hwang, Sungjoo
    • International conference on construction engineering and project management
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    • 2022.06a
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    • pp.1247-1248
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    • 2022
  • Due to rapid urbanization and population growth, it has become crucial to analyze the various volumes and characteristics of pedestrian pathways to understand the capacity and level of service (LOS) for pathways to promote a better walking environment. Different indicators have been developed to measure pedestrian volume. The pedestrian level of service (PLOS), tailored to analyze pedestrian pathways based on the concept of the LOS in transportation in the Highway Capacity Manual, has been widely used. PLOS is a measurement concept used to assess the quality of pedestrian facilities, from grade A (best condition) to grade F (worst condition), based on the flow rate, average speed, occupied space, and other parameters. Since the original PLOS approach has been criticized for producing idealistic results, several modified versions of PLOS have also been developed. One of these modified versions is perceived PLOS, which measures the LOS for pathways by considering pedestrians' awareness levels. However, this method relies on survey-based measurements, making it difficult to continuously deploy the technique to all the pathways. To measure PLOS more quantitatively and continuously, researchers have adopted computer vision technologies to automatically assess pedestrian flows and PLOS from CCTV videos. However, there are drawbacks even with this method because CCTVs cannot be installed everywhere, e.g., in alleyways. Recently, a technique to monitor bio-signals, such as electrodermal activity (EDA), through wearable sensors that can measure physiological responses to external stimuli (e.g., when another pedestrian passes), has gained popularity. It has the potential to continuously measure perceived PLOS. In their previous experiment, the authors of this study found that there were many significant EDA responses in crowded places when other pedestrians acting as external stimuli passed by. Therefore, we hypothesized that the EDA responses would be significantly higher in places where relatively more dynamic objects pass, i.e., in crowded areas with low PLOS levels (e.g., level F). To this end, the authors conducted an experiment to confirm the validity of EDA in inferring the perceived PLOS. The EDA of the subjects was measured and analyzed while watching both the real-world and virtually created videos with different pedestrian volumes in a laboratory environment. The results showed the possibility of inferring the amount of pedestrian volume on the pathways by measuring the physiological reactions of pedestrians. Through further validation, the research outcome is expected to be used for EDA-based continuous measurement of perceived PLOS at the alley level, which will facilitate modifying the existing walking environments, e.g., constructing pathways with appropriate effective width based on pedestrian volume. Future research will examine the validity of the integrated use of EDA and acceleration signals to increase the accuracy of inferring the perceived PLOS by capturing both physiological and behavioral reactions when walking in a crowded area.

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A Study on the Gungwi Perception of Year, Month, Day and Hour in the East (동양의 연월일시 궁위 인식에 관한 고찰)

  • Sun-Ok Shin;Hyeok-Jin Na
    • Industry Promotion Research
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    • v.9 no.1
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    • pp.167-177
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    • 2024
  • The purpose of this paper is to restore the academic status of Gungwi perception a little. The symbolism of Gungwi, or Year Month Day Hour, likened to Geun Myo Hwa Sil, is not just a technique of interpretation. Recognizing that it corresponds to Saju's most fundamental Mingli principle, the study was conducted to the effect that more academic research should be conducted in the future. The intrinsic idea that constitutes Saju is the yin-yang and the five elements, the letters recorded are twelve-dimensional, and the elements in charge of the space and time are Cheongan, Jeeji, and Gungwi, which are woven into four pillars. Through this consideration of Gungwi's perception, we presented the "spectrum of time" phenomenon that past time and information pass through the point of time, spread like a spectrum, and lead future time and action at the time when humans are born, that is, the energy of the universe is formatted throughout the brain and body. We discussed the change point of Eight Trigrams used by Lim Cheol Cho as a basis for explaining 'Won Hyong I Jeong' and the assumption that the time change or distortion of the two cones penetrating the present, which is assumed in parallel theory, one of the modern cosmologies, leaves an afterimage in the future universe as Gungwi's deductive basis.

Pseudo Image Composition and Sensor Models Analysis of SPOT Satellite Imagery of Non-Accessible Area (비접근 지역에 대한 SPOT 위성영상의 Pseudo영상 구성 및 센서모델 분석)

  • 방기인;조우석
    • Proceedings of the KSRS Conference
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    • 2001.03a
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    • pp.140-148
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    • 2001
  • The satellite sensor model is typically established using ground control points acquired by ground survey Of existing topographic maps. In some cases where the targeted area can't be accessed and the topographic maps are not available, it is difficult to obtain ground control points so that geospatial information could not be obtained from satellite image. The paper presents several satellite sensor models and satellite image decomposition methods for non-accessible area where ground control points can hardly acquired in conventional ways. First, 10 different satellite sensor models, which were extended from collinearity condition equations, were developed and then the behavior of each sensor model was investigated. Secondly, satellite images were decomposed and also pseudo images were generated. The satellite sensor model extended from collinearity equations was represented by the six exterior orientation parameters in 1$^{st}$, 2$^{nd}$ and 3$^{rd}$ order function of satellite image row. Among them, the rotational angle parameters such as $\omega$(omega) and $\phi$(phi) correlated highly with positional parameters could be assigned to constant values. For non-accessible area, satellite images were decomposed, which means that two consecutive images were combined as one image. The combined image consists of one satellite image with ground control points and the other without ground control points. In addition, a pseudo image which is an imaginary image, was prepared from one satellite image with ground control points and the other without ground control points. In other words, the pseudo image is an arbitrary image bridging two consecutive images. For the experiments, SPOT satellite images exposed to the similar area in different pass were used. Conclusively, it was found that 10 different satellite sensor models and 5 different decomposed methods delivered different levels of accuracy. Among them, the satellite camera model with 1$^{st}$ order function of image row for positional orientation parameters and rotational angle parameter of kappa, and constant rotational angle parameter omega and phi provided the best 60m maximum error at check point with pseudo images arrangement.

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Pseudo Image Composition and Sensor Models Analysis of SPOT Satellite Imagery for Inaccessible Area (비접근 지역에 대한 SPOT 위성영상의 Pseudo영상 구성 및 센서모델 분석)

  • 방기인;조우석
    • Korean Journal of Remote Sensing
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    • v.17 no.1
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    • pp.33-44
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    • 2001
  • The paper presents several satellite models and satellite image decomposition methods for inaccessible area where ground control points can hardly acquired in conventional ways. First, 10 different satellite sensor models, which were extended from collinearity condition equations, were developed and then behavior of each sensor model was investigated. Secondly, satellite images were decomposed and also pseudo images were generated. The satellite sensor model extended from collinearity equations was represented by the six exterior orientation parameters in $1^{st}$, $2^{nd}$ and $3^{rd}$ order function of satellite image row. Among them, the rotational angle parameters such as $\omega$(omega) and $\Phi$(phi) correlated highly with positional parameters could be assigned to constant values. For inaccessible area, satellite images were decomposed, which means that two consecutive images were combined as one image, The combined image consists of one satellite image with ground control points and the other without ground control points. In addition, a pseudo image which is an imaginary image, was prepared from one satellite image with ground control points and the other without ground control points. In other words, the pseudo image is an arbitrary image bridging two consecutive images. For the experiments, SPOT satellite images exposed to the similar area in different pass were used. Conclusively, it was found that 10 different satellite sensor models and 5 different decomposed methods delivered different levels of accuracy. Among them, the satellite camera model with 1st order function of image row for positional orientation parameters and rotational angle parameter of kappa, and constant rotational angle parameter omega and phi provided the best 60m maximum error at check point with pseudo images arrangement.

Studies on a Plan for Afforestation at Tong-ri Beach Resort(II) -Analyses of Crown Amounts and Soil Properties in the Disaster-damage Prevention Forests of Pinus thunbergii PARL., the Valuation on Soil Properties for Planting and Planning for Afforestation- (통리(桶里) 해수욕장(海水浴場) 녹지대(綠地帶) 조성(造成)에 관(關)한 연구(硏究)(II) -곰솔 해안방재림(海岸防災林)의 수관량(樹冠量) 및 토양분석(土壤分析), 식재기반평가(植栽基盤評價) 및 녹지대계획(綠地帶計劃)-)

  • Cho, Hi Doo
    • Journal of Korean Society of Forest Science
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    • v.77 no.3
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    • pp.303-314
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    • 1988
  • Tong-ri beach has not enough vegetation to be enjoyed by the sea bathers and to be satisfied with preventing the disaster-damages, but mixed forest near the beach can work its funtions and the old forest of Pirus thunbergii $P_{ARL}$. near the beach do a Little. Therefore it is very urgent to plant more trees near the beach for bathers and disaster-damage prevention. This study was carried out for planning an afforestation, with reporting upon the crown amounts and soil properties of disaster-damage prevention forests of P. thunbergii $P_{ARL}$. planted on the coast sand dunes in 1970 and 1976, and with reporting upon the valuation on soil properties of the lands near the beach in order to set the afforestation site. The results are as follows : 1. In disaster-damage prevention forests, crown surface area and crown volume became increasingly greater in proportion to the height. To D.B.H., crown volume also became increasingly greater in proportion, but crown surface area was directly proportional. 2. In comparison to sail characteristics of sand dune, those of the forests were in large quantity in OM, T-N and avail. $SiO_2$, and almost in the same in avail. $P_2O_5$, but in small quantity in exchangeable canons : K, Ca, Mg and Na. 3. EC, Cl and pH were in small value in the forest soils, but CEC was in large value in those soils. 4. Above facts showed that the forests fulfill their functions for preventing disaster-damages and improve their soil properties. 5. The forests have naturally been thinned up to 34% in 17 years and 39% in 11 years, and one can easily pass through the forest(planted in 1970), because of its sufficient clear-length(2.71m) and its space to pass. 6. A plan for afforestation was oracle nut after judging several sites by the evaluation on the soil properties and considering the best relaxation and the prevention of the various disaster-damages upon which were reported in the last issue. 7. Afforestation should be kept for maintaining its appropriate density for best relaxation and disaster-damage prevention.

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Perfusion MR Imaging of the Brain Tumor: Preliminary Report (뇌종야의 관류 자기공명영상: 예비보고)

  • 김홍대;장기현;성수옥;한문희;한만청
    • Investigative Magnetic Resonance Imaging
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    • v.1 no.1
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    • pp.119-124
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    • 1997
  • Purpose: To assess the utility of magnetic resonance(MR) cerebral blood volume (CBV) map in the evaluation of brain tumors. Materials and Methods: We performed perfusion MR imaing preoperatively in the consecutive IS patients with intracranial masses(3 meningiomas, 2 glioblastoma multiformes, 3 low grade gliomas, 1 lymphoma, 1 germinoma, 1 neurocytoma, 1 metastasis, 2 abscesses, 1 radionecrosis). The average age of the patients was 42 years (22yr -68yr), composed of 10 males and S females. All MR images were obtained at l.ST imager(Signa, CE Medical Systems, Milwaukee, Wisconsin). The regional CBV map was obtained on the theoretical basis of susceptibility difference induced by first pass circulation of contrast media. (contrast media: IScc of gadopentate dimeglumine, about 2ml/sec by hand, starting at 10 second after first baseline scan). For each patient, a total of 480 images (6 slices, 80 images/slice in 160 sec) were obtained by using gradient echo(CE) single shot echo-planar image(EPI) sequence (TR 2000ms, TE SOms, flip angle $90^{\circ}$, FOV $240{\times}240mm,{\;}matrix{\;}128{\times}128$, slice-thick/gap S/2.S). After data collection, the raw data were transferred to CE workstation and rCBV maps were generated from the numerical integration of ${\Delta}R2^{*} on a voxel by voxel basis, with home made software (${\Delta}R2^{*}=-ln (S/SO)/TE). For easy visual interpretation, relative RCB color coding with reference to the normal white matter was applied and color rCBV maps were obtained. The findings of perfusion MR image were retrospectively correlated with Cd-enhanced images with focus on the degree and extent of perfusion and contrast enhancement. Results: Two cases of glioblastoma multiforme with rim enhancement on Cd-enhanced Tl weighted image showed increased perfusion in the peripheral rim and decreased perfusion in the central necrosis portion. The low grade gliomas appeared as a low perfusion area with poorly defined margin. In 2 cases of brain abscess, the degree of perfusion was similar to that of the normal white matter in the peripheral enhancing rim and was low in the central portion. All meningiomas showed diffuse homogeneous increased perfusion of moderate or high degree. One each of lymphoma and germinoma showed homogenously decreased perfusion with well defined margin. The central neurocytoma showed multifocal increased perfusion areas of moderate or high degree. A few nodules of the multiple metastasis showed increased perfusion of moderate degree. One radionecrosis revealed multiple foci of increased perfusion within the area of decreased perfusion. Conclusion: The rCBV map appears to correlate well with the perfusion state of brain tumor, and may be helpful in discrimination between low grade and high grade gliomas. The further study is needed to clarify the role of perfusion MR image in the evaluation of brain tumor.

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A Study of Task and Approach for the Insurance Fee Application of Packed Medical Herbs (첩약의 보험급여 적용을 위한 과제 및 접근방안에 대한 연구)

  • Park Yong-Sin;Cho Byung-Hee;Kim Ho;Lee Si-Baek
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.17-28
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    • 2003
  • We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

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Development of a Pre-treating Equipment and the Carcass Disposal System for Infected Poultry (감염가금 전처리 및 폐사가축 처리시스템 개발)

  • Hong, J.T.;Kim, H.J.;Yu, B.K.;Lee, S.H.;Hyun, C.S.;Ryu, I.S.;Oh, K.Y.;Kim, S.;Kwon, J.H.;Tack, D.S.
    • Journal of Animal Environmental Science
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    • v.17 no.2
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    • pp.81-92
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    • 2011
  • When we bury the infected poultry into the ground, we have many problems such as the difficulty of making sufficient area for burying, environmental contamination by the leachate, unpleasant ordor. Also, in case of burning the carcass of the infected poultry, there are some problems such as high cost, dust, unpleasant odor, etc. It could cause environmental contamination which many peoples and environmental organization complains about. In this study, we develop a treating system which treats the infected poultry carcass in a environmental method preventing the environment contamination. This system is composed of many processes. The euthanasia system uses rigid vinyl to trap and to do a euthanasia the infected poultry with lethal gas, carbon dioxide. And then, with the tractor attached grappler infected poultry carcass could be put into the carcass treating system. The euthanasia system uses rigid vinyl to trap the infected birds and to confine lethal gas, carbon dioxide. Infected poultry carcass are moved to carcass disposal system by collecting device which is attached at tractor. The carcass treatment system (capacity of disposal : 6.3 $m^3$) is installed on a truck and do one pass work, which is input, crush, stir, sterilize, and discharge treated carcass. 1,000 chickens was killed within 9.7min by $CO_2$ (300L/min) in the tent (10 $m^3$). The collecting device could carry 142 chickens at a time, and the movable carcass treatment system could sterilize 2 tons carcass per hour (at one time). This treatment systems was eco-friendly because it reduced the volume of carcass by 31.9% with no wastewater generation.

Comparative Study on the Dancheong(丹靑) of Buddhist Temples in Jeolla Region focused on the Dancheong of the main building of Mihwangsa Buddhist Temple at Haenam(海南) (전라도지역 사찰단청(寺刹丹靑)의 비교 연구 해남 미황사(美黃寺) 대웅전(大雄殿) 단청을 중심으로)

  • Lee, Su Yee
    • Korean Journal of Heritage: History & Science
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    • v.42 no.4
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    • pp.152-171
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    • 2009
  • The Dancheong(丹靑) of the main building of Mihwangsa Buddhist Temple(美黃寺) in Haenam(海南) is the leading work of the Jeolla Dancheong style, which was created in the 18th century and has been passed down to the early modern days, and boasts its excellence and originality. On the outside, one can only see the traces of the Dancheong due to the colors that fell off and deteriorated severely. On the inside, however, the general Dancheong pattern is accompanied by the painting of 1,000 Buddhas(千佛圖), which is hardly found in other Buddhist temples, and the Arahan painting, which is truly magnificent in technique and can pass as an independent painting. The Dancheong also has unique methodological characteristics that can't be found in other Dancheong works such as the painting and attaching technique. The Dancheong inside is estimated to have been created in 1754 considering the records of "Dalmasan Mihwangsasa Daebeopdang Jungsusangryangmun(達摩山美黃寺大法堂重修上樑文)", the calligraphical writings of "Mudeungsanindanhwakya(無等山人丹?也)"and "Geonryungshipgu(乾隆十九)" left in the Jungryang, and the style characteristics reflected in the Dancheong patterns and the painting of 1,000 Buddhas. The fact that there are no traces of re-Dancheong also supports the estimation that the Dancheong was created in the absolute age of 1754. The absolute age will be the reference of deciding the chronological years of Dancheong patterns and be helpful in examining the characteristics and changes by the periods. There were certain style characteristics in Dancheong by the periods and regions. The Dancheong of Jeolla region also had its own style, which includes the tendency of finishing with two- or three-fold green belts without giving meokdanggi to the meoricho and the huge jar decoration of huigol. Treating the baetbadak of all materials, whether it's Geumdancheong or morodancheong, with lines of certain thickness and colors is another style of Jeolla Dancheong from the 18th to the 20th century. The Dancheong of the Geukrakbojeon(極樂寶殿) of Cheoneunsa Buddhist Temple and Daewoongbojeon(大雄寶殿) of Naesosa Buddhist Temple in Jeolla is especially noteworthy in that it bears similar patterns and techniques to that of the main building of Mihwangsa Buddhist Temple in addition to the characteristics mentioned above. The Dancheong of Mihwangsa Buddhist Temple must have exerted so great influences on that of the two temples that it's called "the style of Mihwangsa Buddhist Temple."When adopting a broader point of view, it can be classified as one of the Dancheong styles of Jeolla. The common icons and techniques found in the Dancheong of Mihwangsa, Cheoneunsa, and Naesosa Buddhist Temple provide some clues about the influential relationships among painters of the days. They may have been created by the painters of the same school or the painters affected by those who created the Dancheong of Mihwangsa Buddhist Temple.

An integrated Method of New Casuistry and Specified Principlism as Nursing Ethics Methodology (새로운 간호윤리학 방법론;통합된 사례방법론)

  • Um, Young-Rhan
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.51-64
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    • 1997
  • The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

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