• 제목/요약/키워드: Refusal

검색결과 317건 처리시간 0.031초

종교상의 이유로 수혈을 거부하여 사망한 메틸 말로닌산 혈증 환아 2례 (Two Cases of Methylmalonic Acidemia where Refusal to Blood Transfusion Led to Death)

  • 장하원;이용욱;장미영;길홍량;김숙자
    • 대한유전성대사질환학회지
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    • 제18권2호
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    • pp.50-54
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    • 2018
  • Jehovah's Witnesses do not accept blood transfusions, because of their particular interpretation of the Old and New Testaments. When people with such religious convictions are in need of medical care, their faith and belief may become an obstacle for proper treatment, and pose legal, ethical, and medical challenges for the health care providers. We report two inherited metabolic disorder cases in South Korea where the infants died whilst under medical care because of parental refusal of blood transfusions for religious reasons. Case 1 had methylmalonic acidemia, Down syndrome and associated congenital cardiac anomalies requiring surgery. Case 2 had anemia and methylmalonic acidemia requiring dialysis to treat hyperammonemia and metabolic acidosis. For effective medical management, they needed life-saving blood transfusions. As a part of alternative treatment, Erythropoietin was administered in both cases. As a result, two babies died from their extremely low hemoglobin and hematocrit. The hemoglobin concentrations below 2.7 g/dL without cardiac problem and 5.4 g/dL with cardiac anomaly complicated by pulmonary hypertension are considered life-threatening hemoglobin threshold. The medical professional must respect and accommodate religious beliefs of the patients who can make informed decisions. However, when parents or legal guardians oppose medical treatment of their babies and incompetent care receivers on cultural and religious grounds, the duty to assist and save persons exposed to serious danger, particularly life-threatening events must come first.

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건축미의 경제적 가치 퍼지패턴 분석 (Fuzzy Patterns of Economic Valuating on the Architectural Aesthetic - Case Study of Applying the Fuzzy-Contingent Valuation Method to the Dongdaemoon Design Plaza -)

  • 이동주;고은형
    • 대한건축학회논문집:계획계
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    • 제36권3호
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    • pp.13-20
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    • 2020
  • The purpose of this study is to analyze the fuzzy pattern that is reflected on the inside of the value evaluator in measuring the economic value of architectural aesthetic using the fuzzy-contingent valuation method. The main results of analyzing the relationship between architectural aesthetic and fuzzy patterns by typing 307 fuzzy patterns collected from visitors at Dongdaemun Design Plaza are as follows: First, low levels of architectural aesthetic can be a primary cause of extreme refusal of payment. However, it was confirmed that the extreme refusal of payment could partially involve mentality of free-ride on public goods or mentality that would not give value to past events that are not future. Second, if the architectural aesthetic score is 77.5, the most perfect form of fuzzy pattern is formed. It is confirmed that the fuzzy form, which is the standard in the relationship between architectural aesthetic and money value, is made at 77.5 points. This means that it is most efficient to have 77.5 points of architectural aesthetic to secure balanced data by membership in the study of architectural aesthetic value measurement through fuzzy pattern. Third, according to the architectural aesthetic score, respondents can be interpreted as follows: no monetary willingness arises before or after 52.4, starts to respond to the amount before and after 65.6, severe conflict over payments around 70.6~71.7, stronger willingness to pay around 77.6, want to pay for sure around 80.0.

유아의 까다로운 식습관과 성장상태 및 식생활과의 관련성 (Association between Picky Eating Behavior, Growth, and Dietary Practices in Preschool Children)

  • 김지선;강수경;계승희
    • 대한지역사회영양학회지
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    • 제26권1호
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    • pp.1-11
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    • 2021
  • Objectives: This study was conducted to assess the eating behavior, growth, and dietary practices of children aged 3~5 years living in the Seoul and Gyeonggi Provinces. Methods: Self-administered questionnaires were completed by 237 mothers of preschool children between April and June 2018. Z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated to determine the children's growth status. Dietary practices were evaluated using the nutrition quotient for Korean preschoolers (NQ-P). Results: In our study, 29.5% of children were in the eating-small-amounts group, 46.8% of children were in the neophobic behavior group, and 61.2% of children were in the refusal-of-specific food group. Specific foods found to have a high frequency of rejection are listed in descending order as follows: shellfish, soy, mushroom, shrimp, vegetables, milk, eggs, yogurt, seaweed, meat, fruits, and fish. The eating-small-amounts group had lower Z-scores for weight-for-age, height-for-age, and BMI-for-age than the non-picky eaters' group. Compared to the non-picky eaters' group, the eating-small-amounts group of picky eaters had lower scores on the moderation and environment items of the NQ-P, the neophobic behavior group had lower scores on the balance and environment items of the NQ-P, and the refusal-of-specific food group had lower scores on the balance, moderation, and environment items of the NQ-P. Conclusions: Children classified with picky eating behavior had lower growth and development, lower diet diversity, less balanced food intake, and had greater difficulty in abstaining from eating unhealthy foods than non-picky eaters. Therefore, a lot of patience and intensive efforts are needed to encourage children to encounter, experience, and accept unfamiliar food. It is more effective to provide eating behavior guidance by gently encouraging children, than by being strict and forceful. Besides, since the eating behavior of children is influenced maximally by the dietary lifestyle at their homes, it is important to ensure that a healthy dietary lifestyle is maintained at home.

국제중재판정의 집행을 거부하기 위한 사유로서의 공서 (On Public Policy As bar to Enforcement of International Arbitral Awards.)

  • 박영길
    • 한국중재학회지:중재연구
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    • 제12권1호
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    • pp.3-54
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    • 2002
  • When the ruling of Foreign Arbitral Awards contradicts the public policy of the enforcement state, it can be a ground for a refusal to enforce the ruling. New York Convention V section 2, UNCITRAL section 36, and Korean arbitration law section 36 confirm this principle. The final ruling of international arbitral awards should be respected according to the international convention or the principle of reciprocity, which cancel out the above principle: when the ruling contradicts the country's public policy, it can be refused to enforcement. Since the Helsinki General Convention, ILA have studied upon it and presented the final report and recommendation during the 2002 New Delhi General Convention. In it, firstly, the finality of awards rendered in the context of international commercial arbitration should be respected save in exceptional circumstances. Secondly, every state is recommended the “international public policy”, on which it can refuse to follow the ruling of international arbitral awards, and advised to respect it as far as possible.

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비 접촉원격 토오크 측정 시스템 개발 (Development of pushing force measuring system for coke oven machines using telemetry method)

  • 전종학;허윤기;최일섭
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 1997년도 한국자동제어학술회의논문집; 한국전력공사 서울연수원; 17-18 Oct. 1997
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    • pp.1778-1781
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    • 1997
  • The coke oven plant on a steel works has not, in the past, been regarded as a prime user of modern instrument technology. The reason for this perception may be due to the fact that the basic design of the coke battery has been changed little over the years. The recording and analysis of oven pushing force on a routine basis is seen as a means of monitoring plant operation. A torque sensor is set up at the shaft of the rotor for measuring pushing force. Pushing force data which is communicated form torque sensor to staor by telemetry method are shown on MMI(Man-Machine Interface) screen and stored in the database automatically. Perhaps the most important feature is that is allows a problem oven to be identified at an early stage and for corrective action to be taken before it develops into a refusal to push. In this way the mechanical loads imposed on the battery structlure can be held to a necessary minimum, so helping to prolong its service life.

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저효율 혈액투석 불이행 측정 도구 개발 (A Study of Low Flux Hemodialysis Noncompliance Indicators and Discriminant Standards, Development of Hemodialysis Noncompliance Measurement - Brief Form(HNCM-BF))

  • 허정
    • 간호행정학회지
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    • 제13권4호
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    • pp.462-472
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    • 2007
  • Purpose: Purpose of the this study is to define the hemodialysis noncompliance Indicators and discriminant standards levels for low Flux Hemodialysis patients and development of Hemodialysis noncompliance measurement - brief form. Method: Data was collected from 269 hemodialysis patients. To establish the hemodialysis noncompliance Indicators and to discriminate standards, 13 hemodialysis nurses and 2 nephrology doctors are participated in professional group. To verify the indicators and discriminant standards, data was ananlyzed by the canonical discriminant analysis method using by SAS 8.3 program. Result: 4 Indicators- interdialysis weight gain(IWG); average of recent 4weeks, serum phophate level, skipping of hemodialysis and hemodialysis time shortening without permission- of hemodialysis noncompliance are established and discriminant standards are developed. Discriminant ability of these 4 noncompliance indicators is 99.7%(p=.000). Hemodialysis noncompliance measurement - brief form has 96.3% discriminant accuracy. Conclusion: Hemodialysis noncompliant patients have high risks. It means that special intervention to noncompliance is needed. Also continuous and objective assessment and standards of noncompliance are needed.

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How to approach feeding difficulties in young children

  • Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • 제60권12호
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    • pp.379-384
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    • 2017
  • Feeding is an interaction between a child and caregiver, and feeding difficulty is an umbrella term encompassing all feeding problems, regardless of etiology, severity, or consequences, while feeding disorder refers to an inability or refusal to eat sufficient quantities or variety of food to maintain adequate nutritional status, leading to substantial consequences, including malnutrition, impaired growth, and possible neurocognitive dysfunction. There are 6 representative feeding disorder subtypes in young children: infantile anorexia, sensory food aversion, reciprocity, posttraumatic type, state regulation, and feeding disorders associated with concurrent medical conditions. Most feeding difficulties are nonorganic and without any underlying medical condition, but organic causes should also be excluded from the beginning, through thorough history taking and physical examination, based on red-flag symptoms and signs. Age-appropriate feeding principles may support effective treatment of feeding difficulties in practice, and systematic approaches for feeding difficulties in young children, based on each subtype, may be beneficial.

다단계판매에 대한 소비자지식, 소비자피해, 소비자만족도 (Consumer Knowledge, Damage and Satisfaction of Multi-Level Marketing)

  • 김민정
    • 대한가정학회지
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    • 제36권9호
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    • pp.75-91
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    • 1998
  • The purpose of this study was to investigate the effect of the multi-level marketing(MLM) on consumer by examing the degree of damage and the consumers's satisfaction with MLM as well as the overall realities of MLM including the degree of the recognition and the distribution route of the commodities. We analyzed 256 cases which had experienced with MLM among 430 questionnaires collected. The resulted are as follows. 1) Consumers showed a lack of knowledge about MLM regardless of experiencing it. And they were recognized positively with the quality and the availability of the commodities. Expendables such as kitchen utensils and cosmetics were the most favored articles. 2) Transactions with no written contract were the most frequent damage to the consumers, followed by no price-tag and the marketer's refusal of exchange or refund. 3) When we compared the degree of consumer's satisfaction with MLM to the ordinary distribution in terms of the price, quality of goods and the service offered, the consumers were satisfied with the quality of the commodities, though their whole impressin of MLM was not so much favorable.

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총폐정맥 환류이상의 수술적 교정및 후발성 폐정맥 협착 (Total Anomalous Pulmonary Venous Connection; Surgical Correction and Late Pulmonary Venous Obstruction)

  • 서동만;송명근
    • Journal of Chest Surgery
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    • 제26권4호
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    • pp.260-265
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    • 1993
  • Twelve patients underwent surgical correction of total anomalous pulmonary venous connection[TAPVC] between Sep. 1989 and May 1993. There were 9 boys and 3 girls whose ages ranged from 10 days to 17 month [median 1.2 month]. Six patients were less than 1 month of age at operation. The anomalous drainage was supracardiac in 6, cardiac in 2, infracardiac in 2, and mixed in 2. There were 3 early death, and its mortality rate was 25%. There were no operative mortality after Sep. 1991. Age at operation, presence of preoperative pulmonary venous obstruction, preoperative assisted ventilation and type of anomaly did not affect early mortality. Late pulmonary venous obstruction was developed in 4 patients between 1 month to 4 month after operation. Among these patients, 2 were died and one was reoperated and well, and the other one was not operated because of patient`s refusal. We conclude that late pulmonary venous obstruction is fatal and its early detection and correction is important for improving late survival.

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구강내 공여부에서 채취한 자가골 이식을 동반한 조직 유도 재생술의 임상적 치험례

  • 김태훈;이승희
    • 대한치과의사협회지
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    • 제37권2호통권357호
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    • pp.137-145
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    • 1999
  • More and more, esthetic and functional reconstruction of intra oral bone defect by trauma, pathologic disease is increasing in these days. the study about this field is going. Autogenous bone graft has advantage in biocompatyibility, but loss of donor material was relatively large. Allogenic graft has disadvantage in immunologic refusal reaction. We reconstructed several cases of periodontal, alveolar bone defects and pathologic bone defects, In all cases, we used resorbable membrane Biomesh and autogenous bone graft from retromolar triangle area, chin, torus, maxillary tuberosity, and extraction socket. From these cases, we obtained good prognosis, so we report clinical cases of Guided Tissue Regeneration with autogenous bone graft.

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