• Title/Summary/Keyword: Refusal

Search Result 316, Processing Time 0.027 seconds

Groundwater Monitoring Network Design by Employing CPT Rig and BAT Sampling Techniques

  • ;David Lockington;William Clarke
    • Proceedings of the Korean Society of Soil and Groundwater Environment Conference
    • /
    • 1998.06a
    • /
    • pp.79-83
    • /
    • 1998
  • This study was conducted to delineate plume occurred in hazardous waste disposal site. At first, CPT (Cone Penetrometer Test) rig and HydroPunch were used to collect depth-discrete groundwater samples in concerned area. However, it was not capable of sampling the groundwater due to the cone refusal where the residual clay are layered at nominal depth through the aquifer. Alternatively, a number of temporary wells were installed after each of locations was penetrated using a modified steel cone functioned by CPT rig. The samples taken from those of wells were characterized by GCMS and GCFID, which revealed that sulfolane and thiolane were mainly presented. Subsequent analyses performed for the samples taken from permanent nest piezometers consistently demonstrated that possible plume boundary can be presented in the study area where contaminants were found as low as detection limit or levels of not-detectable.

  • PDF

Anesthesia for a Jehovah's Witness Patient Experiencing Unexpected Perioperative Hemorrhage - A Case Report - (수술 중 예상치 못한 과출혈이 발생한 여호와의 증인 환자의 마취 1 예)

  • Lim, Seoung-Ki;Jee, Dae-Lim
    • Journal of Yeungnam Medical Science
    • /
    • v.23 no.1
    • /
    • pp.96-102
    • /
    • 2006
  • Jehovah's Witnesses refuse a transfusion of blood or blood products because of religious beliefs; this refusal at times presents a dilemma for the treating physician. We report a case of a 25-year-old Jehovah's Witness patient who underwent a reoperation for a previous proximal humerus shaft fracture and experienced unexpected massive hemorrhage intraoperatively and postoperatively. The postoperative lowest hemoglobin level was 2.9 g/dl. The patient recovered from the severe anemia without any clinical sequala. We review the legal, ethical and religious issues and suggest the best possible medical care that Jehovah's Witness patient would permit.

  • PDF

Herpetic Esophagitis in Immunocompetent Child

  • Altamimi, Eyad M.;Alorjani, Mohammed S.;Alquran, Wejdan Y
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • v.22 no.3
    • /
    • pp.298-302
    • /
    • 2019
  • A previously healthy 2.5-year-old male child presented with vomiting, diarrhea, and fever. During hospitalization he developed odynophagia and refusal to eat. His symptoms did not respond to acid suppressant therapy. He underwent upper endoscopy which showed severe inflammation, ulcerations and abundant necrosis. Histopathological features and serological testing were consistent with herpetic esophagitis. He had no history of recurrent infections or history of sick contacts. His immunological work up showed normal level of immunoglobulins and his White Blood Cells subpopulations were normal. His HSV serology was positive. The patient was started on acyclovir 5 mg/kg q 8 hours. He resolved his symptoms within 24 hours of treatment.

Criminal Law Issues in Epidemiological Investigations Under the INFECTIOUS DISEASE CONTROL AND PREVENTION ACT (감염병의 예방 및 관리에 관한 법률상 역학조사와 관련된 형사법적 쟁점)

  • Jang, Junhyuk
    • The Korean Society of Law and Medicine
    • /
    • v.23 no.3
    • /
    • pp.3-44
    • /
    • 2022
  • As a result of a close review focusing on the case of obstruction of epidemiological investigation by a religious group A in Daegu, which was a problem when the pandemic of Covid-19 infection began in Korea around February 2, 2020, when an epidemiological investigator requested a specific group to submit a list, While there have been cases where an act of not responding or submitting an edited omission list was sentenced to the effect that the act did not fall under an epidemiological investigation, in the case of non-submission of the visitor list for the B Center, even though a 'list of visitors' was requested. Regarding the fact of refusal without a justifiable reason, 'providing a list of persons entering the building is a key factual act that forms a link between epidemiological investigations accompanying an epidemiological investigation, and refusing to do so is also an act of refusal and obstruction of an epidemiological investigation. There are cases where it is possible to demand criminal punishment. Regardless of whether the request for submission of the membership list falls under the epidemiological investigation, there are cases in which the someones' actions correspond to the refusal or obstruction of the epidemiological investigation. A lower court ruling that if an epidemiological investigation is rejected or obstructed as a result of interfering with factual acts accompanying an epidemiological investigation, comprehensively considering whether or not the list has been diverted for purposes other than epidemiological investigation, the logic is persuasive. Epidemiological investigations such as surveys and human specimen collection and testing are conducted for each infectious disease patient or contact confirmed as a result of the epidemiological investigation, but epidemiological investigations conducted on individual individuals cannot exist independently of each other, and the This is because the process of identification and tracking is essential to an epidemiological investigation, and if someone intentionally interferes with or rejects the process of confirming this link, it will result in direct, realistic, and widespread interference with the epidemiological investigation. In this article, ① there are differences between an epidemiological investigation and a request for information provision under the Infectious Disease Control and Prevention Act, but there are areas that fall under the epidemiological investigation even in the case of a request for information, ② Considering the medical characteristics of COVID-19 and the continuity of the epidemiological investigation, the epidemiological investigator the fact that the act of requesting a list may fall under the epidemiological investigation, ③ that the offense of obstructing the epidemiological investigation in certain cases may constitute 'obstruction of Performance of Official Duties by Fraudulent Means', and ④ rejecting the request for information provision under the Infectious Disease Control and Prevention Act from September 29, 2020 In this case, it is intended to be helpful in the application of the Infectious Disease control and Prevention Act and the practical operation of epidemiological investigations in the future by pointing out the fact that a new punishment regulation of imprisonment or fine is being implemented.

Informed Consent and Refusal of Treatment in Emergency Medical Situation (응급의료에서의 설명·동의 원칙과 응급의료거부죄)

  • Lee, Jung-eun
    • The Korean Society of Law and Medicine
    • /
    • v.23 no.1
    • /
    • pp.37-80
    • /
    • 2022
  • By analyzing informed consent and the refusal of emergency medical treatment (called patient dumping) under the current Emergency Medical Service Act, this study suggests that an emergency medical professional is only liable for patient dumping if their duty to protect the patient's life takes precedence over the patient's right to self-determination. In emergency medical situations, as in general medical situations, medical treatment should be performed after the emergency medical professional informs the patient about the medical treatment, including its necessity and methods, and obtains consent from the patient. Refusing or evading the performance of emergency medical services on the excuse of the informed consent not considering a waiver or alteration of informed consent requirements without reasonable reasons violates the Emergency Medical Service Act and thus makes an emergency medical professional liable to administrative disposition or criminal penalty. In other words, depending on the existence of a waiver of alteration of the informed consent, patient dumping may be established. If the patient is a minor or has no decision-making ability, and their legal representative makes a decision against the patient's medical interests, the opinion of the legal representative is not unconditionally respected. A minor also has the right to decide over their body, and the decisions of their legal representatives should be in the patient's best interests. If the patient refuses treatment, in principle, the obligation of life protection of emergency medical professionals is the top priority. However, making these decisions in the aforementioned situations in the emergency medical field is difficult because of the absence of explicit regulations regarding these exceptional problems. This study aims to organize the following precedents of the Supreme Court of Korea. The court states that, when balancing the conflicting interests between the duty to provide emergency medical service and the duty to inform is unavoidable for emergency medical professionals, they should put the duty to protect the patient's life ahead of the duty to inform if the patient's life matters. Exceptionally, when a patient has seriously considered whether they should receive treatment before the emergency medical situation, their right to self-determination can be considered equal to the obligation of emergency medical professionals to provide emergency medical treatment. This research also suggests that an amendment of the Emergency Medical Service Act should include the following. First, the criteria for determining the decision-making ability of emergency patients should consist of medical content. Second, additional consent from a medical professional is unnecessary for first-aid treatment. Finally, new provisions for emergency medical obligations for minors, new provisions for the decision standard when there are conflicting opinions about the treatment of a patient, and new penalty provisions for professionals who suspend emergency medical examinations and treatments need to be established.

A Research Study on Sexual Awareness of Parents in the Area of City (학부모들의 성의식, 성교육 태도 조사 연구)

  • Lim, Mi-Lm;Byun, Young-Soon
    • Journal of the Korean Society of School Health
    • /
    • v.15 no.1
    • /
    • pp.123-139
    • /
    • 2002
  • This study was conducted to identify the level of sexual awareness and the demand for sex education, to investigate the attitude toward and acceptance of heterosexual friendship, and to identify the experience and direction of sex education of parents. The data were collected from 119 parents with high school students by the structured questionnaire from June 1, 2001 to August 31, 2001. Parents and teachers showed a similar attitude on sexual awareness, but teenagers showed a different attitude. In terms of the level of feeling of and interest in 'sex', teenagers, parents and teachers were comfortably accepting it. As for sexual curiosity in puberty, 84.8% of the parents and 95.5% of the teachers responded that it was natural, whereas only 14.7% of teenagers responded that it was natural. But As for the item that 'sex is natural as one of human needs', 3.6% of the teenagers, 16.8% of the parents and only 1.2% of the teachers responded that it was not. As for the item that 'Man have a stronger sexual impulse than woman", 6.1% of the teenagers, 16.8% of the parents and 17.3% of the teachers responded that it was not. This indicates that teenagers have a far stronger sexist awareness, which also reflect that the sex culture of Korean society that regards sex as man's sexual monopoly. 64.2% of the teenagers and 90.2% of the teachers responded that it was impossible to overcome the sexual impulse, whereas only 8.4% of the parents responded that it was possible. As for the item of masturbation, 64.5% of the teenagers responded that it was possible for male students and not possible for female students. 67.2 of the parents and 91.1% of the teachers responded that it was possible regardless of sex. In case of pregnancy in adolescence, most of the responding teenagers, parents and teachers chose abortion. This indicates that respondents have a poor basic understanding of the life-despising climate, responsible sexual intercourse and motherhood protection. As for the item of 'female refusal on male sexual approach', respondents accepted female refusal as it was in orders of teachers, parents and adolescents. As for item of 'An assaulter is entirely to blame for sexual assault', all of three groups responded in the affirmative.

An Investigative Study on the Recognition for the Talented Children Education, Classified with Parents' Upbringing Styles (학부모 양육태도에 따른 영재교육에 대한 인식도 조사연구)

  • Won, Eun-Sil;Oh, Jong-Chul
    • Journal of Gifted/Talented Education
    • /
    • v.18 no.2
    • /
    • pp.265-292
    • /
    • 2008
  • This thesis was projected for the purpose of looking into the recongnition of the talented children education, classifying with parents' up-bringing styles, and it classified parents' upbringing styles with affection, refusal, and autonomy, aiming at 189 parents whose children are enrolled in public kindergartens located at three urban districts, J City, G City, and I City, and four rural districts, J County, M County, O County, and I County, and investigated the recongnition for the talented children education,, basing on four kinds of inclination. The results are as followings. First, it is important to activate parent education for the talented children, to help parents, who bring up children with refusal attitude, to give their children sufficient affection, to offer children the chances to express freely and explore, to give children possible permission, and to accept children completely, Second, the cultivated experts with specialized culture and disposition are necessary to grasp the peculiarity of talented children in respective fields. Third, the establishment of the expert talented children education institution specializing in research is necessary Fourth, at the national level, no-fee education for the talented children has to be carried into effect, the national talented children education agencies have to be established widely, researches for the talented children have to be established, the experts for educating talented children have to be brought up, and research expenses have to be supplied to respective talented children education agencies.

The Short Term Effects of an Early Intervention Program for Alcoholism Prevention in Adults: A Pilot Study (성인대상 알코올중독 예방 조기개입의 단기효과: 예비 연구)

  • Kang, Kyong-Hwa
    • The Journal of the Korea Contents Association
    • /
    • v.18 no.11
    • /
    • pp.550-561
    • /
    • 2018
  • The aim of this study was to investigate the short term effects of early intervention on alcohol knowledge, alcohol expectancies, drinking refusal self-efficacy for alcoholism prevention in adults and to examine its applicability in the field. This study was a non-equivalent control group pre-post quasi-experimental design. The participants were currently working, and were 12-25 points on result of the Alcohol Use Disorders Identification Test(AUDIT). The participants were a total of 25 men: 13 in the intervention group and 12 in the control group. The intervention group participated in early intervention program once a week for 4 weeks and the control group received only a booklet of alcohol related information. A chi-square test, t-test, Mann-Whitney U test were analyzed by using IBM SPSS Statistics 20.0. The intervention group had significantly higher the alcohol knowledge(t=1.258, p= .002), the negative alcohol expectancies(t=-1.346, p= .042), and the drinking refusal self-efficacy(t=2.817, p= .010) than the control group. In the future, it is need to apply the criteria of problem drinkers considering cultural characteristics, recruitment of participants, and motivational enhancement intervention using motivational interviewing. Especially, web-based alcohol related information providing program will help raise awareness of problem drinking. Early intervention program needs to be applied in community settings where problem drinkers are easily accessible.

Impact of the Coronavirus Disease Pandemic on Patients with Head Injuries in South Korea

  • Nam, Taek Min;Kim, Do-Hyung;Jang, Ji Hwan;Kim, Young Zoon;Kim, Kyu Hong;Kim, Seung Hwan
    • Journal of Korean Neurosurgical Society
    • /
    • v.65 no.2
    • /
    • pp.269-275
    • /
    • 2022
  • Objective : The coronavirus disease 2019 (COVID-19) pandemic is affecting the characteristics of patients with head injuries. This study aimed to evaluate the effect of the COVID-19 pandemic on patients with head injuries at a regional emergency medical center in South Korea. Methods : From April 2019 to November 2020, 350 patients with head injuries were admitted to our hospital. The study period was divided into the pre-COVID-19 (n=169) and COVID-19 (n=181) eras (10 months each). Patients with severe head injuries requiring surgery (n=74) were categorized into those who underwent surgery (n=41) and those who refused surgery (n=33). Results : Head injuries in pediatric patients (<3 years) were more frequent in the COVID-19 era than in the pre-COVID-19 era (8.8% vs. 3.6%, p=0.048). More patients refused surgery in the COVID-19 era than in the pre-COVID-19 era (57.9% vs. 30.6%, p=0.021). Refusal of surgery was associated with old age (67.7±14.5 vs. 52.4±19.1, p<0.001), marital status (married, 84.8% vs. 61.0%, p=0.037), unemployment (42.4% vs. 68.3%, p=0.034), COVID-19 era (66.7% vs. 39.0%, p=0.021), and lower Glasgow coma scale scores (6.12±3.08 vs. 10.6±3.80, p<0.001). Multivariable logistic regression analysis revealed that refusal of surgery was independently associated with old age (adjusted odds ratio [OR], 1.084; 95% confidence interval [CI], 1.030-1.140; p=0.002), COVID-19 era (adjusted OR, 6.869; 95% CI, 1.624-29.054; p=0.009), and lower Glasgow coma scale scores (adjusted OR, 0.694; 95% CI, 0.568-0.848; p<0.001). Conclusion : We observed an increased prevalence of head injuries in pediatric patients (<3 years) during the COVID-19 pandemic. Additionally, among patients with severe head injuries requiring surgery, more patients refused to undergo surgery during the COVID-19 pandemic.

Recent Trends in the Withdrawal of Life-Sustaining Treatment in Patients with Acute Cerebrovascular Disease : 2017-2021

  • Seung Hwan Kim;Ji Hwan Jang;Young Zoon Kim;Kyu Hong Kim;Taek Min Nam
    • Journal of Korean Neurosurgical Society
    • /
    • v.67 no.1
    • /
    • pp.73-83
    • /
    • 2024
  • Objective : The Act on Life-Sustaining Treatment (LST) decisions for end-of-life patients has been effective since February 2018. An increasing number of patients and their families want to withhold or withdraw from LST when medical futility is expected. This study aimed to investigate the status of the Act on LST decisions for patients with acute cerebrovascular disease at a single hospital. Methods : Between January 2017 and December 2021, 227 patients with acute cerebrovascular diseases, including hemorrhagic stroke (n=184) and ischemic stroke (n=43), died at the hospital. The study period was divided into the periods before and after the Act. Results : The duration of hospitalization decreased after the Act was implemented compared to before (15.9±16.1 vs. 11.2±18.6 days, p=0.127). The rate of obtaining consent for the LST plan tended to increase after the Act (139/183 [76.0%] vs. 27/44 [61.4%], p=0.077). Notably, none of the patients made an LST decision independently. Ventilator withdrawal was more frequently performed after the Act than before (52/183 [28.4%] vs. 0/44 [0%], p<0.001). Conversely, the rate of organ donation decreased after the Act was implemented (5/183 [2.7%] vs. 6/44 [13.6%], p=0.008). Refusal to undergo surgery was more common after the Act was implemented than before (87/149 [58.4%] vs. 15/41 [36.6%], p=0.021) among the 190 patients who required surgery. Conclusion : After the Act on LST decisions was implemented, the rate of LST withdrawal increased in patients with acute cerebrovascular disease. However, the decision to withdraw LST was made by the patient's family rather than the patient themselves. After the execution of the Act, we also observed an increased rate of refusal to undergo surgery and a decreased rate of organ donation. The Act on LST decisions may reduce unnecessary treatments that prolong end-of-life processes without a curative effect. However, the widespread application of this law may also reduce beneficial treatments and contribute to a decline in organ donation.