• Title/Summary/Keyword: Self-sustaining

Search Result 145, Processing Time 0.036 seconds

The Effect of Cancer Patients' Knowledge of Advanced Directives and Perception of Good Death on Attitude toward Withdrawal of Life-Sustaining Treatment (암환자의 사전연명의료의향서 지식과 좋은 죽음 인식이 연명의료중단 태도에 미치는 영향)

  • Park, Sang-Un;Kang, Yong-Sil
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.22 no.2
    • /
    • pp.539-547
    • /
    • 2021
  • This study was conducted to identify the effects of knowledge of Advance Directives (AD) and the patient's perception of a peaceful death on their attitude toward the withdrawal of life-sustaining treatment and to provide basic data for the development of a nursing intervention program for activating self-determination in the withdrawal of life-sustaining support of patients. The subjects were 167 adult cancer patients who received outpatient or inpatient treatment, from September 15, 2019, to March 30, 2020. The data was analyzed by mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression by using SPSS 21.0. From the results, it was observed that the knowledge of AD was 8.87±2.46 out of 12, perception of a peaceful death was 2.87±0.42 out of 4, and attitude toward withdrawal of life-sustaining treatment was 3.46±0.49 out of 5. There was a positive correlation between knowledge of AD, perception of a peaceful death, and their attitude toward withdrawal of life-sustaining treatment. The influencing variables were the knowledge of AD, perception of a peaceful death, discussion with family on withdrawal of life-sustaining treatment, and explanation power was 16.0% (F=10.355, p<.001). Therefore, it is necessary to develop a program that would improve the perception of a peaceful death, increase the knowledge of AD to improve the patients' attitude toward the withdrawal of life-sustaining treatment. An intervention to assist a discussion between the patients and their families in advance would also be useful.

Nurses and Physicians' Attitudes toward Withdrawal of Life-Sustaining Treatment and Knowledge of the Guideline of Withdrawal of Life-Sustaining Treatment (간호사와 의사의 연명치료 중지에 대한 태도와 연명치료 중지 지침에 대한 지식)

  • Kim, Ji Seon;Moon, Seongmi;Nam, Kyoung A
    • Journal of East-West Nursing Research
    • /
    • v.23 no.2
    • /
    • pp.171-179
    • /
    • 2017
  • Purpose: The purpose of current study was to investigate nurses and physicians' attitudes towards withdrawal of life-sustaining treatment (LST) and knowledge about withdrawal of LST guideline by Korean Medical Association. Methods: Data were collected from 345 nurses and 88 physicians using a self-report questionnaire and analyzed using descriptive statistics, independent t-test or ${\chi}2$ test. Results: Participants' attitudes towards withdrawal of LST were positive and there was no significant difference between nurses and physicians. Nurses' knowledge of the guideline for withdrawal of LST was significantly higher than that of physicians, whereas physicians' knowledge of the purpose of the guideline was significantly higher than that of nurses. Conclusions: Nurses and physicians' knowledge of and attitudes toward withdrawal of LST may affect the quality of life of patients and their families. The result of this study may be helpful to design a program for improving the perception on LST of healthcare providers.

Preparation of NiO/YSZ Ultra-Fine Powder Composites Using Self-Sustaining Combustion Process (Self-Sustaining Combustion Process를 이용한 NiO/YSZ 초미세 복합분말 제조)

  • 김선재;정충환;김경호;김영석;국일현
    • Journal of the Korean Ceramic Society
    • /
    • v.33 no.4
    • /
    • pp.411-417
    • /
    • 1996
  • Ultrafine NiO/YSZ (Yttria Stabilized Zirconia) powders were made by using a glycine nitrate process which is used as anode material for solid oxide fuel cells. The specific surface areas of synthesized NiO/YSZ powders were examined with controlling pH of a precursor solution and the content of glycine. The binding of glycine with metal nitrates occurring in the precursor solution was analyzed by using FTIR. The characteristics of synthesized powders were examined with X-ray diffraction(XRD) Brunauer Emmett Teller with N2 absorption. scanning electron microscopy (SEM). and transmission electron microscopy (TEM). Ultrafine NiO/YSZ powders of 15-18 m2/g were obtained through GNP when the content of glycine was controlled to 1 or 2 times the stoichiometric ratio in the precursor solutions. Strongly acid precursor solution increased the specific surface area of the synthesized powders. This is suggested to be the increased binding of metal nitrates and glycine under a strong acid solution of pH=0.5 that lets glycine consist of mainly the amine group of {{{{ { NH}`_{3 } ^{+ } }}. After sintering and reducing treatment of NiO/YSZ powders synthesized by GNP the Ni/YSZ pellet showed ideal microstructure where very fine Ni particles of 3-5 ${\mu}{\textrm}{m}$ were distributed uniformly and fine pore around Ni metal particles was formed. leading to anincrease of the triple phase boundary among gas Ni and YSZ.

  • PDF

Simulation of ULP Self-Sustaining Sensor Node System (ULP 자기유지 센서노드 시스템의 시뮬레이션)

  • Kim, Yun-Ho;Seong, Yeong-Rak;Oh, Ha-Ryoung;Park, Jun-Seok
    • The Journal of Korean Institute of Communications and Information Sciences
    • /
    • v.34 no.12B
    • /
    • pp.1435-1443
    • /
    • 2009
  • In this paper, an energy harvesting sensor network system is modeled and simulated by using the DEVS (Discrete Event System Specification) formalism. The system is composed of a sink (master) node, which is battery or mains powered, and a set of sensor (slave) nodes, each of which harvests ambient energy and converts it into electrical energy. For simulation, (i) the behavior of energy harvesting and storing circuits of the slave node is partitioned into a set of piecewise continuous segments and then each segment is represented as a discrete state; (ii) the interaction among the master node and components of the slave node is investigated preciously; and (iii) the investigated result is modeled and simulated by using the DEVS formalism.

Microstructure and Mechanical Properties of ODS Ferrite Produced by Reactive Milling for the MSR Suppression (MSR (Mechanically induced Self-sustaining Reaction)이 억제된 반응성 밀링에 의해 제조된 분산강화 페라이트의 미세조직과 기계적 특성)

  • Hwang, Seung J.
    • Journal of the Korean Society for Heat Treatment
    • /
    • v.26 no.6
    • /
    • pp.279-287
    • /
    • 2013
  • Oxide Dispersion Strengthened (ODS) Fe with $Al_2O_3$ dispersoid was successfully produced by reactive milling with a mixture of Fe, $Fe_3O_4$ (Magnetite), $Fe_2O_3$ (Hematite) and Al reactants at cryogenic temperature. The milled powders were consolidated by Vacuum Hot Press (HP) at 1323 K, and the consolidated materials were characterized by Transmission Electron Microscopy (TEM), Scanning Transmission Electron Microscopy (STEM), and Energy Dispersive Spectroscopy (EDS); the yield strength and the hardness of the consolidated materials were determined by compressive test and Vickers hardness test at room temperature. The grain size of the materials was estimated by X-ray Diffraction technique using the scherrer's formula. The TEM observations showed that the microstructure was comprised with a mixture of nanocrystalline Fe matrix and $Al_2O_3$ nano-dispersoids with a bimodal size distribution; the 0.2% off-set yield strength of the materials was as high as $758{\pm}29$ MPa and the Vickers hardness was $358{\pm}2$. The effect of the cryogenic milling and addition of extra Fe powder was discussed on the suppression of MSR (Mechanically induced Self-sustaining Reaction) for the desired microstructural evolution of ODS alloys.

Design and Implementation on High Efficient EPMS(Energy-Power Management System) for USN Sensor Node Using Self-Charging Module (자가 충전 모듈을 이용한 USN 센서노드용 고효율 에너지 전력관리 시스템 구현 및 검증)

  • Kim, Hyun-Woong;Park, Hee-Jeong;Lim, Se-Mi;Oh, Jong-Hwa;Roh, Hyoung-Hwan;Park, Jun-Seok
    • The Transactions of The Korean Institute of Electrical Engineers
    • /
    • v.60 no.1
    • /
    • pp.124-130
    • /
    • 2011
  • In this paper, We design and implementation of Self-Charging Module for charging to battery which obtaining the environment inergy such as solar energy. The power chared battery through the charging module send to sensor node. And implementation of System Activation Module(SAM) based on ID system and Dynamic Power Management Module(DPM) with SPO(Self Power Off). This system consume power only communication between the sensor nodes. We verification this system by implementing the high efficiency poweer management system.

A Study on Medical-criminal Problem of Withdrawing Life-Sustaining Treatment (치료중단행위에 대한 의료형법적 고찰 -의학적 충고에 반한 퇴원 사례를 중심으로-)

  • Cho, In-Ho
    • The Korean Society of Law and Medicine
    • /
    • v.9 no.1
    • /
    • pp.319-382
    • /
    • 2008
  • As a withdrawing care's study, the purpose of this study is searching about withdrawing care's acceptance and circumstances through Bora-mae hospital case(chapter 1). Withdrawing life-sustaining treatment has various forms. Though the meaning of euthanasia, death with dignity, natural death, physician assisted suicide are duplicated, the meaning of those are different slightly. Firstly, this study looks about the difference of the those meaning and acceptance range(condition) by withdrawing care's forms(chapter 2). Bora-mae hospital case sentenced guilty about physician who discharged incompetent patient who was after surgery by patient's wife determination. This Bora-mae case that sentenced guilty about discharge against medical advise(DAMA) that is regarded to custom has brought intensive confliction of legal, social, medical aspect, Bora-mae hospital case has many legal problems. First, as to criminal law rule 250(murder), the problem is whether discharge and withdrawing life-sustaining treatment is commission or omission. this study concluded omission(district court: omission, appeal, supreme court: commission). Because legal denounce point of discharge and medical treatment withdrawing is omission that physician who is obligatory on patient to cure. If physician's act is regarded omission, it is necessary to determine whether he has guardian status and obligation. Without guardian status and obligation, omission crime can't exist. This study decided that physician had guardian status and obligation and foundation of guardian status was pre-action or acceptance of emergency patient. Physician's medical treatment duty finished when patient(or patient's guardian) demands discharge. But when patient death is foreseen and other possible treatment does not exist, his duty of life prolonging treatment does not finish. This originate from physician's social responsibility and public status that limits patient's private liberty. This study regarded physician's action as accomplice about whether physician's discharging action is accomplice or the principal offender(district court: the principal offender, appeal, supreme court: accomplice). Though the principal offender needs criminal determination and action, there is no this common determination and functional action control of physician in Bora-mae case(chapter 3). Bora-mae hospital case partly originated from deficiency of legal, institutive system including medical security system shortage, the instruction is 1. medical security system strengthening, 2. hospital ethical committee's activity strengthening, 3. institutionalization of withdrawing life-sustaining treatment, 4. acceptance of pre-decision making system, 5. sufficient persuasion of physician for patient and faithful writing of medical paper, 6. respect for patients' self-determination and rights, 7. consciousness's changing for withdrawing life-sustaining treatment and persistent education about medical ethics(chapter 4). Considering Bora-mae case, medical sector is not the dead ground of a criminal punishment. Intervention of criminal law in medical sector give rise to ill effect, that is, excess medical examination and treatment, safeguard treatment, delay of discharge from a hospital. Because sufficient guarantee of life becomes mere empty slogan under situation that impose a burden of heavy cost to family or hospital, public and systematic solution should be given(chapter 5).

  • PDF

The Supreme Decision on the Withdrawal of Life Sustaining Treatment: 'Madam kim' Case Reviewed by the Life Sustaining Treatment Determination Act ('김할머니' 사례로 살펴본 가정적 연명의료결정에 관한 연구 -호스피스·완화의료 및 임종과정에 있는 환자의 연명의료결정에 관한 법률과 관련하여-)

  • Kim, Jang Ha
    • The Korean Society of Law and Medicine
    • /
    • v.17 no.2
    • /
    • pp.257-279
    • /
    • 2016
  • Recently, the Well-dying Act was legislated in Korea, and it will come into effect in August 4, 2017. This Act allows to withdraw the life sustaining treatment from impending death patients and also provide the hospice and palliative treatment to terminal patients. In the Supreme Court's case so called "Madam Kim", medical condition of Madam Kim was a persistent vegetative status owing to brain damage and her family members wanted to remove the artificial ventilation. In 2009, the Supreme Court allowed to withdraw the artificial ventilation under the specific conditions. We applied this new Well-dying Act to the Madam Kim's case hypothetically in order to know this Act can reasonably solve the problem of life sustaining treatment for dying or terminal patients. For the impending patients, the Well-dying Act has the problem not to withdraw the futile treatment due to the advance directives of patients. Vice versa, the terminal patients have no chance to withdraw the life sustaining treatment due to the this Act impose the duty to provide the hospice and palliative treatment despite of advance directives. We need to ruke out the persistent vegetative patients from the terminal patients caused by the cancer, acquired immune deficiency syndrome, chronic obstructive lung disease and chronic liver cirrhosis, In addition, we have to discuss the effect of the advance directives of terminal patients in view of self determination right.

  • PDF

A Study on Aid in Dying (조력사망(Aid in Dying)에 대한 고찰)

  • Lee, Jieun
    • The Korean Society of Law and Medicine
    • /
    • v.23 no.2
    • /
    • pp.67-96
    • /
    • 2022
  • "Aid in Dying" means that when a decision-making patient suffers from an incurable disease, a drug that can speed up death is prescribed by a doctor and used to lead to death. Since the suspension of life-sustaining treatment was institutionalized based on human dignity and patient autonomy, the question of whether assisted death can be legally justified in relation to the right to receive medical help to shorten one's life to die with dignity has recently been actively discussed. In Korea, since the suspension of life-sustaining treatment was institutionalized by the enactment of the Life-sustaining Treatment Decision Act in 2016, an amendment to the Life-sustaining Treatment Act was recently proposed to legalize Aid in Dying. The global trend is that human "Right to Die" is discussed in the division of life and death, from the suspension of life-sustaining treatment to assisted death, and again in the order of euthanasia. In this paper, we started discussing dignified death and institutionalized patients' right to self-determination, looked at the controversy in the United States, which legislated assisted death in many states since the 2000s, and analyzed the main contents of California's End of Life Option Act and the data after enforcement. The strict requirements for Aid in Dying, such as voluntary confirmation of patients' intentions and doctors' obligation to provide information, and the results of California's Aid in dying system, composed of relatively diverse races, were reviewed.

Experimental study on self-sustaied $1kW_e$ liquid fuel reforming operation (자립형 $1kW_e$ 액체 연료 개질기 운전에 관한 연구)

  • Yoon, Sang-Ho;Bae, Gyu-Jong;Bae, Joong-Myeon
    • 한국신재생에너지학회:학술대회논문집
    • /
    • 2008.05a
    • /
    • pp.503-506
    • /
    • 2008
  • Liquid hydrocarbon fuels, such as gasoline, kerosene, diesel and JP 8, can be good candidates for SOFC (solid oxide fuel cell) system fuel due to their high hydrogen density. Autothermal reforming (ATR) is suitable for liquid hydrocarbon fuel reforming because oxygen can decompose the aromatics in liquid fuel and steam can suppress the carbon deposition during catalytic reaction. The advantage of ATR is that it has a simple system construction due to exothermicity of ATR reaction. We control the exothermicity of reaction, make the reaction possible design a self-sustaining ATR reactor. A self-sustained 1kW-class kerosene autothermal reformer is introduced in this paper. The 1kW-class kerosene reformer was continuously operated for about 140 hours without degradation of reforming performance.

  • PDF