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ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

Real-Time 3D Ultrasound Imaging Method Using a Cross Array Based on Synthetic Aperture Focusing: I. Spherical Wave Transmission Approach (합성구경 기반의 교차어레이를 이용한 실시간 3차원 초음파 영상화 기법 : I. 구형파 송신 방법)

  • 김강식;송태경
    • Journal of Biomedical Engineering Research
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    • v.25 no.5
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    • pp.391-401
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    • 2004
  • 3D imaging systems using 2D phased arrays have a large number of active channels, compelling to use a very expensive and bulky beamforming hardware, and suffer from low volume rate because, in principle, at least one ultrasound transmit-receive event is necessary to construct each scanline. A high speed 3D imaging method using a cross array proposed previously to solve the above limitations can implement fast scanning and dynamic focusing in the lateral direction but suffer from low resolution except at the fixed transmit focusing along the elevational direction. To overcome these limitations, we propose a new real-time volumetric imaging method using a cross array based on the synthetic aperture technique. In the proposed method, ultrasound wave is transmitted successively using each elements of an 1D transmit array transducer, one at a time, which is placed along the elevational direction and for each firing, the returning pulse echoes are received using all elements of an 1D receive array transducer placed along the lateral direction. On receive, by employing the conventional dynamic focusing and synthetic aperture method along lateral and elevational directions, respectively, ultrasound waves can be focused effectively at all imaging points. In addition, in the proposed method, a volume of interest consisting of any required number of slice images, can be constructed with the same number of transmit-receive steps as the total number of transmit array elements. Computer simulation results show that the proposed method can provide the same and greatly improved resolutions in the lateral and elevational directions, respectively, compared with the 3D imaging method using a cross array based on the conventional fixed focusing. In the accompanying paper, we will also propose a new real-time 3D imaging method using a cross array for improving transmit power and elevational spatial resolution, which uses linear wave fronts on transmit.

A Case Study on the Calculation of Delay Damages for Contractors according to the Extension of Contract Period (계약기간 연장에 따른 시공자의 손실비용 산정에 관한 사례 연구.)

  • Lee Gi-Han;Kim Yong-Su
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • autumn
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    • pp.305-310
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    • 2001
  • The purpose of this study is to calculate delay damages for contractors. The study has been performed by investigation of delay cost occurrence status and the analysis of subway construction cases. The results of this study are as follows: 1. Delay cost( 1day) equivalent to $0.005\%$ of total construction cost by analysis case studies. 2. Including bank interest, dealy cost is analysed as the following; $1.1\~9.2\%$ of total construction cost in part extension period, $3.3\~11.0\%$ of total construction cost in total extension period. 3. In comparison between liquidated damages and delay cost, liquidated damages account for average 20.1 times of delay costs. 4. Acceleration cost will be calculate on the basis of delay cost calculation method. In the result of this method, acceleration cost is equal to delay cost at least or must be large than delay cost

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A Study on the Development of Web-based STS Instruction Model for the Scientifically Gifted Students- Centered on Biology Education - (과학영재교육을 위한 웹기반 STS수업모형 개발-생물교육을 중심으로-)

  • Lim, Gil-Sun;Jeong, Wan-Ho
    • Journal of The Korean Association For Science Education
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    • v.24 no.5
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    • pp.851-868
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    • 2004
  • The main purposes of this study is to develop a web-based STS biology instruction program (WB-STS) for the scientifically gifted students. The specific main research questions were as follows; 1. How can the WB-STS for biology education be developed and what are the primary components involved in it? 2. Is there any proper validity for developed the WB-STS in biology education? To solve the above mentioned problems, several procedures were applied. First, in order to develop WB-STS for the scientifically gifted students, NCISE, Renzulli' s Enrichment Triad Model and the Iowa Chautauqua program's main characteristics were analyzed systematically and the principles and general process for constructing WB-STS were examined. Additionally, the needs of students and the goals of Biology education were identified thoroughly. And then all these ideas were embodied in an agenda for constructing WB-STS. Second, to analyse the validity and utility of developing WB-STS, a questionnaire was developed and submitted to seven specialists and a group of twenty students who would participate in the experiment later. The main results of study are summarized below: First, WB-STS appeared to be successfully constructed based on Renzulli' s Enrichment Triad Model and the Iowa Chautauqua program. Its main features are that it was made emphasizing a learner-centered approach and constructive learning. It is composed of five steps: Scientific theme selection -${\rightarrow}$Exploration ${\rightarrow}$ Concept & Principle Check ${\rightarrow}$ Finding Solution ${\rightarrow}$ Action. Second, seven specialists and a group of students assessed the developed WB-STS's validity and utility with a questionnaire, the results appeared satisfactory. Students showed high interest in WB-STS and gave a positive evaluation of WB-STS.

Effective Management Interval Focused on Professional Mechanical Tooth Cleaning (전문가 치면세균막관리 중심의 예방관리프로그램의 효과적인 관리주기)

  • Cho, Min Jeong
    • Journal of dental hygiene science
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    • v.17 no.6
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    • pp.508-515
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    • 2017
  • This study was conducted to investigate the optimal management interval in 33 healthy adults by observing changes in oral health on the basis of the plaque control index and gingival index. When plaque control score was compared according to the period, it was found that oral hygiene management was the best in the fourth visit (p<0.05). Improved oral hygiene status was observed during the 3- and 6-month follow-up (p<0.05). Regarding gingival index, the fourth visit showed the healthiest gingival status (p<0.05). At the 3-month follow-up, the gingival index worsened, but a healthy gingival status was attained by 6-month follow-up (p<0.05). The plaque control score according to interest in dental health showed that the 'interested' group had good oral hygiene management (p<0.05). As a motivation for oral hygiene status and gingival health, examination with a 'phase contrast microscope' in the first visit and calculation of the 'evaluation index' in the follow-up visit tended to improve the patients' ability for oral hygiene management (p>0.05). The questionnaire survey showed, that the optimal management interval was 1, 3, and 6 months. As a result, with the effective management interval for the preventive management program focused on professional mechanical tooth cleaning, which was administered weekly, the maximum ability for oral hygiene management was attained at the fourth visit. The effective management period was 1 month. The use of a phase contrast microscope and the calculation of the evaluation index for oral hygiene management could influence the motivation to improve oral hygiene management.

Effect of gender on the pharmacokinetics and metabolite formation of sulfamethazine in the rabbit (토끼의 성차가 sulfamethazine의 약동학 및 대사산물 생성에 미치는 영향)

  • Yun, Hyo-in;Park, Il-hyun
    • Korean Journal of Veterinary Research
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    • v.32 no.1
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    • pp.35-39
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    • 1992
  • SMZ is one of the most widely used antibacterial agents in veterinary medicine. It is also used as a growth promotant in many species of domestic animals There are marked species differences in its metabolism and pharmacokinetics. However, its pharmacokinetic and metabolism in rabbits. which are ragarded not only as good laboratorty animals hut also as good economical animals in its own, are lacking. Sex-differences in drug metabolism are well recognized in wide range of animal species including rats. Males are known to he more active than females. It is also know that there are Significant differences in the direction of metabolic pathways. But recently, female goats are reported to be more active in the metabolie capacity of SMZ than the other sex by Dutch researchers at Utrecht. Therefore, it is not easy to make general conclusicn of having higher SMZ metal-die capacity in the male compared to the opposite sex in every animal species. In this regard, the study on metabolic pattern of SMZ in rabbits, which are regarded as hervivorous, is of interest because the dietary habbits of rabbit are comparable to thai of goal, NEW Zealand White rabbits of each sex were given SMZ(35mg/kg) as a bolus injection into the marginalean, vein in order to study its pharmacokinetic profiles(using plasma) anc metabolic pattem(24h urine) as specified in the methods anc materials. 1. In the rabbit, the major metabolic pathway of SMZ was the acetylation(the formation of $N_4AcSMZ$). There were hydroxylation pathways(50HSMZ, $6CH_2OHSMZ$) as well, in the metabolism of SMZ in the rabbit, but minor pathways. 2. No sex differences in the metabolic direction of SMZ and its metabolites formation were found from the urinary excreted metabolites of SMZ out of 24h collected urine. 3. The concentration-time curves of SMZ(35mg/kg, iv) in the plasma compartment were fitted to a one-compartment open model when using a computer program(NONLIN). There was also no difference in the pharmacokinetic pattem of SMZ between two sexes. 4. The emergence of $N_4AcSMZ$ metabolized from SMZ was very fast in the plasma of the rabbit The elimination of $N_4AcSMZ$ was prolonged as compared to that of the parent drug Vie found no sex difference in the elimination pattern of $N_4AcSMZ$ in the rabbit.

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Perception of Undergraduate Environmental Education Program Students of Hangu University on Their Career Prospect and Career Preparation (항구대학교 환경교육과 학생들의 진로전망인식과 진로준비 고찰)

  • Ahn, Sun-Young;Lee, Yong-Hwan;Yang, An-Na;Kum, Ji-Hun
    • Hwankyungkyoyuk
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    • v.21 no.1
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    • pp.82-96
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    • 2008
  • The primary purpose of this research is to examine the career development of under-graduate environmental education program students. More specifically, it intends to understand how they perceive their career prospect, how they prepare for they career and what kind of career development assistance they receive from their school. For most of college students, a primary purpose for attending college is to prepare for a career, but often academic preparation in college is not enough to get the job they aspire. Career preparation becomes even more complex when their major does not dictate any specific career path or when the major does dictate a specific career path but it does not provide sufficient and quality job opportunities. Undergraduate environmental education programs are typical examples of the latter. To illuminate the understanding of the context surrounding undergraduate environmental education program students, semi-structured interviews were conducted through an instance message software program from August 17th, 2007 to August 20th, 2007. The subjects of this study consisted of 4 undergraduate students and 2 graduates of Hangu University (a tentative name). Each participant was interviewed once or twice for about 2 hours each interview. The findings of the study are as follow. First, they maintain a positive attitude regarding the career outlook and the career decision but it is not well founded. Second, career search and career preparation are conducted individually, and their school does not provide much systematic career assistance. Third, they did not see the relevance of the curriculum of their program to their future career. A few preliminary implications for practices related to career development may be drawn from the findings reported in this study. First, undergraduate students in environmental education programs appear to be in need of comprehensive career development assistance ranging from exploration of job opportunities related to majors, to development of job-seeking skills, to general issues of career preparation and choice. Experiential modes of career exploration seem to be helpful in clarifying their interest and aptitude in the area of environmental education. Second, career development assistance for these students should start at early college years. Third, these students may need help in exploring diverse opportunities related to their major as well as other academic areas. Finally, it is recommended to create more careers in the area of environmental education.

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3-D Inversion of 3-D Synthetic DC Resistivity Data for Vein-type Ore Deposits (국내 맥상광체조사를 위한 3차원 전기비저항 모델링자료의 3차원 역산 해석)

  • Lee, Ho-Yong;Jung, Hyun-Key;Jeong, Woo-Don;Kwak, Na-Eun;Lee, Hyo-Sun;Min, Dong-Joo
    • Journal of the Korean earth science society
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    • v.30 no.6
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    • pp.699-708
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    • 2009
  • Recently as the interest in the development of domestic ore deposits has increased, we can easily find some studies on exploration geophysics-based ore-deposit survey in literature. Based on the fact that mineralized zone are generally more conductive than surrounding media, electrical resistivity survey among several geophysical surveys has been applied to investigate metallic ore deposits. Most of them are grounded on 2-D survey. However, 2-D inversion may lead to some misinterpretation for 3-D geological structures. In this study, we investigate the feasibility of the 3-D electrical resistivity survey to 3-D vein-type ore deposits. We first simulate 2-D dipole-dipole survey data for survey lines normal to the strike and 3-D pole-pole survey data, and then perform 3-D inversion. For 3-D ore-body structures, we assume a width-varying dyke, a wedge-shaped, and a fault model. The 3-D inversion results are compared to 2-D inversion results. By comparing 3-D inversion results for 2-D dipole-dipole survey data to 3-D inversion results for 3-D pole-pole survey data, we could note that the 2-D dipole-dipole survey data yield better inversion results than the 3-D pole-pole data, which is due to the main characteristic of the pole-pole array. From these results, we are convinced that if we have certain information on the direction of the strike, it would be desirable to apply 2-D dipole-diple survey for the survey lines normal to the strike. However, in most cases, we do not have any information on the direction of the strike, because we already developed the ore deposit with the outcrops and the remaining ore deposits are buried under the surface. In that case, performing 3-D pole-pole electrical resistivity survey would be a reasonable choice to obtain more accurate interpretation on ore body structure in spite of low resolution of pole-pole array.

A Study on Stage of Concern, Level of Use, Innovation Configuration, and Intervention demand of Teachers in Culinary Practice Education (조리실습 교육에 대한 교사의 관심도, 실행 수준, 실행 형태 및 지원 요구도 조사)

  • Park Eun-Sook;Kim Young-Nam
    • Journal of Korean Home Economics Education Association
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    • v.18 no.3 s.41
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    • pp.41-60
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    • 2006
  • The system of teaching culinary practice needs drastic modification to catch up with dietary life and education curriculum changes. To reflect such changes, it is necessary to instill a strong will and interest as well as educational environment improvement in teachers. In this sense, this study researched the teachers' stages of concerns, levels of use, innovation configuration, and intervention demands, based on the CBAM(Concerns Based Adoption Method) developed by Hord et. al. For the survey, 500 questionnaires sent by mail and 187 were analyzed by SPSS/win 10.0 program. The results are summarized as follows. 1) The teachers stages of concerns on culinary practice is assessed to be in the lowest level of perceptual stage, which indicates a state of indifference. 2) In terms of the levels of use, routine use was the highest, followed by refinement use, integrated use, research use, and reinvent use in descending order. Mechanical use posted the lowest level. Even though the stages of concern showed the beginning stage, the Level of use was relatively high. 3) About the innovation configuration, approximately 30% of the teachers were not accomodate the culinary practice referred to the 7th National Education Curriculum. 4) According to the intervention demands on culinary practice education, it was found that teachers generally wanted more interventions in every component. Among the intervention components, the highest demand was on the support for facility. Demand on the financing is the second highest. Teachers in the level of routine use demanded more information and materials supply and individual encouragement, but teachers in the level of preparation needed study opportunity for training on operation skills more.

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An Observational Study of the Developmental Process of Interaction and Attitudes of Children through Instruction for “Making Fabric Doll”- Possibility for Application of Waldorf Education Curriculum- (‘헝겊 인형 만들기’ 바느질 수업을 통한 아동의 상호작용 및 태도 변화 과정 관찰 연구 -발도르프 교육과정 적용 가능성 탐색-)

  • 윤지현;이경선;이지혜
    • Journal of Korean Home Economics Education Association
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    • v.16 no.2
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    • pp.37-53
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    • 2004
  • The purpose of this study is to observe the developmental Process of interaction and attitude of children through instruction for “making fabric doll”. Based on the theory of “Waldorf Education”, instruction of 8 hours for 3 weeks exercised against 40 children(18 boys, 22 girls) of 6th grade, especially focused two group(10 children), in K elementary school in Chunchoen. The results of the study by qualitative research method through observing, recording, interpretation are as follows 1. The changes in interaction among children were observed in increase of quantity and quality of conversation among children, of reliability and dependence among children, of intimacy and cooperation among children, and of intimacy between teacher and children. 2. The changes in the attitude toward instruction were observed in increase of confidence and satisfaction, of active and attentive attitude to instruction via more interest about own fabric doll, of positive attitude through attachment to the doll. Therefore, the instruction of “making fabric doll” based on “Waldorf Education” seems to be efficient to child development and Practical Arts Education.

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