• Journal of Internet of Things and Convergence
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• v.6 no.1
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• pp.45-53
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• 2020

This study aimed to examine the relationship of the knowledge of end-of-life(EOL) care, life-sustaining treatment(LST), and advance directive(AD) with the educational needs regarding AD writing among nurses in convergence era. For this cross-sectional study, participants were 169 nurses at a general hospital in South Korea. Data were collected from July 19 to 26 in 2018 using structured questionnaires. Knowledge on EOL care scored 8.56 out of 11 points, knowledge on LST scored 5.11 out of 6 points, and knowledge on AD scored 8.02 out of 9 points. Educational needs regarding AD writing scored 4.31 out of 5 points. There were statistically correlations between knowledge on LST and educational needs regarding AD writing (r=.182, p=.018), and between knowledge on AD and educational needs regarding advance AD writing (r=.234, p=.002). The findings can be used to develop the educational program regarding AD.

• 한국노년학
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• v.30 no.4
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• pp.1197-1211
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• 2010

This research was concucted to present a model of advance directives(AD) when a patient, who is in consciousness, shows a preference for an end of life care as an act of preparing for an uncertain situation that may arise in the forseeable future. The subjects of the research are 383 doctors/nurese and adults, who live in six cities and provinces, to investigate the status of AD, attitude regarding a meaningless life-prolonging treatment, and moreover, an understanding of and a preference for AD. The research was done by the well-structured questionnaire. Also, SPSS 14.0 is used to analyse the collected data, focused on frequency analysis, avearage and standard deviation, X2 test. As the results of the study, the most of the surveyed doctors/nurese knew DNR orders and AD and a few of them used DNR orders and AD practically. Also, the result shows that there is a negative conception of meaningless life-prolonging treatment among the responents, in addition, most of them agreed upon the idea of introducing AD to Korea, filling it out and making it legally effective. As a method of making AD out, the respondents wanted to use a form that mixed living will with an Power of Attorney in a document. Also, considering the appropriate time, respondents prefered when they are diagnosed with terminal illness. At the moment, the introductory model for AD, which is suitable for the Korean culture and current situation is presented based on the result of this research. In the future, other researches should deal with specific measures that can lead to a social consensus to adopt AD in Korea.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.103-128
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• 2023

According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life-sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life-sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life-sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

• Journal of Hospice and Palliative Care
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• v.24 no.2
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• pp.74-84
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• 2021

Purpose: This study investigated knowledge of and attitudes toward advance directives (ADs) among middle-aged women in South Korea, their willingness to write ADs in the future, and the factors related to knowledge of and attitudes toward ADs. Methods: Data were collected using a self-administrated questionnaire completed by 154 middle-aged women aged 50 to 64 from February to March 2020. The questionnaire asked about participants' knowledge of and attitude toward ADs, willingness to write ADs in the future, experiences with life-sustaining treatment within their families, experience making decisions about life-sustaining treatment, and demographic characteristics. Results: Scores for both knowledge of and attitude toward ADs were relatively high. About 60% of participants gave wrong answers when asked if attorneys were required for writing ADs. A higher knowledge score was significantly associated with a higher attitude score (r=0.227, P<0.01). The women were more likely to be willing to write ADs in the future when they reported a middle income level rather than a lower income level (odds ratio [OR]=5.952, P<0.01), considered themselves unhealthy (OR=5.873, P<0.01), and graduated college or higher (OR=4.096, P<0.05). Furthermore, women who thought that ADs would have an impact on treatment (OR=1.869, P<0.05) and on their families (OR=1.447, P<0.05) were more likely to be willing to write an AD. Conclusion: This study shows that wrong information about ADs persists among middle-aged women, and significant factors associated with knowledge of and attitude toward ADs were identified. Targeted education programs about ADs need to be developed for middle-aged women.

• Geomechanics and Engineering
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• v.36 no.4
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• pp.381-390
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• 2024

The introduction of bio-based materials has been recommended in the geotechnical engineering field to reduce environmental pollutants such as heavy metals and greenhouse gases. However, bio-treated soil methods face limitations in field application due to short research periods and insufficient verification of engineering performance, especially when compared to conventional materials like cement. Therefore, this study aimed to develop a machine learning model for predicting the unconfined compressive strength, a representative soil property, of biopolymer-based soil treatment (BPST). Four machine learning algorithms were compared to determine a suitable model, including linear regression (LR), support vector regression (SVR), random forest (RF), and neural network (NN). Except for LR, the SVR, RF, and NN algorithms exhibited high predictive performance with an R² value of 0.98 or higher. The permutation feature importance technique was used to identify the main factors affecting the strength enhancement of BPST. The results indicated that the unconfined compressive strength of BPST is affected by mean particle size, followed by biopolymer content and water content. With a reliable prediction model, the proposed model can present guidelines prior to laboratory testing and field application, thereby saving a significant amount of time and money.

• THE INTERNATIONAL COMMERCE & LAW REVIEW
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• v.57
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• pp.61-78
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• 2013

The purpose of this study is to clarify the standard of fair and equitable treatment. Although most international investment treaties prescribe fair and equitable treatment that is the obligation to provide fair and equitable treatment to foreign investor, there is no clear definition and specific elements of fair and equitable treatment. Through the arbitral award cases we can find that tribunals have interpreted to include six principles; Due process & Protection from denial of justice, Good faith, Reasonableness & Nondiscrimination, Compliance with contractual obligation, Full protection and security, Transparency & Protection of the investor's legitimate expectations. This study suggest that host countries and investors focus on international trends concerning investment disputes in order to avoid future disputes. So future disputes can be prevented and prepared in advance.

• Journal of Mechanical Science and Technology
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• v.20 no.7
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• pp.1012-1018
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• 2006

Diagnosis and treatment using the conventional flexible endoscope in gastro-intestinal tract are very common since advanced and instrumented endoscopes allow diagnosis and treatment by introducing the human body through natural orifices. However, the operation of endoscope is very labor intensive work and gives patients some pains. As an alternative, therefore, the capsule endoscope is developed for the diagnosis of digestive organs. Although the capsule endoscope has conveniences for diagnosis, it is passively moved by the peristaltic waves of gastro-intestinal tract and thus has some limitations for doctor to get the image of the organ and to diagnose more thoroughly. As a solution of these problems, various locomotive mechanisms for capsule endoscopes are introduced. In our proposed mechanism, the capsule-type microrobot has synchronized multiple legs that are actuated by a linear actuator and two mobile cylinders inside of the capsule. For the feasibility test of the proposed microrobot, a series of in-vitro experiments using small intestine without incision were carried out. From the experimental results, our proposed microrobot can advance along the 3D curved and sloped path with the velocity of about $3.29\sim6.26mm/sec$ and $35.1\sim66.7%$ of theoretical velocity. Finally, the proposed locomotive mechanism can be not only applicable to micro capsule endoscopes but also effective to advance inside of gastro-intestinal tract.

• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.135-143
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• 2021

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

• Journal of Korean Medical classics
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• v.28 no.4
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• pp.65-77
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• 2015

Objectives : This literature study about dental external treatments from Hyangyakjibsungbang Tooth will invigorate applying the therapeutics in the field of Dentistry. Methods : In this study, the parts related to external treatment in the original text of Hyangyakjibsungbang Tooth were reviewed. Results : Examples of frequently used external method were gargling, applying powder, and brushing one's tooth. These methods are still used in modern dental treatment. Conclusions : Discovering new herbal medicines that provide better effects and developing more precise external treatments will advance dental treatment in Korean medicine.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.413-459
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• 2008

The Law has intervened to define rare circumstances in which a person should choose continuing life in United States. On the one hand, the law has traditionally acted to preservelife and to respect the sanctity of life. On the other hand, one's control over one's own body, and the right to determine what kind of medical care one will receive, is equally well respected and historically grounded. The competent patients have the right to forgo life-sustaining treatment, courts in United States have left many unanswered questions about the nature of that right. The right to choose to forgo life-sustaining treatment is a manifestation of a patient's autonomy interest. In United States, The Karen Quilan case gave rise to legislative activity in the host of state capitals, and several states had adopted statutes that formally recognized some forms of written directives describing some circumstances in which certain kinds of medical care could be terminated. These statues were sometimes dominated 'living will' acts, sometimes 'right to die' acts and ocasionally 'natural death' acts. Today virtually every state has produced a living will statue. In Korea, courts do not permit a terminally ill person to withhold or withdraw life-sustaining treatment. Living wills apply in case of terminal illness owing to a defect in legislation. Now In Korea, these lively dispute of legal policy on the preconditions and concrete procedure of living will act and natural death act. Through the legislation of living will act and natural death act, we should prepare some circumstances to respect patient's autonomy on the right to die. We should frame the cultural standard to make a decision of forgoing life-sustainin1g treatment under the discreet procedure.