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Decomposition Characteristics of Fungicides(Benomyl) using a Design of Experiment(DOE) in an E-beam Process and Acute Toxicity Assessment (전자빔 공정에서 실험계획법을 이용한 살균제 Benomyl의 제거특성 및 독성평가)

  • Yu, Seung-Ho;Cho, Il-Hyoung;Chang, Soon-Woong;Lee, Si-Jin;Chun, Suk-Young;Kim, Han-Lae
    • Journal of Korean Society of Environmental Engineers
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    • v.30 no.9
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    • pp.955-960
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    • 2008
  • We investigated and estimated at the characteristics of decomposition and mineralization of benomyl using a design of experiment(DOE) based on the general factorial design in an E-beam process, and also the main factors(variables) with benomyl concentration(X$_1$) and E-beam irradiation(X$_2$) which consisted of 5 levels in each factor was set up to estimate the prediction model and the optimization conditions. At frist, the benomyl in all treatment combinations except 17 and 18 trials was almost degraded and the difference in the decomposition of benomyl in the 3 blocks was not significant(p > 0.05, one-way ANOVA). However, the % of benomyl mineralization was 46%(block 1), 36.7%(block 2) and 22%(block 3) and showed the significant difference of the % that between each block(p < 0.05). The linear regression equations of benomyl mineralization in each block were also estimated as followed; block 1(Y$_1$ = 0.024X$_1$ + 34.1(R$^2$ = 0.929)), block 2(Y$_2$ = 0.026X$_2$ + 23.1(R$^2$ = 0.976)) and block 3(Y$_3$ = 0.034X$_3$ + 6.2(R$^2$ = 0.98)). The normality of benomyl mineralization obtained from Anderson-Darling test in all treatment conditions was satisfied(p > 0.05). The results of prediction model and optimization point using the canonical analysis in order to obtain the optimal operation conditions were Y = 39.96 - 9.36X$_1$ + 0.03X$_2$ - 10.67X$_1{^2}$ - 0.001X$_2{^2}$ + 0.011X$_1$X$_2$(R$^2$ = 96.3%, Adjusted R$^2$ = 94.8%) and 57.3% at 0.55 mg/L and 950 Gy, respectively. A Microtox test using V. fischeri showed that the toxicity, expressed as the inhibition(%), was reduced almost completely after an E-beam irradiation, whereas the inhibition(%) for 0.5 mg/L, 1 mg/L and 1.5 mg/L was 10.25%, 20.14% and 26.2% in the initial reactions in the absence of an E-beam illumination.

A Model for Health Promoting Behaviors in Late-middle Aged Woman (중년후기 여성의 건강증진행위 모형구축)

  • Park, Chai-Soon
    • Women's Health Nursing
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    • v.2 no.2
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    • pp.298-331
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    • 1996
  • Recent improvements in living standard and development in medical care led to an increased interest in life expectancy and personal health, and also led to a more demand for higher quality of life. Thus, the problem of women's health draw a fresh interest nowadays. Since late-middle aged women experience various physical and socio-psychological changes and tend to have chronic illnesses, these women have to take initiatives for their health control by realizing their own responsibility. The basic elements for a healthy life of these women are understanding of their physical and psychological changes and acceptance of these changes. Health promoting behaviors of an individual or a group are actions toward increasing the level of well-being and self-actualization, and are affected by various variables. In Pender's health promoting model, variables are categorized into cognitive factors(individual perceptions), modifying factors, and variables affecting the likelihood for actions, and the model assumes the health promoting behaviors are affected by cognitive factors which are again affected by demographic factors. Since Pender's model was proposed based on a tool broad conceptual frame, many studies done afterwards have included only a limited number of variables of Pender's model. Furthermore, Pender's model did not precisely explain the possibilities of direct and indirect paths effects. The objectives of this study are to evaluate Pender's model and thus propose a model that explains health promoting behaviors among late-middle aged women in order to facilitate nursing intervention for this group of population. The hypothetical model was developed based on the Pender's health promoting model and the findings from past studies on women's health. Data were collected by self-reported questionnaires from 417 women living in Seoul, between July and November 1994. Questionnaires were developed based on instruments of Walker and others' health promotion lifestyle profile, Wallston and others' multidimensional health locus of control, Maoz's menopausal symptom check list and Speake and others' health self-rating scale. IN addition, items measuring self-efficacy were made by the present author based on past studies. In a pretest, the questionnaire items were reliable with Cronbach's alpha ranging from .786 to .934. The models for health promoting behaviors were tested by using structural equation modelling technique with LISREL 7.20. The results were summarized as follows : 1. The overall fit of the hypothetical model to the data was good (chi-square=4.42, df=5, p=.490, GFI=.995, AGFI=.962, RMSR=.024). 2. Paths of the model were modified by considering both its theoretical implication and statistical significance of the parameter estimates. Compared to the hypothetical model, the revised model has become parsimonious and had a better fit to the data (chi-square =4.55, df=6, p=.602, GFI=.995, AGFI=.967, RMSR=.024). 3. The results of statistical testing were as follows : 1) Family function internal health locus of control, self-efficacy, and education level exerted significant effects on health promoting behaviors(${\gamma}_{43}$=.272, T=3.714; ${\beta}_[41}$=.211, T=2.797; ${\beta}_{42}$=.199, T=2.717; ${\gamma}_{41}$=.136, T=1.986). The effect of economic status, physical menopausal symptoms, and perceived health status on health promoting behavior were insignificant(${\gamma}_{42}$=.095, T=1.456; ${\gamma}_{44}$=.101, T=1.143; ${\gamma}_{43}$=.082, T=.967). 2) Family function had a significance direct effect on internal health locus of control (${\gamma}_{13}$=.307, T=3.784). The direct effect of education level on internal health locus of control was insignificant(${\gamma}_{11}$=-.006, T=-.081). 3) The directs effects of family functions & internal health locus of control on self-efficacy were significant(${\gamma}_{23}$=.208, T=2.607; ${\beta}_{21}$=.191, T=2.2693). But education level and economic status did not exert a significant effect on self-efficacy(${\gamma}_{21}$=.137, T=1.814; ${\beta}_{22}$=.137, T=1.814; ${\gamma}_{22}$=.112, T=1.499). 4) Education level had a direct and positive effect on perceived health status, but physical menopausal symptoms had a negative effect on perceived health status and these effects were all significant(${\gamma}_{31}$=.171, T=2.496; ${\gamma}_{34}$=.524, T=-7.120). Internal health locus and self-efficacy had an insignificant direct effect on perceived health status(${\beta}_{31}$=.028, T=.363; ${\beta}_{32}$=.041, T=.557). 5) All predictive variables of health promoting behaviors explained 51.8% of the total variance in the model. The above findings show that health promoting behaviors are explained by personal, environmental and perceptual factors : family function, internal health locus of control, self-efficacy, and education level had stronger effects on health promoting behaviors than predictors in the model. A significant effect of family function on health promoting behaviors reflects an important role of the Korean late-middle aged women in family relationships. Therefore, health professionals first need to have a proper evaluation of family function in order to reflect the family function style into nursing interventions and development of strategies. These interventions and strategies will enhance internal health locus of control and self-efficacy for promoting health behaviors. Possible strategies include management of health promoting programs, use of a health information booklets, and individual health counseling, which will enhance internal health locus of control and self-efficacy of the late-middle aged women by making them aware of health responsibilities and value for oneself. In this study, an insignificant effect of physical menopausal symptoms and perceived health status on health promoting behaviors implies that they are not motive factors for health promoting behaviors. Further analytic researches are required to clarify the influence of physical menopausal symptoms and perceived health status on health promoting behaviors with-middle aged women.

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Historical Studies on the Characteristics of Buyongjeong in the Rear Garden of Changdeok Palace (창덕궁 후원 부용정(芙蓉亭)의 조영사적 특성)

  • Song, Suk-ho;Sim, Woo-kyung
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.1
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    • pp.40-52
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    • 2016
  • Buyongjeong, a pavilion in the Rear Garden of Changdeok Palace, was appointed as Treasure No. 1763 on March 2, 2012, by the South Korea government since it shows significant symmetry and proportion on its unique planar shape, spatial configuration, building decoration, and so forth. However, the designation of Treasure selection was mainly evaluated by concrete science, in that the selection has not clearly articulated how and why Buoungjeong was constructed as a present unique form. Therefore, this study aims to clarify the identity of Buyongjeong at the time of construction by considering its historical, ideological, philosophical background and building intention. Summary are as follows: First, Construction backgrounds and characters of Buyongjeong: Right after the enthronement, King Jeongjo had founded Kyujanggak(奎章閣), and sponsored civil ministers who were elected by the national examination, as a part of political reform. In addition, he established his own political system by respecting "Kaksin(閣臣)", Kyujanggak's officials as much as "Kain(家人)", internal family members. King Jeongjo's aggressive political reform finally enabled King's lieges to visit King's Rear Garden. In the reign of King Jeongjo's 16th year(1792), Naekaksangjohoe(內閣賞釣會) based on "Kaksin" was officially launched and the Rear Garden visitation became a regular meeting. The Rear Garden visitation consisted of "Sanghwajoeoyeon(賞花釣魚宴)" - enjoying flowers and fishing, and activities of "Nanjeongsugye". Afterward, it eventually became a huge national event since high rank government officials participated the event. King Jeongjo shared the cultural activities with government officials together to Buyongjeong as a place to fulfill his royal politics. Second, The geographical location and spatial characteristics of Buyongjeong: On the enthronement of King Jeongjo(1776), he renovated Taeksujae. Above all, aligning and linking Gaeyuwa - Taeksujae - a cicular island - Eosumun - Kyujangkak along with the construction axis is an evidence for King Jeongjo to determine how the current Kyujangkak zone was prepared and designed to fulfill King Jeonjo's political ideals. In 17th year(1793) of the reign of King Jeongjo, Taeksujae, originally a square shaped pavilion, was modified and expanded with ranks to provide a place to get along with the King and officials. The northern part of Buyongjeong, placed on pond, was designed for the King's place and constructed one rank higher than others. Discernment on windows and doors were made with "Ajasal" - a special pattern for the King. The western and eastern parts were for government officials. The center part was prepared for a place where government officials were granted an audience with the King, who was located in the nortern part of Buyongjeong. Government officials from the western and eastern parts of Buyongjeong, could enter the central part of the Buyongjeong from the southern part by detouring the corner of Buyongjeong. After all, Buyongjeong is a specially designed garden building, which was constructed to be a royal palace utilizing its minimal space. Third, Cultural Values of Buyongjeong: The Buyongjeong area exhibits a trait that it had been continuously developed and it had reflected complex King's private garden cultures from King Sejo, Injo, Hyunjong, Sukjong, Jeongjo and so forth. In particular, King Jeongjo had succeded physical, social and imaginary environments established by former kings and invited their government officials for his royal politics. As a central place for his royal politics, King Jeongjo completed Buyongjeong. Therefore, the value of Buyongjeong, as a garden building reflecting permanency of the Joseon Dynasty, can be highly evaluated. In addition, as it reflects Confucianism in the pavilion - represented by distinguishing hierarchical ranks, it is a unique example to exhibit its distinctiveness in a royal garden.

The Storage Stability of Semi-Salted and Dried Mackerel by Free-Oxygen Absorber (탈산소제에 의한 반염건고등어 저장중의 품질안정성)

  • LEE Eung-Ho;CHUNG Young-Hoon;JOO Dong-Sik;KIM Jeong-Hee;OH Kwang-Soo
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.18 no.2
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    • pp.131-138
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    • 1985
  • The preservative effect of modified-atmosphere storage on the shelf-life of packed semi-salted and dried mackerel, Scomber japonicus, was examined. The semi-salted and dried mackerel fillets were packed in laminated plastic film bags (polyester/nylon/casted polypropylene: $12{\mu}m/15{\mu}m/60{\mu}m,\;15{\times}16cm$) filled with air (control, C), nitrogen gas (N), deoxygenized air (O) prepared by using free-oxygen absorber enclosed in the bag, in vacuum(V), and stored at $5^{\circ}C$. The quality of packed sample during the storage were examined in terms of viable cell counts of bacteria, thiobarbituric acid(TBA) value, perozide value(POV), volatile basic nitrogen(VBN), trimethylamine(TMA), adenosine triphosphate(ATP) and its related compounds and sensory evaluation. The results obtained are as follows: The pH of all the samples was in the range of $6.1{\pm}0.2$, and the contents of VBN and amino nitrogen of them increased during storage. In color values, L value(lightness) decreased while a and b values (red and yellow) revealed a tendency to increase during storage. The viable cell counts of the control sample(C) increased to $3.0{\times}10^6/g$ after 15 days storage but those of the other samples(V, N and O)were in the range of $2{\sim}6{\times}10^5/g$ after 20 days storage. The content of TMA increased during storage, but the histamine content showed a little change during storage and its content of all samples were less than 16 mg/100g. The inosinic acid(IMP) was rapidly degraded while inosine and hypoxanthine increased during storage. The TBA value of the control(C) reached a peak in 9 days and then decreased gradually while that of the sample(O) showed a little change during storage. The changes in POV of all the samples during storage showed a similar tendency to the TBA value. Fatty acid composition of raw mackerel consists of $35.6\%$ of saturated acid, $30.3\%$ of monoenoic acid and $34.2\%$ of polyenoic acid. The major fatty acid of the sample products were oleic acid($C_{18:1}$), palmitic acid($C_{16:0}$), docosahexaenoic acid($C_{22:6}$). The contents of polyenoic acid such as $C_{22:6},\;C_{20:5}$ decreased during storage while the other fatty acids showed a little change. From the results of sensory evaluation, the shelf-life of the control sample(C) was about 7 days and that of sample(V), (N) and (O) was about 15 days. It was concluded that deoxygenized atmosphere(free-oxygen absorber enclosed in the bag) was a good condition for preserving the quality of semi-salted and dried mackerel.

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Performance Improvement on Short Volatility Strategy with Asymmetric Spillover Effect and SVM (비대칭적 전이효과와 SVM을 이용한 변동성 매도전략의 수익성 개선)

  • Kim, Sun Woong
    • Journal of Intelligence and Information Systems
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    • v.26 no.1
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    • pp.119-133
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    • 2020
  • Fama asserted that in an efficient market, we can't make a trading rule that consistently outperforms the average stock market returns. This study aims to suggest a machine learning algorithm to improve the trading performance of an intraday short volatility strategy applying asymmetric volatility spillover effect, and analyze its trading performance improvement. Generally stock market volatility has a negative relation with stock market return and the Korean stock market volatility is influenced by the US stock market volatility. This volatility spillover effect is asymmetric. The asymmetric volatility spillover effect refers to the phenomenon that the US stock market volatility up and down differently influence the next day's volatility of the Korean stock market. We collected the S&P 500 index, VIX, KOSPI 200 index, and V-KOSPI 200 from 2008 to 2018. We found the negative relation between the S&P 500 and VIX, and the KOSPI 200 and V-KOSPI 200. We also documented the strong volatility spillover effect from the VIX to the V-KOSPI 200. Interestingly, the asymmetric volatility spillover was also found. Whereas the VIX up is fully reflected in the opening volatility of the V-KOSPI 200, the VIX down influences partially in the opening volatility and its influence lasts to the Korean market close. If the stock market is efficient, there is no reason why there exists the asymmetric volatility spillover effect. It is a counter example of the efficient market hypothesis. To utilize this type of anomalous volatility spillover pattern, we analyzed the intraday volatility selling strategy. This strategy sells short the Korean volatility market in the morning after the US stock market volatility closes down and takes no position in the volatility market after the VIX closes up. It produced profit every year between 2008 and 2018 and the percent profitable is 68%. The trading performance showed the higher average annual return of 129% relative to the benchmark average annual return of 33%. The maximum draw down, MDD, is -41%, which is lower than that of benchmark -101%. The Sharpe ratio 0.32 of SVS strategy is much greater than the Sharpe ratio 0.08 of the Benchmark strategy. The Sharpe ratio simultaneously considers return and risk and is calculated as return divided by risk. Therefore, high Sharpe ratio means high performance when comparing different strategies with different risk and return structure. Real world trading gives rise to the trading costs including brokerage cost and slippage cost. When the trading cost is considered, the performance difference between 76% and -10% average annual returns becomes clear. To improve the performance of the suggested volatility trading strategy, we used the well-known SVM algorithm. Input variables include the VIX close to close return at day t-1, the VIX open to close return at day t-1, the VK open return at day t, and output is the up and down classification of the VK open to close return at day t. The training period is from 2008 to 2014 and the testing period is from 2015 to 2018. The kernel functions are linear function, radial basis function, and polynomial function. We suggested the modified-short volatility strategy that sells the VK in the morning when the SVM output is Down and takes no position when the SVM output is Up. The trading performance was remarkably improved. The 5-year testing period trading results of the m-SVS strategy showed very high profit and low risk relative to the benchmark SVS strategy. The annual return of the m-SVS strategy is 123% and it is higher than that of SVS strategy. The risk factor, MDD, was also significantly improved from -41% to -29%.

Retrograde Autologous Priming: Is It Really Effective in Reducing Red Blood Cell Transfusions during Extracorporeal Circulation? (역행성 자가혈액 충전법: 체외순환 중 동종적혈구 수혈량을 줄일 수 있는가?)

  • Lim, Cheong;Son, Kuk-Hui;Park, Kay-Hyun;Jheon, Sang-Hoon;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.473-479
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    • 2009
  • Background: Retrograde autologous priming (RAP) is known to be useful in decreasing the need of transfusions in cardiac surgery because it prevents excessive hemodilution due to the crystalloid priming of cardiopulmonary bypass circuit. However, there are also negative side effects in terms of blood conservation. We analyzed the intraoperative blood-conserving effect of RAP and also investigated the efficacy of autotransfusion and ultrafiltration as a supplemental method for RAP. Material and Method: From January 2005 to December 2007, 117 patients who underwent isolated coronary artery bypass operations using cardiopulmonary bypass (CPB) were enrolled. Mean age was 63.9$\pm$9.1 years (range 36$\sim$83 years) and 34 patients were female. There were 62 patients in the RAP group and 55 patients in he control group. Intraoperative autotransfusion was performed via the arterial line. RAP was done just before initiating CPB using retrograde drainage of the crystalloid priming solution. Both conventional (CUF) and modified (MUF) ultrafiltrations were done during and after CPB, respectively. The transfusion threshold was less than 20% in hematocrit. Result: Autotransfusions were done in 79 patients (67.5%) and the average amount was 142.5$\pm$65.4 mL (range 30$\sim$320 mL). Homologous red blood cell (RBC) transfusion was done in 47 patients (40.2%) and mean amount of transfused RBC was 404.3$\pm$222.6 mL. Risk factors for transfusions were body surface area (OR 0.01, 95% CI 0.00 $\sim$ 0.63, p=0.030) and cardiopulmonary bypass time (OR 1.04, 95% CI 1.01 $\sim$ 1.08, p=0.019). RAP was not effective in terms of the rate of transfusion (34.5% vs 45.2%, p=0.24). However, the amount of transfused RBC was significantly decreased (526.3$\pm$242.3ml vs 321.4$\pm$166.3 mL, p=0.001). Autotransfusion and ultrafiltration revealed additive and cumulative effects decreasing transfusion amount (one; 600.0$\pm$231.0 mL, two; 533.3$\pm$264.6 mL, three; 346.7$\pm$176.7 mL, four; 300.0$\pm$146.1 mL, p=0.002). Conclusion: Even though RAP did not appear to be effective in terms of the number of patients receiving intraoperative RBC transfusions, it could conserve blood in terms of the amount transfused and with the additive effects of autotransfusion and ultrafiltration. If we want to maximize the blood conserving effect of RAP, more aggressive control will be necessary - such as high threshold of transfusion trigger or strict regulation of crystalloid infusion, and so forth.

Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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An integrated Method of New Casuistry and Specified Principlism as Nursing Ethics Methodology (새로운 간호윤리학 방법론;통합된 사례방법론)

  • Um, Young-Rhan
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.51-64
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    • 1997
  • The purpose of the study was to introduce an integrated approach of new Casuistry and specified principlism in resolving ethical problems and studying nursing ethics. In studying clinical ethics and nursing ethics, there is no systematic research method. While nurses often experience ethical dilemmas in practice, much of previous research on nursing ethics has focused merely on describing the existing problems. In addition, ethists presented theoretical analysis and critics rather than providing the specific problems solving strategies. There is a need in clinical situations for an integrated method which can provide the objective description for existing problem situations as well as specific problem solving methods. We inherit two distinct ways of discussing ethical issues. One of these frames these issues in terms of principles, rules, and other general ideas; the other focuses on the specific features of particular kinds of moral cases. In the first way general ethical rules relate to specific moral cases in a theoretical manner, with universal rules serving as "axioms" from which particular moral judgments are deduced as theorems. In the seconds, this relation is frankly practical. with general moral rules serving as "maxims", which can be fully understood only in terms of the paradigmatic cases that define their meaning and force. Theoretical arguments are structured in ways that free them from any dependence on the circumstances of their presentation and ensure them a validity of a kind that is not affected by the practical context of use. In formal arguments particular conclusions are deduced from("entailed by") the initial axioms or universal principles that are the apex of the argument. So the truth or certainty that attaches to those axioms flows downward to the specific instances to be "proved". In the language of formal logic, the axioms are major premises, the facts that specify the present instance are minor premises, and the conclusion to be "proved" is deduced (follows necessarily) from the initial presises. Practical arguments, by contrast, involve a wider range of factors than formal deductions and are read with an eye to their occasion of use. Instead of aiming at strict entailments, they draw on the outcomes of previous experience, carrying over the procedures used to resolve earlier problems and reapply them in new problmatic situations. Practical arguments depend for their power on how closely the present circumstances resemble those of the earlier precedent cases for which this particular type of argument was originally devised. So. in practical arguments, the truths and certitudes established in the precedent cases pass sideways, so as to provide "resolutions" of later problems. In the language of rational analysis, the facts of the present case define the gounds on which any resolution must be based; the general considerations that carried wight in similar situations provide warrants that help settle future cases. So the resolution of any problem holds good presumptively; its strengh depends on the similarities between the present case and the prededents; and its soundness can be challenged (or rebutted) in situations that are recognized ans exceptional. Jonsen & Toulmin (1988), and Jonsen (1991) introduce New Casuistry as a practical method. The oxford English Dictionary defines casuistry quite accurately as "that part of ethics which resolves cases of conscience, applying the general rules of religion and morality to particular instances in which circumstances alter cases or in which there appears to be a conflict of duties." They modified the casuistry of the medieval ages to use in clinical situations which is characterized by "the typology of cases and the analogy as an inference method". A case is the unit of analysis. The structure of case was made with interaction of situation and moral rules. The situation is what surrounds or stands around. The moral rule is the essence of case. The analogy can be objective because "the grounds, the warrants, the theoretical backing, the modal qualifiers" are identified in the cases. The specified principlism was the method that Degrazia (1992) integrated the principlism and the specification introduced by Richardson (1990). In this method, the principle is specified by adding information about limitations of the scope and restricting the range of the principle. This should be substantive qualifications. The integrated method is an combination of the New Casuistry and the specified principlism. For example, the study was "Ethical problems experienced by nurses in the care of terminally ill patients"(Um, 1994). A semi-structured in-depth interview was conducted for fifteen nurses who mainly took care of terminally ill patients. The first stage, twenty one cases were identified as relevant to the topic, and then were classified to four types of problems. For instance, one of these types was the patient's refusal of care. The second stage, the ethical problems in the case were defined, and then the case was analyzed. This was to analyze the reasons, the ethical values, and the related ethical principles in the cases. Then the interpretation was synthetically done by integration of the result of analysis and the situation. The third stage was the ordering phase of the cases, which was done according to the result of the interpretation and the common principles in the cases. The first two stages describe the methodology of new casuistry, and the final stage was for the methodology of the specified principlism. The common principles were the principle of autonomy and the principle of caring. The principle of autonomy was specified; when competent patients refused care, nurse should discontinue the care to respect for the patients' decision. The principle of caring was also specified; when the competent patients refused care, nurses should continue to provide the care in spite of the patients' refusal to preserve their life. These specification may lead the opposite behavior, which emphasizes the importance of nurse's will and intentions to make their decision in the clinical situations.

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Indication of Dissection of the 14v Lymph Node in Advanced Distal Gastric Cancer (원위부 진행성 위암에서의 상장간막정맥(14v) 림프절 절제술의 적응증)

  • Lim, Jung-Taek;Jung, Oh;Kim, Ji-Hoon;Oh, Sung-Tae;Kim, Byung-Sik;Park, Kun-Choon;Yook, Jeong-Hwan
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.154-160
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    • 2006
  • Purpose: According to the 2nd English Edition of the Japanese Gastric Cancer Association (JGCA) in 1998, in case of distal gastric cancer, the 14v (superior mesenteric vein) lymph node (LN) is included in the N2 group. However, in Korea, a modified radical gastrectomy is performed, and a 14v LN dissection is not done as a routine procedure. Thus, we investigated the rate of metastatic 14v LNs, evaluated the necessity of dissection of the 14v LN, and searched for indications of 14v LN dissection. Materials and Methods: From April 2004 to August 2005, we enrolled the patients who were diagnosed as having advanced gastric cancer in the distal third portion of the stomach. We peformed a distal gastrectomy with D2 lymph node dissection as defined in the 2nd English edition of the JGCA classification. We calculated the positive rate of metastatic LNs of each station and analyzed the relationship between the positive rates of No.6 LNs and 14v LNs. We also compared the positive 14v LN group with the negative 14v LN group. Results: The total number of patients was 50, the mean age was 56 (range $30{\sim}80$) years, and sex ratio (Male/Female) was 1.63 : 1. In 47 (94%) cases, distal a gastrectomy with gastroduodenostomy was done, and in the remaining 3 (6%) cases, a distal gastrectomy with gastrojejunostomy was done. The most frequently metastatic LNs were nos. 3 and 6 (54%). The metastatic rate of the f4v LN was 10%, which was similar to that of LN no. 9. In the comparison of the 14v positive group with the 14v negative group, there were significant differences in the numbers of metastatic LNs (mean 25.4 vs 4.91, P<0.001) and the numbers of metastatic no. 6 LNs, (mean 6.8 vs 1.42, P<0.001), and if no. 6 LNs were metastatic, the possibility of metastasis to the 14v LN was 19.2%. In the 14v positive group, all cases were more than stage 3 by the UICC 6th edition. Conclusion: In cases of advanced cancer with metastasis to the no. 6 IN, there was a good chance of metastasis to the 14v LN. Thus, in the operative field, if the tumor is advanced to more than stage 3 by the UICC classification and the no. 6 LN is metastatic, a 14v LN dissection is necessary. However, the usefulness of a 14v LN dissection should be evaluated prospectively through an analysis of tumor recurrence and long-term survival.

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A Study on the Revitalization of Tourism Industry through Big Data Analysis (한국관광 실태조사 빅 데이터 분석을 통한 관광산업 활성화 방안 연구)

  • Lee, Jungmi;Liu, Meina;Lim, Gyoo Gun
    • Journal of Intelligence and Information Systems
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    • v.24 no.2
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    • pp.149-169
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    • 2018
  • Korea is currently accumulating a large amount of data in public institutions based on the public data open policy and the "Government 3.0". Especially, a lot of data is accumulated in the tourism field. However, the academic discussions utilizing the tourism data are still limited. Moreover, the openness of the data of restaurants, hotels, and online tourism information, and how to use SNS Big Data in tourism are still limited. Therefore, utilization through tourism big data analysis is still low. In this paper, we tried to analyze influencing factors on foreign tourists' satisfaction in Korea through numerical data using data mining technique and R programming technique. In this study, we tried to find ways to revitalize the tourism industry by analyzing about 36,000 big data of the "Survey on the actual situation of foreign tourists from 2013 to 2015" surveyed by the Korea Culture & Tourism Research Institute. To do this, we analyzed the factors that have high influence on the 'Satisfaction', 'Revisit intention', and 'Recommendation' variables of foreign tourists. Furthermore, we analyzed the practical influences of the variables that are mentioned above. As a procedure of this study, we first integrated survey data of foreign tourists conducted by Korea Culture & Tourism Research Institute, which is stored in the tourist information system from 2013 to 2015, and eliminate unnecessary variables that are inconsistent with the research purpose among the integrated data. Some variables were modified to improve the accuracy of the analysis. And we analyzed the factors affecting the dependent variables by using data-mining methods: decision tree(C5.0, CART, CHAID, QUEST), artificial neural network, and logistic regression analysis of SPSS IBM Modeler 16.0. The seven variables that have the greatest effect on each dependent variable were derived. As a result of data analysis, it was found that seven major variables influencing 'overall satisfaction' were sightseeing spot attraction, food satisfaction, accommodation satisfaction, traffic satisfaction, guide service satisfaction, number of visiting places, and country. Variables that had a great influence appeared food satisfaction and sightseeing spot attraction. The seven variables that had the greatest influence on 'revisit intention' were the country, travel motivation, activity, food satisfaction, best activity, guide service satisfaction and sightseeing spot attraction. The most influential variables were food satisfaction and travel motivation for Korean style. Lastly, the seven variables that have the greatest influence on the 'recommendation intention' were the country, sightseeing spot attraction, number of visiting places, food satisfaction, activity, tour guide service satisfaction and cost. And then the variables that had the greatest influence were the country, sightseeing spot attraction, and food satisfaction. In addition, in order to grasp the influence of each independent variables more deeply, we used R programming to identify the influence of independent variables. As a result, it was found that the food satisfaction and sightseeing spot attraction were higher than other variables in overall satisfaction and had a greater effect than other influential variables. Revisit intention had a higher ${\beta}$ value in the travel motive as the purpose of Korean Wave than other variables. It will be necessary to have a policy that will lead to a substantial revisit of tourists by enhancing tourist attractions for the purpose of Korean Wave. Lastly, the recommendation had the same result of satisfaction as the sightseeing spot attraction and food satisfaction have higher ${\beta}$ value than other variables. From this analysis, we found that 'food satisfaction' and 'sightseeing spot attraction' variables were the common factors to influence three dependent variables that are mentioned above('Overall satisfaction', 'Revisit intention' and 'Recommendation'), and that those factors affected the satisfaction of travel in Korea significantly. The purpose of this study is to examine how to activate foreign tourists in Korea through big data analysis. It is expected to be used as basic data for analyzing tourism data and establishing effective tourism policy. It is expected to be used as a material to establish an activation plan that can contribute to tourism development in Korea in the future.