• Title/Summary/Keyword: Non-communication

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A Study on Reduction Effect of Processing Wastewater by Introduction of PACS (PACS 도입에 의한 현상시스템 폐수 감소효과에 관한 연구)

  • Ko, Shin-Kwan;Han, Dong-Kyoon;Kim, Wook-Dong;Kang, Bung-Sam;Yang, Han-Jun
    • Journal of radiological science and technology
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    • v.30 no.2
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    • pp.167-175
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    • 2007
  • There are some positive effects by the introduction of PACS(Picture Archiving Communication System). This study is to analyze the mutual relation between before and after of the introduction of PACS in terms of the environment effect. It is supposed to cause the reduction of developing and fixing wastewater according to the increase in the rate of a non-film. This study will also show the amount of wastewater. Target places were the department of image medicine(diagnostic radiation) of the general hospitals in Seoul and Gyeonggi-Do, which are equiped with full PACS. The authors examined questionnaires on the number of projection, the number of indirect projection, the amount of the film used, the number of radiation image CD loan, the amount of the developing and fixing solution used, the change of the amount of fixing wastewater. According to the analysis, we analyzed the change of the amount of developing and fixing solution per a film and the change of the amount of developing and fixing wastewater which is supposed to be reduced proportionally by the introduction of PACS. We got conclusion as below after analyzing 8 hospitals except the largest and the least amount of examination, film used, developing and fixing solution and the amount of developing and fixing wastewater in order to decrease the deviation from 10 general hospitals located in Seoul and Gyeonggi-Do. We compared data one year before adopting PACS Versus 3 years after adopting PACS. 1. The frequences of examination increased to 7,357.7 cases per month but the amount of film used decreased to 90%, from 42,774.4 to 4,181.88 after adopting the PACS. 2. 3 years after adopting PACS, monthly average amount of developing solution used decreased to 92% and the monthly average amount of fixing solution decreased to 86%. 3. Monthly average amount of developing solution used per film increased to 1.49 times and fixing solution increased as much as three times. 4. Monthly average wastewater for developing decreased to 88% and wastewater for fixing decreased up to 87%. 5. Monthly average wastewater for developing per film increased to 3.77 times and wastewater for fixing increased to 3.85 times. Although the amount of film used and the amount of developing and fixing wastewater affected by the reduction of the developing and fixing solution became less on the whole by introduction of PACS, they did not decrease proportionally. Moreover the amount of the developing and fixing solution used and the amount of developing and fixing wastewater per a film increased. That means the expectation for an environmental improvement differs from the actual condition.

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A study on the shear bond strengths of orthodontic brackets according to surface treatments and polymerizing techniques. (도재표면의 처리방법과 접착제의 중합방식에 따른 교정용 브라켓의 전단강도의 연구)

  • Kim, Young-Joo;Cha, Kyung-Suk;Lee, Jin-Woo
    • The korean journal of orthodontics
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    • v.29 no.4 s.75
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    • pp.445-456
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    • 1999
  • As a result of increased education and communication, the field of orthodontics has recently been expanded to include a greater number of adult treatment procedures. With this increased demand for adult orthodontic treatment, a problem that frequently arises is the placement of appliances on teeth restored with porcelain. But conventional acid-etching is ineffective in the preparation of porcelain surface for mechanical retention of orthodontic attachments. Also, it is possible to damage on porcelain. The purpose of this study was to evaluate the effect of composite bonding materials and the porcelain surface treatment methods on shear bond strength, and to observe the porcelain fracture rates. To accomplish this purpose, this study was carried out with feldsphatic porcelain, Ceram II. Porcelain surface treatment methods were divided into intact glazed porcelain which had not treatment and surface roughening. Surface roughening by etching with Hydroluoric acid(HF), sandblasting with Microetcher II and compound treatment with etching and sandblasting. Bonding materials were Ortho-two and Transbond. All porcelain specimens were applicated with porcelain primer. 1. In comparision according to porcelain surface treatment, surface roughening groups by HF etching and sandblasting had higher shear bond than intact group. No significant difference was found in Transbond group. 2. Ortho-two group had the higher shear bond strength than that of Transbond group in B:.u etching and sandblasting. 3. E(Transbond. Intact)group had the lowest shear bond strength in all experimental group. The bond strength was higher than clinically successful bond strength. 4. Non-treated group had very higher porcelain rates than treated group. 5. This study indicates that porcelain surface-roughening may not be necessary to attachment of orthodontic brackets to porcelain surfaces.

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A Study on the Applicability of Social Security Platform to Smart City (사회보장플랫폼과 스마트시티에의 적용가능성에 관한 연구)

  • Jang, Bong-Seok
    • Journal of the Korea Convergence Society
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    • v.11 no.11
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    • pp.321-335
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    • 2020
  • Given that with the development of the 4th industry, interest and desire for smart cities are gradually increasing and related technologies are developed as a way to strengthen urban competitiveness by utilizing big data, information and communication technology, IoT, M2M, and AI, the purpose of this study is to find out how to achieve this goal on the premise of the idea of smart well fair city. In other words, the purpose is to devise a smart well-fair city in the care area, such as health care, medical care, and welfare, and see if it is feasible. With this recognition, the paper aimed to review the concept and scope of smart city, the discussions that have been made so far and the issues or limitations on its connection to social security and social welfare, and based on it, come up with the concept of welfare city. As a method of realizing the smart welfare city, the paper reviewed characteristics and features of a social security platform as well as the applicability of smart city, especially care services. Furthermore, the paper developed discussions on the standardization of the city in terms of political and institutional improvements, utilization of personal information and public data as well as ways of institutional improvement centering on social security information system. This paper highlights the importance of implementing the digitally based community care and smart welfare city that our society is seeking to achieve. With regard to the social security platform based on behavioral design and the 7 principles(6W1H method), the present paper has the limitation of dealing only with smart cities in the fields of healthcare, medicine, and welfare. Therefore, further studies are needed to investigate the effects of smart cities in other fields and to consider the application and utilization of technologies in various aspects and the corresponding impact on our society. It is expected that this paper will suggest the future course and vision not only for smart cities but also for the social security and welfare system and thereby make some contribution to improving the quality of people's lives through the requisite adjustments made in each relevant field.

The Effect of Supportive Nursing Care on Depression, Mood and Satisfaction in Military Patients with Low Back Pain (지지간호가 군 요통환자의 우울ㆍ기분ㆍ만족에 미치는 영향)

  • 김정아
    • Journal of Korean Academy of Nursing
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    • v.20 no.3
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    • pp.324-340
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    • 1990
  • Support has always been considered an important nursing concept. However, there is no agreement among nurse researchers as to a conceptual definition of supportive nursing or meaningful supportive behaviors. Clarification of the concept, support in nursing, is necessary to promote communication among nurses on nursing behaviors that are effective in providing support and on understanding the relevant properties and charcteristics of the concept, supportive nursing care. The objectives of the study were : 1. to analyse the concept, support in nursing, in order to provide a definition of supportive nursing care, and 2. to operationalize the definition of supportive nursing care and use it as an experimental nursing intervention for patients with low back pain. The first part of the study used the concept analysis approach developed by Walker and Avant(1983) to define the concept of supportive nursing care. The properties of supportive nursing care, defined by this analysis, included perception of supportive need, reciprocal interaction(Transaction), listening, providing empathy and information related to health, and confirmation of the patient's verbal and non - verbal response. The second part, the experimental part of the study, was done using King's(1970) Interpersonal Theory for Nursing. The concept, supportive nursing care, as defined in the concept analysis was operationalized and used as the experimental intervention. The experiment tested the effectiveness of the independent variable, supportive nursing care on the dependent variables, depression, mood and patient satisfaction, in the patients with low back pain in army hospitals. The instruments used to measure the dependent variables were Zung's(1965) Self- Rating Depression Scale, Ryman and Colleagues'(1974) Mood Questionnaire and LaMonica and Colleagues'(1986) Patient Satisfaction Scale. The experimental design used for this study was a Solomon 4 group experimental design. This design has the strength of allowing for observation of the main effects of supportive nursing care and pretesting, and for observation of the interaction effects of pretesting and supportive nursing care. The design includes one experimental group and three control groups. The Subjects of this study were 150 young male patients with low back pain on Neuro - Surgical Wards in three general army hospitals. There were 35 in the experimental group, 39 in the pre - posttest control group, 36 in the treatment - posttest control group and 40 in the posttest only control group. Supportive nursing care, as operationalized by the researcher according to the concept analysis, was given to the patients in the experimental group and the treatment -posttest control group, individually for 30 minute sessions, every other day for 5 days. Data collection was done using a questionnaire. The data were collected in a pretest one week before the supportive nursing care sessions, a posttest immediately after the sessions and follow- up test one week later. Hypotheses testing was done using 2×2 factorial analysis of variance and Meta analysis(Stouffer's Z method). The results of this study are summarized as follows : 1. Hypothesis Ⅰ, “There will be a difference on depression level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=8.49, p<.05). 2. Hypothesis Ⅱ, “There will be a difference on mood level between the patients with low back pain who receive supportive nursing care and those who to not receive supportive nursing care”, was supported (Z meta=2.17, p<.05). 3. Hypothesis Ⅲ, “There will be a difference on satisfaction level between the patients with low back pain who receive supportive nursing care and those who do not receive supportive nursing care”, was supported (F=13.67, p<.05). 4. ANOVA, done to examine the interaction effect of history and maturation, showed no significant difference on the dependent variables between the observations of the pretest scores of the experimental group, the pretest scores of the pre- posttest control group and the posttest score of the posttest only control group. 5. To test for continuing effect of supportive nursing care, paired t-test was done to compare the scores for the dependent variables at the posttest and at the one week later follow-up test. No significant difference on the scores for the dependent variables was found between the posttest scores and the follow-up test scores for the two groups that received supportive nursing care, the experimental group and the treatment-posttest control group. In conclusion, it was found that in the case of young soldiers with low back pain in army hospitals, their depression level was decreased, their mood state was changed positively and their satisfaction level was increased by receiving supportive nursing care. Further, the effectiveness of the supportive nursing care lasted for at least one week in this study. The significance of this study to nursing is in the analysis of the concept of supportive nursing care and the demonstration of the effectiveness of supportive nursing care as an intervention within the limits of the study.

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Impacts of R&D and Smallness of Scale on the Total Factor Productivity by Industry (R&D와 규모의 영세성이 산업별 총요소생산성에 미치는 영향)

  • Kim, Jung-Hwan;Lee, Dong-Ki;Lee, Bu-Hyung;Joo, Won
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.2 no.4
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    • pp.71-102
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    • 2007
  • There were many comprehensive analyses conducted within the existing research activities wherein factors affecting technology progress including investment in R&D vis-${\Box}$-vis their influences act as the determinants of TFP. Note, however, that there were few comprehensive analysis in the industrial research performed regarding the impact of the economy of scale as it affects TFP; most of these research studies dealt with the analysis of the non -parametric Malmquist productivity index or used the stochastic frontier production function models. No comprehensive analysis on the impacts of individual independent variables affecting TFP was performed. Therefore, this study obtained the TFP increase rate of each industry by analyzing the factors of the existing growth accounting equation and comprehensively analyzed the TFP determinants by constructing a comprehensive analysis model considering the investment in R&D and economy of scale (smallness by industry) as the influencers of TFP by industry. First, for the TFP increase rate of the 15 industries as a whole, the annual average increase rate for 1993${\sim}$ 1997 was approximately 3.8% only; during 1999${\sim}$ 2000 following the foreign exchange crisis, however, the annual increase rate rose to approximately 7.8%. By industry, the annual average increase rate of TFP between 1993 and 2000 stood at 11.6%, the highest in the electrical and electronic equipment manufacturing business and IT manufacturing sector. In contrast, a -0.4% increase rate was recorded in the furniture and other product manufacturing sectors. In the case of the service industry, the TFP increase rate was 7.3% in the transportation, warehousing, and communication sectors. This is much higher than the 2.9% posted in the electricity, water, and gas sectors and -3.7% recorded in the wholesale, food, and hotel businesses. The results of the comprehensive analysis conducted on the determinants of TFP showed that the correlations between R&D and TFP in general were positive (+) correlations whose significance has yet to be validated; in the model where the self-employed and unpaid family workers were used as proxy variables indicating the smallness of industry out of the total number of workers, however, significant negative (-) correlations were noted. On the other hand, the estimation factors of variables surrogating the smallness of scale in each industry showed that a consistently high "smallness of scale" in an industry means a decrease in the increase rate of TFP in the same industry.

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Design Evaluation Model Based on Consumer Values: Three-step Approach from Product Attributes, Perceived Attributes, to Consumer Values (소비자 가치기반 디자인 평가 모형: 제품 속성, 인지 속성, 소비자 가치의 3단계 접근)

  • Kim, Keon-Woo;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.23 no.4
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    • pp.57-76
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    • 2017
  • Recently, consumer needs are diversifying as information technologies are evolving rapidly. A lot of IT devices such as smart phones and tablet PCs are launching following the trend of information technology. While IT devices focused on the technical advance and improvement a few years ago, the situation is changed now. There is no difference in functional aspects, so companies are trying to differentiate IT devices in terms of appearance design. Consumers also consider design as being a more important factor in the decision-making of smart phones. Smart phones have become a fashion items, revealing consumers' own characteristics and personality. As the design and appearance of the smartphone become important things, it is necessary to examine consumer values from the design and appearance of IT devices. Furthermore, it is crucial to clarify the mechanisms of consumers' design evaluation and develop the design evaluation model based on the mechanism. Since the influence of design gets continuously strong, various and many studies related to design were carried out. These studies can classify three main streams. The first stream focuses on the role of design from the perspective of marketing and communication. The second one is the studies to find out an effective and appealing design from the perspective of industrial design. The last one is to examine the consumer values created by a product design, which means consumers' perception or feeling when they look and feel it. These numerous studies somewhat have dealt with consumer values, but they do not include product attributes, or do not cover the whole process and mechanism from product attributes to consumer values. In this study, we try to develop the holistic design evaluation model based on consumer values based on three-step approach from product attributes, perceived attributes, to consumer values. Product attributes means the real and physical characteristics each smart phone has. They consist of bezel, length, width, thickness, weight and curvature. Perceived attributes are derived from consumers' perception on product attributes. We consider perceived size of device, perceived size of display, perceived thickness, perceived weight, perceived bezel (top - bottom / left - right side), perceived curvature of edge, perceived curvature of back side, gap of each part, perceived gloss and perceived screen ratio. They are factorized into six clusters named as 'Size,' 'Slimness,' 'No-Frame,' 'Roundness,' 'Screen Ratio,' and 'Looseness.' We conducted qualitative research to find out consumer values, which are categorized into two: look and feel values. We identified the values named as 'Silhouette,' 'Neatness,' 'Attractiveness,' 'Polishing,' 'Innovativeness,' 'Professionalism,' 'Intellectualness,' 'Individuality,' and 'Distinctiveness' in terms of look values. Also, we identifies 'Stability,' 'Comfortableness,' 'Grip,' 'Solidity,' 'Non-fragility,' and 'Smoothness' in terms of feel values. They are factorized into five key values: 'Sleek Value,' 'Professional Value,' 'Unique Value,' 'Comfortable Value,' and 'Solid Value.' Finally, we developed the holistic design evaluation model by analyzing each relationship from product attributes, perceived attributes, to consumer values. This study has several theoretical and practical contributions. First, we found consumer values in terms of design evaluation and implicit chain relationship from the objective and physical characteristics to the subjective and mental evaluation. That is, the model explains the mechanism of design evaluation in consumer minds. Second, we suggest a general design evaluation process from product attributes, perceived attributes to consumer values. It is an adaptable methodology not only smart phone but also other IT products. Practically, this model can support the decision-making when companies initiative new product development. It can help product designers focus on their capacities with limited resources. Moreover, if its model combined with machine learning collecting consumers' purchasing data, most preferred values, sales data, etc., it will be able to evolve intelligent design decision support system.

A Study about The Impact of Music Recommender Systems on Online Digital Music Rankings (음원 추천시스템이 온라인 디지털 음원차트에 미치는 파급효과에 대한 연구)

  • Kim, HyunMo;Kim, MinYong;Park, JaeHong
    • Information Systems Review
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    • v.16 no.3
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    • pp.49-68
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    • 2014
  • These days, consumers have increasingly preferred to digital real-time streamlining and downloading to listen to music because this is convenient and affordable for the consumers. Accordingly, sales of music in compact disk formats have steadily declined. In this regards, online digital music has become a new communication channel to listen musics, where digital files can be delivered over various online networks to people's computing devices. The majority of online digital music distributors has Music Recommender Systems for sales of digital music on their websites. Music Recommender Systems are parts of information filtering systems that provide the ratings or preferences that users give to music. Korean online digital music distributors have Music Recommender Systems. But those online music distributors didn't provide any rules or clear procedures that recommend music. Therefore, we raise important questions as follows: "Is Music Recommender Systems Fair?", "What is the impact of Music Recommender Systems on online music rankings and sales?" While previous studies have focused on usefulness of Music Recommender Systems, this study investigates not only fairness of Current Music Recommender Systems but also Relationship between Music Recommender Systems and online Music Charts. This study examines these issues based on Bandwagon effect, ranking effect, Slot effect theories. For our empirical analysis, we selected the most famous five online digital music distributors in terms of market shares. We found that all recommended music is exposed to the top of 'daily music charts' in online digital music distributors' websites. We collected music ranking data and recommended music data from 'daily music chart' during a one month. The result shows that online music recommender systems are not fair, since they mainly recommend particular music that supported by a specific music production company. In addition, the recommended music are always exposed to the top of music ranking charts. We also find that recommended music usually appear at the top 20 ranking charts within one or two days. Also, the most music in the top 50 or 100 ranks are the recommended music. Moreover, recommended music usually remain the ranking charts more than one month while non-recommended music often disappear at the ranking charts within two week. Our study provides an important implication to online music industry. Because music recommender systems and music ranking charts are closely related, music distributors may improperly use their recommender systems to boost the sales of music that related to their own companies. Therefore, online digital music distributor must clearly announce the rules and procedures about music recommender systems for the better music industry.

Designing female-oriented computer games: Emotional expression

  • Shui, Lin-Lin;Lee, Won-Jung
    • Cartoon and Animation Studies
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    • s.20
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    • pp.75-86
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    • 2010
  • Recently, as the number of female players has increased rapidly, the electronic gaming industry has begun to look at ways to appeal to the largely untapped female market. According to the latest game market investigative report by China Internet Network Information Center (CNNIC), the total number of game players in China increased by 24.8% in 2009, reached 69,130,000 people, and 38.9% of them are female players. This growth in the number of female player is corroborated by a series of investigative reports from IResearch Company in Shanghai, China: from 2003 to 2009, the number of female players grew from 8% to more than 49%. Therefore, no matter how much attention the game production companies have given to male players or how they have ignored the female players before, the companies would be sensible to face up this reality and adjust their marketing policy a bit more. This article analyzes gender preferences in video games which shows that male players are more likely to be attracted to elements of aggression, violence, competition and fast action in electronic game-playing, while female players are drawn to emotional and social aspects of the games such as an understanding of character relationships. The literatures cited indicates that female players also show apparent preference for games with familiar environments, games that allow players to work together, games that have more than one way to win, and games in which characters do not die. It also discusses the characteristics of female-friendly games from the aspect of emotion, pointing out that the simulation games involving pet, dressing-up, and social simulation games are very popular with female players. Because these are the most suitable game types to fill with emotions of love, share, jealousy, superiority, mystery, these are absolutely attractive to female players. Finally, in accord with the above, I propose some principles of designing female-oriented games, including presenting a good-looking leading character, making the story interesting with "live" NPCs(Non-Playing Characters), and finding ways to satisfy female nature instincts such as taking care of others and the inborn interest of classifying and selecting.

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A Study about the Direction and Responsibility of the National Intelligence Agency to the Cyber Security Issues (사이버 안보에 대한 국가정보기구의 책무와 방향성에 대한 고찰)

  • Han, Hee-Won
    • Korean Security Journal
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    • no.39
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    • pp.319-353
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    • 2014
  • Cyber-based technologies are now ubiquitous around the glob and are emerging as an "instrument of power" in societies, and are becoming more available to a country's opponents, who may use it to attack, degrade, and disrupt communications and the flow of information. The globe-spanning range of cyberspace and no national borders will challenge legal systems and complicate a nation's ability to deter threats and respond to contingencies. Through cyberspace, competitive powers will target industry, academia, government, as well as the military in the air, land, maritime, and space domains of our nations. Enemies in cyberspace will include both states and non-states and will range from the unsophisticated amateur to highly trained professional hackers. In much the same way that airpower transformed the battlefield of World War II, cyberspace has fractured the physical barriers that shield a nation from attacks on its commerce and communication. Cyberthreats to the infrastructure and other assets are a growing concern to policymakers. In 2013 Cyberwarfare was, for the first time, considered a larger threat than Al Qaeda or terrorism, by many U.S. intelligence officials. The new United States military strategy makes explicit that a cyberattack is casus belli just as a traditional act of war. The Economist describes cyberspace as "the fifth domain of warfare and writes that China, Russia, Israel and North Korea. Iran are boasting of having the world's second-largest cyber-army. Entities posing a significant threat to the cybersecurity of critical infrastructure assets include cyberterrorists, cyberspies, cyberthieves, cyberwarriors, and cyberhacktivists. These malefactors may access cyber-based technologies in order to deny service, steal or manipulate data, or use a device to launch an attack against itself or another piece of equipment. However because the Internet offers near-total anonymity, it is difficult to discern the identity, the motives, and the location of an intruder. The scope and enormity of the threats are not just focused to private industry but also to the country's heavily networked critical infrastructure. There are many ongoing efforts in government and industry that focus on making computers, the Internet, and related technologies more secure. As the national intelligence institution's effort, cyber counter-intelligence is measures to identify, penetrate, or neutralize foreign operations that use cyber means as the primary tradecraft methodology, as well as foreign intelligence service collection efforts that use traditional methods to gauge cyber capabilities and intentions. However one of the hardest issues in cyber counterintelligence is the problem of "Attribution". Unlike conventional warfare, figuring out who is behind an attack can be very difficult, even though the Defense Secretary Leon Panetta has claimed that the United States has the capability to trace attacks back to their sources and hold the attackers "accountable". Considering all these cyber security problems, this paper examines closely cyber security issues through the lessons from that of U.S experience. For that purpose I review the arising cyber security issues considering changing global security environments in the 21st century and their implications to the reshaping the government system. For that purpose this study mainly deals with and emphasis the cyber security issues as one of the growing national security threats. This article also reviews what our intelligence and security Agencies should do among the transforming cyber space. At any rate, despite of all hot debates about the various legality and human rights issues derived from the cyber space and intelligence service activity, the national security should be secured. Therefore, this paper suggests that one of the most important and immediate step is to understanding the legal ideology of national security and national intelligence.

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Clinical Epidemiology for Elderly Patients of Oral Medicine Clinic (구강내과에 내원하는 노인 환자들의 임상 역학 연구)

  • Oh, Hyun-Sun;Kim, Hye-Kyoung;Park, Jo-Eun;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.19-28
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    • 2013
  • With Korea's rapid entry to aged society, elderly population has become a major age group both in the whole society and medical field and its importance will be constantly stressed out. Elderly population is also important in the field of oral medicine which deals with chronic and recurrent diseases in the orofacial region of non-dental origin but there exist few studies indicating epidemiology of elderly patients in this regards. This study aimed to investigate change of age distribution of new patients in a university-based dental hospital and oral medicine clinic for last decade and to investigate clinical epidemiology of elderly patients (${\geq}$ 65 years) of oral medicine clinic. This study was performed retrospectively using medical records of the new patients in Dankook University Dental Hospital in 2001 and 2011. According to the study, percentage of elderly new patients increased in both dental hospital and oral medicine clinic and degree of the increase was greater in oral medicine clinic than in the whole hospital (p=0.000). 13.5% of adult patients ${\geq}$ 18 years of oral medicine clinic were elderly patients ${\geq}$ 65 years. 83% of elderly patients were suffering from one or more systemic diseases. Although TMD was the most common reason for elderly patients who visited oral medicine clinic, oral soft tissue diseases, dry mouth, burning mouth syndrome and oromandibular dystonia was more frequently diagnosed in elderly patients compared to adult patients aged 18 to 64 years. Pain severity and interference of Brief Pain Inventory and depression and anxiety scores of Hospital Anxiety Depression Scales were higher in elderly patients than in the adult patients (p<0.05). Increase of elderly patients with chronic oral diseases and pain needs more attention of dentists and specialists of oral medicine to improvement of assessment and development of tailored management because large portion of the elderly patients have systemic diseases, polypharmacy and impaired communication, possibly restricting treatment options.