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The Limitations of Advance Directive (사전의료지시의 한계)

  • Oh, Se-Hyuk;Jeong, Hwa-Seong
    • The Korean Society of Law and Medicine
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    • v.11 no.2
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    • pp.239-274
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    • 2010
  • Advance directive refers to a description of the treatment method a patient wants to be provided with in case where the person is unconscious or lacks an ability to decision making in a future period or a declaration of intention that delegates and appoints another person who makes a decision regarding a treatment method on behalf of the person. Advance directive is usually a document form, but oral statement is acceptable as well. Advance directive may have a variety of forms though, it basically consists of two basic forms. That is, one is a living will, and the other is a surrogate decision making. Though the importance of advance directive has been emphasized, and the necessity of adopting the system has been strongly argued for so far, the debates on criteria, method, and procedure alike have not yet reached an agreement. It is because even the concept of advance directive is more or less ambiguous, and each specific method has its own theoretical limitations and practical constraints. Thus the inquiries on advance directive raised in the study are summarized as the meaning, practicability, and philosophical foundation of the advance directive. Firstly, the theoretical limitations of Advance directive may be categorized into conceptual and moral limitations. In case of conceptual limitations, authors of advance directives may not be well aware, in advance, of the particular situation in which he or her will experience in the future, and patients may experience the change in his or her values and lack the understanding and information about the future situation due to the changes in treatment methods. In case of moral limitations, a patient has a limited moral autonomy right and self identity that have an impact on his or her preference. Secondly, in case of practical constraints for advance directive, there exist cultural features, low ratio of documentation, as patients themselves admit, and low predictability and stability of patient's own preference regarding life-sustaining care. And the problem of validity and accuracy in proxy's decision making is also raised. Those who administer a living will, especially, may have a difficulty in understanding the directive by a patient, so that the accuracy of execution cannot be secured. In the sense, it is needed to implement a legal device in order to solve such problems. In summary, it is urgently required to understand the limitations and explore desired alternatives to overcome the relevant problems in advance, which must contribute to successfully adopting and effectively operating the advance directive system in Korea.

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Using the METHONTOLOGY Approach to a Graduation Screen Ontology Development: An Experiential Investigation of the METHONTOLOGY Framework

  • Park, Jin-Soo;Sung, Ki-Moon;Moon, Se-Won
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.125-155
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    • 2010
  • Ontologies have been adopted in various business and scientific communities as a key component of the Semantic Web. Despite the increasing importance of ontologies, ontology developers still perceive construction tasks as a challenge. A clearly defined and well-structured methodology can reduce the time required to develop an ontology and increase the probability of success of a project. However, no reliable knowledge-engineering methodology for ontology development currently exists; every methodology has been tailored toward the development of a particular ontology. In this study, we developed a Graduation Screen Ontology (GSO). The graduation screen domain was chosen for the several reasons. First, the graduation screen process is a complicated task requiring a complex reasoning process. Second, GSO may be reused for other universities because the graduation screen process is similar for most universities. Finally, GSO can be built within a given period because the size of the selected domain is reasonable. No standard ontology development methodology exists; thus, one of the existing ontology development methodologies had to be chosen. The most important considerations for selecting the ontology development methodology of GSO included whether it can be applied to a new domain; whether it covers a broader set of development tasks; and whether it gives sufficient explanation of each development task. We evaluated various ontology development methodologies based on the evaluation framework proposed by G$\acute{o}$mez-P$\acute{e}$rez et al. We concluded that METHONTOLOGY was the most applicable to the building of GSO for this study. METHONTOLOGY was derived from the experience of developing Chemical Ontology at the Polytechnic University of Madrid by Fern$\acute{a}$ndez-L$\acute{o}$pez et al. and is regarded as the most mature ontology development methodology. METHONTOLOGY describes a very detailed approach for building an ontology under a centralized development environment at the conceptual level. This methodology consists of three broad processes, with each process containing specific sub-processes: management (scheduling, control, and quality assurance); development (specification, conceptualization, formalization, implementation, and maintenance); and support process (knowledge acquisition, evaluation, documentation, configuration management, and integration). An ontology development language and ontology development tool for GSO construction also had to be selected. We adopted OWL-DL as the ontology development language. OWL was selected because of its computational quality of consistency in checking and classification, which is crucial in developing coherent and useful ontological models for very complex domains. In addition, Protege-OWL was chosen for an ontology development tool because it is supported by METHONTOLOGY and is widely used because of its platform-independent characteristics. Based on the GSO development experience of the researchers, some issues relating to the METHONTOLOGY, OWL-DL, and Prot$\acute{e}$g$\acute{e}$-OWL were identified. We focused on presenting drawbacks of METHONTOLOGY and discussing how each weakness could be addressed. First, METHONTOLOGY insists that domain experts who do not have ontology construction experience can easily build ontologies. However, it is still difficult for these domain experts to develop a sophisticated ontology, especially if they have insufficient background knowledge related to the ontology. Second, METHONTOLOGY does not include a development stage called the "feasibility study." This pre-development stage helps developers ensure not only that a planned ontology is necessary and sufficiently valuable to begin an ontology building project, but also to determine whether the project will be successful. Third, METHONTOLOGY excludes an explanation on the use and integration of existing ontologies. If an additional stage for considering reuse is introduced, developers might share benefits of reuse. Fourth, METHONTOLOGY fails to address the importance of collaboration. This methodology needs to explain the allocation of specific tasks to different developer groups, and how to combine these tasks once specific given jobs are completed. Fifth, METHONTOLOGY fails to suggest the methods and techniques applied in the conceptualization stage sufficiently. Introducing methods of concept extraction from multiple informal sources or methods of identifying relations may enhance the quality of ontologies. Sixth, METHONTOLOGY does not provide an evaluation process to confirm whether WebODE perfectly transforms a conceptual ontology into a formal ontology. It also does not guarantee whether the outcomes of the conceptualization stage are completely reflected in the implementation stage. Seventh, METHONTOLOGY needs to add criteria for user evaluation of the actual use of the constructed ontology under user environments. Eighth, although METHONTOLOGY allows continual knowledge acquisition while working on the ontology development process, consistent updates can be difficult for developers. Ninth, METHONTOLOGY demands that developers complete various documents during the conceptualization stage; thus, it can be considered a heavy methodology. Adopting an agile methodology will result in reinforcing active communication among developers and reducing the burden of documentation completion. Finally, this study concludes with contributions and practical implications. No previous research has addressed issues related to METHONTOLOGY from empirical experiences; this study is an initial attempt. In addition, several lessons learned from the development experience are discussed. This study also affords some insights for ontology methodology researchers who want to design a more advanced ontology development methodology.

A Comparative Analysis on Safety Evaluation System in the PQ Process of Public Construction Projects - Focus on PQ process in Korea and Los Angeles, California, USA - (공공공사의 PQ 심사 시 안전평가체계 비교분석 - 한국과 미국 캘리포니아 주 LA지역의 PQ 제도를 중심으로 -)

  • Park, Heetaek;Oh, ChiDon;Park, Chansik;Choi, Jinwoo
    • Korean Journal of Construction Engineering and Management
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    • v.14 no.6
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    • pp.3-13
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    • 2013
  • The converted accident rates that included in Pre-Qualification (PQ) are to evaluate the results of accidents which have occurred. Therefore, it is demanded the development of proactive evaluation contents to evaluate the safety management activities and efforts on construction companies. The purpose of this study is to provide basic data for the establishment of proactive evaluation contents at public construction project in Korea through the collected and analyzed the PQ documentation applied by public agencies in Los Angeles, USA. The results indicated that diverse reactive safety evaluations are implemented to examine accidents which occurred in past projects such as occupational health insurance, regulation violation. And also, when the accidents occurred, it is evaluated the proactive safety management actions such as safety education, accident prevention programs, and safety management plans are reflected on the evaluation. Thus, if proactive safety related evaluation contents are established and reflected in PQ examinations together with diverse existing reactive safety evaluations considering converted accident rates, not only the existing function of converted accident rates can be reinforced but also businesses' active safety management activities can be induced and decreases in the construction industry's accident rate can be expected.

Surgical Outcome of Primary Repair in Anterior Cruciate Ligament Rupture - Minimum 4-years follow-up - (전방 십자 인대 봉합술의 수술적 치료 - 최소 4년 이상 추시 결과 -)

  • Byun, Ki-Yong;Rhee, Kwang-Jin;Lee, Suk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.123-127
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    • 2000
  • Purpose : To evaluate of the surgical outcome of primary repair in anterior cruciate ligament rupture. Material & Method : Twenty-five patients underwent arthroscopic primary repair of ACL. We performed pull-out suture of ruptured ligament in 18 cases, and suture and augumentation with gracillis & semitendinosus in 7 cases. At follow up, the International Knee Documentation Committee(IKDC) scale & Lysholm score were used to grade outcome, and also the KT-2000 arthrometer was used to evaluate objective ligament laxity. Results : In analysis of IKDC scale, final evaluation group were group A in 3 cases, group B in 13 cases, group C in 9 cases. The mean value of Lysholm score was 83 points. In KT-2000 arthrometer examination, mean anterior translation was 3.9mm at 201b, 7.3mm at 30lb. The mean difference value between injured knee and uninjured knee was 1.1mm at 201b, 2.29mm at 301b. There was statistical significance in mean difference value between injured and uninjured knee. Conclusion : By analysis of clinical & objective data, we could confirm that the mid-term result of ACL suture is not satisfactory. So, we recommend that ACL reconstruction would be done in young active patient rather than suture.

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Business Process Design to Apply ebXML Framework to the Port and Logistics Distribution Industry (ebXML 적용을 위한 항만물류산업 비즈니스 프로세스 설계)

  • Choi, Hyung-Rim;Park, Nam-Kyu;Lim, Ho-Seob;Lee, Hyun-Chul;Lee, Chang-Sup
    • Information Systems Review
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    • v.4 no.2
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    • pp.209-222
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    • 2002
  • EDI (Electronic Data Interchange) has been widely utilized to support Business Activities since it has such advantages as fast transfer of information, less documentation work, efficient information exchange etc. Recently e-business environment has urged the traditional EDI system to be changed to ebXML framework. To apply the ebXML framework to a certain industry, it is required to implement Business Process (BP), Core Component (CC), Collaboration Protocol Profile (CPP), Collaboration Protocol Agreement (CPA), Messaging system etc. We have selected the port and logistics industry as a target domain to apply ebXML framework, since the EDI usage ratio of it is relatively higher than other industries. In this paper, we have analyzed the current status of EDI system and transaction processes in the port and logistics industry. We have defined the business process that will be registered in the registry/repository, the main component of ebXML framework, using UN/CEFACT modeling methodology. And Business Collaborations, Business Transactions, Business Document Flows, Choreography, Pattern, etc. are represented using UML according to UN/ CEFACT modeling methodology, to apply ebXML Framework to the port and logistics distribution industry. Also we have suggested the meta methodology for applying the ebXML framework to other industries.

The Influence of Park Users' Cognition about the Park Design Concept and Strategy to Satisfaction - A Case Study of the Neighborhood Parks of Gwanggyo New Town - (공원이용자의 설계개념과 설계전략에 대한 인식이 공원 만족도에 미치는 영향 - 광교신도시의 근린공원을 대상으로 -)

  • Jang, Jae-Ho;Kim, Dan-Young;Shin, Min-Ji;Shin, Ji-Hoon
    • Journal of the Korean Institute of Landscape Architecture
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    • v.45 no.1
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    • pp.82-93
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    • 2017
  • The purpose of this study is analyze the impact on users' cognition of design concept, satisfaction of design concept, adapted park space, and effect of design concepts on park use satisfaction. The study sites are Central Mountain Park and Lake Park in Gwanggyo New Town, Suwon. We analyzed importance-satisfaction of park facilities in the park and preference-satisfaction of park. The results of this study are as follows. First, generally users visit the park as a family unit. Second, trails got high scores in importance-satisfaction of park facilities. Third, park users' satisfaction received a high score generally, but it doesn't show statistic significance with users' cognition of design concept. Fourth, cognition of the two parks' design concept and design strategy got a high score - over three points on average - based on the 5 - point Likert scale. However, upon analysis of users' cognition of design concept and satisfaction of design concept adapted park space, there is no statistic significance. Therefore, we noticed that the park's design concept had an effect on park users' satisfaction; rather, personal preference and satisfaction of users had more impact on satisfaction. On the other hand, this study was limited in that we didn't survey across all four seasons and had few target areas. But it has some significance in that we used a visual documentation, attaching existing photos including design concept, to increase users' understanding. Also, we directly asked about the parks' user design concept and strategy.

The Analysis of Professional Education Needs for the Competencies of Occupational Therapists in Cognitive Rehabilitation: Focusing on the Professors in Occupational Therapy Departments of Universities/Colleges in Korea (작업치료사의 인지재활 직무역량에 대한 교육요구도 분석: 국내 대학 작업치료(학)과 교수자를 중심으로)

  • Hong, Seung-Pyo;Lee, Hee-Ryoung;Han, Dae-Sung;Ju, Yu-Mi;Kim, Young-Geun
    • Therapeutic Science for Rehabilitation
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    • v.12 no.3
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    • pp.45-59
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    • 2023
  • Objective : This study aims to identify the status of education in cognitive rehabilitation (CR) in occupational therapy departments of Korean universities/colleges and to analyze the educational needs for professional competencies. Methods : This study was conducted by distributing a questionnaire to professors. The questionnaire extracted items related to professional competencies from the results of a previous Delphi study. A total of 39 respondents from 32 (51.6%) of 62 universities/colleges were analyzed. The questionnaire analysis was conducted using Excel 2010 and SPSS 18.0 to analyze the Borich requirements and the priority of education through the Locus for focus model. Results : The priority of competency in CR was followed by "clinical reasoning ability to explain cognitive problems from the occupational performance perspective", "ability to manage insurance billing for CR", "ability to establish a CR plan based on outcome evaluation", "ability to perform occupation-oriented CR", and "ability to solve problems that occur during CR evaluation and intervention". In the Locus for focus model, items such as occupation-based cognitive assessment, intervention, and skills for documentation were high priorities for education. Conclusion : This study is expected to reflect educational competencies for CR and establish a plan for CR specialists through continuing education.

The Problems and Improvements of Rock Specimens used for Science Education in Elementary Schools (초등학교 과학 교육에서 활용하는 암석 표본의 문제점과 개선 방안)

  • Kwon, Yun-Kyoung;Kim, Jeong-Yul
    • Journal of the Korean earth science society
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    • v.33 no.1
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    • pp.82-93
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    • 2012
  • The purpose of this study is to analyze the problems of rock specimens used for science education in elementary schools and to provide improvements of them. For the study, 20 sets of rock specimens were randomly selected from the five elementary schools in K city of Gyeongbuk Province and they were photographed and investigated. Also three elementary school teachers with more than 5 years of scientific career were interviewed. As a result, the sets of rock specimens that reflected the elementary curriculum were only 10%. The sets of rock specimens had many problems as follows: they were purchased a long time ago (up to 30 years), information presented in the nameplate and documentation was errorneous, some of rock specimens were too small and they did not show typical characteristics for education. In addition, the purchase and verification procedures of rock specimens were often neglected. With lack of interest and knowledge of teachers and lack of information about rock specimens, it was difficult to purchase good rock specimens for education. To improve the situation, a set of rock specimens should be verified by experts and should reflect the contents of curriculum and textbooks thoroughly. A manual of rock specimens is provided for science education in elementary schools.

E-Commerce in the Historical Approach to Usage and Practice of International Trade ("무역상무(貿易商務)에의 역사적(歷史的) 어프로치와 무역취인(貿易取引)의 전자화(電子化)")

  • Tsubaki, Koji
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.19
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    • pp.224-242
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    • 2003
  • The author believes that the main task of study in international trade usage and practice is the management of transactional risks involved in international sale of goods. They are foreign exchange risks, transportation risks, credit risk, risk of miscommunication, etc. In most cases, these risks are more serious and enormous than those involved in domestic sales. Historically, the merchant adventurers organized the voyage abroad, secured trade finance, and went around the ocean with their own or consigned cargo until around the $mid-19^{th}$ century. They did business faceto-face at the trade fair or the open port where they maintained the local offices, so-called "Trading House"(商館). Thererfore, the transactional risks might have been one-sided either with the seller or the buyer. The bottomry seemed a typical arrangement for risk sharing among the interested parties to the adventure. In this way, such organizational arrangements coped with or bore the transactional risks. With the advent of ocean liner services and wireless communication across the national border in the $19^{th}$ century, the business of merchant adventurers developed toward the clear division of labor; sales by mercantile agents, and ocean transportation by the steam ship companies. The international banking helped the process to be accelerated. Then, bills of lading backed up by the statute made it possible to conduct documentary sales with a foreign partner in different country. Thus, FOB terms including ocean freight and CIF terms emerged gradually as standard trade terms in which transactional risks were allocated through negotiation between the seller and the buyer located in different countries. Both of them did not have to go abroad with their cargo. Instead, documentation in compliance with the terms of the contract(plus an L/C in some cases) must by 'strictly' fulfilled. In other words, the set of contractual documents must be tendered in advance of the arrival of the goods at port of discharge. Trust or reliance is placed on such contractual paper documents. However, the container transport services introduced as international intermodal transport since the late 1960s frequently caused the earlier arrival of the goods at the destination before the presentation of the set of paper documents, which may take 5 to 10% of the amount of transaction. In addition, the size of the container vessel required the speedy transport documentation before sailing from the port of loading. In these circumstances, computerized processing of transport related documents became essential for inexpensive transaction cost and uninterrupted distribution of the goods. Such computerization does not stop at the phase of transportation but extends to cover the whole process of international trade, transforming the documentary sales into less-paper trade and further into paperless trade, i.e., EDI or E-Commerce. Now we face the other side of the coin, which is data security and paperless transfer of legal rights and obligations. Unfortunately, these issues are not effectively covered by a set of contracts only. Obviously, EDI or E-Commerce is based on the common business process and harmonized system of various data codes as well as the standard message formats. This essential feature of E-Commerce needs effective coordination of different divisions of business and tight control over credit arrangements in addition to the standard contract of sales. In a few word, information does not alway invite "trust". Credit flows from people, or close organizational tie-ups. It is our common understanding that, without well-orchestrated organizational arrangements made by leading companies, E-Commerce does not work well for paperless trade. With such arrangements well in place, participating E-business members do not need to seriously care for credit risk. Finally, it is also clear that E-International Commerce must be linked up with a set of government EDIs such as NACCS, Port EDI, JETRAS, etc, in Japan. Therefore, there is still a long way before us to go for E-Commerce in practice, not on the top of information manager's desk.

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Adaptation of Intravenous Infusion Nursing Practice Guideline (정맥주입요법 간호실무지침 수용개작)

  • Gu, Mee Ock;Cho, YoungAe;Cho, Myung Sook;Eun, Young;Jeong, Jae Sim;Jung, Ihn Sook;Lee, Young Geun;Kim, Mi Kyung;Kim, Eun Hyun;Kim, Ji Haei;Lee, Sun Hee;Kim, Hyun Lim;Yun, Hee Sook
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.1
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    • pp.128-142
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    • 2013
  • Purpose: This study was conducted to adapt the previously developed intravenous infusion guidelines with good quality for development of the evidence-based intravenous infusion nursing practice guideline in Korea. Methods: Guideline adaptation process was conducted according to guideline adaptation manual version 2.0 developed by NECA (Kim, Kim et al., 2011) which consisted of three main phases, 9 modules including a total of 24 steps. Results: Adapted intravenous infusion nursing practice guideline was consisted of 19 domains and 180 recommendations. The domains and number of recommendations in each domain were: general guide, 4; assessment, 1; vascular access device selection, 4;site selection, 14;site preparation, 5;site care, 29; maintaining patency, 11; blood sampling via vascular access, 4; vascular access device exchange and removal, 9; add-on device selection, 27; infusion related complications, 63; education, 7; and documentation and report, 2. There were 11.9% of A, 28.4% of B, 58.7% of C in grade of recommendations. Conclusion: Adapted intravenous infusion nursing practice guideline is expected to contribute providing an evidence based practice guides for intravenous infusion. The guideline is recommended to be disseminated to nurses nationwide to improve the efficiency of intravenous infusion practice.