• Journal of Korean Society of Water and Wastewater
• /
• v.27 no.1
• /
• pp.1-10
• /
• 2013

Major issues in water supply service have changed from expansion of service area to improvement of service quality, i.e., water quality and safety, and early response to emergency situation. This change in the service concept triggers the perceptions of limitation with the current centralized water supply system and of necessities of decentralized (distributed) water supply system (DWSS), which can make up the limitations. DWSS can reduce the possibility of water supply outage by establishing multiple barriers such as emergency water supply system, and secure better water quality by locating treatment facilities neighboring consumers. On the other hand, fluctuation of water demand will be increased due to the reduced supply area, which makes difficult to promptly respond the fluctuating demand. In order to supplement this, hybrid water supply system was proposed, which combined DWSS with conventional water supply system using distributing reservoir to secure the stability of water supply. The Optimal connection point of DWSS to existing water supply network in urban area was determined by simulating a supply network using EPANET. Optimal location of decentralized water treatment plant (or connection point) is a nodal point where changes in pressure at other nodal points can be minimized. At the same time, the optimal point should be selected to minimize hydraulic retention time in supply network (water age) to secure proper water quality. In order to locate the point where these two criteria are satisfied optimally, Distance measure method, one of multi-criteria decision making was employed to integrate the two results having different dimensions. This methodology can be used as an efficient decision-support criterion for the location of treatment plant in decentralized water supply system.

• Journal of Korean Medicine for Obesity Research
• /
• v.19 no.1
• /
• pp.31-41
• /
• 2019

Objectives: The purpose of this study was to investigate the effects of gender, age, body weight, muscle mass, fat mass, body mass index (BMI), metabolism, and compliance with medication on weight loss in obese adults. Methods: We reviewed the medical records of 178 patients who were visited to the Korean Oriental Clinic for 3~6 month and had obesity treatment using Gamitaeumjowee-tang from April 2017 to May 2017. We conducted a paired T-test, correlation coefficient and decision tree to analyze factors influencing obesity treatment. Results: The results of correlation analysis showed that initial weight (kg), initial fat mass (kg), BMI ($kg/m^2$), compliance with medication (%), Original Harris-Benedict Equation, Revised Harris-Benedict Equation and The Mifflin St Jeor Equation was significantly correlated to weight loss (kg) (P<0.001). As a result of constructing the decision tree model, it showed that over 5% weight loss of their initial weight (n=154) was related with initial BMI ($kg/m^2$), compliance with medication (%) and initial muscle mass (kg). In case of over 5 kg weight loss of their initial weight (n=131), it was related with initial BMI ($kg/m^2$), compliance with medication (%) and final BMI ($kg/m^2$). Conclusions: This study suggests that weight loss may be affected by initial factors and that initial factors can be used for obesity treatment.

• Journal of Korean Academy of Nursing
• /
• v.36 no.6
• /
• pp.1055-1064
• /
• 2006

Purpose: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. Method: This study used the process of Walker & Avant's concept analysis. Result: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. Conclusion: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.

• Genomics & Informatics
• /
• v.12 no.3
• /
• pp.121-126
• /
• 2014

Medication adherence is generally defined as the extent of voluntary cooperation of a patient in taking medicine as prescribed. Adherence to long-term treatment with chronic disease is essential for reducing disease comorbidity and mortality. However, medication non-adherence in chronic disease averages 50%. This study was conducted a genome-wide association study to identify the genetic basis of medication adherence. A total of 235 medication non-adherents and 1,067 medication adherents with hypertension or diabetes were used from the Korean Association Resource project data according to the self-reported treatment status of each chronic disease, respectively. We identified four single nucleotide polymorphisms with suggestive genome-wide association. The most significant single nucleotide polymorphism was rs6978712 (chromosome 7, $p=4.87{\times}10^{-7}$), which is located proximal to the GCC1 gene, which was previously implicated in decision-making capability in drug abusers. Two suggestive single nucleotide polymorphisms were in strong linkage disequilibrium ($r^2$ > 0.8) with rs6978712. Thus, in the aspect of decision-making in adherence behavior, the association between medication adherence and three loci proximal to the GCC1 gene seems worthy of further research. However, to overcome a few limitations in this study, defining the standardized phenotype criteria for self-reported adherence should be performed before replicating association studies.

• Journal of Medicine and Life Science
• /
• v.16 no.3
• /
• pp.80-83
• /
• 2019

First of all, this study shows the legal issues of hospice and palliative care, and the legal basis for lifelong medical practice is generally derived from medical, civil and criminal law regulations, and is applied to patients who are severely ill and dying in principle. In addition, those what is particularly meaningful about hospice and palliative care in terms of legal aspects are discussed the determination of the purpose of care and the provision of medical adaptability and adult guardianship, in particular the legal criteria for the work and status of patient representatives. As such, the purpose of care is to form part of the contract of care and to be agreed between the patient and the physician. In addition, the patient may not write to his/her agent in advance, and the patient may admit discretionary powers to his/her agent, but the patient's will is to be considered. In conclusion, the medical institutional ethics committee should play an active role, especially in the case of no-agents/family or no intention of the patient.

• Nuclear Engineering and Technology
• /
• v.40 no.5
• /
• pp.327-348
• /
• 2008

A risk-informed regulatory approach implies that risk insights be used as supplement of deterministic information for safety decision-making purposes. In this view, the use of risk assessment techniques is expected to lead to improved safety and a more rational allocation of the limited resources available. On the other hand, it is recognized that uncertainties affect both the deterministic safety analyses and the risk assessments. In order for the risk-informed decision making process to be effective, the adequate representation and treatment of such uncertainties is mandatory. In this paper, the risk-informed regulatory framework is considered under the focus of the uncertainty issue. Traditionally, probability theory has provided the language and mathematics for the representation and treatment of uncertainty. More recently, other mathematical structures have been introduced. In particular, the Dempster-Shafer theory of evidence is here illustrated as a generalized framework encompassing probability theory and possibility theory. The special case of probability theory is only addressed as term of comparison, given that it is a well known subject. On the other hand, the special case of possibility theory is amply illustrated. An example of the combination of probability and possibility for treating the uncertainty in the parameters of an event tree is illustrated.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.18 no.1
• /
• pp.7-10
• /
• 2007

Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. The treatment of unilateral vocal cord paralysis has a long history, marked by technical innovations and improvements. These methods typically use endoscopic injection or implants to augment the volume of the affected vocal fold. The first known treatment, reported by Brunnings in 1911, was paraffin injection. The first thyroplasty medializing the paralysed vocal cord was performed by Payr in 1915 ; here, a cartilage door-flap was created from the thyroid ala to obtain better voice quality. In the 1970s, Isshiki systematized and developed the use of the external medialization by Payr. Later he modified his original technique, and achieved safer and better results. Many other methods were introduced for external medialization during the 1980s and 1990s. There has been couple of materials using for medialization laryngoplasty: silicone bloc, cartilage, goretex (polytetrafluoroethylene), titanium, etc. Among them, silicone bloc is the most popularly used material. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralysed vocal fold. In this paper, personal experience for using silicone bloc type I thyroplasty : decision making and practical points, long-term results and complication of the procedure will be discussed.

• Journal of Electrochemical Science and Technology
• /
• v.13 no.1
• /
• pp.1-18
• /
• 2022

Persistent organic pollutants (POPs) and emerging pollutants (EP) are characterized by their difficulty to be removed through biological oxidation processes (BOPs); they persist in the environment and could have adverse effects on the aquatic ecosystem and human health. The electro-oxidation (EO) process has been successfully used as an alternative technique to oxidize many kinds of the aforementioned pollutants in wastewater. However, the EO process has been criticized for its high energy consumption cost and its potential generation of by-products. In order to decrease these drawbacks, its combination with biological oxidation processes has been reported as a solution to reduce costs and to reach high rates of recalcitrant pollutants removal from wastewaters. Thus, the location of EO in the treatment line is an important decision to make, since this decision affects the formation of by-products and biodegradability enhancement. This paper reviews the advantages and disadvantages of EO as a pre and post-treatment in combination with BOPs. A perspective of the EO scale-up is also presented, where hydrodynamics and the relationship of A/V (area of the electrode/working volume of the electrochemical cell) experiments are examined and discussed.

• Journal of Korean society of Dental Hygiene
• /
• v.20 no.3
• /
• pp.369-378
• /
• 2020

Objectives: The purpose of this study is to examine the correlation between the critical thinking disposition of dental hygienists and the variables associated with clinical decision making and job performance to analyze factors affecting job performance. Methods: A questionnaire survey was administered to 166 dental hygienists from June 24 to August 8, 2019. We analyzed results with t-test, Mann-Whitney U test, ANOVA, Pearson's correlation analysis and a multiple regression analysis using the SPSS Windows version 23.0(SPSS Inc. IL, USA). Results: Critical thinking disposition was the highest for open-mindedness and clinical decision making ranked highest for canvassing of objectives and values. Job performance ranked highest in terms of assist with dental treatment. Factors affecting dental hygienists' job performance were clinical decision making and critical thinking disposition(p<0.001, adj. R² =31.4). Conclusions: It is expected that this study will provide basic data for the development of programs to enhance the job performance of dental hygienists. Furthermore, it is necessary to actively support plans such as conducting seminars at dental institutions and providing educational participation opportunities.

• Journal of muscle and joint health
• /
• v.20 no.3
• /
• pp.197-206
• /
• 2013

Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.