• Title/Summary/Keyword: decision problem

Search Result 2,277, Processing Time 0.038 seconds

Evaluation of shade guide using digital shade analysis system (색조 선택 시스템을 이용한 shade guide의 색조 분석)

  • Lee, Seung-Taek;Lee, Jong-Hyuk;Shin, Soo-Yeon
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.47 no.1
    • /
    • pp.1-11
    • /
    • 2009
  • Statement of problem: There are two methods of color choice for the esthetic restoration. One is visual shade matching which draws a comparison between shade guide and teeth in dentist's own eye and the other is using a digital shade analysis system recently introduced. Although the visual shade matching has a lot of problems, decision of color by this visual shade matching and the ways of expression for the decided color are still applicable to clinical dentistry. Purpose: This study is designed to investigate shade guides used in the dental clinics and laboratories have the same value using ShadeEye-$NCC^{(R)}$ dental chroma meter (Shofu Inc., Kyoto, Japan) using shade guide are evaluated. Material and methods: At the first experiment, eight Vita Lumin Vacuum shade guides (Vident Inc., California, USA) were collected from the dental clinics. A1 and B1 shade tabs are chosen and the colors are analyzed five times each in both tooth and porcelain modes by digital shade analysis system, ShadeEye-$NCC^{(R)}$. In the second experiment, twelve Vita shade guides using practically in the dental clinics and laboratories were collected and also A1 and B1 shade tabs are chosen and the colors of A1 and B1 are analyzed one time each in both tooth and porcelain modes by ShadeEye-$NCC^{(R)}$. Results and conclusion: There were significant differences among eight shade guides in terms of shade (chroma), value and hue in both of A1 and B1 (P<.05). Shade guides using in present both dental clinics and laboratories did not show significant differences, except A1 in the porcelain mode, it showed significant differences (P<.05) in the shade even though the shade tab has the same name.

The Development and Effectiveness of a PBL Based Career Education Program (PBL 기반 진로교육 프로그램의 개발 및 효과검증)

  • Lee, Hye-Suk;Kim, You-Me
    • The Korean Journal of Elementary Counseling
    • /
    • v.8 no.1
    • /
    • pp.33-50
    • /
    • 2009
  • The purpose of this study was to develop a PBL-based career education program and to examine its effectiveness on school children's career maturity. It's specifically meant to prepare a career education program to assist students to get an accurate grip on their aptitude, interest and personality and explore various sorts of occupations in the course of solving authentic and contextual career-related problems. After children's developmental characteristics and needs were analyzed, task analysis was implemented, and the objectives were defined. And then the core of the program, PBL problems were developed, and the validity of the problems were verified Evaluation plans and tools were prepared to assess children's problem-solving process and presentation, and an online learning space was designed. The program that consisted of 10-minute 21 sessions was provided to fifth-grade elementary schoolers for eight weeks. The findings of the study were as follows: The experimental group that participated in the PBL-based career education program showed a more significant improvement than the control group that didn't in career attitude and three career attitude subfactors involving planness, disposition and compromise. And the former made a more significant progress than the latter in career ability and its subfactors including vocational comprehension, self-understanding and decision-making skills as well. As a result of making a content analysis to make up for the survey, the students reported that they were able to get an objective understanding of themselves and acquire diverse and profound knowledge on work and the business world in the middle of solving the given PBL problems related to different areas in group and giving a presentation. In conclusion, a PBL based career education program developed by this researcher encouraged the students to have an objective self-understanding, to have a dynamic interactive discussion with their group members. Therefore the program had a positive impact on boosting the career attitude and career ability of the elementary schoolers. The findings suggested that in the field of elementary career education, autonomous learning attitude and subjecthood are the crucial factors to stimulate school children to explore and create their own future.

  • PDF

The Effects of Psychological Contract Violation on OS User's Betrayal Behaviors: Window XP Technical Support Ending Case (심리적 계약 위반이 OS이용자의 배신 행동에 미치는 영향: 윈도우 XP 기술적 지원서비스 중단 사례)

  • Lee, Un-Kon
    • Asia pacific journal of information systems
    • /
    • v.24 no.3
    • /
    • pp.325-344
    • /
    • 2014
  • Technical support of Window XP ended in March, 8, 2014, and it makes OS(Operating System) users fall in a state of confusion. Sudden decision making of OS upgrade and replacement is not a simple problem. Firms need to change the long term capacity plan in enterprise IS management, but they are pressed for time and cost to complete it. Individuals can not help selecting the second best plan, because the following OSs of Window XP are below expectations in performances, new PC sales as the opportunities of OS upgrade decrease, and the potential risk of OS technical support ending had not announced to OS users at the point of purchase. Microsoft as the OS vendors had not presented precaution or remedy for this confusion. Rather, Microsoft announced that the technical support of the other following OSs of Wndow XP such as Window 7 would ended in two years. This conflict between OS vendor and OS users could not happen in one time, but could recur in recent future. Although studies on the ways of OS user protection policy would be needed to escape from this conflict, few prior studies had conducted this issue. This study had challenge to cautiously investigate in such OS user's reactions as the confirmation with OS user's expectation in the point of purchase, three types of justice perception on the treatment of OS vendor, psychological contract violation, satisfaction and the other betrayal behavioral intention in the case of Window XP technical support ending. By adopting the justice perception on this research, and by empirically validating the impact on OS user's reactions, I could suggest the direction of establishing OS user protection policy of OS vendor. Based on the expectation-confirmation theory, the theory of justice, literatures about psychological contract violation, and studies about consumer betrayal behaviors in the perspective of Herzberg(1968)'s dual factor theory, I developed the research model and hypothesis. Expectation-confirmation theory explain that consumers had expectation on the performance of product in the point of sale, and they could satisfied with their purchase behaviors, when the expectation could have confirmed in the point of consumption. The theory of justice in social exchange argues that treatee could be willing to accept the treatment by treater when the three types of justice as distributive, procedural, and interactional justice could be established in treatment. Literatures about psychological contract violation in human behaviors explains that contracter in a side could have the implied contract (also called 'psychological contract') which the contracter in the other side would sincerely execute the contract, and that they are willing to do vengeance behaviors when their contract had unfairly been broken. When the psychological contract of consumers had been broken, consumers feel distrust with the vendors and are willing to decrease such beneficial attitude and behavior as satisfaction, loyalty and repurchase intention. At the same time, consumers feel betrayal and are willing to increase such retributive attitude and behavior as negative word-of-mouth, complain to the vendors, complain to the third parties for consumer protection. We conducted a scenario survey in order to validate our research model at March, 2013, when is the point of news released firstly and when is the point of one year before the acture Window XP technical support ending. We collected the valid data from 238 voluntary participants who are the OS users but had not yet exposed the news of Window OSs technical support ending schedule. The subject had been allocated into two groups and one of two groups had been exposed this news. The data had been analyzed by the MANOVA and PLS. MANOVA results indicate that the OSs technical support ending could significantly decrease all three types of justice perception. PLS results indicated that it could significantly increase psychological contract violation and that this increased psychological contract violation could significantly reduce the trust and increase the perceived betrayal. Then, it could significantly reduce satisfaction, loyalty, and repurchase intention, and it also could significantly increase negative word-of-month intention, complain to the vendor intention, and complain to the third party intention. All hypothesis had been significantly approved. Consequently, OS users feel that the OSs technical support ending is not natural value added service ending, but the violation of the core OS purchase contract, that it could be the posteriori prohibition of OS user's OS usage right, and that it could induce the psychological contract violation of OS users. This study would contributions to introduce the psychological contract violation of the OS users from the OSs technical support ending in IS field, to introduce three types of justice as the antecedents of psychological contract violation, and to empirically validate the impact of psychological contract violation both on the beneficial and retributive behavioral intentions of OS users. For practice, the results of this study could contribute to make more comprehensive OS user protection policy and consumer relationship management practices of OS vendor.

Cardiac Intracoronary Stenting vs CABG: Prevention of Medical Accident (심장 스텐트 시술과 의료사고 예방)

  • Kim, Kyoung Reay;Park, Kook Yang
    • The Korean Society of Law and Medicine
    • /
    • v.18 no.2
    • /
    • pp.163-194
    • /
    • 2017
  • Coronary artery disease has increased in Korea as the country enters the aged society. It is well known that the incidence of coronary artery disease is related to aging, hypertension, diabetes, hyperlipidemia, and dietary habit. For effective treatment of significant coronary stenosis, close coordination between cardiac surgery and cardiology team is essential. Especially cardiologists' decision whether to do the stent placement or CABG is very important because the cardiologists usually start to consult the patients for their treatment. Recently, non-surgical interventions(that is stent placement) in cardiology field have dramatically increased as the national insurance system removed the limitation of the number of stents deployed. However, accidents are often caused by inappropriate use of stents, especially in patients with triple coronary disease or left main disease with heavy coronary calcifications. Another aspect of stent placement is to cope with an emergency case in the event of coronary rupture or pericardial tamponade during coronary interventions without cardiac surgeons. In the past two years, the Korea Consumer Agency (Consumer Dispute Coordination Committee) analyzed eight cases of medical dispute settlement. Only two hospitals were manned with both cardiologists and cardiac surgeons. Seven patients died of procedures of stenting and five patients died on the day of the procedure. Among the 8 cases, 5 cases showed 3 vessel disease and the rest of the cases had either severe calcification, complete occlusion or poor coronary antomies for stenting According to a 2017 national data registry of coronary stenting, less than 3 drug-eluting stents were implanted in 98% of all patients. In 2015, the number of stent procedures was 38,922, and approximately in 800 (2%) cases, more than four stents were used per patient. We emphasize that it is necessary to seriously consider the cost-benefit analysis between stent and CABG. The patient has the right to choose the right procedure by asking the liability of 'instruction explanation obligation'. He should be well informed of the pros and cons of both procedures to avoid overuse of stent. It can be solved by intimate discussion of individual cases with the cardiac surgeon and the patient. Unilateral dialogue with the patient, forceful restriction on the number of stenting, lack of surgeon's backup in difficult cases should all be avoided. It is also necessary to solve the problem not only at the hospital level, such as multidisciplinary integrated medical care, but also a nationwide solution such as expanding cardiac surgeons as essential personnel to public officials.

  • PDF

FEA estimates of margin design in all ceramic crowns (완전 도재관을 위한 지대치 형성시 변연 형태에 따른 응력 분포의 유한요소법적 비교)

  • Han, Sang-Hyun;Cho, Jung-Hyeon;Lee, En-Jung;Jeong, Suk-In;Oh, Nam-Sik
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.46 no.1
    • /
    • pp.1-11
    • /
    • 2008
  • Statement of problem: Over the past decade, increased demand for esthetically pleasing restorations has led to the development of all-ceramic systems. Recent reports suggest that the all-ceramic crowns have excellent physical properties, wear resistance, and color stability. In addition, numerous ceramics have excellent biocompatibility, a natural appearance, and improved physical bonding with resin composite luting agents. However, the brittle nature of ceramics has been a major factor in their restriction for universal usage. Functional occlusal loading can generate stress in the luting agent, and the stress distribution may be affected by the marginal geometry at the finish line. Tooth preparation for fixed prosthodontics requires a decision regarding the marginal configuration. The design dictates the shape and bulk of the all ceramic crowns and influences the fit at the margin. Purpose: The purpose of this study was to evaluate the stress distribution within marginal configurations of all- ceramic crowns (90-degree shoulder, 110-degree shoulder, 135-degree shoulder). Material and methods: The force is applied from a direction of 45 degrees to the vertical tooth axis. Three-dimensional finite element analysis was selected to determine stress levels and distributions. Results and conclusion: The result of stress level for the shoulder marginal configuration was more effective on stress distribution at 135-degree shoulder margin. But the stresses concentrated around at 135-degree shoulder margin. The stress decreased apically at the surface between cements and alumina core, and increased apically at the surface between alumina core and veneering porcelain.

Operative treatment for Proximal Humeral Fracture (상완골 근위부 골절의 수술적 요법)

  • Park Jin-Young;Park Hee-Gon
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.2 no.2
    • /
    • pp.168-175
    • /
    • 2003
  • Fracture about proximal humerus may be classified as the articular segment or the anatomical neck, the greater tuberosity, the lesser tuberosity, and the shaft or surgical neck. Now, usually used, Neer's classification is based on the number of segments displaced, over 1cm of displaced or more than 45 degrees of angulation , rather than the number of fracture line . Absolute indication of a operative treatment a open fracture, the fracture with vascular injury or nerve injury , and unreductable fracture-dislocation . Inversely, the case that are severe osteoporosis, and eldly patient who can't be operated by strong internal fixation is better than arthroplasty used by primary prosthetic replacement and early rehabilitation program than open reduction and internal fixation. The operator make a decision for the patient who should be taken the open reduction and internal fixation, because it's different that anatomical morphology, bone density, condition of patient. The operator decide operation procedure. For example, percutaneous pinning, open reduction, plate & screws, wire tension bands combined with some intramedullary device are operation procedure that operator can decide . The poor health condition for other health problem, fracture with unstable vital sign and severe osteoporosis , are the relative contraindication. The stable fracture without dislocation is not the operative indication . The radiologic film of the prokimal humerus before the operation can not predict for fracture evaluation. It's necessary to good radiologic film for evaluation of fracture form. The trauma serise is better than the other radiologic film for evaluation. The accessary radiologic exam is able to help for evaluation of bone fragment and anatomy. The CT can be helpful in evaluating these injury, especially if the extract fracture type cannot be determined from plain roenterogram of the proximal humerus, bone of humerus head. If the dislocation is severe anatomically , we could consider to do three dimentional remodelling. The MRI doing for observing of bony morphology before the operation is not better than CT If we were suspicious of vascular injury, we could consider the angiography.

  • PDF

Health Economic Approach to End-of-Life Care in the US: Based on Medicare (말기의료의 경제적 요소에 관한 논의: 미국 메디케어 상황을 중심으로)

  • Suk, Ryan
    • The Korean Society of Law and Medicine
    • /
    • v.15 no.1
    • /
    • pp.335-373
    • /
    • 2014
  • According to one Medicare report, in the US, total federal spending on health care expends almost 18 percent of the nation's GDP, about double what most industrialized nations spend on health care. And in 2011, Medicare spending reached close to $554 billion, which amounted to 21 percent of the total spent on U.S. health care in that year. Of that $554 billion, Medicare spent 28 percent, or about $170 billion, on patients' last six months of life. So what are the reasons of this high cost in EOL care and its possible solutions? Much spendings of Medicare on End-of-Life care for the terminally ill/chronically ill in the US has led health economics experts to assess the characteristics of the care. Decades of study shows that EOL care is usually supply-sensitive and poor in cost-effectiveness. The volume of care is sensitively depending on the supply of resources, rather than the severity of illness or preferences of patients. This means at the End-of-Life care, the medical resources are being overused. On the other hand, opposed to the common assumption, "The more care the better utility", the study shows that the outcome is very poor. Actually the patient preference and concerns are quite the opposite from what intense EOL care would bring about. This study analyzes the reasons for the supply-sensitiveness of EOL care. It can be resulted from the common misconception about the intense care and the outcome, physicians' mission for patients, lack of End-of-Life Care Decision which helps the patients choose their own preferred treatment intensity. It also could be resulted from physicians' fear of legal liabilities, and the management strategy since the hospitals are also seeking for financial benefits. This study suggests the possible solutions for over-treatment at the End-of-Life resulting from supply-sensitiveness. Solutions can be sought in two aspects, legal implementation and management strategy. In order to implement advance directive properly, active ethics education for physicians to change their attitude toward EOL care and more conversations about end-of-life care between physicians and patients is crucial, and incentive system for the physicians who actively have the conversations with patients will also help. Also, the general education towards the public is also important in the long run, and easy and official advance directive registry system-such as online registry-has to be built and utilized more widely. Alternative strategies in management are also needed. For example, the new strategic cost management and management education, such as cutting unnecessary costs and resetting values as medical providers have to be considered. In order to effectively resolve the problem in EOL care for the terminally ill/chronically ill and provide better experience to the patients, first of all, the misconception and the wrong conventional wisdom among doctors, patients, and the government have to be overcome. And then there should be improvements in systems and cultures of the EOL care.

  • PDF

Study of Radiological Approach to Treat a Chronic Constipation (만성변비환자의 방사선학적 접근방법에 관한 고찰)

  • Yoon, Seok-Hwan
    • Journal of radiological science and technology
    • /
    • v.27 no.3
    • /
    • pp.5-12
    • /
    • 2004
  • I. Introduction : The constipation is one of the common gastrointestinal symptoms seen in the clinical practice. When people come to the clinic complaining of the constipation, it is generally one of the cases of infrequent, painful or difficult evacuation as well as the hardened feces and unsatisfactory evacuation sense. Since the constipation is heavily influenced by dietary habit as well as the social and medical environment, the diagnostic radiology is useful to establish the objective and standardized definition in consideration of those various factors before diagnosis and treatment of the constipation patient. This paper describes the study of such diagnosis. II. Main Subject : Testing of CTT (colon transit time) is key study of the colon performance. CTT is very helpful in classifying the pathologic physiological types and defining the treatment plan for the chronic constipation. The study methods include using the radipaque marker, multiple marker technique and scintigraphic measurement. The defecography is the functional radiologic examination a that provides not only the anatomical information of anorectal but also performance of the pelvic floor and rectal change during evacuation. Study of dynamic movement of the anorectal during evacuation is helpful for diagnosis and treatment planning as well as follow-up testing for the constipation patient. One of the issues essential for the case history is the thorough observation of whether the patient shows the psychic psychological symptoms such as the behavior disorder or emotional disturbance. In that case, the decision must be made whether or which type of medication is needed for such psychiatric problem. III. Conclusion : The main causes of the constipation are insufficient intake of fiber or liquid. The key objective of such tests is to check etiology of the constipation. In general, the radiological examination does not provde the colon or anorectal performance information. It is envisaged that this study will provide the information to decide the testing and treatment plans and predict the prognosis of the patient by classifying the pathologic physiological types.

  • PDF

The Development of a Model for Selecting Method of Entry for Apartment in Remodeling an Underground Parking Lot (지하주차장 리모델링 공사시 주동진입방법 선정 모델 개발)

  • Song, Nak-Hyun;Jung, In-Su;Lee, Chan-Sik
    • Korean Journal of Construction Engineering and Management
    • /
    • v.10 no.2
    • /
    • pp.65-74
    • /
    • 2009
  • It is expected that the number of apartment complexes in Korea that are over 20 years old will rapidly increase to more than 3,500,000. Consequently, the remodeling of these buildings is being revitalized throughout the country. Among the requirements for such remodeling, the expansion of parking lots has considerable weight. When enlarging a parking lot, the access route from an underground floor to the main building (i.e., the means of entry into the main building) determines the possibility of vertical enlargement for elevators, the size of the parking lot, the construction period, and construction expenses, etc. When enlarging an underground parking lot of an apartment complex, the access between the main building and the parking lot, as well as the inhabitants' requirements for entering the main building, are generally determined based on the designer's experience, rather than on the exact estimation of the peculiarity of the complex. In order to resolve such a problem, when enlarging an underground parking lot, a systematic and rational method is needed for selecting the means of entry into the main building. In this study, a selection model is derived for the method of selecting an access route into the main building when constructing an underground parking lot, in order to provide a reasonable decision-making process. A research method was investigated for determining the access route into the main building when enlarging a parking lot. On the basis of research carried out through in-depth interviews with experts, the characteristics for each means of entry into the main building were analyzed and the factors affecting the selection of the access route were deduced. The affecting factors selected were construction efficiency, convenience efficiency and economic efficiency. Weight values were then estimated for the selected affecting factors by applying the AHP method. Results showed that convenience efficiency, which gained the highest value, is the most important factor in selecting the means of entry into the main building. The most suitable means of entry into the main building was also suggested after estimating the applicability of the site by selecting complexes with remodeling possibility. This study will be applied as a reference for selecting the means of entry into the main building when constructing an underground parking lot particularly for older apartment complexes.

A Study on Comparison and Analysis of Civic Education in Place for Children -A Case Study on the United States, Britain, Finland, Japan, and South Korea- (어린이 공간교육의 국내외 사례 비교연구 -미국, 영국, 핀란드, 일본, 한국의 사례를 중심으로-)

  • Hue, Youn-Sun;Im, Seung-Bin
    • Journal of the Korean Institute of Landscape Architecture
    • /
    • v.39 no.2
    • /
    • pp.40-51
    • /
    • 2011
  • Recently, the public's interest in quality of life and good design has increased, and the opportunities for their participation in space planning and the design process are expanding. However, the public still lacks understanding of the role(and importance) of space and environment and is not experienced in expressing their opinion on improving the urban environment. At this point, 'Built Environment Education for Kids' will be the key to understanding space and environment as future citizens and to developing the ability of problem-solving and expressing their opinions. This study aims to change the awareness of the public as well as experts, and to make a better urban space through comparison and analysis of domestic and foreign 'Built Environment Education.' In 27 countries around the world(more than 110 institutions), 'Built Environment Education' from childhood is being implemented. Such movements aim to make people participate in the space design and decision-making process by understanding a fundamental element of the built environment and space perception. In this study, the United States, Britain, Finland, Japan and South Korea's 'Built Environment Education' are discussed Above all, the definition, range and target of 'Built Environment Education' are discussed For each case, the purpose and effect, laws and educational processes, systems and roles, and examples of programs are analyzed. Through reviewing each attribute and their implications, a conclusion is drawn on the aspects we have to consider in laying the foundation for implementing the 'Built Environment Education' in Korea, such as consideration of the locality, organizing systematic networks and composing a pool of experts, building proper institutions, and establishing the role of the government. This case study of 'Built Environment Education' can help increase the awareness of the public and build their strength in establishing a better future space. Through the analysis of the purpose, laws, systems, and contents, this case study is expected to provide and build the foundation for an educational system and develop an appropriate program that best suits our society.