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Refusal of care by chronically and terminally ill patients : An ethical problem faced by nurses (간호사의 간호 제공 의무와 말기 환자의 간호 거부에 관련된 윤리 문제에 관한 연구)

  • 엄영란;홍여신
    • Journal of Korean Academy of Nursing
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    • v.24 no.2
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    • pp.190-205
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    • 1994
  • Respect for human life and respect for human dignity are two basic values to which organized nursing has urged its members to adhere in their service to mankind. Thus it is the nurses’ duty to provide health care in support of sustenance of life and to pay respect for the patient’s right to dignity. In practice, however, nurses may experience dilemmas between these duties much due to the de velopment of modern advanced techniques. These dilemmas have become more complex and difficult to resolve. Nurses are often faced with situations in which the terminally ill refuse professional care, posing serious conflicts between respect for human life and respect for human rights to self-determination. In such cases, resolution of the problem is not a simple matter, thus requires intensive study into the ethical questions related to the situation. The purpose of this study was to identify ethical problems that nurses experience in caring for terminally ill patients and explore the ways to the resolution of problems within the context of the situations. The methodology used for the study was a case study method which ‘New Casuistry’ proposed by Jonsen & Toulmin(1988) and the ‘Specified Principlism’ proposed by Degrazia(1992) as an alternative to old deductive and intuitive method. Cases were developed through semistructured indepth interviews according to the casutistry method. A total of seven nurses were interviewd who were caring for therminally ill patients. Four cases out of a total 14 cases were related to the topic. Through the case analysis it became evident that nurses appreciated other values more often than respect for the patient’s right to self-determination. These other values were convenience and efficiency in nursing practice in case 1, preservation of life above all other values in case 2, provision of nursing care to fulfill the nurse’s professional obligation at most in case 3, and respect for the family’s demand against the patient’s wish in case 4. This study showed that the most important ethical problems were conflict between respect for the patient’s right to self-determination and sustenance of life for the fulfillment of professional obligation. For this problem, benefit /burden analysis from the perspective of the patient and family for the promotion of patient’s wellbeing may be a way to resolve the conflict. Further, through these analysis it was shown that physicians’ and families’ opinions dominated in the decision - making and the opinions of nurses’ and patients’ tended not to be reflected. Thus the patient's right to his or her care was not readily respected. To solve this problem. nurses should make efforts to communicate reciprocally with their patients, family members and physicians in an effort to respect for their patient’s rights to life and diginity from the point of view and values of the patient. It is also important that nurses provide good basic nursing care up to the time of death regardless of decisions about providing or not aggressive treat-ment for chronically and terminally ill patients.

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Estimating Method of Starting Point Bias in Bidding Game (서베이를 이용한 입찰게임에서 출발점 편의의 추정)

  • 박용치
    • Survey Research
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    • v.4 no.2
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    • pp.63-86
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    • 2003
  • The objective of this study was to investigate the existence of starting point bias in the bidding game contingent valuation elicitation technique when determining willingness to pay (WTP) for improving the qualify of running water in Seoul and its vicinity. Of all existing contingent techniques, the bidding game most closely mimics the normal price taking behavior in local markets. Three different starting points (low, medium and high) were used to determine WTP and the existence of starting point bias in the meanwhile respectively. The respondents were randomly assigned to the three different starting point groups in order to ensure homogeneity, so that any variation seen in WTP could be attributed to the starting point effects. And a pretested interviewer-administered questionnaire used to elicit WTP. Non-parametric test and the logit model were used to analyze the data for evidence of starting point bias. In this instance, the high starting point group had a high WTP, and low starting point group had a low WTP. This means there exist starting point bias in estimating WTP by bidding game in this instance. This finding might signal that people may actually be making up their minds on the maximum amount they are willing to pay for running water service as a bidding iterating is going on and is influenced by the starting point used in the bidding game. The problem of slaking point bias can be avoided if the respondent is asked directly for the maximum WTP without payment cards or a bidding game. But such a question is perceived as being very difficult to answer and this leads to problems of non-response and being unrealistic.

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Geotechnical Engineering Progress with the Incheon Bridge Project

  • Cho, Sung-Min
    • Proceedings of the Korean Geotechical Society Conference
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    • 2009.09a
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    • pp.133-144
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    • 2009
  • Incheon Bridge, 18.4 km long sea-crossing bridge, will be opened to the traffic in October 2009 and this will be the new landmark of the gearing up north-east Asia as well as the largest & longest bridge of Korea. Incheon Bridge is the integrated set of several special featured bridges including a magnificent cable-stayed girder bridge which has a main span of 800 m width to cross the navigation channel in and out of the Port of Incheon. Incheon Bridge is making an epoch of long-span bridge designs thanks to the fully application of the AASHTO LRFD (load & resistance factor design) to both the superstructures and the substructures. A state-of-the-art of the geotechnologies which were applied to the Incheon Bridge construction project is introduced. The most Large-diameter drilled shafts were penetrated into the bedrock to support the colossal superstructures. The bearing capacity and deformational characteristics of the foundations were verified through the world's largest static pile load test. 8 full-scale pilot piles were tested in both offshore site and onshore area prior to the commencement of constructions. Compressible load beyond 30,000 tonf pressed a single 3 m diameter foundation pile by means of bi-directional loading method including the Osterberg cell techniques. Detailed site investigation to characterize the subsurface properties had been carried out. Geotextile tubes, tied sheet pile walls, and trestles were utilized to overcome the very large tidal difference between ebb and flow at the foreshore site. 44 circular-cell type dolphins surround the piers near the navigation channel to protect the bridge against the collision with aberrant vessels. Each dolphin structure consists of the flat sheet piled wall and infilled aggregates to absorb the collision impact. Geo-centrifugal tests were performed to evaluate the behavior of the dolphin in the seabed and to verify the numerical model for the design. Rip-rap embankments on the seabed are expected to prevent the scouring of the foundation. Prefabricated vertical drains, sand compaction piles, deep cement mixings, horizontal natural-fiber drains, and other subsidiary methods were used to improve the soft ground for the site of abutments, toll plazas, and access roads. Light-weight backfill using EPS blocks helps to reduce the earth pressure behind the abutment on the soft ground. Some kinds of reinforced earth like as MSE using geosynthetics were utilized for the ring wall of the abutment. Soil steel bridges made of corrugated steel plates and engineered backfills were constructed for the open-cut tunnel and the culvert. Diverse experiences of advanced designs and constructions from the Incheon Bridge project have been propagated by relevant engineers and it is strongly expected that significant achievements in geotechnical engineering through this project will contribute to the national development of the longspan bridge technologies remarkably.

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Smart Farm Expert System for Paprika using Decision Tree Technique (의사결정트리 기법을 이용한 파프리카용 스마트팜 전문가 시스템)

  • Jeong, Hye-sun;Lee, In-yong;Lim, Joong-seon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.10a
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    • pp.373-376
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    • 2018
  • Traditional paprika smart farm systems are often harmful to paprika growth because they are set to follow the values of several sensors to the reference value, so the system is often unable to make optimal judgement. Using decision tree techniques, the expert system for the paprika smart farm is designed to create a control system with a decision-making structure similar to that of farmers using data generated by factors that depend on their surroundings. With the current smart farm control system, it is essential for farmers to intervene in the surrounding environment because it is designed to follow sensor values to the reference values set by the farmer. To solve this problem even slightly, it is going to obtain environmental data and design controllers that apply decision tree method. The expert system is established for complex control by selecting the most influential environmental factors before controlling the paprika smart farm equipment, including criteria for selecting decisions by farmers. The study predicts that each environmental element will be a standard when creating smart farms for professionals because of the interrelationships of data, and more surrounding environmental factors affecting growth.

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Developmental disability Diagnosis Assessment Systems Implementation using Multimedia Authorizing Tool (멀티미디어 저작도구를 이용한 발달장애 진단.평가 시스템 구현연구)

  • Byun, Sang-Hea;Lee, Jae-Hyun
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.3 no.1
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    • pp.57-72
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    • 2008
  • Serve and do so that graft together specialists' view application field of computer and developmental disability diagnosis estimation data to construct developmental disability diagnosis estimation system in this Paper and constructed developmental disability diagnosis estimation system. Developmental disability diagnosis estimation must supply information of specification area that specialists are having continuously. Developmental disability diagnosis estimation specialist system need multimedia data processing that is specialized little more for developmental disability classification diagnosis and decision-making and is atomized for this. Characteristic of developmental disability diagnosis estimation system that study in this paper can supply quick feedback about result, and can reduce mistake on recording and calculation as well as can shorten examination's enforcement time, and background of training is efficient system fairly in terms of nonprofessional who is not many can use easily. But, as well as when multimedia information that is essential data of system construction for developmental disability diagnosis estimation is having various kinds attribute and a person must achieve description about all developmental disability diagnosis estimation informations, great amount of work done is accompanied, technology about equal data can become different according to management. Because of these problems, applied search technology of contents base (Content-based) that search connection information by contents of edit target data for developmental disability diagnosis estimation data processing multimedia data processing technical development. In the meantime, typical access way for conversation style data processing to support fast image search, after draw special quality of data by N-dimension vector, store to database regarding this as value of N dimension and used data structure of Tree techniques to use index structure that search relevant data based on this costs. But, these are not coincided correctly in purpose of developmental disability diagnosis estimation because is developed focusing in application field that use data of low dimension such as original space DataBase or geography information system. Therefore, studied save structure and index mechanism of new way that support fast search to search bulky good physician data.

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3D Precision Measurement of Scanning Moire Using Line Scan Camera (라인스캔 카메라를 이용한 3차원 정밀 측정)

  • Kim, Hyun-Ju;Yoon, Doo-Hyun;Kim, Hak-Il
    • Korean Journal of Optics and Photonics
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    • v.19 no.5
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    • pp.376-380
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    • 2008
  • This paper presents the Projection Moire method using a line scan camera. The high resolution feature of a line scan camera makes it possible to scan an image quickly, thus enabling a much quicker 3D profile. This method uses a high resolution line scan camera making it possible to scan an image at high speed simultaneously measuring the 3D profile of a large FOV. When using a high resolution scan camera, a full FOV is scanned, thus requiring just one movement of a projection grating. As a result, the number of grating movements is reduced drastically. The end result is a faster and more accurate 3D measurement. Moving the grating too quickly causes vibration in the imaging system, which will normally be required to apply a stitching technique when using an area scan camera. However the technique is not required when using a line scan camera. Compared with the previous techniques, it has the advantages of simple hardware without moving mechanical parts - single exposure for obtaining three-dimensional information. A method using a high resolution line scan camera can be used in mass production to measure the bump height of wafers or the bump height of package substrates.

Development and Application of a Big Data Platform for Education Longitudinal Study Analysis (교육종단연구 분석을 위한 빅데이터 플랫폼 개발 및 적용)

  • Park, Jung;Cho, Wan-Sup
    • The Journal of Bigdata
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    • v.5 no.1
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    • pp.11-27
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    • 2020
  • In this paper, we developed a big data platform to store, process, and analyze effectively on such education longitudinal study data. And it was applied to the Seoul Education Longitudinal Study(SELS) to confirm its usefulness. The developed platform consists of data preprocessing unit and data analysis unit. The data preprocessing unit 1) masking, 2) converts each item into a factor 3) normalizes / creates dummy variables 4) data derivation, and 5) data warehousing. The data analysis unit consists of OLAP and data mining(DM). In the multidimensional analysis, OLAP is performed after selecting a measure and designing a schema. The DM process involves variable selection, research model selection, data modification, parameter tuning, model training, model evaluation, and interpretation of the results. The data warehouse created through the preprocessing process on this platform can be shared by various researchers, and the continuous accumulation of data sets makes further analysis easier for subsequent researchers. In addition, policy-makers can access the SELS data warehouse directly and analyze it online through multi-dimensional analysis, enabling scientific decision making. To prove the usefulness of the developed platform, SELS data was built on the platform and OLAP and DM were performed by selecting the mathematics academic achievement as a measure, and various factors affecting the measurements were analyzed using DM techniques. This enabled us to quickly and effectively derive implications for data-based education policies.

Factors Required to Sustain Pastoral Farming Systems and Forage Supply In Winter-Cold Zones in Korea (한국의 동계한냉지역에 있어서 초지개발과 조사료 공급의 활성화에 필요한 요인)

  • 김동암
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.12 no.3
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    • pp.30-40
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    • 1992
  • The area of grassland established and the arable land in forage production have been decreased recently in Korea. As a result, forages available from the grassland and the arable land provided only 40% of the total roughage consumed by cattle in 1991, compared with 54% in 1989. The decreasing trend of the forage production has been impinged on by a number of legislative. socio-economic. technical and other constraints negatively affecting grassland and forage development. Consequently. effective systems and strategies are quite necessary to have sustainable grassland farming in Korea. In spring and autumn, temperatures are too low for subtropical forage crops, and the summer monsoon climate is another serious limitation to the use of cool-season species. Therefore it is an imperative that not only the research-based grassland development but also the forage crop production should be strongly supported by the government authorities to overcome such climatic limitations. Private forest land holdings are of relatively small units in Korea. Accordingly. it is necessary and important to enlarge the forest land holdings per farm to develop as economic units of grassland. For this the government should introduce new policy measures such as for example: long-term leases of Sorest land and the idle arable land of absentee owners ; rational rental system of national and public forest lands; integrating livestock and forest production. All the laws and regulations standing in the way of the grassland development in forest lands should be modified and revised to open the way for much easier development of grassland. It is also proposed that a high level of financial incentives -hould be provided for structural improvements for the grassland development. They may be: mechanization facilitation, construction of new roads relating to grassland, and land exchange and consolidation. And it is basically necessary that financial enumeration or profits must be garanteed in order to motivate farmers to keep up farming continuously. For more efficient grassland development in mountainous areas, reorganization of Alpine Experiment Station and NAB1 Namwon Branch Station may be needed. Research should be strengthened for completion of pasture mixtures, development of maximum forage production methods with a view to saving labor and reducing production costs, introduction of grazing and forage conservation techniques. and utilization of rice straw as more palatable and nutritious forage source. In order to have more efficient and effective transfer of advanced forage production technologies to livestock farmers the user-clients. it is also essential that special training measures should be given to livestock farmers through making greater use of specialized research and extension workers.

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Analysis on Organization Performance Based on Hospital Culture (기독병원과 일반병원의 조직문화 특성에 따른 조직성과 분석)

  • Kim, Woon-Shin;Nam, Eun-Woo
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.242-265
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    • 1999
  • Our study attempt is to see organizational performance according to the differences between types of hospital cultures. To determine theoretical relationship between the organizational culture and the performance, we select two hospitals in Pusan which are different in the purposes and shapes of establishment. We surveyed their members on a questionnaire based on the type of the organizational culture of the two institutions, analyzed, and review its organizational effectiveness. For the survey with questionnaires, which had been preliminary studied to raise its validity, question forms were distributed to 528 persons in April, 1999 based on the self-responses and recollected within 48 hours. The recollection rate was high(89.96%) and the quantity of questionnaires used for our final analysis was 430(81.44%). The Cronbach Coefficient Alpha of the questionnaires was 0.742. Regarding statistical techniques for analysis of the written materials, dispersion analysis(ANOVA) was adapted to test the organizational effectiveness of the two hospitals having the different organizational cultures, and Pearson Correlation was applied to determine correlations was among all variables. T-test was performed to test organizational effectiveness based on the differences in the extent of sharing the culture, organizational committment and work satisfaction between the two health institutions. From our analysis, we obtain the following conclusions. First, concerning with organizational culture of the two hospital, one of which is a christian hospital and the other is a private foundation hospital, the former is conservative and human-oriented but the latter focuses on renovation and accomplishment. Second, the private establishment has a relatively higher organizational effectiveness that the religious hospital as a result of analyzing the extent of sharing culture, organizational committment and work satisfaction. Third, it has been found that the correlations between the extent of the sharing culture and the organizational committment, the extent and work satisfaction, and the committment and the satisfaction are respectively positive influencing organizational effectiveness, especially work satisfaction. Fourth, cultural factors by which the christian hospital is affected more positively including human relations among its members, belief, its idea of establishment, tradition, work responsibility, power, and wage. On the other hand, factors such as director's leadership, personnel management, wage, hospital regulations and department managers' management ability have been seen as negative influences in order. And fifth, for the private foundation hospital human relations among its members, wages, work responsibility, director's leadership and department managers' management ability were positive in their sequence while wages, personnel management, hospital regulations, welfare and department managers' management ability were considered as negative influences in order. As these results of this study, the higher extent of sharing organizational culture, the more increasing in both organization committment and work satisfaction, the higher the effectiveness. Although it was somewhat difficult to generalize the results whose subjects were the two hospitals only, it was obvious that organizational culture was an important influential factor of organizational effectiveness. It is questionable that the extent of sharing organizational culture, organizational committment and work satisfaction as variables affecting the effectiveness have their validity, but this study has its significance in that it provided an approaching to evaluate the organizational culture of individual hospitals making allowances for such variables related to the general activities in its hospital. We hope the results of the study could be useful for the managerial strategies of the institutions.

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An Investigation on Core Competencies of Data Curator (데이터 큐레이터의 핵심 직무 요건 고찰에 관한 연구)

  • Lee, You-Kyoung;Chung, EunKyung
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.26 no.3
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    • pp.129-150
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    • 2015
  • As the digital technologies and internet have advanced, data have centered in the process of meaningful scientific ramifications and policy making in a wide variety of fields. Data curator in charge of managing data plays a significant role in terms of improving the effectiveness and efficiency of data management and re-uses. The purpose of this study is to identify the core competencies for data curator. For achieving the purpose of this study, two sets of data were collected. First, a total of 255 job descriptions were collected from the web sites including ARL, Digital Curation Exchange, Code4lib, ASIS&T JobLine for the period of 2011-2014. Second, in-depth interviews with five data curators from four diverse organizations were collected. The two sets of data were analyzed into seven categories identified from the related studies. Findings of this study showed that core competencies for data curator were identified into four categories, communication skills, data management techniques, knowledge and strategies for data management, and instructions and service provisions for users. The implications of this study can be considered as integrated and professional curriculum developments for data curator with core competencies.