bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood-Flow Restricted Warm-Up Alters Muscle Hemodynamics and Oxygenation during Repeated Sprints in American Football Players
Authors: Fortin Jean-François , Billaut François
Published: May 2019

Team-sport athletes and coaches use varied strategies to enhance repeated-sprint ability (RSA). Aside from physical training, a well-conducted warm-up enhances RSA via increased oxidative metabolism. Strategies that impede blood flow could potentiate the effects of a warm-up due to their effects on the endothelial and metabolic functions. This study investigated whether performing a warm-up combined with blood-flow restriction (WFR) induces ergogenic changes in blood volume, muscle oxygenation, and RSA. In a pair-matched, single-blind, pre-post parallel group design, 15 American football players completed an RSA test (12 × 20 m, 20 s rest), preceded by WFR or a regular warm-up (SHAM). Pressure was applied on the athletes’ upper thighs for ≈15 min using elastic bands. Both legs were wrapped at a perceived pressure of 7 and 3 out of 10 in WFR and SHAM, respectively. Changes in gastrocnemius muscle oxygen saturation (SmO2) and total hemoglobin concentration ([THb]) were monitored with near-infrared spectroscopy. Cohen’s effect sizes (ES) were used to estimate the impact of WFR. WFR did not clearly alter best sprint time (ES −0.25), average speed (ES 0.25), total time (ES −0.12), and percent decrement score (ES 0.39). While WFR did not meaningfully alter average SmO2 and [THb], the intervention clearly increased the maximum [THb] and the minimum and maximum SmO2 during some of the 12 sprint/recovery periods (ES 0.34–1.43). Results indicate that WFR positively alters skeletal muscle hemodynamics during an RSA test. These physiological changes did not improve short-term RSA, but could be beneficial to players during longer activities such as games.
Outdoor Adventure Builds Resilient Learners for Higher Education: A Quantitative Analysis of the Active Components of Positive Change
Authors: Allan John F. , McKenna Jim
Published: May 2019

The inability of young adults to adapt to university life has been attributed to their declining resilience. Resilience refers to any individuals’ capacity to change or modify behaviour in response to environmental hazards, so they thrive. Outdoor Adventure (OA) residential programmes have helped higher education inductees to acquire skills associated with resilience such as increased self-perception, better interpersonal relationships. However, this study addresses important gaps in existing literature by deploying a high-quality research design to examine the short-term impact of OA experiences on inductees’ resilience and to identify the active components of those experiences that best cultivate inductees’ adaptive capabilities. Multivariate analyses evaluated the efficacy of OA programming to build the resilience of over 2500 inductees. Significant positive gains were reported in the resilience of inductees attending 1-week residential OA programmes measured by an Effect size (ES) = 0.38 and 6.29% increase. Compared to students inducted at university, this represented an 8.35% greater increase in resilience (ES difference = –0.526). Camp-based experiences such as mastering new skills, developing new relationships and being female predicted heightened resilience. A defined blend of embodied, adventure-based meaningful challenges provides a template for helping university inductees to re-adjust, grow and persevere.
Safety and Efficacy of Intracavernosal Injections of AbobotulinumtoxinA (Dysport®) as Add on Therapy to Phosphosdiesterase Type 5 Inhibitors or Prostaglandin E1 for Erectile Dysfunction—Case Studies
Authors: Giuliano Francois , Joussain Charles , Denys Pierre
Published: May 2019

Erectile dysfunction (ED) is a highly prevalent condition with a variety of possible risk factors and/or etiologies. Despite significant advances regarding ED pharmacological management, there are still insufficient responders to existing pharmacological treatments e.g., approximately 30% of patients are insufficient responders to phosphodiesterase type 5 inhibitors (PDE5-Is). It has been recently proposed that botulinum toxin A intracavernosally (IC) delivered could be effective in these patients. Data from a retrospective uncontrolled single center study of 47 ED patients, consecutively recruited, insufficient responders to existing pharmacological treatments e.g., PDE5-Is or IC PGE1 injections treated with IC abobotulinumtoxinA 250 or 500 U as free combination with their existing treatment have been analyzed. Response rate, according to the International Index of Erectile Function-Erectile Function domain score, 6 weeks following IC abobotulinumtoxinA in combination with prior pharmacological treatment, was 54%. Two patients have reported mild penile pain on injection or during the 3 days following injection. Therapeutic efficacy did not seem to be influenced by the etiologies and/or risk factors for ED. Conversely, the less severe ED, the higher the response rate. Preliminary evidence for the therapeutical potential with acceptable safety of IC abobotulinumtoxinA as add-on therapy for ED not sufficiently responsive to standard therapy should be confirmed in randomized clinical trials.
The Efficiency of Microstrainers Filtration in the Process of Removing Phytoplankton with Special Consideration of Cyanobacteria
Authors: Czyżewska Wanda , Piontek Marlena
Published: May 2019

The research presented in this manuscript concerns the evaluation of the effectiveness of microstrainers, which are designed to reduce the amount of plankton in treated surface water. The efficiency of microstrainer filtration analysis is very important for the proper course of the water-treatment process not only in the Water-Treatment Plant (WTP) in Zielona Góra (central western Poland) but also in other WTPs around the world. The qualitative and quantitative monitoring of the abundance of plankton including cyanobacteria during the particle-filtration process allows not only for the assessment of the potential cyanotoxic risk in surface water providing a source of drinking water, but also allows the evaluation of the action and the prevention of adverse impacts of microstrainers. Over four years of research, it was observed that the largest amount of cyanobacteria before microstrainer filtration took place in May. The dominant species was Limnothrix redeckei. The microstrainer removal of plankton and cyanobacteria was statistically significant. The quantity of removed plankton increased with its increasing content in raw water. The particle-filtration process, by reducing the amount of cyanobacteria, contributes to a decrease in intracellular microcystins.
Correction: Calcagni, G. Taming the Beast: Diffusion Method in Nonlocal Gravity. Universe 2018, 4, 95
Authors: Calcagni Gianluca
Published: May 2019

The author did not realize that some of the initial conditions in [...]
Die Erzähltechnikerin an der Arbeit
Authors: Szőke Máté
Published: May 2019

Die vorliegende Studie untersucht die Nachweisbarkeit literarischer und narrativer Traditionen der DDR-Prosa in der deutschen Nachwendeliteratur, indem sie Heike Geißlers 2014 erschienenen Roman „Saisonarbeit“ und das Fortleben der Programmliteratur der DDR unter die Lupe nimmt. Die Arbeit weist durch die Typologisierung der ostdeutschen Textcharakteristika in heutigen und marxistischen literaturtheoretischen Monografien und durch die Aufzählung erzähltechnischer und extratextueller Eigenschaften des analysierten Romans die einzigartige Rolle von Arbeit und Produktion in den Werken der Generation Mauer nach, die dementsprechend eine enge Beziehung zu den Texten der zentral gesteuerten literarischen Konzeption der DDR haben und gewisse Reste der sozialistischen Traumata weitervererben. Die Studie stellt eine erzähltechnische Methode vor, die die Bühne der Diegese in die Richtung des Lesers eröffnet und ihn dadurch zu einer Art literarischer Sklavenarbeit zwingt. Wie ein Buch als Gegenstand die Grenzen des Arbeits- und des Leseprozesses in Frage stellt, wie ein antikapitalistischer Text durch (pseudo)sozialistische Erzählstrategien auf produktionszentrierte Prinzipien der Literatur des 3. Jahrtausends hinweist sowie den Literaturbetrieb und die multinationale Firma Amazon zur Rechenschaft zieht, veranschaulicht die vorliegende Studie mit einer narratologischen Untersuchung und mit einem kurzen diskurslinguistischen Ausblick.
Das Phänomen des Numerus und der Plural der deutschen Substantive
Authors: Galac Ádám
Published: May 2019

Die vorliegende Arbeit setzt sich mit der Problematik der Pluralallomorphie in der deutschen Substantivdeklination auseinander. Zuerst werden der Begriff des Numerus und seine Begleitphänomene anhand von Beispielen aus verschiedenen europäischen Sprachen dargestellt. Darauf folgen eine Zusammenfassung der Regeln und Regelmäßigkeiten der Pluralzuweisung in der deutschen Gegenwartssprache und ein diachroner Überblick über die Entstehung dieses Allomorphenreichtums. Das letzte Kapitel beschreibt eine mit Muttersprachlern durchgeführte Umfrage, in deren Rahmen die Befragten 40 Substantive mit uneindeutigen Pluralformen in den Plural setzen mussten. Die Vielfalt der Antworten und einige persönliche Rückmeldungen lassen darauf schließen, dass die Pluralbildung der deutschen Substantive nicht nur Deutschlernenden, sondern auch Muttersprachlern Schwierigkeiten bereiten kann. Welche Prinzipien leiten die Pluralbildung von neuen Wörtern im heutigen Deutsch?
Probleme der Leseradressierung
Authors: Müller Dóra
Published: May 2019

DieArbeit behandelt bekannte literarische Phänomene, die hier in einen teilweise neuen Zusammenhang gestellt werden sollen. Es geht dabei um die Gattung Kurzgeschichte, die Leseradressierung, die drei Kurzgeschichten von Luise Rinser und letztendlich um Luise Rinser als Schriftstellerin. Die Kurzgeschichte ist eine relativ neue, bemerkenswerte Gattung des 20. Jahrhunderts, deren Beschreibung eine ziemlich schwere Aufgabe für die Literaturwissenschaft darstellt. Besonders interessiert sich aber diese Arbeit für die Erzähltechniken der drei Kurzgeschichten von Luise Rinser („Die kleine Frau Marbel“, „Die rote Katze“, „Ein alter Mann stirbt“). Den Ausgangpunktzudiesem Thema bietet die Behauptung von Paul Otto Gutmann, deren Bedeutung und Relevanz in Bezug auf die Beziehung der Leser und des Textes in den Kurzgeschichten untersucht wird. Folglich wird parallel mit der Erzähltechnik die Leseradressierung unter die Lupe genommen, da sie in diesem Fall kaum voneinander zu trennen sind. Als Schlussfolgerung der Analyse wird behauptet, dass die Kurzgeschichten von Rinser als Musterbeispiele für die Gattung Kurzgeschichte wahrgenommen werden können, außerdem erfordern sie das besonders aktive Mitdenken der Leser durch ihre spezielle Erzähltechnik.
Based on a comparative analysis of the use of the names of the seismic impact 2.03-30-2006 RK and RK SP 2.03-30-2017
Authors: Shokbarov Eraly , Omarov Zhasulan
Published: May 2019

The report discusses some features of determining the design seismic effects and loads on buildings and structures designed in accordance with the provisions of the old and new norms of the Republic of Kazakhstan.
DETERMINATION OF THE VALUE OF SINGLE RAPID VOLTAGE CHANGES IN NETWORKS SUPPLYIND ELEKTRIC WEIDING INSTALLATIONS
Authors: Kargabaev Yryskeldi , Osmonaliev Kubat
Published: May 2019

The article deals with the tasks of ensuring the required quality of electricity in modern power systems of industrial enterprises.
The main tasks of designing and operating modern power supply systems for industrial enterprises are in addition to the rational choice of elements of power supply systems, it is also to ensure the required quality of electricity at the terminals of the power receivers. Ensuring the required quality of electricity is generally associated with the electromagnetic compatibility of the supplynetwork. The intensification of production processes is associated with the improvement of technological processes and the introduction of advanced technologies, with the use of high-performance equipment, in particular, valve converters, welding plants, powerful metalworking machines are being introduced. They are currently controlled using digital technology, these devices strictly impose high demands on the quality of electrical energy.In connection with the requirements of the quality of electricity, in the Russian Federation every 10-15 years new standards are developed, where the indicators of the quality of electric energy are normalized
NATURAL RESOURCE POTENTIAL AND ITS ROLE IN THE DEVELOPMENT OF PRODUCTIVE FORCE
Authors: Sharshebaev A. , Umaralieva Ch..
Published: May 2019

This article discusses the natural resources potential and its development. The study of the natural resource potential is of great scientific and practical value, but remains a challenge of his appraisal. Estimates of natural-resource potential of a particular territory do not lose their obvious relevance and applied nature of the economic and geographical research.
SITUATION OF DESIGN AND CONSTRUCTION FOR RETROFITTING OF BUILDINGS IN THEKYRGYZ REPUBLIC
Authors: Begaliev Ulugbek , Brzev Svetlana
Published: May 2019

There is a significant experience related to seismic retrofitting of existing buildings in many earthquake-prone regions of the world. Majority of older existing buildings were not designed to the seismic hazard level expected by current design codes; also, some structural types (like unreinforced masonry) are inherently more vulnerable to earthquake effects than others, e.g. well-designed reinforced concrete (RC) and steel buildings. It should be noted that seismic retrofitting of school buildings has been performed in several countries.It is proposed to effective strengthening of structures on the basis performance-design and pushover analyses, whis are an first time innovation for Kyrgyz Republic.
FORMATION OF PROFESSIONAL COMPETENCIES OF A JOURNALIST AS A CONDITION FOR TRAINING ACOMPETITIVE SPECIALIST
Authors: Abdikerimova Zhibek
Published: May 2019

The article is devoted to the problems of training journalists, about the requirements that the public presents to them, on the one hand, the public, on the other -the editorial staff of the media, reveals the concept of professional journalism competencies and the tasks of educational organizations -the formation of professional competencies of journalists still on the bench. It analyzes what professional competencies a true journalist should possess.Since journalism, as a social institution, implies a greater or lesser coordination between the needs and expectations of society from the media, on the one hand, and the professional readiness of a journalist to implement these requests, on the other. Journalists depend on the success of the media themselves, and the information environment in which public opinion is shaped. In the standards of the new generation, the main criteria for evaluating a specialist, such as the fundamental nature of education, in which a graduate must possess a certain setof knowledge and skills, and the principle of social responsibility, must remain unchanged.
The influence of training experiences on career intentions of the future GP workforce: a qualitative study of new GPs in England
Authors: Spooner Sharon , Laverty Louise , Checkland Kath
Published: May 2019

Background

The capacity of the UK GP workforce has not kept pace with increasing primary care workloads. Although many doctors successfully complete GP specialty training programmes, some do not progress to work in NHS general practice.

Aim

This article explores the training experiences and perceptions of newly qualified GPs to understand how their education, training, and early experiences of work influence their career plans.

Design and setting

A qualitative study of doctors in their final year of GP training (ST3) and within 5 years of completion of GP training (F5).

Method

Participants across England were recruited through training programmes, First5 groups, and publicity using social media and networks. Open narrative interviews were conducted with individuals and focus groups. Audiorecorded interviews were transcribed, and a thematic analysis was supported by NVivo and situational analysis mapping techniques.

Results

Fifteen participants engaged in individual interviews and 10 focus groups were carried out with a total of 63 participants. Most doctors reported that training programmes had prepared them to deal confidently with most aspects of routine clinical GP work. However, they felt underprepared for the additional roles of running a practice and in their understanding of wider NHS organisational structures. Doctors wished to avoid unacceptably heavy workloads and voiced concerns about the longer-term sustainability of general practice.

Conclusion

Strategies to attract and retain enough GPs to support delivery of comprehensive primary care should consider how doctors’ early career experiences influence their career intentions. A coherent plan is needed to improve their preparation and increase confidence that they can achieve a professionally satisfying, effective, and sustainable career in NHS general practice.
Attitudes toward Medical Ethics among Resident Physicians in One Korean University Hospital
Authors: PARK Sang-Hyoung , KOH Youn-Suck
Published: May 2019

This article reports on a study designed to assess the professional training in, and attitudes toward, medical ethics among the resident physicians in one university hospital in Korea. The study is based on a questionnaire, which was administered to the 470 residents at Asan Medical Center. Of the 346(73.6%) residents who responded, 66.8% reported having completed a medical ethics course during their residency training. Serious ethical dilemmas were encountered by 69.1% of the residents at least once a year. The majority of these residents claimed to have resolved those dilemmas either alone or through discussions with colleagues. Frequently encountered issues included doctor-patient relationships, decisions to discontinue life-sustaining therapies, and do-notresuscitate orders. Most respondents were aware of the existence of the hospital ethics committee, but did not know how to consult it. Furthermore, most participants were willing to attend medical ethics courses and believed that these should be mandatory during residency training. The results of this study suggest that hospitals should provide a well-developed medical ethics education program for resident physicians.
The Dutch Debate on Euthanasia
Authors: KIM Moon-Jeong
Published: May 2019

This article describes the origins and rationale of the Dutch policy on euthanasia. Euthanasia is in principle illegal in the Netherlands, as it is in other countries. However, under certain conditions euthanasia is “tolerated” in the Netherlands. The Dutch ethicist Bert Gordijn attributes this to the typical Dutch mentality to avoid radical positions and instead compromise in disputes. According to Gordijn, two dominant and somewhat contrary social forces from the 17th century influenced the Dutch mentality and policy: conservative Calvinism and free trade. Disputes emerging from conflicting interests were traditionally resolved according to the policy of tolerance, and certain illegal acts remained unpunished. The Dutch policy concerning euthanasia, a typical example of pragmatic tolerance, attempts to prevent the greater evil of unregulated euthanasia by tolerating the lesser evil of euthanasia under strict preconditions. Ongoing public discussion in the Netherlands about the legitimacy of more liberal euthanasia laws have given rise to the current Dutch policy on euthanasia and medically assisted suicide.
Killing or Letting Die? Omissions from a Causal Point of View
Authors: KIM Moon-Jeong
Published: May 2019

Whereas active and direct euthanasia is ethically and legally prohibited, passive or indirect euthanasia is, except for special cases, acceptable and even recommendable. The actual difference between an intentional act of killing and an act of withholding or withdrawing life-sustaining treatment can be described most clearly in terms of the causal role of the physician. Active euthanasia represents a new cause of death: the patient’s death results from the physician’s medical intervention (iatrogenic). In the case of passive euthanasia, the cause of death is the patient’s underlying disease. But a physician’s omission’ which allows the patient to die may be a cause of the patient’s death in the sense of an inus-condition, that is, an insufficient but non-redundant part of an unnecessary but sufficient Condition. The inus-condition is responsible for the causation of the occurrence. Both killing and letting die are inus-conditions of minimally sufficient conditions of the patient’s death. The abandonment of withholding or withdrawing of persistence-treatment is thus causally responsible for the fatal outcome.
An Analysis of Attitudes toward Advance Directives among Judicial Apprentices and Medical Trainees
Authors: SHIN Young-Tae , LEE Il-Hak , KIM Sun-Hyun , LEE Hee-Il
Published: May 2019

Background: The legal and ethical issues related to advance directives have recently become controversial in Korea. This study was designed to determine whether there are any significant differences between judicial apprentices and medical trainees (including residents and interns) with respect to their attitudes toward advance directives.
Methods: A questionnaire was administered to 283 judicial apprentices from May 29 to June 9, 2006, and to 254 medical trainees (150 residents and 104 interns) from May 1 to July 31, 2006. Thus, there were a total of 537 respondents in this study.
Results: More medical trainees than judicial apprentices were familiar with advance directives (P < 0.05). More medical trainees than judicial apprentices claimed that a law for advance directives was necessary (P < 0.05). After adjusting for other predisposing factors, differences between the two groups were still statistically significant (P = 0.038). After adjusting other predisposing factors, it is found that the group which knew about advance directives beforehand responded more positively to the question whether legislation for advance directives was necessary than the group which didn't(P=0.000).
Conclusion: In this study, the difference in the number of medical trainees versus judicial apprentices who were familiar with advance directives was found to be statistically significant (P < 0.05). This caused statistically significant differences between the number of judicial apprentices versus medical trainees who believed that a law covering advance directives is needed. Therefore, greater awareness of advance directives is needed in order to establish a law governing them.
The Necessity of Ethical Education and a System for Reporting Medical Errors:A Study of Disputes Arising from Medical Errors
Authors: HWANG Soon-Young , BAE Hyun A
Published: May 2019

Purpose: Claims of malpractice and medical error are on the rise in South Korea. In this paper we argue that, in order to prevent or reduce such medical disputes, ethical education must be strengthened and an effective system for reporting medical errors must be established.
Method: The research subjects for this study were patients who complained of inadequate treatment at the emergency center of one Korean hospital between January 2006 and December 2007. The complaints of these subjects were examined in order to determine the nature and cause of the complaints, including any human factors that led to the complaints.
Result: A total 54 complaints were reported. Among these, “unkindness” was the most frequently reported complaint. In 27 (49%) of the cases, the cause of the complaint was traced to a human factor, with “lack of explanation” and “bad attitude” totally 69% of the cases. Such complaints were resolved by a variety of methods, including further explanations, apologies, reduction or exemption from the cost of treatment or asking for assistance from related departments.
Conclusion: Patients that experience medical errors tend to lose trust in the doctor-patient relationship, which hinders the resolution of such medical errors. This study emphasizes the need to strengthen ethical education and establish a proper procedure for reporting medical errors in order to prevent and resolve medical error and the disputes to which they give rise.
The Medical Professionalism of Dr. Chang Kee-Ryo
Authors: PARK Jae-Hyun
Published: May 2019

There is widespread agreement among medical professionals that it is essential to teach medical professionalism to medical students and residents. While role modeling is regarded as an important way of teaching medical professionalism, it is not always easy to find positive role models. Dr. Chang Kee-Ryo provides an admirable example of a physician who practices medicine with professionalism; the values of medical professionalism can be acquired through attention to his deeds and words. Dr. Chang demonstrated the most fundamental principles and professional responsibilities described in “Medical Professionalism in the New Millenium: A Physician Charter.” Exposure to his life and work enables students to understand the concept of medical professionalism concretely and comprehensively rather than abstractly.
Amendment of the “Acceptable Limit for Abortion” in Article 14 of the Mother and Child Health Law
Authors: LEE Eun Young , KANG Hyun Hee , KIM Yun Deok , SOHN Myongsei , KIM Soyoon
Published: May 2019

Since its enactment in 1973 the Mother and Child Health Law in Korea has not properly reflected the rapid social changes that have taken place in Korea and has been enforced without appropriate legislative amendments. According to Henshaw and Simon, Korea posted a 19.6% rate of abortion, which is the highest among OECD countries. In Chapter 27 of the Criminal Law, established in 1953, before the passage of the Mother and Child Health Law, abortion was designated as a crime and was subject to punishment without exception. Although the Mother and Child Health Law has been revised six times, including an extensive amendment in 1986, Article 14 of the Law has not been revised due to possible ethical and social controversies. Accordingly, the Ministry of Health & Welfare and the Medical Law and Ethics Research Center at Yonsei University began studying an amendment of Article 14 in September 2007. These groups prepared an amendment bill for Article 14 based on existing research into the policies on abortion in other countries and ensured that the bill fully reflects the opinions of different social groups in Korea. This article summarizes the problem with Article 14 of the Mother and Child Health Law and the proposed amendments to it.
The Right to Refuse Life-Sustaining Medical Treatment in South Korea: The Case of Ms. Kim*
Authors: McGuire John Michael
Published: May 2019

In North America and elsewhere there exists a legal and ethical consensus concerning the right of patients to refuse life-sustaining treatment and the right of families or other proxies to make such decisions for patients who are themselves unable to do so. This consensus emerged gradually and through several landmark legal rulings, such as those made in the cases of Karen Ann Quinlan and Nancy Cruzan. In South Korea, on the other hand, there is no consensus on the rights of families to make decisions concerning the refusal of life-sustaining treatment on behalf of incompetent patients and, until recently, there was no legal recognition of a patient’s right to refuse life-sustaining treatment. However, the situation in Korea seems to be changing with the recent court rulings in the case of Ms. Kim, a case which may do for medical practice in Korea what the case of Karen Ann Quinlan did for the practice of medicine in the US. This paper makes a contribution to the much-needed consensus-building process in Korea by reviewing some of the landmarks cases in the international right-to-die movement, identifying the key legal and ethical lessons from those cases, and then applying those lessons to the case of Ms. Kim in order to evaluate the decisions that have been made in her case so far and to make further recommendations on what else needs to be done.
Ethical Issues in Medical Enhancement
Authors: PARK Jae-Hyun
Published: May 2019

The enhancement of human capacities through medical practice is becoming increasingly common and raises many ethical issues. One important question is whether it is even possible to distinguish between medical “treatment” and “enhancement.” On the one hand, there are those who believe that the distinction is both impossible and meaningless; on the other hand, it seems necessary to draw such a distinction in order to determine which medical procedures are compatible with the proper goals of medicine. Other important ethical issues raised by medical enhancement procedures include balancing a patient’s individual autonomy with the effects of these procedures on social equality and justice. This article argues that there is an urgent need for public debate and discussion on the ethical issues raised by medical enhancement procedures.
The Limits of Medical Care and the Termination of Life-Sustaining Treatment
Authors: Ahn Yong Hang , Kim Hye Joung
Published: May 2019

On May 21, 2009, the Supreme Court of Korea ruled that patients have the right to terminate medically meaningless treatment upon confirmation that their terminal illness is indeed irreversible. The Supreme Court’s decision thus makes proof of the irreversibility of a patient’s condition an important process in legitimatizing a patient’s decision to terminate life-sustaining treatment. However, since medical practice rejects explanations in terms of “essences” and is affected by issues of subjectivity, we argue that physicians cannot give indisputable confirmation of the irreversibility of a patient’s terminal illness, as required by the Supreme Court’s ruling.
Advance Directives and Proxy Decision-making
Authors: Kim Shinmi
Published: May 2019

The purpose of this study was to explore the main features of proxy decision-making in advance directives. Fifty-three advance directive documents from the US, New Zealand, and Korea were retrieved through database searches and then analyzed. The following eight distinctive categories concerning proxy decision-making were identified: 1) establishment of proxy authority; 2) certification of proxy authority; 3) extent of proxy authority; 4) qualifications for proxies; 5) legal validity of proxy documents; 6) period of proxy authority; 7) revocation of proxy authority; and 8) exceptional regulations. It is pointed out in this article that prior to the regulation of proxy decision-making in Korea, relevant experts should consider each of the eight elements listed above and articulate clear guidelines for proxy decision-making.
Legal and Ethical Issues concerning the Fair Competition Code on Pharmaceutical Trade
Authors: Park Hyoung Wook
Published: May 2019

In 2007 the Korean Research-based Pharmaceutical Industry Association (KRPIA) developed a Fair Competition Code on Pharmaceutical Trade, and in 2010 the Korean Pharmaceutical Manufacturers Association (KPMA) revised its Code of Fair Competition. Prior to 2007, the KRPIA and KPMA made voluntary agreements on pharmaceutical trade. This article examines the three codes in terms of the limits they set on various forms of gift-giving, donations, the funding of academic conferences inside and outside of Korea, the provision of drugs for clinical studies, market surveys, and post-market surveillance studies. The results of this examination show that the KPMA 2010 Code reflects a moral bias against donations to healthcare organizations and grants an exclusive power to the KPMA regarding sponsorships to participate in academic conferences.
Residents’s perspectives on ethical conflicts and professional boundaries: a vignette-based survey
Authors: Lee Young-Mee , Lee Young Hee , Lee Mee Jeong , Park Jaeyoung , Lim Ki-Young , Choi Chang-Min , Kim Hyung Kyu
Published: May 2019

The importance and recognition of medical ethics and professionalism has been growing. However, in Korea it is widely thought that there is still an insufficient amount of medical ethics education during resident training. The purpose of this study was to identify residents’ ethical sensitivity and coping strategies on ethical conflicts that can occur in clinical practice and research settings.

The survey was conducted in 16 university-based or affiliated hospitals; a total of 1,187 residents participated in the survey. A questionnaire was developed consisting of 18 questions including 7 question areas concerning residents’ perspectives on ethical conflicts and professional boundaries in clinical practice or research. The seven question areas were as follows: coping and reporting mistakes (2 items), responding to impaired colleagues (2 items), relationship with colleagues, senior residents, and faculty (4 items), balancing personal and professional life (2 items), family (relatives) and friends’ requests (2 items), relationships with patients and their family members (3 items), clinical research ethics (3 items). For each item, a vignette was developed on the basis of situations derived from the authors’ educational and clinical experiences. To facilitate the participants’ response, 4 or 5 answer options, as well a space to for open responses, were provided for each question.

A total of 1,072 samples (male 65.9%, female 34.1%) were analyzed. The majority of the respondents answered that if a medical mistake happens, they will report it to a faculty member and follow their instructions. Regarding impaired colleagues who may threaten patient safety, more than 70% of respondents answered that they will resolve the problem among residents themselves rather than notify a faculty member or resolve it officially. More than half of the respondents also said that if they observe non-professional or unethical conduct by either faculty members or residents, they will solve the problem by consulting with colleagues. However, more than 60% of the residents responded that they would put priority on patient care when facing conflicts between medical services and personal life. In questions about research ethics, the majority of respondents answered that they would maintain truth in managing data and research results.

The results of this study suggest that medical ethics and professionalism curricula during residency should be strengthened to develop residents’ ethical sensitivity and coping strategies concerning ethical conflicts in either clinical practice or research.
The Use of Chaperones in Clinical Practice
Authors: Kim Han-Nah , Park Yoonhyung
Published: May 2019

Personal relationships between doctors and patients are essential for effective treatment. Optimal care is possible only when there is trust between the doctor and patient. In recent years, disputes between healthcare providers and patients have been increasing. In particular, there have been disputes related to the sexual harassment of patients during physical examinations, causing harm to doctor-patient relationships. Fundamental measures are needed to deal with these disputes. In some countries, such disputes are prevented by means of a chaperone system that helps to establish trust between the doctor and the patient. With the chaperone system, when a doctor conducts a physical examination of a patient, an assistant helps with the examination or is present during the examination. When the chaperone system is used, communication between the doctor and the patient is enhanced, thereby reducing the chances of legal disputes. This article argues that a chaperone system with detailed guidelines is needed in South Korea in order to ensure patient safety and effective treatment, especially for gynecological and other intrusive physical examinations.
Predictive Factors Affecting the Preferences for Care Near the End of Life among Nurses and Physicians
Authors: Jo Kae Hwa , Kim Gyun Moo
Published: May 2019

Purpose: The purpose of this study was to identify the levels of the preferences for care near the end of life-korean version(PCEOL-K) and factors affecting the PCEOL-K among nurses and physicians.
Methods: A descriptive study was conducted with 407 nurses and physicians working in general hospital and university hospital, Daegu and Busan. Data were collected through selfreported questionnaires from June to September, 2010. Data were analyzed using the Pearson’s Correlation Coefficient, t-test, ANOVA, Turkey’s HSD, and multiple regression with SPSS/WIN 15.0.
Results: The mean score of PCEOL-K was 69.03±5.48 for nurses and 68.69±7.15 for physicians.Factors predicting subjects’ PCEOL-K were clinical experience, fear of death, and the personal meaning of death. These factors explained 40.0% of the PCEOL-K (F=21.00, p<.001).
Conclusion: The results of this study suggest that the construction of comprehensive framework for nurses and physicians in relation to end-of-life care may contribute to improved positive preferences for care near the end of life by encouraging their professional careers and spirituality.
Medical Unprofessionalism, De-professionalization, and Virtue Ethics
Authors: LEE Dong Ik , KIM Soo Jung , CHOI Sook Hee
Published: May 2019

Medical unprofessionalism and the deprofessionalization of medicine have of late become serious concerns to physicians, medical educators, and the public. Medical professionalism, which signifies a set of values, behaviors, and a relationship that underpins the trust the public places in physicians, is a core feature of medical practice. Commercialism and consumerism in medicine are among the main factors currently contributing to medical unprofessionalism and the deprofessionalization of medical practice. The unprofessionalism and deprofessionalization of physicians produce negative images of physicians. In this article we argue for a virtue-ethics approach to solving the problems of medical unprofessionalism and deprofessionalization. We argue for the promotion of certain virtues among physicians and the need for virtuous role models. Furthermore, we claim that since physicians are also members of society,the nurturing of virtue within the medical profession both promotes and requires the nurturing of virtue within society at large.
Controversial Ethical Issues and the Current Progress of Stem Cell Research*
Authors: LEE Sang Mok
Published: May 2019

While stem cell research offers great hope for the development of the life sciences and the discovery of medical treatments for a variety of diseases, it also raises many controversial ethical issues. The ethical issues raised by stem cell research can be divided into two broad categories. The first category consists of the controversies relating to the destruction of human embryos during the process of stem cell extraction. The second category involves the ethical questions surrounding the use of adult stem cells or induced pluripotent stem cells. This article provides an overview of the current state of stem cell research and an analysis of some of the associated ethical issues. Furthermore, on the basis of the analysis provided in this article, suggestions are offered concerning the best direction for future stem cell research.
Hans Jonas’ Responsibility Ethics and the Ethical Foundation of Biobanks*
Authors: KIM Jin Kyong
Published: May 2019

In the era of personalized medicine, in which human biological materials are becoming more important,the demand for biobanks is increasing. However, as the research potential of biological materials made available through biobanks increases, concerns are growing over the processes and consequences of biobank technology. Accordingly, there are calls for the establishment of biobanks and the setting of ethical criteria for research involving biobanks. This article examines new ethical criteria for research involving biobanks using the concept of ethical responsibility presented by Hans Jonas.
Development of Korean Shared Medical Decision-Making Model for Dignified Dying Based on King's Theory*
Authors: JO Kae Hwa , AN Gyeong Ju , KIM Gyun Moo
Published: May 2019

The study was conducted to develop and test a hypothetical model which explains Korean shared medical decision-making was established based on the King's theory. The participants were 580 adults who lived in one of 3 Korean metropolitan cities: Seoul, Daegu, and Busan. The data were collected using questionnaires from August 10 through October 25, 2011. The descriptive and correlation statistics were analyzed using the SPSS/WIN 15.0 and the structural equation modeling procedure was performed using the Amos 20.0 program. The results of this study showed that the attitude of dignified death were the strong factors influencing shared decision making in this sample. The attitude of withdrawal of life sustaining treatment didn't influenced to the shared decision making but the attitude of withdrawal of life sustaining treatment and the attitude of dignified death showed correlation between two factors. The proposed model was concise and extensive in predicting shared decision making of the participants. Findings may provide useful assistance in developing effective medical and nursing interventions for maintaining and promoting shared decision making in clinical situations.
Knowledge, Attitude, and Will for Organ Donation of Nursing Students and Non-nursing Students toward the Brain Death Organ Donation
Authors: KIM Miok , JOO Sae-Jin , CHOI Jung-Hyun , KIM Kyung-Sook , YOO Mi , KIM Hee-Jeong
Published: May 2019

This study investigated knowledge, attitude, and will for brain death organ donation (BDOD) of college students, and identified influencing factors on knowledge, attitude and will using structured questionnaire. The subjects of the research were 108 nursing students and 78 non-nursing students at N university. The data was analyzed with static analysis, t-test, χ2-test, ANOVA, pearson correlation coefficient,and Logistic regression. The mean score of knowledge toward BDOD of nursing students was 11.05 and non-nursing students scored 8.10 on average. The mean score of attitude toward BDOD of the nursing students was 3.39 and that of the non-nursing students was 3.28. There was a significant difference in knowledge according to sex, religion in nursing students. There was a significant difference in attitude according to the experience of blood donation in nursing students, and perceived health status in non-nursing students. For nursing students, there was a significant difference in the will for organ donation between students who have considered about organ donation and those who have not. There was a significant relation between the attitude and the knowledge of BDOD. However, in non-nursing students, attitude toward BDOD was not correlated with knowledge. Nursing students as future health professionals were aware of the roles and responsibilities of nurses to augment organ donation. Although nursing students scored higher in knowledge and attitude about BDOD than non-nursing students,more specifically structured education programs are needed. To promote BDOD, relevant policies and effective campaigns need to be developed.
Building the Ethical Foundations on Clinical Interventions for Old People in Aging Society: From Biomedicalization to Care*
Authors: KIM Jin Kyong
Published: May 2019

With biomedical treatments being the predominant form of care for elderly patients in clinical situations, the only way for family members to show their affection and care for elderly patients is to be involved in these patients’ medical treatments. In aging societies especially, there is a need for reflection on the paradigm of geriatrics, not only for the benefit of elderly patients, but for everyone. In this article we focus on the importance of a type of care that reaches beyond standard medical treatments. We analyze the meaning of ‘care’ and consider different methods to achieve it alongside biomedical treatments.
Relationships among Ethical Dilemma Experienced by Nurses, Burnout and Coping
Authors: LEE Hyea Kyung , SHIN Jea Sook
Published: May 2019

This study was designed to examine the relationships between nurses’ experiences with ethical dilemmas and their burnout and coping responses. Self-reported questionnaires were completed by 184 registered nurses working in a general hospital with 500 beds in Cheong-Ju city, South Korea. The data were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient, using the SPSS/WIN 18.0 program. The mean score for the level of ethical dilemma was 0.60/1, and the area of professional nursing practice was the highest (M=0.71). The results showed that nurses experienced many ethical dilemmas in their practice. The mean score of the level of burnout was 2.65/4, and physical burnout was the highest (M=2.86). The mean score of the level of coping with ethical dilemma was 2.64/4. The ethical dilemma demonstrated significant correlations with coping (r=0.160, p=0.030). Ethical dilemmas in the clinical setting can lead to feelings of burnout and frustration. Nurses need further education on how to reduce ethical conflicts as well as training to develop strategies for effective coping with the ethical dilemmas they confront in practice.
Philosophical Inquiry on Ontological Characters of Human Body Parts*
Authors: CHO Sunwoo
Published: May 2019

It is uncontroversial that human body parts, including human material, are physical beings. However, they seem to be treated not just as physical objects but as those of a special kind. There seems to be some ontological characters of human body parts that explain why we tend to feel uncomfortable or unpleasant when those parts are treated in certain ways that will be introduced in this paper. This paper explores the ontological characters of human body parts by means of comparison with other physical beings that also cannot be explained by reductive materialism-that is, human beings and works of art. For this goal, I examine Dworkin’s discussion of the sanctity of human life-based on the concept of ‘creative investment’- and Margolis’ analysis of the ontology of artworks-based on the concept of ‘cultural emergence’. The insight that each of these can offer as well as the applicability of these to human body parts will be discussed.
The Present Conditions and Issues of Korean Humanity Care Nursing Education
Authors: PARK Myeung Hee
Published: May 2019

This paper considers humanistic perspectives for nursing science considering the invisible aspects of human life in scientific nursing which is heavily dependent on positivism. Humanity care is caring based on a comprehensive understanding of the true nature of humanity. Humanity care has to be executed at the nursing education level. For this we need to examine accreditation in baccalaureate nursing programs, the educational objectives of nursing colleges, the nature of nursing, the features of nursing-science, the tendencies of modern nursing, and the views of nursing scholars. The common key-concepts of such categories can be summarized as follows: nursing professionalism, holistic care, and life. For this, I have grasped the current situation of the curriculum related to liberal arts taught at 60 nursing colleges, and nursing departments, nationwide, in view of these categories. The result is that subjects such as personality and self-development, life, writing, nursing philosophy, creativity exploration, culture and nursing, and art and nursing, are insufficient. So, this dissertation suggests that there is need to open these subjects sufficiently. Nursing-education has to be based on a curriculum enabling students to consider holistic care and life from the view of nursing-professionalism. The assignments for holistic care, an independent arena of nursing, include shedding new light on the nature of nursing and having educational introspection into reestablishing the status and identity of nursing-science.