bluuebunny/crossref_metadata_2025 huggingface dataset:
Denominális diminutívumképzés az orosz, német és magyar nyelvben
Authors: Nyéki Bence
Published: May 2019

Jelen dolgozatban az orosz, német és magyar denominális diminutívumképzést vizsgálom a morfológiai produktivitás és a szemantika szempontjából. Ez egy sajátos toldalékolás, melyet hagyományosan derivációnak szokás tekinteni. A dolgozat fő célja a három nyelv diminutívumképzése közötti hasonlóságok valamint különbségek feltárása. A kutatás részben nonszensz szavakat tartalmazó internetes kérdőíveken alapul. A diminutívumok, melyeket a válaszadók a nonszensz szavakból képeztek, nem mindig támasztják alá a szakirodalom alapján megfogalmazott hipotéziseket a deriváció szabályairól. Korpuszok tették lehetővé a produktivitás további vizsgálatát és a szubjektív-evaluatív szóképzési jelentés aktualizációinak megfigyelését. Látszólag „a lehető legáltalánosabban vett kicsinyítés” az általános diminutí­vum­jelentés legjobb meghatározása a három nyelv tekintetében. Az orosz képes a legtöbbféle realizációra, a német és magyar diminutívumképzés ebből a szempontból majdnem azonos szinten áll.
Die Verwendung von doppelten Perfektbildungen im Gegenwartsdeutschen
Authors: Mizser Viktória
Published: May 2019

Die vorliegende Arbeit befasst sich mit einem besonderen Phänomen der deutschen Gegenwartssprache. Der Schwerpunkt liegt in der Analyse von doppelten Perfektbildungen, d.h. von Doppelperfekt und Doppelplusquamperfekt. Der erste Abschnitt behandelt die Termini Aspekt und Tempus. In dem zweiten Teil werden u.a. die Bedeutungen und die Verwendungsweisen der Doppelperfektformen unter die Lupe genommen. Das dritte Kapitel widmet sich einer Korpusanalyse. Anhand der selbst erstellten Belegsammlung wird der Frage nachgegangen, welche temporalen bzw. welche aspektuellen Bedeutungen diese Strukturen haben.
Über die Beschreibung der Krönung von Ferdinand I. in Ungarn anhand einer deutschsprachigen Flugschrift aus dem Jahre 1527
Authors: Kovács Dániel
Published: May 2019

Der Beitrag setzt sich zum Ziel, die Krönung von Ferdinand I. an der Grenze des Mittelalters und der Frühen Neuzeit einer gründlichen Analyse zu unterziehen. Nach der Zusammenfassung der bisherigen Forschungen über diese Krönung wird aus der Sammlung der Széchényi-Nationalbibliothek eine deutschsprachige Flugschrift interpretiert, und zwar ein Bericht von einem Buchdrucker in Augsburg auf dem Jahr 1527 herausgegeben, um die möglichen Übereinstimmungen und Unterschiede zu den früheren Königskrönungen beschreiben zu können.
Figurenkonzeption und Figurenkonstellation im Opernzyklus „Der Ring des Nibelungen“ von Richard Wagner
Authors: Davidesz Mária Magdolna
Published: May 2019

Die Grundlage der Arbeit stellt die vorgangszentrische Auffassung der Figuren dar. Meiner in Anschluss an Étienne Souriau entworfenen These zufolge will die Vorgangsfigur jemandem (der positiven Zielfigur) ähnlich sein oder sich von jemandem (von der negativen Zielfigur) unterschieden, dafür benutzt sie die Kraft von jemandem (der Mittelfigur), wobei verschiedene Kräfte (die abstrakten Mittelfiguren) auf sie wirken. In der Arbeit werden die einzelnen Figuren des Opernzyklus unter diesem Aspekt analysiert. Nach ihrer eingehenden Untersuchung lässt sich feststellen, dass man Wotan als Vorgangsfigur betrachten kann. Die Mittelfiguren (z.B. Hunding, Siegmund, Gunther, Gutrune) treten als Boten der Götter auf und vermitteln ihren Willen, wobei die Frauenfiguren als positive Zielfiguren, die Nibelungen hingegen als negative Zielfiguren, als Antagonisten auf Wotan wirken. Sie alle helfen bei der Erzählung von Wotans Entwicklungsgeschichte, der die Stationen eines Menschenlebens durchwandert.
ARBOLITE FROM LIGHT-WEIGHT CONCRETE
Authors: Matyevav Аrbermet , Keneshbek u. Tolkunbek , Sayitkaziev N
Published: May 2019

Thispaperinvestigates the technology of energy and resource saving materials, involving the use of local raw materials of plant origin as a filler (aggregate) material, and the alkali base composition as a binder material. Fillers(aggregates)have a significant impact on the technological and operational properties, as well as on the process of structure formation of plant-binding composites.The introduction of Portland cement, construction gypsum, ash and structure-forming additives and polymer silicate compositions with plasticizers in a plant-binding composition (PBC) contributes to the enhancement of the strength properties and obtaininga cement-gypsum-alkali binder with improved technical and mechanical characteristics on their basis and properties. To obtain arbolitewith higher strength, thermal characteristics, it is necessary to completely eliminate the influence of extractive substances of organic fillers (aggregate)on the cement stone, increase the adhesion of organic aggregate with a mineral binder material and modifying additives.According to obtained results on the base ofscientific studiesand researchesondeterminationof the composition and properties of arbolitematerials using crushed rice straw, the possibility of developing arbolitewall blocks based on the developed new building technologies has been established.
INVESTIGATION OF INFLUENCE OF COMPLEXACTIVATION ON RHEOTECHNOLOGICAL CHARACTERISTICSOF CERAMIC MASSES
Authors: Mavlyanov A. , Sardarbekova E
Published: May 2019

in the work, rheological characteristics of ceramic masses based on loam with ash, mechanical-and complex activated loam with ash are investigated.Joint mechanical activation of loam with ash was carried out in a mixer-activator,
operating on the principle of a centrifugal impact mill. Complex activation includes joint mechanical activation of loam with ash, followed by treatment with surface active additive -PO-PB-7 in an amount of 0.1%.When determining the plastic strength of the masses on the basis of mechanical-, complexlyactivated and non-activated (original) loam with ash (in an amount of from 0 to 75%), optimal compositions of the masses were found.It was found that the plastic strength of the complex activated ceramic masses increases. The coefficient of sensitivity increases in mechanical-and complexly activated loams, and decreases with the introduction of ash, which predetermines the possibility of intensifying the drying process of samples based on complexly activated clay-ash mass.It has been established that the masses on the basis of complexly activated clay-ash raw turn into structural-mechanical type I with improved rheological properties
EFFICIENT QUALITY MANAGEMENT OF EDUCATION THROUGH QMS IDEOLOGY
Authors: Omurbekova Marina
Published: May 2019

Annotation: The article discusses the current state of quality management systems in universities of Kyrgyzstan, their main characteristics, and also offers some recommendations for improving the quality management of education based on the QMS. Special emphasis is placed on the premises of the formation of a quality management system in the conditions of development of the higher education system of the Kyrgyz Republic. It is noted that until now there are no regulatory documents regulating the choice of one of the models of the quality management system in higher education. Educational institutions have the right to choose a model for the formation of a quality management system. The authorselected the main problems of the current state of education quality management in higher educational institutions of the Kyrgyz Republic. Based on the analysis, were proposed specific ways and directions of work in order to improve the quality of education based on quality management. It is emphasized that in modern conditions the introduction of a quality management system guarantees the quality of education and increases the competitiveness of universities.
From Letters to Loyalty: Aline la Despenser and the Meaning(s) of a Noblewoman’s Correspondence in Thirteenth-Century England
Authors: Neal Kathleen Bronwyn
Published: May 2019

This chapter performs a close reading of a letter sent by the Countess of Norfolk to the Chancellor of England, Sometime between the summer of 1273, and early August 1274, concerning a rather banal administrative matter. Although this is hardly the place one might naturally look for evidence of intersections between emotion and governance, I argue that the letter was in fact a finely tuned articulation of affective persuasion, weaving between observing the expectations shaping letters of governance, and transgressing them in targeted and gendered ways. Through simultaneous reproduction and disordering of the rules of letter-writing, it sought to evoke a range of positive responses in one person – the chancellor to whom it was addressed – in ways uniquely reflective of the relationship between him and its sender, the countess. This example reveals how all senders of letters to royal officers might manipulate affective rhetoric to achieve their political, legal, or fiscal aims, and how emotion and governance regularly interacted in medieval England. The letter is also an especially rich source for interrogating how women accessed this particular discourse of authority, and how they adopted and adapted expected, masculine forms of rhetorical presentation to political ends.
Étude de la dynamique des cristaux moléculaires par diffusion des rayons X
Authors: Deprez Gilbert
Published: May 2019

In this paper is discussed the scattering of X-Rays by molecular crystals ; it is shown that the thermal scattering power

P[th] # P₁ + P₂ only for 4Π² | X |² u[x]² ⪡ 1

Measurements of X-Rays scattered by a crystal of hexamethylenetetramine for scattering vectors X along symmetry axes (3 and [-4]) yield directly the dispersion curves and the coupling constants ; for X in a symmetry plan (m) , librational motion perpendicular to m, gives a non vanishing contribution.

These coupling constants are compared with the experimental data of Dolling & Powell.
Changement de phase et mouvements orientationnels dans les cristaux moléculaires
Authors: Brot Claude , Renaud Michel
Published: May 2019

Certains cristaux moléculaires présentent comme propriété intrinsèque une liberté d'orientation de leurs molécules dans un domaine déterminé de température et de pression. La dynamique du désordre peut être envisagée selon deux types de modèles : celui de Pauling˗Fowler, qui suppose un état de rotation continue des molécules, semble rarement valable et, s'il existe, limité à des entités de faible moment d'inertie (H₂) ; celui de Frenkel paraît plus réaliste dans la majorité des cas (sauts aléatoires des molécules entre quelques positions discrètes).

L'étude de ces phases désordonnées et du passage de l'ordre au désordre nécessite l'utilisation de techniques expérimentales complémentaires (RMN, relaxation diélectrique, calorimétrie, diffraction X, spectrométrie infrarouge,...). La RMN, par exemple, est sensible essentiellement à la dynamique du réarrangement moléculaire mais ne l'est guère à l'existence du désordre ; la diffraction des rayons X détecte, au contraire, l'existence de ce désordre mais non sa dynamique.

On distingue deux cas selon que le groupe de symétrie des orientations permises est ou n'est pas un sous-groupe de symétrie propre de la molécule. Quelques exemples de chacun de ces cas sont donnés ainsi qu'une discussion des renseignements apportés par les diverses techniques employées :

— pour une réorientation modulo 2 π/n autour d'un axe d'ordre n, toutes les orientations permises sont énergétiquement indiscernables et il n'y a pas de transition thermodynamique (par exemple, benzène, hexafluorobenzène, cyclohexane II).

— une transition thermodynamique intervient pour libérer la réorientation :

— transition discontinue (du premier ordre) : il y a discontinuité de l'énergie interne, l'incrément d'entropie dépendant du rapport du nombre de sites permis dans les deux phases (par exemple, furanne, cristaux plastiques de molécules globulaires tel le cyclohexane I),

— transition progressive (d'ordre supérieur à 1) : le degré de corrélation des molécules diminue quand la température augmente (par exemple, certains dérivés hexasubstitués chlorométhylés du benzène).

Des études récemment effectuées, on peut conclure à une large validité du modèle de Frenkel, y compris pour une phase plastique caractéristique.

On donne enfin une discussion de cas où il n'est pas sûr que ce modèle soit applicable.
Structures et propriétés des radicaux libres nitroxydes
Authors: Lajzerowicz-Bonneteau Janine
Published: May 2019

Les structures cristallographiques des radicaux libres nitroxydes nous intéressent à divers titres :

— configuration des molécules (hétérocycles et groupements C—NO•—CN),

— arrangement des molécules en relation avec les interactions d'échange entre spins.

— utilisation des résultats de RPE dans la détermination des structures.
Les phases mésomorphes et leur identification
Authors: Billard Jean
Published: May 2019

Some pure compounds do not pass directly from a solid state into a liquid state when heated up. They have one or several intermediary phases which are separated from the previous ones by first order transitions. For achiral substances, those phases can be classified in two structural types models : smectic and nematic models. Their polymorphic transitions are discussed in connection with structures. The case of chiral compounds is examinated. The structures of some of their mesomorphic phases are derived from those achiral substances when twisted. No limit for the number of mesomorphic phases which are possible for a pure substance can be given. The practical method of identification of mesomorphic phases is based upon isomorphy. The mesomorphic phases of two substances can give continuous solutions. The different types of thermal diagrams of equilibrium and their calculus methods are recalled. The process of the practical method of identification is presented. Some applications are given to illustrate the mistakes to which the identification can lead in case of a mere examination of the textures.
Propriétés optiques non linéaires des cristaux moléculaires
Authors: Jerphagnon Jean
Published: May 2019

Non linear optics is a new and attractive tool for fundamental investigations of physical and chemical properties of crystalline materials. This paper is concerned with phenomena arising from the dielectric polarization proportional to the square of the optical electric field, in particular, with second harmonic generation. Processes responsible for optical non linearities in molecular crystals are studied with particular emphasis on the relations between non linear susceptibility tensor and crystal structure. The reliability of the powder second harmonic generation test as a proof of lack of inversion center in crystal structure is analysed and compared to the one of experiments involving other physical phenomena. In view of recent results it is shown that molecular crystals have for applications (frequency doublers and mixers, optical parametric oscillators, and light modulators) some inherent advantages over the other materials.
A Study of the Moral Sensitivity of Nurses and Nursing Students in Korea
Authors: HAN Sung-Sook , KIM Yong-Soon , PARK Jin-Hee , AHN Sung-Hee , MENG Kwang-Ho , KIM Ju-Hoo
Published: May 2019

This article reports on the results of a study of nurses and nursing students' sensitivity to the ethical dimensions of nursing practice. The sample consisted of 215 nursing students from two nursing colleges and 283 nurses working in two medical centers. The instrument used was the Moral Sensitivity Questionnaire (MSQ), a self-reporting Likert-type questionnaire consisting of 30 assumptions related to moral sensitivity in health-care practice. Each of these assumptions was categorized into a theoretical dimension of moral sensitivity: relational orientation, structuring moral meaning, expressing benevolence, modifying autonomy, experiencing moral conflict, and following rules. In structuring moral meaning, relational orientation, and following rules, significant differences were found between nurses and nursing students. However, a significant difference in the general characteristics of subjects was not found.
The Ethics of Nurses from the Standpoint of Doctors
Authors: SON Young-Soo
Published: May 2019

This article was written for the purpose of improving communication and understanding between nurses and doctors. It is written from the standpoint of doctors. The “ethics of nurses” is used in this article to refer both to the ethical standards or principles that nurses observe in nursing practice as well as to statements concerning the ethical principles with which nurses or their associations claim to comply. It is pointed out that medical practice requires a division of labor and that most associations of medical and paramedical practitioners explicitly endorse principles specifying the need for, and duties regarding, collaboration among medical and paramedical practitioners. Such principles of collaboration not only promote systematic cooperative relationships, they also encourage each group to hold the other in check, so as to safeguard medical ethics in clinical practice. It is argued that nurses and doctors should strive to reconstruct an advanced, democratic, complementary, coexistent, productive, and consonant relationship in order to promote effective communication in medical practice.
The Boundaries of American Bioethics and Beyond
Authors: KIM Eun-Sung
Published: May 2019

American bioethicists have established several conceptual boundaries in institutionalizing bioethics into hospitals, academic programs, and the government. Bioethical expertise has been shaped and maintained through such boundary-making practices. This paper examines the following three boundaries of American bioethics: the boundary between bioethics and society, between bioethics and politics, and between scientific knowledge and society. The first boundary designates the view that bioethics is de-contextualized from society, the second boundary results from the view that bioethics should be politically neutral, and the third boundary is built on the dichotomy between scientific knowledge and social values. These boundaries have been both contested and strengthened by American bioethicists. Through the analysis of such boundary-making practices of American bioethics, this paper aims to suggest fruitful lessons concerning the institutionalization of Korean bioethics.
Ethical and Legal Problems of Randomized Clinical Trials
Authors: CHOI Kyungsuk
Published: May 2019

Human experimentation can be ethically justified when subjects participate on a voluntary basis. Informed consent is required for clinical trials, including randomized clinical trials. Nevertheless, ethical issues arise when subjects are randomly distributed to experimental and control groups in randomized clinical trials. I argue that equipoise as well as informed consent is a condition of randomized clinical trials. Benjamin Freedman distinguishes theoretical equipoise from clinical equipoise. I call the former the “individual physician equipoise” and the latter the “clinical community equipoise.” Under clinical community equipoise, randomized clinical trials are ethically justified because physicians may still provide the best treatment to their patients. The above ethical principle should be applied to placebo-controlled randomized clinical trials. When experimental drugs and placebos are in clinical community equipoise, a trial may be ethically justified. In addition, placebo-controlled randomized clinical trials should be designed with double-blinding. The reason for this requirement is that physicians would cheat their patients without double-blinding. Current FDA regulations in Korea and the US do not sufficiently reflect the above ethical points. Institutional review boards should review their protocols in light of these ethical points. In particular, IRB regulations should reflect the basic ideas of equipoise in randomized clinical trials and double-blinding in placebo-controlled randomized clinical trials.
Korean Nurses' Awarenss of Patients' Rights in Hospitals
Authors: Kim Yong-Soon , Yoo Moon-Sook , Park Jin Hee
Published: May 2019

Patients’ rights and patient–nurse relationships in nursing practice have been viewed increasingly as essential aspects of nursing care. A cross-sectional questionnaire survey was conducted between August 1 and 30, 2005 to examine 618 Korean nurses’ awareness of patients’ rights regarding autonomy, informed consent, privacy, and confidentiality. Data were collected by means of a structured questionnaire. The results indicate that nurses have little awareness of the importance of patients’ rights regarding autonomy, privacy, and confidentiality. As an understanding of these rights is essential to good clinical practice, this study suggests that there is a need for education programs focused on understanding the legal and ethical rights of patients in the care of nurses.
The Current Debates and Social Trends Regarding Euthanasia and the Withdrawal of Life-Sustaining Treatment in Korea
Authors: CHOE Ji-Yoon , KWON Ivo
Published: May 2019

Progress in biomedical technology has resulted in a number of patients experiencing painfully slow deaths by means of artificial ventilators or other inhumane treatments. Such experiences give rise to the question of whether it is right to provide these life-sustaining treatments when no effective or curative therapies are available. The purpose of this study is to examine respective views on this issue given by criminal law experts, the courts, medical professionals, and the public. In Korea, there is still disagreement on the definition of the terms “euthanasia” and “death with dignity.” The current criminal law prohibits euthanasia for a dying patient with incurable disease and the withdrawal of life-sustaining treatment for a patient in a persistent vegetative state (PVS). However, a group of judicial and bioethics experts and policy-makers think that euthanasia or the withdrawal of life-sustaining treatment can be permitted under certain conditions. A recent court decision, which permitted the withdrawal of life-sustaining treatment on a PVS patient based on the patient’s right to self-determination and medical futility has stimulated a nationwide discussion for developing a legal framework for dealing with this issue. However, this article argues that care is needed in drafting the appropriate legislation as many unsolved problems related to this issue remain.
A Study of the Moral Judgments of Nursing and Non-Nursing Students Using a DIT Test
Authors: Cho Mee-Kyung
Published: May 2019

This study was performed to evaluate the moral judgments (P(%) and 4stage) of nursing and nonnursing student using a DIT test. The data were collected through self-reported questionnaires from 483 college students and measured by the Korean version of the Defining Issues Test (KDIT). The results were as follows. The mean P(%) scores of nursing and non-nursing student were 43.83(SD=15.70) and 38.27(SD=15.18) respectively. The difference between the scores for the two groups was statistically significant, as was the difference between the P(%) scores for males and females. The mean stage 4 scores for nursing and non-nursing students were 20.06(SD=11.97) and 18.83(SD=10.63) respectively. There were significant differences in the stage 4 scores for gender (F=3.18, p=.049), nursing ethics learning experience (t=4.59, p=.025), and number of siblings (t=5.17, p=.026). While the P(%) score for third-year students was lower than that for first-and second-year students, third-year students had the highest stage 4 score. The moral judgment score of third-year students is thought to be affected by clinical nurses during their practical training. The results of this study indicate a need for further longitudinal studies to measure the moral judgments of nursing students.
Advance directives in Korea and other countries
Authors: KIM Shin-Mi , HONG Young-Seon , KIM Hyun-Sook
Published: May 2019

Advanced directives (AD) facilitate communication between patients, family members, and health care providers regarding the care of patients who can longer communicate for themselves. However, in Korea, the notion of “advance directives” has never been regarded as a legally endorsed expression of the patient’s intention. This article reviews the historic background and content of AD legislation in several countries, revealing the advantages and disadvantages of each type of AD. Additionally, this article argues that culturally sensitive and user-friendly AD legislation is urgently needed in South Korea.
Attitude on Biomedical Ethics in a Tertiary Hospital Nurses
Authors: Kim Eun Hee , Lee Eun-joo , Hong Sung Jung
Published: May 2019

This study was conducted to identify the bioethical attitude of nurses working in a tertiary hospital. Data were collected from 208 nurses who agreed to participate in the study and analyzed by descriptive statistics, t-test, ANOVA and Scheffé test, and pearson’s correlation. Mean score of bioethical attitude of the subjects was 2.88±0.23 and slightly took up for the position of deontology. Especially, in the areas of right to life fetus, organ transplantation, right to life newborn, artificial insemination, artificial abortion, and euthanasia were more took up for the position of deontology than brain death and human biotechnology. Those who were older,moderate economic level, firm ethical attitudes, the intent to attend class on biomedical ethics, and the possibility of increasing ethical problems according to the development of the life science took up for more deontological position than those who were not. In addition, in the areas of right to life fetus, prenatal diagnosis of fetus, right to life newborn, euthanasia, artificial insemination,organ transplantation, human biotechnology, brain death, and artificial abortion were all significantly correlated each other.
Casuistical Deliberation in Medical Ethics Consultation
Authors: Lee Ilhak
Published: May 2019

In this article casuistical deliberation is explained and examined in regards to whether or not it is suitable for clinical ethics deliberation. Casuistry is the analysis of moral issues using reasoning based on paradigms and analogies. Such case-based reasoning leads to the formation of expert opinions about moral obligations that are general but not universal or invariable. Casuists try to give guidance in cases in which no clear ethical principles can be applied and to categorize cases into paradigms and maxims. This article provides a casuistical analysis of a clinical case and argues that casuistical deliberation is an effective means of giving guidance on clinical ethics to clients.
The Implementation and Effect of Ethics Education on Researchers Working in the Field of Xenotransplantation
Authors: Mo Hyo-Jung
Published: May 2019

Xenotransplantation research raises a number of ethical issues, such as a possible outbreak of new/zoonotic infection, violating an individual’s privacy, and harm to the animals (especially to onhuman primates) that are used in experiments. Since 2004, xenotransplantation researchers and doctors associated with the Xenotransplantation Research Center (XRC) have been receiving education related to the ethical issues involved in xenotransplantation research at least twice per year. Learners’ attitudes toward xenotransplantation have been investigated three times: in 2004, 2007, and 2010. The objective of this study was to discover the changes in learners’ attitudes toward xenotransplantation issues and to identify the best form of ethics education for xenotransplantation researchers. The Ethics Education for Researchers provided to XRC associates since 2005 has involved seven units on laws and regulations, nine units on general ethical issues, five units on the ethics of animal research, and ten units on laboratory management and ethics. To the question concerning the justifiability of xenotransplantation research, 100 percent of respondents answered “Yes, it is justifiable” in 2004. However, the proportion of positive responses decreased to 90.9% in 2007 and 86.2% in 2009. The proportion of respondents who considered “the risk of zoonosis” and “lack of established legal framework” as top-priority projects has increased. The preferred educational method was “case-based study.” After receiving the Ethics Education for Researchers, researchers tended to be more conscious of the ethical issues raised by xenotransplantation research. This study suggests a need for mandatory ethics education for xenotransplantation researchers using a variety of educational methods.
Narrative as a medium of virtue and practice in medicine*
Authors: Kim Jin Kyong
Published: May 2019

Every human being is a “narrative being” in the sense that he or she has a life story. It is not advisable, or even technicall possible, for a physician to separate a patient’s life history when making medical decisions. The best medical decision-making involves the patient, the physician, and concerned family members who come together to mediate conflicts that may arise through the patient’s life stories, rather than merely relying on regulations and principles. The ability to understand the meaning and importance of a patient’s life story is an important one for physicians to have. Physicians with this ability form stronger bonds with patients. This article examines some of the problems caused by scientific medicine and emphasizes the importance of patients’ life experiences and physicians’ willingness to listen to and understand patients’ life-narratives.
Conflicts of Interest in the Development and Dissemination of Clinical Practice Guidelines
Authors: Bae Jong-Myon
Published: May 2019

Clinical practice guidelines are systematically developed statements to assist practitioners and patients in making appropriate health care decisions in specific clinical circumstances. The potential influence of industry in the development or dissemination of clinical practice guidelines raises ethical concerns. A review of the development and dissemination of the Surviving Sepsis Campaign guidelines shows that the interaction between the pharmaceutical industry and academic societies can undermine clinical guidelines and harm the industry’s reputation. Thus, it is argued here that the process of developing and disseminating clinical practice guidelines should not be tainted by problems of corporate support and transparency. Furthermore, the process should identify and manage any conflicts of interest and ensure the patient-centeredness of the evaluation of emerging medical evidence.
Physician-industry Relationships in Continuing Medical Education
Authors: PARK Jae-Hyun , CHEONG Yoo-Seock
Published: May 2019

Physicians have both an ethical obligation and a right to participate in continuing medical education (CME) programs to constantly maintain and upgrade their knowledge and skills after the completion of their formal education. CME is the pharmaceutical industry’s most important marketing tool. CME is increasingly being funded by the pharmaceutical industry; currently the financial support from drug and device companies accounts for up to 60% of the costs of all accredited CME programs in the U.S. CME requirements for Korean physicians are somewhat lax at the present time, but industry sponsored CME is on the rise in Korea. With the increase in industry funded CME, there is cause for concern about potential conflicts of interest, scientific biases, and the educational quality of industry-funded CME. Physicians’ reliance on industry-funded CME has the potential to influence negatively their clinical decisions and to increase spending on prescription drugs. For these reasons, a growing number of medical institutions in the U.S. have limited or phased-out industry sponsorship of CME at their institutions. This article argues that in order to ensure the professional integrity of physicians and the process of learning in CME, physicians and pharmaceutical industries need more explicit codes of conduct and guidelines. Individual doctors should recognize the potential for the industry to influence their prescribing habits and follow the ethical principles of physician-industry relationships. Also, in order to better balance learning needs and patient concerns, physicians should have the information and skills required to make informed decisions in CME.
Death Anxiety and Preferences Regarding End-of-life Medical Care
Authors: KIM Shinmi , KIM Soon Yi , KIM Kisook
Published: May 2019

A survey was conducted to examine death anxiety and preferences regarding end-of-life care among adults aged 40 years or older. A total of 352 subjects were recruited from two areas in South Korea by trained research assistants, who used structured questionnaires consisting of demographic characteristics, Templer’s Death Anxiety scale, and the Korean version of the Preference of Care at the End of Life. The data were analyzed using descriptive statistics, a t-test, an ANOVA, and Pearson’s correlation coefficient. Subjects reported a moderate level of death anxiety. Furthermore, while a gender effect was detected, an age effect was not. There was a low preference for life-sustaining treatment with no significant differences among the various demographic groups including age. This study suggests that in order to promote clients’ self-determination and end-stage quality of life, health care providers need to be aware of clients’ attitudes toward death and their preferences regarding end-of-life care.
Understanding the Experiences of Family Members Who Make Do-Not-Resuscitate Decisions for Cancer Patients
Authors: OK Jeonghui , YI Myungsun
Published: May 2019

The purpose of the study was to understand the experiences of family members of who made do-notresuscitate(DNR) decisions for patients with cancer. A phenomenological approach was used to understand and describe the decision-making experiences of such family members. The data were collected by individual in-depth interviews from six participants at their homes. All interviews were audio-taped and transcribed for later analysis. The data were analyzed using Colaizzi’s method to extract the major themes that describe the essence of the DNR experience. Upon analysis eight themes emerged: commitment to become a primary caregiver; painful acceptance of the impending death of the patient: DNR as a sentence to death; the intensive care room as a place of execution; discreet DNR decisions made for the patient’s comfortable death; DNR decisions made urgently without preparation; being alone with the dying patient; feelings of guilt and lingering attachment to the death of a patient. These themes characterize the DNR decision-making experiences of family members. The results of this study should assist oncology professionals and others in the understanding of family members who make DNR decisions on behalf of cancer patients.
Korean College Students’ Attitudes and Preferences Toward Shared Decision-Making between Patients and Physicians
Authors: LEE Su Hyun , HAN Heung Sik , CHANG Chulhun L. , PARK Byung Kyu , KIM Sung Soo
Published: May 2019

Purpose: The purpose of this study was to examine Korean college students’ attitudes and preferences toward shared decision-making (SDM).
Methods: Questionnaires were collected from 142 college students in Korea. Subjects were asked about four main items: (1) attitudes toward SDM; (2) experiences with SDM; (3) preferences for treatment decision-making for four diseases; (4) barriers to SDM.
Results: It was found that 78% of the participants had never heard of SDM and 61% indicated that the doctor-patient relationship is paternalistic. The majority of subjects believed that the final treatment decision should be made by doctors and patients together. While 39% of subjects said that their doctors had asked them to participate in treatment decision-making, only 10% of subjects felt that their doctors actually wanted them to participate in SDM. The type of disease in question had no effect on the subjects’ preferences for treatment decisionmaking; all subjects expressed a preference for playing a collaborative role in the decisionmaking process. Furthermore, subjects believed that when patients and physicians disagree on treatment options, patient preferences should take precedence. Finally, subjects indicated that the main factors impeding SDM are (a) a lack of information about prognosis (28%), (b)beliefs about doctors’ sole authority for treatment decision (25%), (c) the lack of consultation time with doctors (19%), (d) the difficulties of understanding medical terms, and (e) the scarcity of available opportunities for participation in SDM.
Conclusion: Although most subjects in this study were not familiar with SDM, they showed high preferences for it. Additionally, subjects did not feel that their doctors often used shared decision making. Physicians in Korea should make greater efforts to engage in SDM with their patients.
A Comparison of First-Year and Senior Nursing Students’ Ethical Values and Understanding of Biomedical Ethics
Authors: KIM Eun Hee , LEE Eunjoo
Published: May 2019

The purposes of this study were, first, to identify whether the clinical experience of nursing students influences their ethical values and, secondly, to determine what factors influence the understanding of biomedical ethics. A total of 811 nursing students (355 students with clinical practical experience [CPE]; 476 students with no clinical practice [NCP]) were recruited from six different BSN programs in one city in South Korea. Data were analyzed using descriptive statistics, a χ2-test, a t-test, a one-way ANOVA, and a Scheffé test using the SPSS/WIN 17.0 program. Comparing the differences in the values or ethical attitudes of the two groups, NCP students were found to have a more deontological orientation (2.76 for CPE students; 2.81 for NCP students). There were statistically significant differences between the responses of the two groups in the following areas: the right to life of a fetus, the right to life of newborns, artificial abortion, and brain death. For the NCP students, the predicting variables were the following: ethical values, club participation, and source for information or knowledge of biomedical ethics. On the basis of these results, it is argued that the clinical experience of nursing students should be regarded as an important factor inthe development of educational programs in biomedical ethics for nursing students.
Biobank and Broad Consent
Authors: KIM Moon-Jeong
Published: May 2019

The biobank, which is recently pursued by many countries, is supposed to play an important role for the development of the Biomedical science. Thus, I argue that there are a number of important ethical issues needed to be examined for the successful operation of the biobank. Especially, I've focused on “informed consent”, which is fundamental ethical norm in protecting donors' safety and right. But the informed consent for the biobank has to be quite “broad” due to the intrinsically uncertain nature of the future research related to it, and social, for the unique characteristics of genetic information. Therefore the focus of this study is to examine “broad consent” as an alternative approach for protecting of sujects safety and right in using human biological materials and personal medical information.
Evaluation of Accuracy of Pharmaceutical Marketing Brochures
Authors: LEE Hong-Yeon , CHEONG Yoo-Seock , CHOI Eun-Young , PARK Eal-Whan
Published: May 2019

As information provided in pharmaceutical marketing brochures has the potential to change doctors’prescribing behavior, ongoing efforts to increase awareness about drug promotion are crucial. However medical information in journal advertising has been criticized in several studies for being of poor quality. To find out the accuracy and ethical status of pharmaceutical marketing brochures about proton pump inhibitors prescribed in one university hospital in South Korea, six brochures were collected from pharmaceutical representatives visiting the family medicine out-patient department of that hospital between May 2010 to March 2011. We examined these brochures for the types of claims that were made, the amount and type of evidence provided, the authenticity of the quoted references, and whether or not the brochures satisfied the “World Health Organization (WHO) criteria 1988.” We also ascertained the source of funding for the original research cited in the brochures. Upon analysis, none of the promotional brochures fulfilled all of the WHO criteria. All brochures used emotionally loaded language and made exaggerated claims about the efficacy of the medicine in question. A total of 61 references were found in these brochures, 86.8% of which were journal articles. Of the journal articles cited in these brochures, 73.6% were SCI level, most were based on randomized controlled trials (RCT, 53.8%), and 41.5% were sponsored by pharmaceutical companies. Additionally, 17.1% of the claims made in these brochures were incorrect according to the published articles cited in the brochures, and 10.4% contained vague descriptions. We conclude that some of the information provided in pharmaceutical brochures for physicians is incorrect. Accordingly, we suggest that physicians need to be cautious about the reliability of information provided in drug advertisements and should follow the principles of evidencebased medicine in assessing the validity of information provided by pharmaceutical companies.
The Effect of Nurses’s Experiences with DNR Orders on Their Knowledge and Attitudes Concerning the Withdrawal of Life-sustaining Treatment
Authors: KIM Sun Ja , KIM Hyun Sook , CHAE Young , KIM Won Jeong , KANG Ji Sook
Published: May 2019

This study was designed to investigate how nurses’ experiences with DNR orders affects their knowledge of, and attitudes toward, the withdrawal of life-sustaining medical treatment. After receiving IRB approval, the 245 nurses who agreed to participate in this study completed a self-report questionnaire. The collected data were analyzed with PASW 18.0, which was used to measure frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficients. The major findings of this study were as follows. 1) The percentage of participants who had some experience with DNR orders was 35.1%. 2) The knowledge score concerning the withdrawal of life-sustaining treatment for nurses with DNR experience was significantly higher than that for nurses without DNR experience (t=2.319, p=0.021). 3) There was no significant difference in attitudes toward the withdrawal of life-sustaining treatment between the two groups of nurses. However, there were significant differences between the two groups on respect for family’s CPR decisions. 4) Higher knowledge scores were significantly related to lower attitude scores (r=-0.250, p<0.001) for the withdrawal of life-sustaining treatment. Nurses with DNR experience have greater knowledge about the withdrawal of life-sustaining treatment than nurses without such experience. Attitudes toward the withdrawal of life-sustaining treatment between these two groups of nurses differ only partially.
Intensive Care Providers’ Perceptions of Medically Futile Treatment: Focus Group Interviews*
Authors: KIM Sang Hyun , SON Myungsei , KOH Shin Ok , LEE Ilhak
Published: May 2019

This study was designed to examine intensive care providers’ perceptions of medically futile treatment. Focus group interviews were conducted with 18 intensive care physicians in charge of critical care units at tertiary hospitals in Daegu, Gwangju, and Seoul, South Korea. Results are as follow. 1. More than half of the participants opposed the inclusion of persistent vegetative state (PVS) patients in the category of medically futile treatment. 2. And though the distinctions between ordinary and extraordinary treatment, and between the withholding and withdrawal of treatment, were not clinically meaningful in the intensive care units under study, they are nevertheless relevant because of individual religious beliefs and Korean cultural traditions. 3. Since the beliefs and traditions of family members often makes it difficult for a patient to fill out advance directives, we argue that a gradual approach would be useful in choosing advance directives, making those directives optional rather than mandatory. 4. Economic factors also play a crucial role in the decision-making process regarding futile treatment in Korea. These factors were neglected in earlier surveys. Finally, the participants insisted that the physician’s right to make clinical decisions about medically futile treatment should be legislatively guaranteed based on their convictions. Based on the results of this study, we suggest the follow: a) that detailed criteria for medically futile treatments be established; b) that a decision-making process be developed that is culturally, ethically, medically, and legally acceptable; and c) that ethical education be provided to intensive care physicians.
A Survey on Doctors' Attitude towards Organ Donation in Brain Death Patient after Cardiac Arrest
Authors: CHOI Eun Ah , CHA Won Chul , SHIN Tae Gun , SIM Min Seob , JO Ik Joon , SONG Keun Jeong , LEE Taerim , CHOI B.I
Published: May 2019

This study was conducted over 1 month in 2012 to investigate doctors` attitude towards organ donation in brain death patient after restoration of spontaneous circulation from cardiac arrest. A total of 107 residents and staffs were answered the questionnaire. Participants were selected from departments that frequently involved in managing brain death patients after cardiac arrest. More than 50% responders had an experience of managing brain death patient after cardiac arrest. However they still had difficulties in making a decision whether their patient was brain death or not, suggesting organ donation to brain death patient`s family members. To improve results of organ donation from brain death patient after cardiac arrest, further education and attitude change of doctors who are in charge of taking care of those patinets will be needed.
The Definition and Ethical Issues of Part-Human Animals*
Authors: MO Hyojung
Published: May 2019

Recent advances in the development of biotechnology have led to the creation of a variety of organisms, named part-human animals, with both human and animal components. Scientists have created part-human animals that have both human cells and animal cells in their body. I want to avoid the term 'chimera' and 'hybrid' because of using both creation methods of chimeras and hybrids in making part-human animals. The part-human animals might hold enormous potential for clinical application as well as basic research into human physiology. Despite its potential, however, the progression of part-human animal research has given rise to many ethical concerns. The arguments against the creation of part-human animals are related to the concerns about human dignity and moral confusion and also the crossing and violating of the “species boundary” are morally repugnant and wrong. For these reason, we found that the public's negative attitudes toward making part-human animals, We should know that part-human animals research is required the deeply consideration.
The Practical Model of Medical Decision Making: Interaction with Three Main Forces (Patient-Doctor-Society)
Authors: LEE Hyo Jean
Published: May 2019

Physicians come face to face with many crises concerning the medical decision making. Apart from medical problems, they have to consider patient’s personal needs, social ethics and law. Because physician-patient relationship changed from doctor-centered to cooperation-based like shared decision making. Meanwhile the conflicts between patients and doctors are growing all the time, since each patient has to bear a socioeconomic cost of disease. Therefore, the approach by ethics and law is needed to solve their problem, for example, hospital ethics committee. In conclusion, the medical decision making process is an outcome from the interaction with three forces : medical opinion of doctor, personal needs of patient and limitation of society like law and ethics. This article shed light on these three main forces and propose practice model.