BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

On the history, structure, and importance of the elementary Buddhist logic and dialectrical studies in Tibet.

volume ka-pa [1-13]. ʼDul ba -- volume ka-a [14-25]. ʼBum [Sher phyin] -- volume ka-kha, a [26-28]. Nyi khri -- volume ka-nga [29-32]. Khri brgyad stong pa -- volume ka [33]. Brgyad bstong pa -- volume ka [34.] Sher phyin sna tshogs -- volume ka-ga, a [35-38]. Phal chen -- volume ka-cha [39-44]. Dkon brtsegs -- volume ka-am [45-76]. Mdo sde -- volume ka-wa [77-96]. Rgyud ʼbum -- volume ka-ga [97-99]. Rnyin rgyud -- volume shri [100]. Dus ʼgrel -- volume (...) e-wam101-102. Gzungs ʼdus -- volume 103. Dkar chag. (shrink)

Collected works of Dpal-sprul O-rgyan-ʼjigs-med-chos-kyi-dbaṅ-po, b. 1808, on diverse topics predominantly on Rnying-ma-pa doctrines and Budhist philosophy; includes rituals.

Collected works of Dpal-sprul O-rgyan-ʾjigs-med-chos-kyi-dbang-po, 1808-1887, a Nyingmapa master on diverse topics predominantly on Rnying-ma-pa doctrines and Budhist philosophy; includes rituals.

Predominantly on Tibetan Buddhist doctrines and philosophy.

What is the relation of love and pedagogy? Two recent phenomena have called into question whether love has any place within pedagogy at all: teacher‐student sexual scandal and the standardization movement. As love walks the thin line between inspiration and sex, and as standardization has assumed love to be synonymous with bias, it has become more important than ever to provide a clear account of love and its relation to teaching. For this account, I turn to Lacanian psychoanalysis and, in (...) particular, to Lacan's contentious claim that “There is no such thing as a sexual relationship.” Through an explication of Lacan's position on love, I conclude that love not only has a place within pedagogy but is necessary for it. (shrink)

정체전중변(正體傳重辨) 3편과 논문 6편을 우리말 로 옮기고 주를 달았다.

Big data and artificial intelligence (“AI”) promise to transform virtually all aspects of biomedical research and health care (Matheny et al. 2019), through facilitation of drug development, diagno...

The American Buddhist nun and author of the best-selling When Things Fall Apart counsels readers on how to live compassionately and well during times of instability, demonstrating the use of the Three Commitments practice to promote ...

Gemass ihrer grundlegenden Bedeutung wurde die Ousia- und Eidoslehre des Aristoteles uber viele Forschergenerationen hinweg intensiv diskutiert und steht immer noch im Mittelpunkt der Aristoteles-Forschung. Die Lehre bleibt jedoch nur einseitig interpretiert und verstanden. Ihre bisherige Interpretation hat sich allzu sehr auf die sogenannten Substanzbucher der Metaphysik beschrankt, ohne dabei den der Lehre wesentlichen biologischen Aspekten gebuhrende Beachtung zu schenken. Der Autor schliesst diese Forschungslucke. So wird im ersten Teil des Werkes Metaphysik Z, der Haupttext der Ousialehre, sorgfaltig kommentiert, und (...) im anschliessenden zweiten Teil werden unter Bezugnahme auf die im vorhergehenden Teil erorterte Problematik drei wichtigste biologische Schriften des Aristoteles besprochen. Dadurch wird ein wesentlicher Zusammenhang zwischen der Ousia- und Eidoslehre in der Metaphysik und der Biologie hergestellt. (shrink)

인간이해와 교육, 인간교육의 다차원성, 인간이해와 교육한을 설명한 전공서.

In the current study, we examine the changes in disclosure practices on compliance and the fight against corruption at Siemens AG, a large German multinational corporation, over the period 2000–2011 during which a major corruption scandal was revealed. More specifically, we conduct a content analysis of the company’s annual reports and sustainability reports during that period to investigate the changes of Siemens’ corruption and compliance disclosure using both quantitative and qualitative methods. Through the lens of legitimacy theory, stakeholder analysis, and (...) organizational façades, we find evidence that Siemens changed its compliance and corruption disclosure practices to repair its legitimacy in the wake of the 2006 corruption scandal. We analyze these strategies more closely by using the rational, progressive, and reputation façades framework. Our primary findings suggest that the annual reports show peaks of disclosure amounts on corruption and compliance disclosures earlier than sustainability reports, which can be partly explained by analyzing the disclosures made about—and to—the different stakeholder groups. We find that the annual report focuses more on internal stakeholders such as employees, while the sustainability report focuses more on external stakeholders such as suppliers. We also find that the company uses the façades differently depending on which report is being analyzed. (shrink)

The Great Synthesis of Wang Yangming Neo-Confucianism in Korea, a pioneering study of Chŏng Chedu (Hagok, 1649-1736) and Korean Yangming Neo-Confucianism, includes an annotated translation of the Chonŏn, Hagok's most important work on self-cultivation, and a comprehensive introduction to his life, scholarship, and thought.

The use of racial categories in biomedicine has had a long history in the United States. However, social hierarchy and discrimination, justified by purported scientific differences, has also plagued the history of racial categories. Because “race” has some correlation with biological and genetic characteristics, there has been a call not to “throw the baby out with the bathwater” by eliminating race as a research or clinical category. I argue that race is too undefined and fluid to be useful as a (...) proxy for biology or genetics. (shrink)

Selection of author's works on Svātantrika Madhyamika philosophy and logic.

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)