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Noninvasive Prenatal Diagnosis using Cell-Free Fetal DNA in Maternal Plasma: Clinical Applications

  • Yang, Young-Ho;Han, Sung-Hee;Lee, Kyoung-Ryul
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.1-16
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    • 2011
  • Owing to the risk of fetal loss associated with prenatal diagnostic procedures (amniocentesis, chorionic villus sampling), noninvasive prenatal diagnosis (NIPD) is ultimate goal of prenatal diagnosis. The discovery of circulating cell-free fetal DNA (cffDNA) in maternal plasma in 1997 has opened up new probabilities for NIPD by Dr. Lo et al. The last decade has seen great development in NIPD. Fetal sex and fetal RhD status determination by cffDNA analysis is already in clinical use in certain countries. For routine use, this test is limited by the amount of cell-free maternal DNA in blood sample, the lack of universal fetal markers, and appropriate reference materials. To improve the accuracy of detection of fetal specific sequences in maternal plasma, internal positive controls to confirm to presence of fetal DNA should be analyzed. We have developed strategies for noninvasive determination of fetal gender, and fetal RhD genotyping using cffDNA in maternal plasma, using real-time quantitative polymerase chain reaction (RT-PCR) including RASSF1A epigenetic fetal DNA marker (gender-independent) as internal positive controls, which is to be first successful study of this kind in Korea. In our study, accurate detection of fetal gender through gestational age, and fetal RhD genotyping in RhD-negative pregnant women was achieved. In this assay, we show that the assay is sensitive, easy, fast, and reliable. These developments improve the reliability of the applications of circulating fetal DNA when used in clinical practice to manage sex-linked disorders (e.g., hemophilia, Duchenne muscular dystrophy), congenital adrenal hyperplasia (CAH), RhD incompatibility, and the other noninvasive pregnant diagnostic tests on the coming soon. The study was the first successful case in Korea using cffDNA in maternal plasma, which has created a new avenue for clinical applications of NIPD.

Achieving Health Equity Through Health Promotion (건강증진사업의 효율성과 형평성: 건강증진을 통한 건강 형평성 제고)

  • Moskowitz, Joel M.
    • Proceedings of The Korean Society of Health Promotion Conference
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    • 2005.09a
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    • pp.91-119
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    • 2005
  • 오타와 헌장에 따르면 건강증진은 건강형평성을 성취하는 것이다. 건강격차를 감소시키고, 모든 사람들이 건강잠재력을 달성할 수 있도록 동등한 기회와 자원이 제공되어야 한다. 또한 각 개인들은 자신의 건강에 대한 결정요인들에 대한 통제능력을 가져야 한다. 미국의 조기사망은 40%가 행동양식에 의하여, 30%가 유전적인 문제로, 15%가 사회적 환경에 의하여, 10%는 의료적 치료의 부족으로, 그리고 5%는 환경위해 물질에 대한 노출로 발생한다. 건강불평등을 발설시키는 사회적 요인으로는 경제적 요인을 들 수 있다. 이러한 요인으로 야기되는 건강불평등의 문제를 해결하여 건강형평성을 달성하기 위해서는 절대적 목표들과 평등관련 목표들이 모두 필요하다. 건강형평성은 인구집단의 건강과 함께 향상되는 것으로 나은 건강상태에 있는 사람들의 건강을 악화시키면서 건강형평성을 달성하는 것은 아니다. 각자의 관심이 형평성을 어떻게 규정하는가에 영향을 미친다. 혜택을 받은 사람들은 성과/투입의 정의를 선호하며, 소외계층은 똑같은 성과 또는 요구에 기반한 정의를 선호한다. Healthy People 2010은 미국의 국가적 예방체계를 의미하며, 가장 중요하며 예방 가능한 건강위협들을 파악하고 이러한 위협들을 감소하기 위한 목적들이 설정되어 있다. 궁극적인 목적은 건강한 삶의 질적인 면과 양적인 측면을 향상시키는 것이며, 건강불평등을 제거하는 것이다. 그러나 미국이 유럽의 국가들에 비해서 사회 프로그램에 대한 투자가 적은 이유는 재분배는 소수인종만을 위한 것이라는 믿음과, 우리는 개방되고 공정한 사회에 살고 있기 때문에 가난하다는 것은 가난한 사람들 자신들의 잘못으로 인한 것이라는 믿음 그리고 재분배를 방지하는 정치체계 때문이다. 국가기관인 CDC의 예방연구센터(Prevention Research Centers)는 지역사회 파트너들과 함께 건강증진, 질병예방, 그리고 질병과 상해로 인한 합병증을 관리하게 위한 효과적인 예방 전략을 개발하고 있다. 예방연구센터의 프로그램들은 지역사회 기반 참여연구와 소외된 계층에 중점을 두며, 다학제 간 접근방법을 활용하고, 교육기관, 공공보건기관 그리고 지역사회의 파트너들 간의 네트웍을 형성을 통한 협력관계를 강조하고 있다. 지역사회 위원회가 구성되어 있으며, 또한 근거중심 프로그램을 개발하고 있다. 이들은 건강 결정요인에 관한 연구, 형성적 연구, 개입 프로그램 및 프로그램의 확산에 관한 연구를 진행한다. UC Berkeley의 가족/지역사회 보건센터(Center for Family & Community Health)는 1993년에 설립되었다. 사업의 대상이 되는 주요 지역사회는 한국교민사회이며, 한국교민사회 자문위원회(Korean Community Advisory Board, KCAB)가 구성되어 있다. 1993년부터 2003년까지는 'Health is Strength' 사업이 시범연구사업으로 진행되었는데, 그 내용은 유방암과 자궁경부암 검진 프로그램이었다. 2003년부터 2009년까지 진행될 'Quitting is Winning'이라는 두 번째 시범연구사업은 남성들의 금연에 중점을 둔 사업이다. 'Health is Strength'는 아시아 보건서비스 및 한국교민사회 자문위원회가 함께 협력하여 진행된 사업으로, 주요 목표는 18세 이상 여성의 자궁암 조기 검진(Pap test)과 자가 유방검진 실천을 증가시키는 것이며, 50세 이상여성의 유방 임상검사와 유방 X선촬영 비율을 증가시키는 것이었다. 한 지역의 카운티에 거주하는 한국 여성들은 4년간의 개입프로그램의 대상이 되었으며, 이들을 대상으로 횡단적인 전화조사를 3번(사전, 중간, 사후)실시하였다. 개입 프로그램은 교회에서 워크샵 개최, Tell-A-Friend Form 작성하기, 포스터 및 책자 발행, 신문광고 등과 함께 자궁암 조기 검진(Pap test)과 유방 X선 촬영권을 무료로 제공하는 것으로 구성되었다. 'Quitting is Winning'은 지역사회 기반 참여 연구모형으로 한국교민사회 자문위원회는 흡연을 1순위의 사업으로 선정하였고, 근거에 기반한 금연 프로그램에 대한 연구들을 검토하여, 기존의 보편적 방법이 아닌 인터넷을 활용하는 프로그램을 진행하는 것으로 결정되었다. 이는 무작위 임상실험으로 연구대상으로 미국에 거주하는 한국인 남성흡연자 2300명을 모집하였다. 이들의 1/2은 실험군인 인터넷 프로그램 집단에, 또 다른 1/2은 대조군인 인쇄책자 집단에 무작위 할당되었다. 12개월 동안 11번의 진단이 인터넷을 통하여 진행되었으며, 참여와 참여유지에 대한 금전적인 보상이 제공되었다.

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An Analysis of Elementary School Students' Interpretation of Data Characteristics by Cognitive Style (초등학생의 인지양식에 따른 자료해석 특성 분석)

  • Lim, Sung-Man;Son, Hee-Jung;Yang, Il-Ho
    • Journal of The Korean Association For Science Education
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    • v.31 no.1
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    • pp.78-98
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    • 2011
  • The purpose of this study was to analyze elementary school students' interpretation of data characteristics by cognitive style. Participants were elementary students in sixth grade who can use integrated inquiry process skills. The students were divided into two groups, analytic cognitive style and wholistic cognitive style according to their response to Cognitive Style Analysis. They performed scientific interpretation of data activity. To collect data for this study, participants recorded the result on scientific interpretation of data activity paper and researcher recorded the situation on videotape and interviewed with participants after the end of interpretation of data to get additional data. And the findings of this study were as follows: First, the study analyzed interpretation of data characteristics by the operator regarding different situations of interpreting data according to cognitive style. For example, in the intermediate state, analytic-cognitive style students showed high achievement in identifying variables, and wholistic-cognitive style students were active in using prior knowledge to interpret data. Second, the result of analysis on the direction of interpreting data and preference for data types in interpreting data activities according to cognitive style are as follows: Wholistic-cognitive style students showed relatively high perception of information through the top-down approach. On the other hand, analytic-cognitive style students usually used the bottom-up approach gradually expanding detailed information to the scientific question-related answer and showed a preference data of the table type. Through the result, this study aimed to help establish a data interpretation strategy for learners to solve problems based on understanding of interpretation of data characteristics according to learners' cognitive style, and purposed the instruction design suggesting the data requiring various data interpretation strategies to develop learners' data interpretation ability.

Comparative Analysis of Conceptual and Algorithmic Problem Solving Ability on Boyle's Law and Charles's Law in Middle School 1st Grade Students (보일의 법칙과 샤를의 법칙에 대한 중학교 1학년 학생들의 개념 문제 해결력과 수리 문제 해결력 비교 분석)

  • Park, Jin-Sun;Kim, Dong-Jin;Park, Se-Yeol;Hwang, Hyun-Sook;Park, Kuk-Tae
    • Journal of the Korean Chemical Society
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    • v.55 no.6
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    • pp.1042-1055
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    • 2011
  • The purpose of this study was to compare the conceptual and algorithmic problem solving ability on Boyle's law and Charles's law according to cognitive levels and characteristics of students in middle school 1st grade students. For this study, questionnaire items of conceptual and algorithmic problem solving ability were developed. and the problem solving ability according to cognitive levels and characteristics of students was compared. The long-term memory effect in conceptual and algorithmic problem solving ability according to cognitive levels was investigated, and problem solving process were analyzed by questionnaire items. In the results of this study, conceptual problem solving ability was higher than algorithmic problem solving ability in all cognitive levels. There was statistically significant difference in concrete operational period and transitional period students. In comparison of the long-term memory effect in conceptual and algorithmic problem solving ability, formal operational period students had the long-term memory effect. There was no statistically significant difference in the conceptual and algorithmic problem solving ability according to private education among the characteristics of students. But there was statistically significant difference in the problem solving ability according to experiences of the scientific activities and hopes to related scientific careers. From results of analysis of problem solving process, it is known that the students had a tendency to just remember macroscopic phenomena and to solve the problems without understanding the concepts. Therefore, teaching and learning strategy is necessary to replace unscientific concepts by the scientific concepts through identifying students's unscientific concepts in advance.

The comparison of Patient Hygiene Performance(PHP) Index according to the number of Oral Health Care worker with Disabled (장애인 구강건강관리인력에 따른 구강환경관리능력 지수 비교)

  • Kim, So-Yeon;Kim, Su-ji;Kim, Yeon-seon;Kim, Ji-Hong;Kim, Hyo-Jin;Jung, Seung-min;Hong, Ji-Hee
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.28 no.2
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    • pp.116-126
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    • 2019
  • Objectives: Currently, oral health of the disabled is taken care of by the social workers, not by dental hygienists, who are the oral health professional in this area. Therefore, we aim to enhance the equity of oral health for the disabled by providing the correct oral health care method to social workers residing in the welfare facility for the disabled. Methods: Four dental hygienists and four social workers were given the class I intellectual disabilities living in 'o' welfare facilities for disabled people in Songpa-gu, Seoul from April 13, 2019 to April 20, 2019. Patient Hygiene Performance(PHP) Index were measured and compared. In advance, the social workers were taught brushing (Rolling method), and the method of brushing and measuring tools were integrated. Results: Twice a total of dental hygienists and social workers practiced toothbrushing(Rolling method) for the class I intellectual disabilities who is a person to be brushed. When comparing the Patient Hygiene Performance(PHP) Index after the second round, the result shows that both the first and second dental hygienists' Patient Hygiene Performance(PHP) Index is lower. Conclusions: Comparing oral health knowledge level and Patient Hygiene Performance(PHP) index of dental hygienist and social workers, the result shows that dental hygienist has higher oral health care ability. Therefore, the dental hygienist should be placed in welfare facility for the disabled as an expert in oral health management to create an environment in which the disabled and social workers can be trained. In addition, the curriculum of the college that nurtures the dental hygienists should have a course to understand the characteristics of the disabled person in order to enhance the professionalism of dental hygienists.

Discourse Analysis of Business Chinese and the Comparison of Negotiation Culture between Korea and China - Focused on Business Emails Related to 'Napkin Holder' Imports - (무역 중국어 담화 고찰과 한중 협상문화 비교 - '냅킨꽂이' 수입 관련 비즈니스 이메일을 중심으로 -)

  • Choi, Tae-Hoon
    • Cross-Cultural Studies
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    • v.50
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    • pp.103-130
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    • 2018
  • This research aims to explore the associated linguistic features and functions of Chinese as used for business trading purposes, and which is based on a discourse analysis through a case in which a Korean buyer and a Chinese supplier have exchanged Internet based e-mails. The research questions include first, the linguistic functions and characteristics of Chinese shown as identified in this trade case through e-mails, second, the use of Chinese trade specific terms, and third, the apparent and dynamic negotiation strategies that are identified as followed by the cultural value systems which are used for resolving interest conflicts and issues between the buyer and supplier in the course of negotiating business contracts between two parties. The participants of this research pertain to a Korean buyer, James and a Chinese supplier, Sonya. The associated data consists of 74 e-mails exchanged between the two parties, initiated in an effort to begin and complete a trade item, in this case namely the product of napkin holders. The research for the study is based on the discourse analysis and empirically analyses models of Chinese linguistic functions and features. The findings are the following. First, as identified, the specific Chinese functions used and sequenced in this trade case are of a procedure, request, informing, negotiation and persuasion. Second, the essential trade terms used in this business interaction involve the relevant issues of 1) ordering and price negotiating, 2) marking the origin of the products, 3) the arrangement of the product examination and customs declaration for the anticipated import items, 4) preparation of the necessary legal documents, and 5) the package and transport of the product in the final instance. Third, the impact of the similarities and differences in the cultural value systems between Korea and China on the negotiations and conflict resolution during a negotiated contract between two parties are speculated in terms of the use of culturally based techniques such as face-saving and the utilization of uncertainty-avoiding strategies as meant to prevent misunderstandings from developing between the parties. The concluding part of the study discusses the implications for a practical Chinese language education utilizing the linguistic functions and features of the Chinese culture and language strategies as useful in business associations for trading purposes, and the importance of intercultural communication styles based on similar of different identified cultural values as noted between two parties.

A Study on a Korean-Translated Version of the Pediatric Volitional Questionnaire (PVQ) (Pediatric Volitional Questionnaire의 국내적용을 위한 번역연구)

  • Ra, Dae-Yeop;Chang, Ki-Yeon;Kong, Myung-Ja;Lee, Sun-Wook
    • The Journal of Korean Academy of Sensory Integration
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    • v.16 no.3
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    • pp.34-49
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    • 2018
  • Objective : This study aimed to examine the psychometric properties of Korean version of Pediatric Volitional Questionnaire (PVQ-K) using classical test theory. Methods : For the translation of Pediatric Volitional Questionnaire (PVQ), as recommended in the literature, four-stage translation method was used. For the psychometric properties of Korean version of the Pediatric Volitional Questionnaire (PVQ-K), internal consistency reliability, content validity, and construct validity of the test using the known groups method and convergent and divergent methods were examined. For the recruitment of participants, a convenience sampling method is used. Participants of this study were 10 children with neuro-developmental disabilities hospitalized two different rehabilitations center and 10 children with typical development living in Daejeon, South Korea. All 20 participants were in aged from two to five years. Results : In terms of the content validity index, it was over 0.78, confirmed by nine experts of children development. PVQ-K successfully discriminated the scores of children with typical development from those with neurodevelopmental disabilities (p < .05). It is found that there is significant correlations between achievement stage of PVQ-K and the Korean Developmental Screening Test for Infants & Children (K-DTS)(.652 ~ .799 for subcategory, .706 for total scale). The internal consistency was .944 (Cronbach's ${\alpha}$). In qualitative content analysis, it was examined that how Korean children behave and respond in the environment, and how children's volition was strengthened or weakened by the environment. Conclusion : The results propose that PVQ-K can be a useful occupation-focused measure. This study recommend further study on PVQ-K with larger samples combined with the item-response theory approach.

Effects of a Short-term Multimodal Group Intervention Program on Cognitive Function and Depression of the Elderly (단기 집단 복합중재가 정상 노인의 인지기능 및 우울에 미치는 영향)

  • Jung, Beom-Jin;Choi, Yu-Jin
    • Therapeutic Science for Rehabilitation
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    • v.8 no.3
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    • pp.57-68
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    • 2019
  • Purpose: This study aimed to investigate the effects of a short-term group multimodal intervention program that mixes physical activity, cognitive motion, and social interaction, on the cognitive function and depression level of healthy over 75-year-old individuals. Method: This study used a one group pre-test-post-test design, and intervention was made for 70 minutes per session, once a week, for four sessions in total. To compare changes in cognitive function, depression level and physical function before and after intervention, this study used the Mini-Mental State Examination-Dementia Screening (MMSE-DS), Geriatric Depression Scale-Short Form (GDS-SF), and Berg Balance Scale (BBS). Result: After applying group multimodal interventions to healthy over 75-year-old individuals, there was a statistically significant improvement in their cognitive function (p < 0.01), and there was a statistically significant decrease in their depression level (p < 0.05). Also, there was an increase in the rating score of the degree of balance from $46.83{\pm}9.11$ points before the intervention, to $48.08{\pm}7.00$ points after the intervention; however, it was not statistically significant (p > 0.05). Conclusion: Short-term group multimodal intervention that mixes physical activity, cognitive motion, and social interaction had a significant effect on slowing down the deterioration of cognitive function in healthy over 75 year-old individuals, and decreased their depression level. This study is significant in that it presents a foundation for providing more systematic intervention for the prevention of dementia and depression in the healthy older individuals. Follow-up studies should verify the result through research on the effects of an occupational therapist's professional treatment, and experimental group-control research.

The effects of out of hospital ACLS simulation training on the paramedic's duty ability (구급대원의 전문심장소생술 시뮬레이션훈련이 직무수행융합능력에 미치는 영향)

  • Park, Yoo-Na;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.99-106
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    • 2019
  • The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.

Development and Effect of Cooperative Consumption Education Program Using Design Thinking in Home Economics Education: Focusing on the Improvement of Cooperative Problem Solving Competency of Middle School Students (디자인씽킹을 활용한 가정교과 협력적 소비 교육 프로그램의 개발 및 적용 효과: 중학생의 협력적 문제해결 역량 향상을 중심으로)

  • Kim, Seon Ha;Park, Mi Jeong
    • Journal of Korean Home Economics Education Association
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    • v.33 no.3
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    • pp.85-105
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    • 2021
  • The purpose of this study is to develop and implement cooperative consumption education programs using design thinking in middle school home economics education classes to understand the impact on students' cooperative problem solving competency. Accordingly, a cooperative consumption education program based on design thinking was developed according to the ADDIE model, and the evaluation was conducted on a total of 25 students. The results of the study were as follows. First, based on prior research, we developed a consumption education program based on D. school's design thinking process under the theme of 'Creating a Shared School' for the practice of cooperative consumption. As a result of expert validity verification of the teaching/learning course plan and workbook for the eight sessions, the average question was 4.72 (out of 5 points) and the average CVI was 0.93, indicating that the content validity and field suitability were excellent. Second, to summarize the results achieved from the implementation of the cooperative consumption education program, the pre-/post-test using the revised and supplemented cooperative problem-solving competency tool, and the open-ended survey, It was confirmed that the developed program had a significant effect on improving not only the students' knowledge and perceived necessity for cooperative consumption along with the awareness of practice, but also the cooperative problem-solving competency. As a follow-up study, we propose to expand the research to a wider audience, and to further conduct research and develop programs applied with design thinking in home economics curriculum and in consumer competency development. This study confirmed that cooperative consumption education programs using design thinking are effective in improving youth's cooperative problem-solving competency and is meaningful in that they developed consumption education programs under the theme of 'cooperative consumption' in response to changing consumer education needs.