Journal of Family Resource Management and Policy Review
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v.25
no.3
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pp.87-102
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2021
Child abuse and neglect are recently increasing in Korea, and although the government has actively improved the child protection system, the number of abused children and the rate of cases judged as abuse have continuously risen. Given that 75% of child abusers are parents, child abuse and neglect are expected to recur. To prevent such a recurrence, various intervention programs for abused children and their parents are required. The purpose of this study were to design a recovery support service process and investigate the effectiveness of pilot program for families of origin, including neglected(protected) children, to improve the system by which these programs are operated, and formulate policy alternatives that reinforce "family preservation" principles. The pilot program was implemented from June to November 2020 in 4-local healthy family support center. The number of program participants and the frequency of participation in each other differed, because of the difference in number of confirmed coronavirus cases in each region and the requirement for social distancing. Through the program, a community-based service process was developed for neglected(protected) children and their parents, and cooperative networks between related facilities and institutions were established. The study formulated the following recommendations: First, a cooperation system among government departments mandated to provide different services to neglected(protected) children is needed. Second, wider and various channels through which abused children can avail of protective services should be developed within communities. Third, more stable environments for program operation should be cultivated, and cooperative partnerships should be sought for knowledge sharing among relevant government departments. Another necessary measure is for a center to develop its own business model, in which the duplication of services provided by involved organizations is avoided. Finally, clear guidelines, administrative standards, and specific plans for program operation should be arranged. Also regional characteristics are maintained, but services should be standardized.
Moon, Yi Ji;Shin, Hee Young;Kim, Min Sun;Song, In Gyu;Kim, Cho Hee;Yu, Juyoun;Park, Hye Yoon
Journal of Hospice and Palliative Care
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v.22
no.1
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pp.39-47
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2019
Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.
In Jungian psychology, creation myths regard as the story of unconscious and preconscious processes(projection of archaic identity) which describe not necessary the origin of our cosmos, but the origin of man's conscious awareness of the world. Therefore projections have nothing to do with matter itself but experience of one's own unconscious. Jung emphasizes importance to understand projection in individual's conscious experience rather than in philosophical doctrine. The purpose of this thesis is to explore unconscious process of creation myths with egg symbolism in clinical cases to present universal feature of Cosmic/alchemical egg. Psychologically, creation myths retold when human mind needs new order. Depending on the attitude of ego, it can be sudden expansion of consciousness or contamination of ego by unconscious. In this study, 'chaos(messa confusa)' in creation myths as archaic identity, experience of uroboros or infant, and nigredo state in alchemy. 'Separation of primordial parents' as beginning of consciousness refers to separatio operation in alchemical process. 'Light' as attainment of consciousness. Discussion of psychological meaning of egg starts with amplification which include the concept of cosmic/alchemical/philosophical egg. Egg symbolism in this study refers to emergence of egg, tapas/brooding of egg, and separation of egg. Emergence of egg as a state of preconscious totality, psychic wholeness conceived as the thing which came before the rise of ego consciousness. Discussion of conceptssuch as Shiva bindu, hiranyagharba, germ of gold, Tathāgatagarbha follows. 'Tapas/brooding of egg' as concentration of all psychic energy into one point for self reflection. Discussion includes The I Ching Hexagram 61, image of brooding egg identified with inner truth, Wonhyo's concept of jikwansasang, and Gnostic idea of Ennoia, introverted act of thinking, as well as the concept of 'Night Sea Journey'. 'Separation or hatching of egg' regarded as the idea of sudden illumination, Phanes, the shining God, and "sun-point," in alchemy. Birth of fledgling as birth of new personality. As a conclusion, psychological meaning of cosmic egg/creation myths is the story of separating from 'Not-I'(unconscious, object, undifferentiated) to 'I'(ego, subject, differentiated) which shares the same meaning as individuation process.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.13
no.1
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pp.139-152
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2002
Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.11
no.2
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pp.209-220
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2000
The purpose of this study is to find out the characteristics of depressive episode about major depression and bipolar disorder in child and adolescent. The subjects of this study were 34 major depression patients and 17 bipolar disorder patients hospitalized at child and adolescent psychiatry in OO university children's hospital from 1st March 1993 to 31st October 1999. The method of this study is to review socio-demographic characteristics, diagnostic classification, chief problems and symptoms at admission, frequency of symptoms, maternal pregnancy problem history, childhood developmental history, coexisting psychiatric disorders, family psychopathology and family history and therapeutic response through their chart. 1) The ratio of male was higher than that of female in major depressive disorder while they are similar in manic episode, bipolar disorder. 2) Average onset age of bipolar disorder was 14 years 1 month and it was 12 years 8 months in the case of major depression As a result, average onset age of major depression is lower than that of bipolar disorder. 3) The patients complained of vegetative symptoms than somatic symptoms in both bipolar disorder and depressive disorder. Also, the cases of major depression developed more suicide idea symptom while the case of bipolar disorder developed more aggressive symptoms. In the respect of psychotic symptoms, delusion was more frequently shown in major depression, but halucination was more often shown in bipolar disorder. 4) Anxiety disorder coexisted most frequently in two groups. And there coexisted symptoms such as somartoform disorder, mental retardation and personality disorder in both cases. 5) The influence of family loading was remarkable in both cases. Above all, the development of major depression had to do with child abuse history and inappropriate care of family. It is apparent that there are distinctive differences between major depression and bipolar disorder in child and adolescent through the study, just as in adult cases. Therefore the differences of clinical characteristics between two disorders is founded in coexisting disorders and clinical symptoms including onset age, somatic symptoms and vegetative symptoms.
Quaternary Geological and geophysical investigation was performed at the Eurimji reservoir of Jaechon City in order to interprete depositional environment and genesis of lake sediments. For this purpose, echo sounding, bottom sampling and columnar sampling by drilling on board and GPR survey were employed for a proper field investigation. Laboratory tests cover grain size population analysis, pollen analysis and $^{14}C$ datings for the lake sediments. The some parts of lake bottom sediments anthropogenically tubated and filled several times to date, indicating several mounds on the bottom surface which is difficult to explain by bottom current. Majority of natural sediments were accumulated both as rolling and suspended loads during seasonal flooding regime, when flash flow and current flow are relatively strong not only at bridge area of the western part of Eurimji, connected to stream valley, but at the several conduit or sewage system surrounding the lake. Most of uniform suspend sediments are accumulated at the lake center and lower bank area. Some parts of bottom sediments indicate the existence of turbid flow and mudflow probably due to piezometric overflowing from the lake bottom, the existence of which are proved by CM patterns of the lake bottom sediments. The columnar samples of the lake sediments in ER-1 and ER-3-1 boreholes indicate good condition without any human tubation. The grain size character of borehole samples shows poorly sorted population, predominantly composed of fine sand and muds, varying skewness and kurtosis, which indicate multi-processed lake deposits, very similar to lake bottom sediments. Borehole columnar section, echo sounding and GPR survey profilings, as well as processed data, indicate that organic mud layers of Eurimji lake deposits are deeper and thicker towards lower bank area, especially west of profile line-9. In addition the columnar sediments indicate plant coverage of the Eurimji area were divided into two pollen zones. Arboreal pollen ( AP) is predominant in the lower pollen zone, whreas non-aboreal pollen(NAP) is rich in the upper pollen zone. Both of the pollen zones are related to the vegetation coverage frequently found in coniferous and deciduous broad-leaved trees(mixed forest) surrounded by mountains and hilly areas and prevailing by aquatic or aquatic margin under the wet temperate climate. The $^{14}C$ age of the dark gray organic muds, ER1-12 sample, is 950$\pm$40 years B.P. As the sediments are anthropogenetically undisturbed, it is assumed that the reliability of age is high. Three $^{14}C$ ages of the dark gray organic muds, including ER3-1-8, ER3-1-10, ER3-1-11 samples, are 600$\pm$30 years B.P., 650$\pm$30 years B.P., 800$\pm$40 years B.P. in the descending order of stratigraphic columnar section. Based on the interpretation of depositional environments and formation ages, it is proved that Eurimji reservoir were constructed at least 950$\pm$40 years B.P., the calibrated ages of which ranges from 827 years, B.P. to 866 years B.P. Ancient people utilize the natural environment of the stream valley to meet the need of water irrigation for agriculture in the local valley center and old alluvium fan area.
Introduction : The purpose of this study was to analyze the safety, pullout strength and radiographic characteristics of unicortical and bicortical screws of cervical facet within cadaveric specimens and evaluate the influence of level of training on the positioning of these screws. Methods : Twenty-one cadavers, mean 78.9 years of age, underwent bilateral placement of 3.5mm AO lateral mass screw from C3-C6(n=168) using a slight variation of the Magerl technique. Intraoperative imaging was not used. The right side(unicortical) utilized only 14mm screws(effective length of 11mm) while on the left side to determine the length of the screw after the ventral cortex had been drilled. Three spine surgeons(attending, fellow, chief resident) with varying levels of spine training performed the procedure on seven cadavers each. All spines were harvested and lateral radiographs were taken. Individual cervical vertebrae were carefully dissected and then axial radiographs were taken. The screws were evaluated clinically and radiographically for their safety. Screws were graded clinically for their safety with respect to the spinal cord, facet joint, nerve root and vertebral artery. The grades consisted of the following categories : "satisfactory", "at risk" and "direct injury". Each screw was also graded according to its zone placement. Screw position was quantified by measuring a sagittal angle from the lateral radiograph and an axial angle from the axial radiograph. Pull-out force was determined for all screws using a material testing machine. Results : Dissection revealed that fifteen screws on the left side actually had only unicortical and not bicortical purchase as intended. The majority of screws(92.8%) were satisfactory in terms of safety. There were no injuries to the spinal cord. On the right side(unicortical), 98.9% of the screws were "satisfactory" and on the left side(bicortical) 68.1% were "satisfactory". There was a 5.8% incidence of direct arterial injury and a 17.4% incidence of direct nerve root injury with the bicortical screws. There were no "direct injuries" with the unicortical screws for the nerve root or vertebral artery. The unicortical screws had a 21.4% incidence of direct injury of the facet joint, while the bicortical screws had a 21.7% incidence. The majority of "direct injury" of bicortical screws were placed by the surgeon with the least experience. The performance of the resident surgeon was significantly different from the attending or fellow(p<0.05) in terms of safety of the nerve root and vertebral artery. The attending's performance was significantly better than the resident or fellow(p<0.05) in terms of safety of the facet joint. There was no relationship between the safety of a screw and its zone placement. The axial deviation angle measured $23.5{\pm}6.6$ degrees and $19.8{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The resident surgeon had a significantly lower angle than the attending or fellow(p<0.05). The sagittal angle measured $66.3{\pm}7.0$ degrees and $62.3{\pm}7.9$ degrees for the unicortical and bicortical screws, respectively. The attending had a significantly lower sagittal angle than the fellow or resident(p<0.05). Thirty-three screws that entered the facet joint were tested for pull-out strength but excluded from the data because they were not lateral mass screws per-se and had deviated substantially from the intended final trajectory. The mean pull-out force for all screws was $542.9{\pm}296.6N$. There was no statistically significant difference between the pull-out force for unicortical($519.9{\pm}286.9N$) and bicortical($565.2{\pm}306N$) screws. There was no significant difference in pull-out strengths with respect to zone placement. Conclusion : It is our belief that the risk associated with bicortical purchase mandates formal spine training if it is to be done safely and accurately. Unicortical screws are safer regardless of level of training. It is apparent that 14mm lateral mass screws placed in a supero-lateral trajectory in the adult cervical spine provide an equivalent strength with a much lower risk of injury than the longer bicortical screws placed in a similar orientation.
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