• Title/Summary/Keyword: 치료성과

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An Observational Study of the Developmental Process of Interaction and Attitudes of Children through Instruction for “Making Fabric Doll”- Possibility for Application of Waldorf Education Curriculum- (‘헝겊 인형 만들기’ 바느질 수업을 통한 아동의 상호작용 및 태도 변화 과정 관찰 연구 -발도르프 교육과정 적용 가능성 탐색-)

  • 윤지현;이경선;이지혜
    • Journal of Korean Home Economics Education Association
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    • v.16 no.2
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    • pp.37-53
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    • 2004
  • The purpose of this study is to observe the developmental Process of interaction and attitude of children through instruction for “making fabric doll”. Based on the theory of “Waldorf Education”, instruction of 8 hours for 3 weeks exercised against 40 children(18 boys, 22 girls) of 6th grade, especially focused two group(10 children), in K elementary school in Chunchoen. The results of the study by qualitative research method through observing, recording, interpretation are as follows 1. The changes in interaction among children were observed in increase of quantity and quality of conversation among children, of reliability and dependence among children, of intimacy and cooperation among children, and of intimacy between teacher and children. 2. The changes in the attitude toward instruction were observed in increase of confidence and satisfaction, of active and attentive attitude to instruction via more interest about own fabric doll, of positive attitude through attachment to the doll. Therefore, the instruction of “making fabric doll” based on “Waldorf Education” seems to be efficient to child development and Practical Arts Education.

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The Rehabilitation Services Utilization of People with Disabilities in a Rural Area (농촌지역 재가장애인의 재활서비스 이용실태)

  • Choi, Gyeong-Jin;Kim, Keon-Yeop;Lee, Duck-Hee;Han, Chang-Hyun;Choi, Se-Mook
    • Journal of agricultural medicine and community health
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    • v.36 no.4
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    • pp.227-237
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    • 2011
  • Objectives: This study was conducted to investigate the utilization and its determinants of rehabilitation services of people with disabilities in a rural area. Methods: From March 2 to April 1, 2011, we interviewed 101 disabled people with either physical disabilities or brain lesions. The subjects completed questionnaires about the utilization of rehabilitation services, general characteristics (age, sex, marital status, education level, economic status, health insurance, housing, and employment) and disability characteristics (type, level, comorbidity, reason for the occurrence of the disability, self-rated degree of disability, and daily life care giver). Frequency, Pearson's chi-square test, and a multiple logistic regression were used for statistical analysis. Results: This study showed that 70.3% of the people in this rural area with disabilities were using rehabilitation services. The two most common reasons for not using the services were "doubt about the effectiveness of the service" and "no facilities nearby." The facilities that the disabled people were currently using, in the order of most used to least, were general hospitals or clinics, rehabilitation centers, oriental medicine clinics, and public health centers. Only 19.7% of those who received rehabilitation responded that they were satisfied with the service. Significant factors in the utilization of rehabilitation services were sex, employment, self-rated economic status, and the reason for the occurrence of the disability. Women, people who were currently working, people who were of middle or higher economic status, or people who had acquired a disability were significantly more likely to use the services. Conclusions: A large number of people with disabilities in a rural area use rehabilitation services at present, but accessibility and satisfaction were low. Quantitatively and qualitatively, rehabilitation services for disabled people in a rural area should be centered around Community-based Rehabilitation (CBR). Effective strategies, for example reaching those who have not used the rehabilitation services, will be needed to improve services in rural areas.

Necessity of Education for Emergency Medical Technicians to Improve Awareness of Early Symptoms of Stroke and Assessment of Stroke Patients (응급구급대원에서 뇌졸중 조기증상 인지 및 환자평가 향상을 위한 교육 필요성)

  • Lee, Jeong-Mi;Lee, Jang-Yeol;Park, Seong-Bin;Lee, Young-Hoon;Oh, Gyung-Jae
    • Journal of agricultural medicine and community health
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    • v.38 no.2
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    • pp.130-141
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    • 2013
  • Objectives: The purpose of this study was to reconsider the necessity of stroke-related educational programs by investigating early symptoms of stroke that emergency medical technicians (EMTs) may experience. Methods: An interview survey was carried out, targeting all EMTs 298 people who were working at 119 fire safety centers and local units in Jeollabuk-do province, from April 1 to 30, 2011. An interviewer administered questionnaire was used to obtain data on ETMs' demographic characteristics, educational level on stroke, and awareness level about early symptoms of stroke and treatment-related characteristics of stroke patients. Results: The results showed that 63.2% of those surveyed had completed the required educational programs on stroke during the past year. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition was relatively high for women, those who were 30 years under, low position people, emergency service practitioners, emergency medical technicians, and people who have completed education, respectively. It was also turned out that 82.8% of those surveyed took stroke patients to the nearest hospitals first so that they could receive appropriate treatment. The level of awareness about early symptoms of stroke and assessment of stroke patients' condition in people who have completed education were higher than non-complete. The level of awareness about early symptoms of stroke was positively correlated with confidence, satisfaction and appropriateness in treatment of stroke patients. Conclusions: These results strongly suggest that it is necessary to operate specialized educational programs to enhance EMTs' appropriate awareness of the early symptoms of stroke and assessment of stroke patient's condition.

Bronchial Responsiveness in Patients with Mitral Valvular Heart Disease (승모판 심장질환 환자에서 기관지 반응성에 대한 연구)

  • Kim, Ho-Cheol;Kim, Min-Gu;Hwang, Young-Sil
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.752-759
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    • 1995
  • Background: Bronchial asthma is characterized by noctunal dyspnea, cough and wheezing because of airway hyperresponsiveness to nonspecific stimuli. These symptoms and signs are also observed in patients with congestive heart failure. Therefore, this is so called "cardiac asthma". There are lots of experimental and clinical datas to suggest that airway dysfunctions occur in acute and chronic congestive heart failure. However, it is still controversial whether bronchial hyperresponsiveness is present in patients with congestive heart failure. To assess whether bronchial hyperresponsiveness is present in patients with congestive heart failure and to demonstrate the relationship between bronchial responsiveness and vascular pressure, we performed methacholine provocation test in 11 patients with mitral valvular heart disease. Methods: All patients were in the New York Heart Association functional class II and treated continuously with digoxin and/or dichlozid and/or angiotensin converting enzyme inhibitor except one patient. All patients were undergone right and left side heart catheterization for hemodynamic measurements. A 20 percent fall of peak expiratory flow rate were considered as positive response to methacholine provocation test. Results: 1) Only one patient who has normal pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index was positive in methacholine provocation test. 2) Their mean pulmonary artery pressure, pulmonary capillary wedge pressure were $21.72{\pm}9.70mmHg$, $15.45{\pm}8.69mmHg$ respectively which were significantly higher. Conclusion: It is speculated that in stable congestive heart failure patients, bronchial responsiveness as assessed by methacholine provocation test may not be increased.

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The Diagnostic Value of Bronchoalveolar lavage fluid microscopic study and PCR in Pulmonary tuberculosis (폐결핵에 있어서 기관지폐포세척액 결핵균검사 및 PCR의 진단적 가치)

  • Park, Moon-Hwan;Choi, Choon-Han;Kim, Nam-Jin
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.128-137
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    • 1996
  • Background : We can diagnose pulmonary tuberculosis with sputum AFB smear and culture, but sputum AFB smear has low sensitivity and culture needs long period, and they are not available in the patients who can not expectorate effectively. Recently developed, PCR is a fast diagnostic tool in tuberculosis, but false positive and false negative are important problems. So, we studied the diagnostic value of bronchoalveolar lavage fluid AFB smear, culture, PCR through the bronchoscopy. Methods : The 67 pulmonary tuberculosis patients and 43 non-pulmonary tuberculosis patients were analyzed with their sputum specimen AFB smear and culture. Also, bronchoscopy and bronchoalveolar lavage were done, and bronchoalveolar lavage fluid AFB smear, culture and PCR were done. Results: 1) In the cases of pulmonary tuberculosis, the sensitivity of sputum AFB smear and culture were 32.8% and 57.4%, respectively. And the sensitivity of bronchoalveolar lavage fluid AFB smear and culture were 47.8% and 80.6%. respectively. 2) In the cases of pulmonary tuberculosis, the sensitivity and the positive predictive value(for predicting a positive culture) of PCR were 80.6% and 81.5%, respectively. 3) In the cases of sputum AFB smear-negative and culture-negative pulmonary tuberculosis, the sensitivity of bronchoalveolar lavage fluid AFB smear, culture, PCR, and the positive predictive value(for predicting a positive culture) of PCR were 23.1%, 100%, 88.5%, and 82.4%, respectively. 4) The specificity of bronchoalveolar lavage fluid PCR was 77.0%. 5) The median number of days between obtaining a specimen and starting therapy was 5 days for sputum AFB smear, 9 days for bronchoalveolar lavage fluid AFB smear, 26 days for bronchoalveolar lavage fluid PCR, 32 days for sputum culture, 56 days for bronchoalveolar lavage fluid culture. Conclusion : The sensitivity of bronchoalveolar lavage fluid AFB smear and culture are higher than sputum AFB smear and culture. So, the bronchoscopy must be considered for evaluating suspected cases of pulmonary tuberculosis in patients from whom smears of expectorated sputum do not reveal mycobacteria or from whom no sputum can be obtained. Especially, combined with PCR, it is expected that pulmonary tuberculosis can be diagnosed more rapidly and more accurately, so bronchoalveolar lavage fluid APB smear and PCR can be helpful in the early treatment of pulmonary tuberculosis.

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Risk Factors of Extubation Failure and Analysis of Cuff Leak Test as a Predictor for Postextubation Stridor (발관 실패의 위험 인자 및 발관 후 천음과 재삽관의 예측에 있어 Cuff Leak Test 의 유용성과 의미 분석)

  • Lim, Seong Yong;Suh, Gee Young;Kyung, Sun Yong;An, Chang Hyeok;Park, Jung Woong;Lee, Sang Pyo;Jeong, Sung Hwan;Ham, Hyoung Suk;Ahn, Young Mee;Lim, Si Young;Koh, Won Jung;Chung, Man Pyo;Kim, Ho Joong;Kwon, O Jung
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.1
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    • pp.34-40
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    • 2006
  • Background: Extubation failure was associated with poor prognosis and high hospital mortality. Cuff leak test (CLT) has been proposed as a relatively simple method for detecting laryngeal obstruction that predispose toward postextubation stridor (PES) and reintubation. We examined the risk factors of extubation failure and evaluated the usefulness and limitation of CLT for predicting PES and reintubation. Methods: Thirty-four consecutive patients intubated more than 24 hours were examined. The subjects were evaluated daily for extubation readiness, and CLT was performed prior to extubation. Several parameters in the extubation success and failure group were compared. The accuracy and limitation of CLT were evaluated after choosing the thresholds values of the cuff leak volume (CLV) and percentage (CLP). Results: Of the 34 patients studied, 6 (17.6%) developed extubation failure and 3 (8.8%) were accompanied by PES. The patients who had extubation failure were more likely to have a longer duration of intubation and more severe illness. The patients who developed PES had a smaller cuff leak than the others: according to the CLV ($22.5{\pm}23.8$ vs $233.3{\pm}147.1ml$, p=0.020) or CLP ($6.2{\pm}7.3$ vs $44.3{\pm}24.7%$, p=0.013). The best cut off values for the CLV and CLP were 50ml and 14.7%, respectively. The sensitivity, negative predictive value, and specificity of CLT were relatively high, but the positive predictive value was low. Conclusion: The likelihood of developing extubation failure increases with increasing severity of illness and duration of intubation. A low CLV or CLP (<50ml or 14.7%) is useful in identifying patients at risk of PES, but the CLT is not an absolute predictor and should not be used an indicator for delaying extubation.

A Study on Experimental Construction of Community Garden - A Case Study on Rooftop of SAHA Disabled Welfare House - (커뮤니티 가든 조성을 위한 실험 연구 - 사하 장애인복지관 옥상을 대상으로 -)

  • Kim, Seung-Hwan;Yoon, Sung-Yung;Cha, Min-Jun;Yoo, yeon-seo;Cho, Ji-Young;Kim, Yoon-Sun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.2
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    • pp.24-37
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    • 2012
  • In this study, Community Garden of various national and international practices trends to an advanced research, the concept of community garden participated with a group operation out of initiative to produce safety food while securing space for the community, ensuring the area that has gone through a new form of active secure urban green space plan, urban renewal movement was defined as the mean. Furthermore, for the purpose of improving the poor welfare environment by attempting to experimentally make a community garden of a disabled welfare house rooftop and how to target its planning and construction process, partnership involvement, business processes have been investigated, such as cost sharing. The whole process including a budget for development of this case was conducted by the Busan Green Trust. Standard Chartered (SC) First Bank's 50% fund share by community chest, participation of volunteers, support of Busan City and Saba-gu, outside of that, sharing parts or trial to participate by diverse partnership of enterprise, public corporation and laboratory, these are the key in developing community garden's model. Established community garden places resulted food production to users of welfare center for the disabled, participating urban agricultural experience program, horticultural therapy, complex community chapter and cultural center. Furthermore, we could find the meaning of rooftop community garden in the point that it is a low cost garden by applying movable and unmovable planters. This study is profitable for improving urban environment, ensuring community chapter and urban green areas, regenerating a city to develop experimental community garden model by using a welfare house rooftop.

A historical study on the flexibility square-format typeface and the prospects - Focused on the three-pairs fonts of hangeul - (탈네모글꼴에 관한 역사적 연구와 전망 - 세벌식 한글 글꼴을 중심으로 -)

  • Yu, Jeong-Mi
    • Archives of design research
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    • v.19 no.2 s.64
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    • pp.241-250
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    • 2006
  • Hangeul as the Korean unique characters were invented according to some character-making principles and based on scholars' exhaustive researches. While most of the characters in the world evolved naturally, Hangeul was invented based on a precise linguistic analysis of the time, and therefore, it is most scientific and reasonable among various characters throughout the world. Nevertheless, Hangeul typeface designs do not seem to inherit the ideology of scientific and reasonable Hangeul correctly. For the square forms have been used intact due to the influences from the Chinese characters which prevailed during the time. If a single set of square characters should be designed, as much as 11,172 fonts should be designed, which suggests that advantages of Mangeul may not well be used fully; Hangeul was invented to visualize every sound with the combinations of 28 vowels and consonants. Problems of such square fonts began to be identified since 1900's when typewriters were introduced first from the West. Since a typewriter is designed with 28 characters laid out on its keyboard by using such combinations, the letters may be easily combined on it. The so-called the flexibility square-format typeface was born as such. Specially, the three-pairs fonts of these can be combined up to 67 letters including vowels and consonants. The three-pairs fonts system can help to solve the problems arising form the conventional square fonts and inherit the original ideology of Hangeul invention. This study aims to review the history of the three-pairs fonts designs facilitated by mechanic encoding of Hangeul and thereupon, suggest some desirable directions for future Hangeul fonts. Since the flexibility square-format typeface is expected to evolve more and more owing to development of the digital technology, they would serve our age of information in terms of both functions and convenience. Just as Hunminjongum tried to be literally independent from the Chinese characters, so the flexibility square-format typeface designs would serve to recover identity of our Hangeul font designs.

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Role of Intra-aortic Balloon Pump in High Risk Patients undergoing Off-Pump Coronary artery bypass graft (심폐바이패스 없이 시행하는 관상동맥 우회술시 고위험군 환자에서 대동맥내 풍선 펌프의 유용성)

  • Cho, Suk-Ki;Jang, Woo-Ik;Lim, Cheong;Lee, Cheul;Lee, Jae-Ik;Kim, Yong-Lak;Ham, Byung-Moon;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.895-900
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    • 2001
  • Background : This study aimed to evaluate the usefulness of preoperative placement of intraaortic balloon pump(IABP) in reducing operative risk and facilitating posterior vessel OPCAB in high risk patients with left main disease( 75% stenosis), intractable resting angina, postinfarction angina, or left ventricular dysfunction(ejection fraction 35%). Material and Method : One hundred eighty- nine consecutive patients who underwent multi-vessel OPCAB including posterior vessel revascularization were studied. The patients were divided into group I(n=74) that received preoperative or intraoperative IABP and group II(n=115) that did not receive IABP. In group I, there were 39 patients with left main disease, 40 patients with intractable resting angina, 14 patients with left ventricular dysfunction and 7 patients with postinfarction angina. Ten patients received intraoperative IABP support due to hemodynamic instability during OPCAB. Result : There was one operative mortality in group I and two mortalities in group II. The average number of distal anastomoses was not different between group I and group II(3.5$\pm$0.9 vs 3.4$\pm$0.9, p=ns). There were no significant differences in the number of posterior vessel anastomosis per patient between the two groups. There were no differences in ventilator support time, length of hospital stay, and morbidity between the two groups. There was one case of IABP-related complication in group I. Conclusion : IABP facilitates posterior vessel OPCAB in high risk patients, with comparable surgical results to low risk patients

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Video-Assisted Thoracic Surgery Lobectomy: Experience with 36 Cases (비디오 흉강경을 이용한 폐엽절제술: 치험 36예)

  • Lee, Hee-Sung;Lee, Jae-Woong;Kim, Kun-Il;Cho, Sung-Woo;Park, Sang-Jun;Kim, Hyoung-Soo;Shin, Yoon-Cheol;Shin, Ho-Seung
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.732-737
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    • 2009
  • Background: Many video-assisted thoracic surgery (VATS) lobectomies are performed as a potential alternative to thoracotomy despite the controversy about the safety and the associated morbidity/mortality rates. Material and Method: Between November 2006 and August 2008, we performed 87 lobectomies (VATS 36, Thoracotomy 51) and we retrospectively reviewed the surgical treatment results. A VATS lobectomy was performed by a 4~5 cm thoracotomy without rib spreading and this included anatomic hilar dissection, individual vessel and bronchus stapling and lymph node dissection. Result: We studied 52 male and 35 female patients whose age ranged from 6 to 79 (average age: $59.8{\pm}15.0$ years). The cases were diagnosed with lung cancer (66) (SQC 24, ADC 38, others 4), pulmonary metastasis (2), carcinoid (2) and benign diseases (17). There was no intraoperative death. Postoperative complications were seen in 5 (15.6%) VATS and 33 (64.7%) thoracotomies, and perioperative death caused by adult respiratory distress syndrome occurred in 1 (2.8%) VATS and 3 (5.9%) thoracotomies. Three patients Underwent conversion to thoracotomy (8.3%). The mean time to chest tube removal was 6 days for VATS and 9.4 days for thoracotomy (p<0.001), and the mean length of the hospital stay was 8 days for VATS and 12.8 days for thoracotomy (p<0.001). Conclusion: VATS lobectomy can be performed safely with low morbidity/mortality rates. Furthermore, all the patients benefited from earlier postoperative rehabilitation and less pain and they were candidates for an earlier return to normal activities.