• Title/Summary/Keyword: Behavioral intervention

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A Case of Childhood Obstructive Sleep Apnea Syndrome with Co-morbid Attention Deficit Hyperactivity Disorder Treated with Continuous Positive Airway Pressure Treatment (지속적(持續的) 상기도(上氣道) 양압술(陽壓術)을 시행(施行)하여 치료효과(治療效果)를 본 주의력(注意力) 결핍(缺乏).과잉(過剩) 운동장애(運動障碍)를 동반(同伴)한 소아기(小兒基) 폐쇄성(閉鎖性) 수면무호흡증(睡眠無呼吸症) 1례(例))

  • Sohn, Chang-Ho;Shin, Min-Sup;Hong, Kang-E;Jeong, Do-Un
    • Sleep Medicine and Psychophysiology
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    • v.3 no.1
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    • pp.85-95
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    • 1996
  • Obstructive sleep apnea syndrome(OSAS) in childhood is unique and different n-om that in adulthood in several aspects, including pathophysiology, clinical features, diagnostic criteria, complications, management, and prognosis. Characteristic features of childhood OSAS in comparison with the adult form are the variety of severe complications such as developmental delay, more prominent behavioral and cognitive impairments, vivid cardiovascular symptoms, and increased death risk, warranting a special attention to the possible diagnosis of OSAS in children who snore. However, the childhood OSAS is often neglected and unrecognized. We, therefore, report a case of very severe OSAS in a 5-year-old boy who was sucessfully treated with continuous positive airway pressure(CPAP) treatment. Interestingly, the patient was comor-bid with the attention deficit hyperactivity disorder. Prior to the initial visit to us, adenotonsillectomy had been done at the age of 4 with no significant improvement of apneic symptoms and heavy snoring. On the initial diagnostic procedures, marked degree of snoring was audible even in the daytime wake state and the patient was observed to be very hyperactive. Increased pulmonary vascularity with borderline cardiomegaly was noted on chest X-ray. The baseline polysomnography revealed that the patient was very sleep-apneic and snored very heavily, with the respiratory disturbance index(RDI) of 46.9 per hour of sleep, the mean SaO2 of 78.8%, and the lowest SaO2 of 40.0%(the lowest detectable oxygen level by the applied oxymeter). The second night polysomnography was done for CPAP titration and the optimal pressure turned out to be $8.0\;cmH_2O$. The applied CPAP treatment was well tolerated by the patient and was found to be very effective in alleviating heavy snoring and severe repetitive sleep apneas. After 18 months of the CPAP treatment, the patient was followed up with nocturnal polysomnography(baseline and CPAP nights) and clinical examination. Sleep apneas were still present without CPAP on the baseline night. However, the severity of OSAS was significantly decreased(RDI of 15.7, mean SaO2 of 96.2%, and the lowest SaO2 of 83.0%), compared to the initial polysomnographic findings before initiation of long-term CPAP treatment. Wechsler intelligence tests done before and after the CPAP treatment were compared with each other and surprising improvement of intelligence(total 9 points, performance 16 points) was noted. Clinically he was found to be markedly improved in his attention deficit hyperactive behavior after CPAP treatment, but with minimal change of TOVA(test of variables of attention) scores except conversion of reaction time score into normal range. On the chest X-ray taken after 18 months of CPAP application, the initial cardiopulmonary abnormalities were not found at all. We found that the CPAP treatment in a young child is very effective, safe, and well-tolerated and also improves the co-morbid attention deficit hyperactive symptoms. Overall, the growth and development of the child has been facilitated with the long-term use of CPAP. Cardiovascular complications induced by OSAS have been also normalized with CPAP treatment. We suggest that early diagnosis and active treatment intervention of OSAS in children are crucial in preventing and ameliorating possible serious complications caused by repetitive sleep apneas and consequent hypoxic damage during sleep.

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The Effects of Treadmill Exercise on Cognitive Performance, Brain Mitochondrial Aβ-42, Cytochrome c, SOD-1, 2 and Sirt-3 Protein Expression in Mutant (N141I) Presenilin-2 Transgenic Mice of Alzheimer's Disease (트레드밀 운동이 mutant (N141I) presenilin-2 유전자를 이식한 알츠하이머질환 모델 생쥐 뇌의 Aβ-42, cytochrome c, SOD-1, 2와 Sirt-3 단백질 발현에 미치는 영향)

  • Koo, Jung-Hoon;Eum, Hyun-Sub;Kang, Eun-Bum;Kwon, In-Su;Yeom, Dong-Cheol;An, Gil-Young;Oh, Yoo-Sung;Baik, Young-Soo;Cho, In-Ho;Cho, Joon-Yong
    • Journal of Life Science
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    • v.20 no.3
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    • pp.444-452
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    • 2010
  • The purpose of this study was to investigate the effects of treadmill exercise on $A{\beta}$-42, cytochrome c, SOD-1, 2 and Sirt-3 protein expressions in brain cytosol and mitochondria in mutant (N141I) presenilin-2 transgenic mice with Alzheimer's disease (AD). The mice were divided into four groups (Non-Tg-sedentary, n=5; Non-Tg treadmill exercise, n=5; Tg-sedentary, n=5; Tg treadmill exercise, n=5). To evaluate the neuroprotective effect of treadmill exercise, Non-Tg and Tg mice were subjected to exercise training on a treadmill for 12 wk, after which their brain cytosol and mitochondria were evaluated to determine whether any changes in the cognitive performance, $A{\beta}$-42 protein, cytochrome c protein, anti-oxidant enzymes (SOD-1, SOD-2) and Sirt-3 protein had occurred. The results indicated that treadmill exercise resulted in amelioration in cognitive deficits of Tg mice. In addition, the expressions of mitochondrial $A{\beta}$-42 and cytosolic cytochrome c protein were decreased in the brains of Tg mice after treadmill exercise, whereas antioxidant enzymes, SOD-l and SOD-2 were significantly increased in response to treadmill exercise. Furthermore, treadmill exercise significantly increased the expression of Sirt-3 protein in Non-Tg and Tg mice. Taken together, these results suggest that treadmill exercise is a simple behavioral intervention which can sufficiently improve cognitive performance and inhibit $A{\beta}$-induced oxidative stress in AD.

A Meta-Analysis of Korean Literatures about Sick Role Behavior of Pulmonary Tuberculosis Patients applied Health Belief Model (건강신념모형을 적용한 폐결핵 환자의 환자역할행태 연구에 대한 메타분석)

  • Kim, Chun-Bae;Jo, Heui-Sug;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.1-13
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    • 2003
  • Objectives: The purpose of this study is to summarize results from 11 domestic studies about sick role behavior applied health belief model and to assess the effectiveness of components on behavior change by using meta-analysis. Methods: We collected the existing literatures by using major web search of 'pulmonary tuberculosis patients', 'health belief model', and 'sick role behavior' as key words and by reviewing content of journals. Quantitative meta-analysis was performed by SAS program. Results: Among 66 articles, 11 studies were selected for quantitative meta-analysis. The knowledge level about pulmonary tuberculosis had more effect for only sick role behavior as general characterisitcs(d=0.7870). All the components of health belief model produced significant effects on sick role behavior with the magnitude of effect size from 0.31 to 0.73. The largest effects were benefits on actions of sick role behavior. Conclusions: Overall, these investigation provide very substantial empirical evidence supporting health belief model dimensions as important contributors to the explanation and prediction of sick role behavior among the type of health related behavior in pulmonary tuberculosis patients. Strategic intervention including health education, etc. based on health belief model showed clear advantage in improvement of behavioral change.

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Environmental Factors, Types of Bullying Behavior, and Psychological and Behavioral Outcomes for the Bullies (괴롭힘 가해자의 환경적 요인, 괴롭힘 행동유형, 가해자의 심리.행동적 결과에 대한 연구)

  • Lee, Myung-Shin
    • Korean Journal of Social Welfare
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    • v.51
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    • pp.29-61
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    • 2002
  • This study was designed to find out the determinants of types of bullying behavior, and the effects of types of bullying behavior on the bullies. For this purpose, a hypothetical model which explains the relationships among 6 environmental factors, 5 types of bullying behavior, and 5 outcome variables for the bullies was developed. Using the data collected from 177 junior and high school students who have bullied the other students, the hypothetical model was tested. For data analysis, a path analysis was used, and the best-fitting model was found (df=78, GFI=0.953, CFI=1.00). As a result of analyzing the model, types of bullying behavior were found to be determined by the different environmental factors: Isolation was determined by 2 factors (feeling of isolation from friends, exposure to bullying), social bullying by 2 factors (lack of support from parents, exposure to bullying), verbal bullying by conflicts with parents, physical bullying by 3 factors (lack of support from parents, exposure to isolation and exposure to bullying), and instrumental bullying by lack of support from parents. On the other hand, the pleasure that the bullies feel after bullying behavior was increased by isolation, verbal bullying and physical bullying, while decreased by instrumental bullying. Guilt feeling was decreased by isolation and instrumental bullying, while increased by physical bullying. Isolation increased the tendency of blaming the victim. Isolation and instrumental bullying increased bullies' self-esteem, while social bullying decreased self-esteem. Verbal bullying increased the extent of bullying, while instrumental bullying decreased the extent of bullying. Based on the findings, the intervention strategies to change the bullies' attitudes toward victim, and to increase social support from the significant others as well as the effective ways to reorganize the school environment in order to reduce and prevent bullying behavior were suggested.

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A Reliability and Validity Study of the Korean versions of the Eating Disorder Examination Questionnaire version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) (한국판 섭식장애검사-자기보고형 6.0 (EDE-Q version 6.0) 및 한국판 임상손상평가(CIA)의 신뢰도와 타당도 연구)

  • Bang, Eun Byul;Han, Cho Long;Kim, Yu Ri;Kim, Mirihae;Lee, Young Ho;Heo, Si Young;Kim, Youl-Ri
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.152-163
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    • 2018
  • Objectives : The Eating Disorder Examination Questionnaire, version 6.0 (EDE-Q version 6.0) and the Clinical Impairment Assessment Questionnaire (CIA) measure attitudes and behavioral features of eating disorders and impairments secondary to eating disorders, respectively. The aims of this study were to examine the reliability and the validity of the Korean versions of the EDE-Q version 6.0 and the CIA. Methods : Four hundred nineteen participants (370 female university students and 49 women with eating disorders) completed the EDE-Q version 6.0, the CIA, the Body Shape Questionnaire (BSQ) and the Weight Concern Scale (WCS). Results : Excellent internal consistencies were obtained for the EDE-Q version 6.0 (Cronbach's ${\alpha}=0.92$) and the CIA (Cronbach's ${\alpha}=0.91$). Exploratory factor analysis of CIA extracted the 3 factors of personal, social, and cognitive impairments, as the original CIA had. The EDE-Q version 6.0 and the CIA were well correlated with the BSQ and the WCS, in respect to their contextually concordant variables. Patients with eating disorders had higher scores both in the EDE-Q 6.0 and the CIA than university women had, supporting good discriminant validity. Conclusions : The EDE-Q version 6.0 and the Korean versions of the CIA had adequate reliability and validity. These data will help clinicians and researchers to use the EDE-Q and the CIA in diagnosis, prevention and intervention of eating disorders in Korea.

Development and Validation of the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC) (한국형 긍정적 행동지원 3차 실행충실도 척도(KT3-FC)의 개발과 타당화)

  • Won, Sung-Doo;Chang, Eun Jin;Cho Blair, Kwang-Sun;Song, Wonyoung;Nam, Dong Mi
    • Korean Journal of School Psychology
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    • v.17 no.2
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    • pp.165-180
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    • 2020
  • As a tiered system of supports, School-Wide Positive Behavior Support (SWPBS) is an evidence-based practice in the educational system of Korea. An important aspect of SWPBS is the ongoing progress monitoring and evaluation of implementation fidelity. This study aimed to develop and validate the Korean Tier 3 School-Wide Positive Behavior Support Implementation Fidelity Checklist (KT3-FC). The preliminary KT3-FC consisted of a 37-item, 6-factor checklist. In the first phase of the study, 10 experts reported that the range of content validity of the KT3-FC was adequate. In the second phase of the study, 185 teachers (52 men and 133 women) who implemented SWPBS completed the KT3-FC, Individualized Supports Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and PBS Effectiveness Scale. An exploratory factor analysis resulted in a 5-factor structure, with 20 items, instead of 37 items, consisting of: (a) progress monitoring and evaluation of the individualized supports, (b) provision of supports by aligning and integrating mental health and SWPBS, (c) crisis management planning, (d) problem behavior assessment, and (e) establishment of individualized support team. The internal consistency of the KT3-FC was good (full scale α = .950, sub-factor α = .888 ~ .954). In addition, the KT3-FC showed good convergent validity, having statistically significant correlations with the Individualized Support Questionnaire, School Climate Questionnaire, School Discipline Practice Scale, and the PBS Effectiveness Scale. Finally, the confirmatory factor analysis showed that the 5-factor model of the KT3-FC had some good model fits, indicating that the newly developed fidelity measure could be a reliable and valid tool to assess the implementation of Tier 3 supports in Korean schools. Accordingly, the KT3-FC could contribute to implement SWPBS as an evidence-based behavioral intervention for Korean students.

A Study on the Emotional Happiness of Human (인간의 감성적 행복감에 관한 연구)

  • Jeong, Cheol-Yeong
    • Journal of Korea Entertainment Industry Association
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    • v.13 no.6
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    • pp.211-220
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    • 2019
  • It helps to wisely abstain from errors of the a priori subjective emotions related to human emotions, and orders emotions to make rational choices. These emotional happiness of human and moral sensitivities work directly or indirectly in rational choice of rational thought and reason. Abraham would have been troubled by the divine mandate to sacrifice a son who was only one, and a son who had been healed. Was his reason reasonable at this time? In rational reason, it can be said that the act of dedicating his son is an appropriate act, but is it possible in the human mind? Aristoteles also called human virtue virtue in good for human beings. Because happiness is also a mental activity, we have to know a certain degree about the mind. This ψυχή(psyche, spirit) spirit is an irrational element that is invisible but an intervention in rational principles. Also C. G. Jung states that all human beings have four dynamic psychological functions that are not visible, and that the mind is driven by these four functional dimensions. This means that the elements of S, Sensing, N, Intuition, T, Thinking, and Feeling are combined. David Hume also emphasized the principle of empathy, asserting that morality can not be derived from reason, and Max Ferdinand Scheler, before grasping the visual characteristics of a person, has already captured the whole feeling of the person, And that the value given to this feeling is the value, and that the function of emotion that is elevated to the perceived object by grasping the value through this process and the value is always preceded by the reason. Emmanuel Levinas states that emotional emotions of love are ahead of reason and that emotions precede human reasoning and rationality is the inability of emotional control that we need rational thought and rational and wise action as reason of control and temperance. As part of human emotional education, in the 7th curriculum, Bloom's cognitive, perceptive, and behavioral domain, which is a person with integrated thinking, is trying to be a moral practitioner. It focuses on how to act according to the direction of emotions for virtuous acts and how to develop emotions for emotions on behalf of vicious acts. We can design the possibility and direction of cultivating human emotions and emotional happiness and happy sensitivities by the principle of strengthening virtue and the principle of elimination of ill feeling.

Health and quality of life for Korean people in ageing society (고령화 사회에서 한국인의 건강과 삶의 질)

  • Kyung-Hyun Suh
    • Korean Journal of Culture and Social Issue
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    • v.12 no.5_spc
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    • pp.133-147
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    • 2006
  • Korean society is rapidly becoming an ageing society. The Korean may have to live longer than did their parents. Increasing life expectancy and changing social structure, Korean people are getting interested in quality of life, and well-being is becoming a matter of concern. And, the Korean is fully aware of the importance of health for well-being or good life. This concern about health may bring about specific behaviors related to health. Although health care expenditures of Korea are currently smaller than those of other developed countries, it is continuously increasing. Large portion of increased amount of health care expenditures is to spend for disease prevention and expansion of long-term care facilities. Constructs of well-being of the Korean, not living in western culture, may be different from those of people living in western society. Health is not top-ranked to importance for quality of life in previous studies. It does not mean health isn't determinant factor for good life or well-being. Health is an essential element for well-being. It has been proved in several researches which examined poor quality of life caused by certain diseases and management of health-related quality of life. Some theories relate to health-seeking behaviors suggested the health belief or the attitude toward health, intention to do health behavior, perceived behavioral control, and self efficacy as important factors which could predict health-related behaviors. With getting older, people decline in physical and physiological functions and become vulnerable to chronic diseases. Quality of life depends on how to adjust to these changes in senescence. Social supports, especially supports from offspring, are very important to quality of life in senescence, because supports from offspring have influence on pride of the older, they may be afraid of disclose the conflict with their offspring. Avoiding self-disclosure exclude other source of social supports and harm individual's health, therefore psychological intervention is needed to. Increasing life expectancy of the Korean, Korean government has to provide numerous long-term care facilities as well as psychosocial supports. The Korean, so far, does not recognize that psychologist could render great service to promoting individual or community health and improving individual's quality of life. It is highly expected that psychologists take actively interested and involve in health related to quality of life.