• Title/Summary/Keyword: Clinical Education

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The ages and stages questionnaire: screening for developmental delay in the setting of a pediatric outpatient clinic (ASQ :소아과외래에서의 발달지연 선별검사)

  • Kim, Eun Young;Sung, In Kyung
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1061-1066
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    • 2007
  • Purpose : Early identification of developmental disabilities allows intervention at the earliest possible point to improve the developmental potential. The Ages and Stages Questionnaire (ASQ), a parent- completed questionnaire, can be used as a substitute for formal screening tests. The purpose of this study was to evaluate the validity of the Korean version of the ASQ (K-ASQ) as a screening tool for detecting developmental delay of young Korean children in the setting of a busy pediatric outpatient clinic. Methods : Parents completed the K-ASQ in the waiting room of the pediatric outpatient clinic of St. Mary's Hospital, Catholic University Medical College. Out of 150 completed the ASQ, 67 who were born term and had no previous diagnosis of developmental delay, congenital anomalies, or neurological abnormalities were enrolled. The cut-off values of less than 2 standard deviations (SD) below the mean for the ASQ were used to define a "fail", and children who failed in one or more domains tested were classified as "screen-positive". Diagnosis of developmental delay was made when the developmental indices fell below -1 SD of the Bayley Scales of Infant Development-II. Results : (1) The mean age of children was $16.4{\pm}7.4$ months. Ten children (14.9%) were small-for- gestational age infants. The mean birth weight and gestational age were $3.1{\pm}0.6kg$ and $38.8{\pm}1.4$ weeks. Nine children (13.4%) were twins and 33 (49.0%) were male. The mean maternal education in years was $13.6{\pm}2.4$, and 31.3% had full-time jobs. The time for completing the ASQ was $10.2{\pm}3.0$ minutes. (2) Seventeen children (25.4%) were classified as screen-positive, four of them were delayed in development. Among eight children diagnosed with developmental delay, four were screen-positive and the other four were screen-negative by the ASQ. (3) The test characteristics of the ASQ were as follows: sensitivity (50.0%); specificity (78.0%); positive predictive value (23.5%); negative predictive value (92.0%). Conclusion : The high negative predictive value of the K-ASQ supports its use as a screening tool for developmental delay in the setting of a pediatric outpatient clinic.

Effects of Different Physical Frequency on Food-Dependent Exercise Induced Allergy Anaphylaxis (FDEIA) and Related Mechanisms (운동빈도의 차이가 식이유도 운동알레르기 질환과 관련기전에 미치는 영향)

  • Kim, Cheol-Woo;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.22 no.7
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    • pp.897-903
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    • 2012
  • Food allergies have become a serious health concern in the past two decades, especially in developed countries. Foods associated with allergies include vegetables, some fruits, shellfish, wheat, egg, chicken, and nuts. To describe the specific fundamentals, etiological factors, and clinical manifestations, we analyzed the different physical frequency on spleen index in sensitized and regular exercise-trained mice. We also conducted a proliferation assay of lymphocytes to OVA, ROS, ASAS, and we determined the cytokine levels. Female BALB/c mice were bred in the animal laboratory of the P and D university under controlled conditions ($22{\pm}2^{\circ}C$, RH 45-55%, and a 12-hour photoperiod). The animals were 6 weeks old at the start of the study and were fed a standard commercial chow diet from 09:00 to 15:00 for the 8-week study period. All animals had access to distilled deionized water ad libitum. They were divided into four groups: a control group (S; control sensitized, n=25), a low-frequency training group (F2, n=25), a mid-frequency training group (F3, n=25), and a high-frequency training group (F5, n=25) following the treatment of exercise time per week. The results were as follows: The mice spleen index showed the highest grade in the F5 group compared with the other groups; this level showed in an exercise frequency-dependent manner. In the proliferation assay of OVA, the F5 group showed the highest grade compared with the other groups; this level was also showed in an exercise frequency-dependent manner. Peritoneal ROS and ASAS showed a statistically significant increase in the F5 group and decreased in the F2 group compared with the S group. However, there were no significant differences in the F3 group. The highest level of IL-4 was found in the F5 group compared with the other groups. However, the highest level of INF-${\gamma}$ was in the F2 group. The results suggest that FDEIA is positively correlated with the frequency of exercise due to the direct effect of physical exercise on peritoneal ROS and the cytokine profile. Further research is needed on the specific mechanism underlying the combined effects of exercise intensity and frequency on physical-induced allergy anaphylaxis.

OBSTETRICIAN'S VIEW OF TEENAGE PREGNANCY:PRESENT STATUS, PREVENTION AND PSYCHIATRIC CONSULTATION (산과 의사가 인지한 10대 임신의 현황, 예방, 정신과 자문)

  • Kim, Eun-Young;Kim, Boong-Nyun;Hong, Kang-E;Lee, Young-Sik
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.117-128
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    • 2002
  • Objectives:For the purpose of obtaining the more vivid present status and prevention program of teenage pregnancy, this survey was done by Obstetricians, as study subject, who manage the pregnant teenager in real clinical situation. Methods:Structured survey form about teenage pregnancy was sent to 2,800 obstetricians. That form contained frequency, characteristics, decision making processes, and psychiatric aspects of the teenage pregnancy. 349 obstetricians replied that survey form and we analysed these datas. Results:(1) The trend of teenage pregnancy was mildly increased. (2) The most common cases were unwanted pregnancy by continuing sexual relationship with boyfriends rather than by forced, accidental sexual relationship with multiple partners. (3) The most common reason of labor was loss the time of artificial abotion. (4) Problems of pregnant girls' were conduct behaviors and poor informations about contraception rather than sexual abuse or mental retardation. (5) Most obstetricians percepted the necessity of psychiatric consultation, however psychiatric consultation was rare due to parents refusal and abscense of available psychiatric facility. (6) For the prevention of teenage pregnancy, the most important thing was practical education about contraception. Conclusions:Based on the result of this study, further study using structured interview schedule with pregnant girl is needed for the detecting risk factor of teenage pregnancy and effective systematic approach to pregnant girl.

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A study on hypertension relevant nutritional knowledge and dietary practices in Chinese college students studying in South Korea (재한 중국 유학생들의 고혈압 관련 영양지식과 식생활 실천에 관한 연구)

  • Sun, Zhe;Cho, Wookyoun
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.441-450
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    • 2015
  • Purpose: The purpose of this study was to investigate the effects of hypertension relevant nutrition knowledge on practices for prevention of hypertension in Chinese college students studying in South Korea. Methods: We conducted a survey of 276 Chinese students studying more than three months in Korean universities who were aged 19 and older about hypertension and sodium relevant nutrition knowledge, intake of salty processed food, hypertension prevention practices, and stages of behavior change for hypertension. Results: The average score on the questionnaire for hypertension relevant nutritional knowledge was 40.62 out of 50 points, and the average score for sodium relevant nutritional knowledge was 24 out of 30 points. Kimchi was the most frequently eaten salty processed food. The average score for hypertension prevention practices was 3.10 out of 5 points. The behavior change stages for prevention of hypertension were contemplation (47.1%), action (32.2%), and pre-contemplation (20.7%). The students received high scores on nutrition knowledge and showed significantly higher scores on the action stage than on pre-contemplation or contemplation. Nutritional knowledge of hypertension and sodium showed positive correlation with hypertension prevention practices, whereas negative correlation with salty processed food intake. Conclusion: Development of an education program for Chinese students in Korea on hypertension and sodium relevant nutritional knowledge is needed so that they can practice for prevention of hypertension.

A Study of Content Analysis on ICU(Intensive Care Unit) Nurses' Knowledge of Basic Nursing Sciences (중환자실 간호사의 기초간호과학 지식의 필요성 분석)

  • Byeon, Young-Soon;Choe, Myoung-Ae;Kim, Hee-Seung;Park, Mi-Jung;Seo, Wha-Sook;Lee, Kyung-Sook;Choi, S-Mi;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.4 no.1
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    • pp.41-49
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    • 2002
  • The purpose of this study was to identify the knowledge contents of basic nursing sciences needed by nurses in the practices of the intensive care unit(ICU). To attain the goal of this study, the nurses working at 10 hospitals in the areas of Seoul and Kangwon Province were randomly selected. They were primarily interviewed, and the open question was secondarily put to them through the questionnaire. In the process of the 1st interview, the interviewees were asked of the question, "What is the knowledge of basic sciences such as anatomy, pathology, physiology. microbiology, pharmacology and the like thought to be lacking when you communicate with doctors in the ICU and when you carry out your nursing practices in it?" The contents of the interview were tape-recorded. The period of data collection ranged from May 1, 2001 to Sept 30. The interviews were conducted with total of 20 nurses. The open-end questionnaire was secondarily mailed to nurses. 113 questionnaires were returned. 100 questionnaires except 13 ones thought to be poorly completed in content were used for data analysis. Three coders classified data obtained from the interview and the questionnaire research into 5 detailed items relating to such as anatomical physiology, pathology, pharmacology. microbiology and basics of nursing. The three coders had experiences in nursing education of 18 years, 8 years and 6 years, respectively, and of them one coder was professor in basic nursing sciences. Data were statistically treated using frequency analysis and percentage by the SAS program. As a result, the following findings were obtained : It was found that the contents that ICU nurses responded were most needed in the field of Human structure and function were water and electrolytic balance(38%), blood and circulatory system(20%), changer in the patient's skin(12%), the arrangement of the human body(10%) and the endocrine system(10%), nervous system(6%), and assessment of the state of the patient's consciousness(4%). It was found that the contents that ICU nurses responded were most needed in the field of pathology were found to be the process of the progress of the disease(32%), symptoms of the disease(27%), prognosis of the disease(22%), followed by the injury-healing process, clinical pathological examination, and examination by radiation. It was found that the contents that nurses responded were most needed in the field of pharmacology were the effect of drug(25%), the side effect of drug(22%), the relationship between diseases and drug(20%), the relationship between disease-causing bacteria and drug(20%) and chemotherapy(2%). It was found that the contents that ICU nurses responded were most needed in the field of microbiology were the relationship between diseases and disease-causing bacteria(45%), Kinds and characteristics of disease-causing bacteria(18%), infection control(16%), application of the aseptic technique(12%), isolation(9%) and the like. It was found that the basic knowledge that ICU nurses responded were needed were the identification of the patient's current state(36%), understanding of the therapeutic process(22%), the operating principle of medical equipment and instrument(20%), medical terminology(9%), equipment and instrument management(7%), calculation of the dose of injection(2%) and the like.

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Application of Occupational Therapy Intervention Process Model: A Case of Child With Sensory Integration Dysfunction (작업치료중재과정모델의 적용: 감각통합기능장애 아동 사례)

  • Kim, Ji-Hyun
    • The Journal of Korean Academy of Sensory Integration
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    • v.9 no.2
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    • pp.1-13
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    • 2011
  • Objective : Purpose of this study is to discuss benefits and implications of the clinical reasoning process and re-evaluation in the OTIPM by introducing a single case that occupational therapy intervention is provided based on the OTIPM. Methods : The case subject is a boy aged 5 years and 10 month who had diagnosed as attachment disorder and anxiety disorder from a pediatric psychiatrist before. The boy is referred to sensory integration therapy clinic and underwent occupational therapy intervention service twice a week for four month. Therapeutic activities for the intervention were consisted of sensory integration activities for restorative model, care-giver education for educational model, and performance skill training for acquisitional model. Measurements used in the initial evaluation are JSI-R, DDST-2, Social Maturity Test, KPPS-R, and observation-based performance task analysis. For the performance task analysis, performance skill items were constructed based on the Occupational Therapy Process Framework (OTPF), and those were assessed by the evaluation system of Assessment of Motor and Process Skill (AMPS) and Evaluation of Social Participation (ESI). Results : The detail process of implementing of the OTIPM in this study is reported by following four phases; 1) establish client-centered performance context; 2) establish baseline and interpret cause (initial evaluation); 3) intervention planning and implementing; and 4) recognize intervention outcome (reevaluation). Conclusion : In this case, occupational therapist could provide the client an occupation-based intervention within comprehensive performance context based on the OTIPM. Therapist could clearly identify the cause of problematic performance skills and behaviors and so provide effective intervention to improve client's occupational performance. Additionally, it was found that client's satisfaction of the intervention can be raised when the concept of 'who is the client' is expanded based on the OTIPM. From this study, it is proposed that OTIPM may be a model educible 'comprehensive' enhancement of 'specific' occupational engagement, as it considers both improvement of occupational performance and satisfaction.

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Prediction of Sleep Disturbances in Korean Rural Elderly through Longitudinal Follow Up (추적 관찰을 통한 한국 농촌 노인의 수면 장애 예측)

  • Park, Kyung Mee;Kim, Woo Jung;Choi, Eun Chae;An, Suk Kyoon;Namkoong, Kee;Youm, Yoosik;Kim, Hyeon Chang;Lee, Eun
    • Sleep Medicine and Psychophysiology
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    • v.24 no.1
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    • pp.38-45
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    • 2017
  • Objectives: Sleep disturbance is a very rapidly growing disease with aging. The purpose of this study was to investigate the prevalence of sleep disturbances and its predictive factors in a three-year cohort study of people aged 60 years and over in Korea. Methods: In 2012 and 2014, we obtained data from a survey of the Korean Social Life, Health, and Aging Project. We asked participants if they had been diagnosed with stroke, myocardial infarction, angina pectoris, arthritis, pulmonary tuberculosis, asthma, cataract, glaucoma, hepatitis B, urinary incontinence, prostate hypertrophy, cancer, osteoporosis, hypertension, diabetes, hyperlipidemia, or metabolic syndrome. Cognitive function was assessed using the Mini-Mental State Examination for dementia screening in 2012, and depression was assessed using the Center for Epidemiologic Studies Depression Scale in 2012 and 2014. In 2015, a structured clinical interview for Axis I psychiatric disorders was administered to 235 people, and sleep disturbance was assessed using the Pittsburgh Sleep Quality Index. The perceived stress scale and the State-trait Anger Expression Inventory were also administered. Logistic regression analysis was used to predict sleep disturbance by gender, age, education, depression score, number of coexisting diseases in 2012 and 2014, current anger score, and perceived stress score. Results: Twenty-seven percent of the participants had sleep disturbances. Logistic regression analysis showed that the number of medical diseases three years ago, the depression score one year ago, and the current perceived stress significantly predicted sleep disturbances. Conclusion: Comorbid medical disease three years previous and depressive symptoms evaluated one year previous were predictive of current sleep disturbances. Further studies are needed to determine whether treatment of medical disease and depressive symptoms can improve sleep disturbances.

Hospice and Palliative Care for the Terminal Patients with Colorectal Cancer (말기 대장직장암 환자의 호스피스 완화의료)

  • Hong, Young-Hwa;Lee, Choon-Sub;Lee, Ju-Ri;Lee, Jung-Ho;Kim, You-Jin;Lee, Tae-Kgyu;Moon, Do-Ho
    • Journal of Hospice and Palliative Care
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    • v.10 no.1
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    • pp.35-42
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    • 2007
  • Purpose: Colorectal ranter is the 4th leading cause of cancer death in Korea and the prevalence is increasing continuously. This study was aimed to figure out the problems through the clinical consideration about terminal colorectal ranter patients who had died in hospice unit. Methods: We retrospectively reviewed the medical records in 78 patients with colorectal ranter who had admitted, received palliative care, and died in a hospice unit between April 2003 and November 2006. Results: The median age of patients was 59.6 years with 45 men (58%) and 24 women (42%). The median survival in hospice and palliative care was 36 days. The median hospitalization was 22 days. The most prevalent reason for admission was pain (38 patients, 49%), and the most common symptom was also pain (70 patients, 90%). Forty eight patients (62%) took analgesics before hospice referral. Twenty seven patients (65%) of 45 patients with intestinal obstruction have been performed palliative procedures. Median survival of patients with palliative procedure was higher than that of no palliative procedure group (47 days vs 19 days, P-value=0.005). Conclusion: The duration of hospice and palliative care was not enough to care the terminal colorectal cancer. Therefore, we suggest that proper education and information should be provided to physician, patients and their family members for effective hospice and palliative care.

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Impact of Feeding Multiple Probiotics on Performance and Intestinal Microflora in Broiler Chicks (혼합 미생물제의 수준별 급여가 육계의 생산성 및 장내 미생물에 미치는 영향)

  • 류경선;신원집;박재홍;류명선;김종설;김상호;리홍룡
    • Korean Journal of Poultry Science
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    • v.30 no.3
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    • pp.197-202
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    • 2003
  • Feeding probiotics in broiler chicks still critical in several aspects. Thus, this study was conducted to investigate the impact of feeding multiple probiotics on performance, intestinal microflora, blood cholesterol and ND antibody vaccine titer in broiler chicks. Three hundred twenty one day old male broiler chicks(cobb ${\times}$ cobb) were divided into four levels of multiple probiotics(0, 0.1, 0.2, 0.3%) with five replicates for 35 days. Basal diets contained 21.5, 19.0% CP and 3,100 kcal/kg ME for starting and finishing period, respectively. Weight gain, feed intake and feed conversion were measured weekly. The number of Salmonella, E. coli, Lactobacillus, and yeast were examined from ileum and cecum at the end of experiment. ND vaccine titer, cholesterol were detected from sera. Weight gain of birds fed probiotics were 669.33, 679.75 at the level of 0.1 and 0.2% supplemental groups for starting period. It was also improved in those treatments for finishing period and higher than control for total period. Feed conversion tended to be improved compared to that of control by the supplementation of probiotics for the first three weeks and seemed to show the similar tendency for the rest of two weeks. It was 1.611, 1.621 for the entire feeding period and improved compared with control. Total salmonella, was not decreased in ileal digesta of birds fed the probiotics compared with control, whereas the number of yeast increased in 0.1% treatment. However, the number of Lactobacillus and yeast in cecum was higher than control. Even though the blood cholesterol seem to high in 0.1% probiotics treatment, the ratio of HDL to total cholesterol showed higher than control. ND vaccine titer of birds fed probiotics were significantly higher than control (P<0.05). These results 0.1% multiple probiotics would be possible to improve the performance of broiler chicks and ND vaccine titer.

Study on Short Term Smoking Cessation Treatment in Dental Hospitals in Korea (국내 치과대학병원에서 시행한 단기 금연진료에 대한 조사)

  • Song, Je-Il;Lee, Gi-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.35 no.4
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    • pp.245-258
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    • 2010
  • Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.