• Title/Summary/Keyword: Clinical Education

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A study of mothers knowledge of weaning of infants with iron-deficiency anemia (철결핍빈혈 영·유아에서 어머니의 이유지식)

  • Kim, Sung Jin;Kim, Dong Hyun;Chang, Joo Hee;Jun, Yong Hun;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.468-473
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    • 2008
  • Purpose : Iron-deficiency anemia (IDA) is still one of the most common nutrient deficiency disorders, despite improvements in general health and nutrition. This study was designed to investigate the diagnostic values of hematological profiles, including the level of ferritin, and to evaluate the knowledge of mothers on weaning practices for infants and young children with IDA. Methods : This study was conducted on 111 infants and young children from six to 40 months of age with IDA. Their parents completed a questionnaire. IDA was defined as a level of hemoglobin <11.0 g/dL, the presence of microcytosis, a level of ferritin <10.0 ng/dL, transferrin saturation <15%, or an 1 g/dL increase in the level of hemoglobin after iron administration. The questionnaire made inquiries into their weaning practices. Results : In 111 infants and young children aged from six to 40 months, the average level of Hb was $9.5{\pm}1.0g/dL$. The prevalence of ferritin level (>10 ng/dL) was 48.6%, in spite of IDA. Seventy-four infants (66.7%) began to wean between four and six months, and 37 infants (33.3%) after seven months of age. The main food given after weaning was rice gruel. The weaning periods showed a significant relationship to the severity of anemia (P<0.05). There was no significant difference in the severity of anemia in terms of the educational levels of the mothers. Fifty-five mothers (49.5%) gave a wrong answer to a questionnaire describing that breast-fed infants aged over four months need to be fed with iron-sufficient food. Of all mothers, 49.6% took one month or more to complete the weaning process and 20% took three months or more. Conclusion : Many infants and young children with IDA have been provided with non-iron fortified foods and inadequate weaning. To improve nutritional status, especially among infants with iron deficiencies, nutritional education for mothers with infants at the weaning age must be increased and related programs must be implemented effectively.

Evaluating and managing hypertension in children: a survey of Korean cardiologists and nephrologists (소아 고혈압의 평가와 관리 방법; 한국 소아심장 전문의와 소아신장 전문의 설문)

  • Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.992-997
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    • 2008
  • Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

Risk Factors in Relation to Blood Pressure in Schoolchildren (국민학교 학동의 혈압에 관련된 요인분석)

  • Lee, Dong-Soo;Lee, Kyeong-Soo;Kang, Pock-Soo
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.345-359
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    • 1993
  • This study was conducted to identify the factors related to the blood pressure in school children. The study subjects were 144 boys and 140 girls aged 10 years old, 4th grade student of one elementary school in Taegu City. Blood pressure and 18 variables for 284 school children were measured in May 1992. A weight-for-height index, R$\ddot{o}$hrer index(weight/$height^3$) was calculated for each individual as a measure of obesity. Body fat percent, fat weight, and lean body mass were measured by impedance fat meter(Model SIF-891). Serum total cholesterol, high-density lipoprotein, triglyceride, uric acid, total protein, and electrolyte were measured by automated clinical chemistry analyzer(Hitachi 4020). Low-density lipoprotein and atherogenic index were calculated by the equation. The variables assessed were sex, systolic blood pressure, diastolic blood pressure. R$\ddot{o}$hrer index, body fat percent, body fat weight, lean body mass, total cholesterol, high-density lipoprotein, low-density lipoprotein, uric acid, total protein, serum electrolyte and blood glucose. The mean systolic and diastolic blood pressures for boys were 104.1mmHg and 66.6mmHg and those for girls were 102.9mmHg and 67.5mmHg. Systolic blood pressure of boys was positively correlated with height, weight, R$\ddot{o}$hrer index, fat weight, lean body mass, and triglyceride. Systolic blood pressure of girls was positively correlated with height, weight, lean body mass, and uric acid. Diastolic blood pressure of boys was positively correlated with weight. R$\ddot{o}$hrer index, and lean body mass. Diastolic blood pressure of girls was positively correlated with height, weight, fat weight, and lean body mass and negatively with total serum protein. In multiple regression analysis for the systolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index and serum sodium in boys, and serum uric acid, fat percent, and R$\ddot{o}$hrer index in girls. In multiple regression analysis of the diastolic blood pressure, the significant independent variables were R$\ddot{o}$hrer index in boys and total serum protein in girls. This study indicated that important factors influencing blood pressure in school children were R$\ddot{o}$hrer index, fat percent, serum sodium, uric acid, and total protein. R$\ddot{o}$hrer index was most important among these. It is recommended to enforce the nutritional education for diet control of obesity to prevent hypertention in children and to adopt healthy life-styles that promote good health and prevent development of cardiovascular risk factors.

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Art Therapy and Hospice & Palliative Care in Korea (한국의 예술치료와 호스피스 완화의료)

  • Kim, Chang Gon
    • Journal of Hospice and Palliative Care
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    • v.18 no.2
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    • pp.85-96
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    • 2015
  • In Korea, modern art therapy was developed in the 1960s and 1970s in the form of supplementary activities for patients in psychiatry. Along with the foundation of the Korean Association for Clinical Art in 1982 by psychiatric doctors, the therapy involved more various arts forms such as music, art, dance, poetry therapy, and psychodrama. More organizations with specific expertise opened such as the Korean Art Therapy Association, Korean Art Therapy Association, etc. in the 1990s and the Korea Arts Therapy Institute in 2001. As of April 2015, the members of the Korean Art Therapy Association total 15,000, including 6,200 regular members. The arts in integrative arts therapy (IAT) is an individual's creative activity which is related to his inner world, and the forms of IAT include music, drawing, dance and poetry therapy. From the aspect of phenomenology, IAT is psychophysical therapy involving the arts that helps patients recognize and perceive their experiences with an aim of at a recovery of the body and creativity from the phenomenological aspect. It is also a therapeutic activity that targets growth and development of the body and mind. Meta-analysis of the effects of art therapy with a focus on that involving music, drawing, dance movement and IAT in recent years in Korea, significant effects were observed in all factors but physical function. The biggest effect was mentality adaptation followed by activity adaptation and physiology. In the run up to the implementation of the daily flat-rate system for the health insurance reimbursement for palliative care in July 2015, the Ministry of Health and Welfare is reviewing the coverage of music therapy, drawing therapy and flower therapy, which are currently practiced by 56 hospice institutes in Korea. This is a meaningful step because the coverage of hospice and palliative care came after that of art therapy for psychiatric patients was approved in 1977. Still, there is a need clarify the therapeutic mechanism by exploring causality among the treatment media, mediation type and treatment effects. To address the issue of indiscriminately issued licenses, more efforts are needed to ensure expertise and identity of the licensed therapists through education, training and supervision.

An Epidemiologic Study on the Seropositive Rate of Hepatitis A Virus in Children of Gwangju and Jeonnam (광주, 전남 지역 소아의 A형 간염 항체 보유율에 대한 연구)

  • Jung, Ji;Ahn, Young-Joon;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.1
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    • pp.67-73
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    • 2011
  • Purpose: Recently, the incidence of acute hepatitis A has increased nationwide and is related to a low rate of IgG anti-HAV production. To establish effective measures for preventing hepatitis A virus infection, an epidemiologic study on the seroprevalence of anti-HAV is needed. Thus, we investigated the seroprevalence of IgG anti-HAV in children living in Gwangju and Jeonnam. Methods: IgG anti-HAV levels were measured in a total of 1,435 patients who visited Chosun University Hospital between January 2009 and December 2009. Results: The overall seropositve rate was 40.8% (586/1,435). The seropositive rates were 41% among children under the age of 1 year, 49.9% for children 1~5 years old, 51.1% among individuals 5~10 years old, 12.9% for individuals 10~15 years old, and 8.2% for subjects over 15 years old. There was no significant difference between genders in any group. The seropositive rates in Gwangju and Jeonnam were 57.3% and 32.9% for children under the age of 1 year, 52.5% and 44.3% for children 1~5 years old, 60.2% and 33.9% among children 5~10 years old, 14.1% and 9.7% for children 10~15 years old, and 10.8% and 4.2% for individuals over 15 years old. Conclusion: The results demonstrated the low rates of IgG anti-HAV, particularly among subjects over 10 years old, which suggests the possibility of increasing clinical HAV infection rates among adults in the near future. We should actively prevent the spread of hepatitis A virus. Vaccination is the most effective means of preventing hepatitis A virus transmission among persons at risk for infection. Hepatitis A vaccination is recommended for children who have low IgG anti-HAV seropositive rates.

Infantile risk factors for obesity in preschool children (학령전기 소아비만에 영향을 주는 영유아기 인자)

  • Park, Sun Ju;Moon, Jae Won;Kim, Hyun Ji;Cho, Min Jung
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.804-811
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    • 2008
  • Purpose : Childhood obesity is a problem that places a child at great risk for becoming an obese adult. To prevent obesity, it is important to focus on early life risk factors that may contribute to childhood obesity. The aim of this study is to find obesity-causing infantile risk factors in preschool children. Methods : A total of 223 children aged 3 to 5 years old from Busan were the subjects of this study. We calculated their body mass index (BMI) and classified them into two groups (normal weight and overweight/obese children). Information regarding parental weight and height, mother's educational level and employment status, birth weight, feeding patterns, start time of weaning, duration of night feeding, and fosterer was obtained by using questionnaires. Results : There were 68 (30.5%) overweight/obese children and 155 (69.5%) normal weight children. Overweight/obese children were significantly associated with formula milk feeding, rapid weight gain during the first 6 months, and maternal obesity (P<0.05). There were no statistical differences in paternal obesity, mothers educational level and employment status, birth weight, start time of weaning, duration of night feeding, and fosterer between the normal and overweight/obese children. Conclusion : Although healthy diet and regular exercise will remain the cornerstones of weight management in obese children, our data supports the view that education about maintaining a normal weight could be introduced much earlier in families with high-risk children.

Norm-referenced criteria for strength of the elbow joint for the korean high school baseball players using the isokinetic equipment: (Focusing on seoul and gyeonggi-do) (등속성 장비를 이용하여 한국고교야구선수 주관절 근력 평가기준치 설정: (서울 및 경기도 중심으로))

  • Kim, Su-Hyun;Lee, Jin-Wook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.442-447
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    • 2017
  • The purpose of this study was to establish norm-referenced criteria for the isokinetic strength of the elbow joint in Korean high school baseball players. Two hundred and one high school baseball players participated in this study, none of whom had any medical problem with their upper limbs. The elbow flexion/extension test was conducted four times at a speed of $60^{\circ}/sec$. The HUMAC NORM (CSMI, USA) system was used to obtain the values of the peak torque and peak torque per body weight. The results were presented as norm-referenced criterion valuesusing the 5-point scale of Cajori which consists of five stages (6.06%, 24.17%, 38.30%, 24.17%, and 6.06%). In the results of this study, the peak torques of the elbow (flexor and extensor?) at an angular velocity of $60^{\circ}/sec$ were $37.88{\pm}8.14Nm$ and $44.59{\pm}11.79Nm$, and the peak torque per body weight of the elbow (flexor and extensor?) were $50.06{\pm}8.66Nm$ and $58.28{\pm}12.84Nm$, respectively. The reference values of the peak torque and peak torque per body weight of the elbow flexor and extensor were setat an angular velocity of $60^{\circ}/sec$. On the basis of the results analyzed in this study, the following conclusions were drawn. There is a lack of proper studies on the elbow joint strength, even though the most common injury in baseball players occurs in the elbow joint. Therefore, we need to establish a standard muscle strength in order to prevent elbow joint injuries and improve their performance. The criteria for the peak torque and peak torque per body weight established here in will provide useful information for high school baseball players, baseball coaches, athletic trainers and sports injury rehabilitation specialists in injury recovery and return to rehabilitation, which can beutilized as objective clinical assessment data.

Survey on Counseling about Infant Nutrition Among Doctors on Practicing Pediatric Patients in Primary Medical Facilities (소아 환자를 진료하는 의사들의 영아기 영양에 대한 상담 실태 조사)

  • Doe, Eun Jung;Lee, Eun Sil;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.45 no.11
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    • pp.1332-1339
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    • 2002
  • Purpose : Through a survey undertaken among doctors practicing pediatric patients in primary medical facilities on nutrition during infancy, the present study was done to determine whether these doctors were giving appropriate advice on infant nutrition. Methods : We visited pediatric specialists(group one) and non-pediatric specialists or general practitioners(group two) who were practicing in Daegu to ask them to fill out a questionaire on infant nutrition. Results : When 10 points were given to each question for a total of 100 points, the results of the evaluation showed that the score in group one was $73.0{\pm}15.8$ points and $45.1{\pm}18.4$ points in group two, showing a significant difference. No statistical difference was seen in the scores between non-pediatric specialists and general practitioners. Each answer to each question on the feeding period of breast milk, on loose stools during breast milk feeding, methods to deal with jaundice during breast milk feeding, choice of commercial baby food, criteria on directing soy milk, and criteria of guiding infant cereal was different between group one and two. Conclusion : The results of the present investigation showed that specialists in other fields or general practitioners were giving inappropriate advice on nutrition during the infant stage compared with pediatric specialists; thus, we need to confirm methods to prevent inappropriate consultations by specialists of other fields, together with continued education of pediatric specialists.

Development and Evaluation of Consumer Educational Contents on Safety Management of Imported Foods for Female College Students in Seoul (수입식품 안전관리에 관한 소비자 교육 컨텐츠 개발 및 교육효과 조사 - 서울시에 거주하는 여대생 중심으로 -)

  • Jung, Ji-In;Kang, Eun-Jin;Cho, Mi-Young;Choi, Gye-Sun;Hong, Young-Pyo;Seo, Kab-Jong;Kim, Gun-Hee
    • Journal of Food Hygiene and Safety
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    • v.24 no.4
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    • pp.291-298
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    • 2009
  • This study was carried out to evaluate the consumer recognition with regard to the safety management for imported foods. In order to evaluate the effect of the prgram on consumer education, the program was practiced for 89 female college students in Seoul, Korea. The participants were given an instruction with materials on imported food safety, including the safety management of imported foods and their distribution. The results showed that the participants achieved a greater understanding of imported foods. In particular, they had firmly grasped the importance of expiration date in selecting imported foods. Before the instruction, 50.6% of total participants blamed the Korean government for the problems arising from imported foods; only 18.0% placed the blame on individuals or businesses importing from foreign countries. After the instruction, 39.3% had blamed the individuals or businesses importing from foreign countries. Furthermore, 36.0% had disapproved of the foods that are imported from China before the instruction, while 32.6% found objectionable the views on the illegally distributed foods; 29.2% criticized the junk foods that target children (after the instruction). In addition, the level of participant satisfaction via-a-vis imported foods safety supervision had improved from $2.76{\pm}1.59$(before the instruction) to $3.37{\pm}1.58$(after the instruction). The results indicate that consumers are concerned with the imported foods that contain adulterated or forbidden substances and the illegally distributed foods from foreign countries. Thus, consistent and informative educational programs on imported food safety could help consumers in choosing safer products, resulting in an improvement in the consumer confidence with respect to imported foods.

Therapeutic use of percussion instruments for children with aggressive behaviors - Case studies with quantitative and qualitative approaches - (공격성 아동을 위한 음악치료 -타악기 연주활동 중심의 사례연구-)

  • Han, Jee hyun
    • Journal of Music and Human Behavior
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    • v.2 no.2
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    • pp.33-56
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    • 2005
  • The purpose of this study is to measure the effect of musical activities on children's aggressiveness using percussion playing through case studies and to present the therapeutic programs. Musical activities using percussion playing were organized for three aggressive children. Twenty-one small group sessions were conducted over seven weeks with 30 minutes given each session. Fourth-grade children involved in using Aggressiveness Measuring Tool for Teachers-revised by Gwak Geum-Joo(1992) was selected for case studies. Children's impulsiveness was also tested through self-test measuring tool for impulsiveness-revision of 16 questions used by Cho Hae Yeon (2001) and Lee Joo Shik (2003). As quantitative method, comparative analysis was made between the pre and post test results using measuring tools for aggressiveness and impulsiveness of children as well as between aggressive behaviors occurring in the initial stage of the first three sessions and in the latter stage of the last three sessions. Qualitative method was used at the same time to examine the effect of percussion playing on children. After the musical activities, child A showed reduced Aggressive Measuring Tool scores from 19 to 18, with child B from 23 to 19 and child C from 21 to 18. The results show that occurrence of aggressive behaviors were lowered in the post test. Impulsiveness Measuring Tool scores in the post test were decreased as well in all three children. During the music therapy programs, it was also observed that the frequency of the target behaviors in all three children has reduced more in the latter stage than the initial stage of music therapy. The qualitative findings indicate that the children experienced releasing stress through self-expression after percussion playing. These findings indicate therapeutic effectiveness of music therapy using on percussion playing in reducing aggressiveness of children as well as the effectiveness of percussion as a therapeutic intervention for aggressive children. These results can be adapted and reapplied by teachers in primary schools to approach children with behavior problems, and can present a useful therapeutic approach to therapists practicing in clinical environments.

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