• Title/Summary/Keyword: Clinical training hours

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A Review of the Plasticity and Constraint Induced Movement Therapy : Children With Spastic Hemiplegic Cerebral Palsy (신경가소성 원리를 이용한 강제유도운동치료에 대한 고찰: 경직성 편마비형 뇌성마비 아동을 대상으로)

  • Cho, Sang-Yoon
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.13-23
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    • 2013
  • Constraint-Induced Movement Therapy(CIMT) is considered as one of the most interesting upper extremity rehabilitation in the field of neurorehabilitation. CIMT is an intensive training provided in the affected upper limb for 6 hours a day, 5 days a week for 2 weeks, while unaffected arm is restrained for 90% of waking hours. Recently, instead of CIMT, modified Constraint-Induced Movement Therapy(mCIMT) has been applied because of the clinical limitations of CIMT. CIMT or mCIMT studies have used various outcome instruments to measure different aspects of upper limb function after intervention. There are various kinds of evaluation tools to measure different aspects of upper limb function after CIMT intervention. It has been proven that Pediatric Motor Activity Log(PMAL), Quality of Upper Extremities Skills Test(QUEST), Melbourne Assessment of Unilateral Upper Limb Function(MAULF), Assisting Hand Assessment (AHA) are effective. The purpose of this study was to investigate the cortical change in children with hemiplegic cerebral palsy after CIMT. As a result, use-dependent cortical reorganization was revealed. Also, increased activity of the contralateral motor cortex and decreased activity of the ipsilateral cortex were found. It supports the mechanism of cortical reorganization, the principles of neural plasticity and specifically activation of the contralateral cortex, for improving upper limb function after CIMT.

The Factors Affecting the Registration Rates for Emergency Department Based Post-suicidal Care Program (응급실 기반 자살 시도자 사후 관리사업의 등록률에 영향을 미치는 인자)

  • Lee, Junchul;Kang, Hyung Goo;Kim, Changsun;Oh, Jaehoon;Lim, Taeho;Ahn, Dong Hyun;Lee, Jung Im;Park, Min Hee;Kim, Kyung Hee
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.25-32
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    • 2015
  • Purpose: The aim of this study was to investigate the independent factors associated with the registration rate for the community-based post suicidal care program in the emergency department (ED). Methods: This prospective observational study was conducted between March and December 2013 at the academic ED at the tertiary urban hospital. During the study period, the pre-designed registry was recorded. The variables examined included the following: patients' demographic data (Sex, age, address, type of insurance, marital status, level of education, and history of previous psychiatric disease), suicide-related data (suicidal methods, combined drink of alcohol and number of previous attempts), and management-related data (disposition at ED, physician's training level, etc.). Univariated and multivariated logistic regression analyses were performed for identification of factors affecting the registration rate for the community-based post suicidal care program. Results: A total of 163 suicides were included during the study period. Of these, 33 (20.2%) patients were registered in the post-suicide care program. Factors including a patient's address (OR: 14.92, 95% CI: 3.606-61.711), immediate intervention by psychiatric healthcare center (OR: 5.05, CI: 1.688-15.134), admissions in hospital (OR: 3.69, CI: 1.286-10.605), and history of previous psychiatric disease (OR: 3.52, CI: 1.216-10.201) showed significant association with registration for the program. Conclusion: The community-based post-suicidal care program, which is available 24 hours a day, should be operated in each district in order to increase the registration rate. Emergency physicians should actively consider the inpatient treatment program for suicidal patients and strongly recommend registration to the program, particularly for patients without previous history of psychiatric disease.

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Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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A Study on the Development of a Competency-Based Intervention Course Curriculum of the Korean Academy of Sensory Integration (대한감각통합치료학회 역량기반 중재과정 교육커리큘럼 개발연구)

  • Namkung, Young;Kim, Kyeong-Mi;Kim, Misun;Lee, Jiyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.3
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    • pp.26-45
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    • 2019
  • Objective : The purpose of this study is to develop educational goals, training content, and training methods for the intervention course of the Korean Academy of Sensory Integration (KASI) and to conduct competency-based intervention courses based on the competency model for sensory integration intervention. Methods : This study was conducted on work therapists who participated in the 2019 intervention course of KASI. In the first phase, educational needs were analyzed to set goals for the interventional course. In the second phase, a meeting of researchers drafted the intervention course education program and the methods of education, and the intervention course was conducted. In the third phase, the changes in educational satisfaction and performance level pre- and post-intervention course for each competency index were investigated. Results : The educational goals of "learning and applying the clinical reasoning process of sensory integration intervention" and "intervention by applying the principle of sensory integration intervention" were set after reflecting on the results of the analysis of the educational requirements. The length of the competency-based intervention course was 42 hours. The average education satisfaction level of participants in the arbitration process was 4.48±0.73, and the average education satisfaction level of the supervisor was 3.92±0.71. In both groups, the most satisfying curriculums were the data-driven decision-making process and the intervention goal-setting lecture. But the satisfaction level of was the lowest. Before and after the intervention course, there were significant changes in the performance of the two behavioral indicators of the analytic skills in the expertise competency cluster of the competency model. Conclusion : This study is meaningful in that it conducted a survey of educational needs, the development and implementation of an educational curriculum, and an education satisfaction survey through systematic courses necessary for education development.

A study on work environments for dental hygienists: - focusing on kind of workplace. career and service area (치과위생사의 근무환경 연구 -근무기관·경력·지역을 중심으로-)

  • Yoo, Jung-Sook;Kim, Young-Nam;Han, Gyeong-Soon
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.2
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    • pp.135-151
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    • 2007
  • The purpose of this study was to examine the work environments of dental hygienists, to find out about what problems there were with their work environments and ultimately to help improve their work environments. It's basically intended to pave the way for furthering the welfare and interests of dental hygienists. The subjects in this study were dental hygienists who were selected by random sampling from among the members of Korean Dental Hygienists Association. Approximately 20 percent of the members each were selected from every region across the nation, and their work environments were investigated in consideration of the kind of their workplaces, service area, career and field of duties. As for the demographic characteristics of the dental hygienists investigated, there were differences between those who worked in the field of health care and the clinical workers. More of the former were older and married, and the former was ahead of the latter in career and education as well. Regarding working hours and leave of absence by kind of workplace, the number of regular average holidays was different according to their place of employment. Dental hospitals(6.66 days) and dental clinics(6.81 days) gave their employees less days off on the whole, whereas public dental clinics(19.29 days) granted the dental hygienists the longest leave of absence. Also, there was a broad gap in the number of regular average holidays among different regions in the nation. The dental hygienists who worked in Gangweon province enjoyed the longest holidays(10.88 days), while those on Jeju Island took the shortest vacation(4.46 days). Concerning monthly mean pay by place of employment, those who worked in public dental clinics were paid the best, and the dental hospital employees received the smallest pay. Their monthly mean pay significantly varied with the kind of their workplaces. As to connections between service area and pay level in the event of the dental hygienists with a four-year career, those who served in Seoul were paid the best(1,820,800 won), followed by Gyeonggi province(1,795,800 won), Gyeongsang province(1,604,200 won), metropolitan cities(1,424,800), Gangweon province(1,300,000 won) and Jeolla province(1,016,700 won). In regard to the starting pay in the different areas, the starting pay was largest in Seoul(1,501,800 won) and smallest in Jeolla province(904,000 won). Concerning work environments by place of employment, the dental hygienists in public dental clinics, general hospitals and university hospitals were far older than the others, and the career of the former was much larger than that of the latter. As to the number of regular leave of absence, public dental clinics, general hospitals and university hospitals were different from dental hospitals and clinics in that regard as well. Concerning monthly pay, public dental clinics paid their employees the best, and dental hospitals and clinics were ahead in terms of pay raise. But the reason seemed that public dental clinics and general hospitals increased the pay of their employees based on a fixed wage system and according to a fixed rate at the same time. As for relations between career and work environments, the pay of the dental hygienists differed with their career. The amount and rate of pay raise were largest for those whose career was between four years and less than six years, and smallest for those whose career was between seven years and less than nine years. The above-mentioned findings of the study suggested that in order to give dental hygienists better treatment, pay and welfare benefits should urgently be improved, and that it's required to take actions to boost their job satisfaction. Besides, they should be given more chances to receive education or to take training courses in pursuit of self-development, and how to narrow gaps in work environments among different regions or fields should carefully be considered.

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