• Title/Summary/Keyword: Cognitive disability

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DENTAL TREATMENT OF A CHILD WITH LENNOX-GASTAUT SYNDROME UNDER GENERAL ANESTHESIA, SUFFERED FROM HYPOXIA CAUSED BY CHLORAL HYDRATE (Chloral hydrate에 저산소증 병력을 가진 Lennox-Gastaut syndrome 환아의 전신마취 하 치과 치료)

  • Jang, Seok Hun;Nam, Ok Hyung;Kim, Mi Sun;Lee, Hyo-Seol;Kim, Kwang Chul;Choi, Sung Chul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.13 no.1
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    • pp.28-32
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    • 2017
  • Lennox-Gastaut syndrome (LGS) is a type of childhood epilepsy, and this syndrome can compromise dental treatment. LGS represents variable etiologies, multiple types of intractable seizures, and cognitive impairment in most patients. A 7-year-4-month old girl with LGS was referred to our hospital for dental treatment under general anesthesia. Clinically, the patient presented with multiple dental caries. The patient had been prescribed a ketogenic diet for the management of repetitive seizures. In addition, she experienced severe types of hypoxia during medical examination using chloral hydrate. Therefore, dental treatment was performed under general anesthesia. LGS patients have a high risk of seizure during dental treatment and can induce a lot of complications. Dental treatment under general anesthesia for LGS patients can be carried out careful preoperative evaluation and in cooperation with medical care.

TREATMENT BARRIERS OF SPECIAL NEEDS PATIENTS - PART 2. CONSIDERATION FROM THE PERSPECTIVES OF CAREGIVERS (장애인 구강진료 접근성 제약 - Part 2. 장애인 환자 보호자 측면에서의 고찰)

  • Chang, Juhea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.14-22
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    • 2019
  • The aim of this study was to determine the factors contributing to the barrier of dental treatment for special needs patients perceived by the main caregivers of the patients. A questionnaire was developed with three parts: patient-related factors, caregiver-related factors, and factors for treatment barriers. Patient- and caregiver-related factors were analyzed for correlations with the barrier factors. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 52 caregivers (mean age [SD]=50.2 [11.5] years) for the patients with intellectual and cognitive disabilities (mean age [SD]=38.9 [21.3]) responded to the questionnaires. Oral hygiene status, need for assistance in tooth brushing, and cooperation for tooth brushing were correlated with the level of treatment cooperation of the patients (p<0.05). The above three factors were also correlated with the treatment barrier despite patients presenting oral symptoms (p<0.05). Two thirds of the caregivers felt the treatment cost as severe or a considerable financial burden. For patients, insurance types and need for assistance in tooth brushing, and for caregivers, education levels and financial status were significant factors contributing to financial burden (p<0.05). There were background factors of the patients and their caregivers associated with access to dental treatment for special needs patients. Deficient cooperative skills and financial burdens were the main obstacles to treatment access. Tooth brushing skills and oral hygiene status can be proxy measures to cooperative ability for dental treatment.

Specialists' Views Concerning the Assessment, Evaluation, and Programming System (AEPS) in Associations for Children with Disabilities in Saudi Arabia

  • Munchi, Khiryah S.;Bagadood, Nizar H.
    • International Journal of Computer Science & Network Security
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    • v.22 no.2
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    • pp.91-100
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    • 2022
  • To support early intervention, it is necessary to develop programming system tools that enable accurate, valid, and reliable assessments and can help achieve reasonable, generalizable, and measurable goals. This study examined the Assessment, Evaluation, and Programming System (AEPS) used by associations of children with disabilities in Saudi Arabia to assess its suitability for children with intellectual disabilities. A group of 16 specialists with different professional backgrounds (including special education, physiotherapy, occupational therapy, speech therapy and psychology) from 11 associations of children with disabilities took part in semi-structured personal interviews. The study concluded that AEPS is generally suited for use with children with intellectual disabilities. However, its suitability depends on the type and severity of the child's disability. The more severe the disability, the less effective the AEPS is likely to be. On the basis of this finding the researchers formed interdisciplinary teams to organise and integrate the children's learning and assess the benefits of AEPS, including its accuracy and ability to achieve adaptive, cognitive, and social targets, enhance family engagement and learning and develop basic development skills. This study also identified obstacles associated with the use of AEPS. These include the lack of comprehensiveness and accuracy of the goal, lack of precision and non-applicability to large movements and the fact that it cannot be used with all children with intellectual disabilities. In addition, the research showed that non-cooperation within the family is a major obstacle to the implementation of the AEPS. The results of this study have several implications.

Influences of Self-esteem, Rehabilitation Motivation on Quality of Life in Stroke Pateints with Rehabilitation Therapy (재활치료 중인 뇌졸중 환자의 자아존중감, 재활동기가 삶의 질에 미치는 영향)

  • An, Eun-Seo;Suh, Soon-Rim;Kim, Eun-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.176-187
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    • 2019
  • This study was conducted to investigate the levels of self-esteem, rehabilitation motivation and quality of life and to identify the influencing factors of quality of life in stroke patients who were receiving rehabilitation therapy. Data were collected from February 22 to March 20, 2016 using self-administered questionares and the data from 216 participants were analyzed using SPSS WIN 21.0 program(SPSS Inc., Chicago, IL, USA). The results of this study were as follows: the mean self-esteem was 3.09/5, rehabilitation motivation was 3.60/5, and quality of life was 2.95/5. Sex, age, education, caregiver, occupation, duration after attack, the degree of disability(dependence), and cognitive function were significantly associated with quality of life. There was positive correlation between quality of life and self-esteem(r=.45, p<.001) and there was positive correlation between quality of life and rehabilitation motivation(r=.27, p<.001). Variables such as self-esteem, duration after attack, the degree of disability(dependence), and cognitive function explained 43.6%(F=14.87 p=<.001) of the variance in quality of life in model 3. Consequently, it is needed to develop and apply nursing intervention and programs for improving self-esteem during rehabilitation in order to improve quality of life of stroke patients.

A Study of the Effect of the Factors of Successful Aging on the Life Satisfaction of Older Adults - Focusing on the Relationship with Adult Children - (노인의 성공적 노화 요소의 삶의 만족도 영향 연구: 성인자녀와의 관계를 중심으로)

  • Kim, Meeryoung
    • Korean Journal of Family Social Work
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    • no.57
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    • pp.159-182
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    • 2017
  • With using the 4th and 5th wave of KLoSA(Korean Longitudinal Study of Aging), this study analyzed the effect of the factors of Rowe and Kahn's successful aging model on the life satisfaction of older adults. The target population of this study was 1,385 who is older than 65. As data analysis, hierarchical multiple regression was used. The variables such as demographics, avoiding diseases and disability, high cognitive and physical function and engagement with life, relationship with adult children were entered hierarchically for the regression analysis. Since there are differences of longevity by gender, the difference of factors of successful aging were compared by marital status. In this study (besides Rowe and Kahn's successful aging model such as avoiding disease and disability, high cognitive and physical function, and engagement with life), the relationships with adult children were analyzed additionally. Findings show that married older adults were older and reside with their adult children twice more than those who do not have a spouse. According to research results, regular exercise and memory skills were important factors of affecting life satisfaction. Among the categories of active engagement, meeting with friends, relatives and neighbors were significant. Contact with their adult children by mail or phone were the most important factors affecting the older adults' life satisfaction. The three parts of successful aging were various depending on the operationalization of variables.

A Study on Factors Influencing The State of Adaptation of The Hemiplegic Patients (편마비 환자의 퇴원후 적응상태와 관련요인에 대한 분석적 연구)

  • 서문자
    • Journal of Korean Academy of Nursing
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    • v.20 no.1
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    • pp.88-117
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    • 1990
  • The purposes of this study are to delineate a profile of the state of a stroke patient's adaptation at 3 months after hospitalization and to explore the relationship between the level of adaptation and the variables which influence the adaptation of hemiplegic patients. To these ends, theoretical framework was derived basically from the stress adaptation model. The basic assumption underlying the level of adaptation is influenced by the presenting focal, contextual and residual stimuli. This group of stimuli is further operationalized and represented by a perception of stress. which is the perceived effect of the disability and by the mediating variables such as sociodemographic factors as an external conditioning variables and perceived social support and hardiness personality characteristics as an internal intervening variables. The dependent varibales in this study is the level of physical, psychological and social adaptation and is hypothesized to be a function of the interaction between 3 sets of variables namely, the perceived disability effect, external conditioning variables and internal intevening varibles. A total of fourty three subjects from 3 general hospitals in Seoul were observed and interviewed with the aid of 7 structured instruments. The data were collected twice on each subject : first at the pre-discharge period arid at 3 months post-discharge from hospital for the second time. The study was carried out for the period from February to August, 1988. The instruments used for the study include 4 existing scales and 3 scales developed by the researcher for this study. They are : 1) The ADL dependency scale and the scale of the clinical physical functions for the assessment of physical adaptation. 2) the SDS(self report of depression) to measure the level of psychological adaptation. 3) The scale for the amount of social activities for the measurement of the level of social adaptation. 4) The scale for the perceived effect of disability for the measurement of the focal stimuli. 5) The health related hardiness scale and the perceived interpersonal support self evaluation list(ISEL) for the measurement of the hardiness personality character and the perceived social support. The data obtained were analyzed using percentage, oneway ANOVA, Pearson coefficients correlation and stepwise multiple regression. The findings provide valuable information about the present level of physical adaptation at 3 months after discharge. The patient revealed a decreased ADL dependency and lowered limitation of physical function as compared with pre - discharge state. Psycholcgically, the average degree of depression at follow up was within normal range of depression. Socially, the amount of social activities was very low. The one way ANOVA and the correlational analysis revealed the relationship between the 3 sets of variables and the adaptation level as follows : 1) The perceived disability effect was related to the degree of the depression and the amount of social activities but was not related to the physical adaptation. 2) Among the sociodemographic variables, sex and education were related to the difference of ADL dependency and the change of physical function. These factors indicate that women more than men and educated more than the less educated were found more independent. The education was also related to the degree of depression suggesting that the higher the educational level, the more well adapted the patients were both physically and psychologically. Age, marital status and job state were not found to be related to the patient's adaptation level. 3) Among the internal intervening variables, the health related hardiness characteristic was related to the differences of ADL dependency, physical functions and the social activities, indicating that the higher the hardiness character the higher the level of physical and social adaptation. 4) The perceived social support, another internal intervening variable, was related to the degree of depression and the social activities. This data suggest that the higher the perception of social support, the better adapted the patients were psychogically and socially. In summarizing the results of the correlational analysis, the level of physical adaptation was influenced by sex, the years of education and the hardiness character. The level of psychological adaptation was influenced by the years of education, the perceived disability effect and the perceived social support. And the level of social adaptation was influenced by the perceived disability effect, the hardiness character and the perceived social support. The stepwise multiple regression analysis shows findings as follows : 1) The most important factor to explain the difference of ADL dependency was sex, indicating females were more independent than males. 2) The most important factor to explain the difference of physical function and the degree of depression was the patient's education level. 3) The strongest explaining factor for the amount of social activities was perceived self esteem(one of the subconcepts of perceived social support). Thus the most important factors influencing the level of adaptation were found to be sex, education, the hardiness character and self esteem. From the above findings, the significance of this study can be delineated as follows : 1) Corroboration of the assumed relationship between the various variables and the adaptation level as suggested in the conceptual model. 2) Support for the feasibility of the cognitive approach for nursing intervention such as hardness character training, counselling and teaching for self-care in the chronic patients.

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Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up

  • Kono, Yumi
    • Clinical and Experimental Pediatrics
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    • v.64 no.7
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    • pp.313-321
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    • 2021
  • Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

Inhibition of LPA5 Activity Provides Long-Term Neuroprotection in Mice with Brain Ischemic Stroke

  • Sapkota, Arjun;Park, Sung Jean;Choi, Ji Woong
    • Biomolecules & Therapeutics
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    • v.28 no.6
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    • pp.512-518
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    • 2020
  • Stroke is a leading cause of long-term disability in ischemic survivors who are suffering from motor, cognitive, and memory impairment. Previously, we have reported suppressing LPA5 activity with its specific antagonist can attenuate acute brain injuries after ischemic stroke. However, it is unclear whether suppressing LPA5 activity can also attenuate chronic brain injuries after ischemic stroke. Here, we explored whether effects of LPA5 antagonist, TCLPA5, could persist a longer time after brain ischemic stroke using a mouse model challenged with tMCAO. TCLPA5 was administered to mice every day for 3 days, starting from the time immediately after reperfusion. TCLPA5 administration improved neurological function up to 21 days after tMCAO challenge. It also reduced brain tissue loss and cell apoptosis in mice at 21 days after tMCAO challenge. Such long-term neuroprotection of TCLPA5 was associated with enhanced neurogenesis and angiogenesis in post-ischemic brain, along with upregulated expression levels of vascular endothelial growth factor. Collectively, results of the current study indicates that suppressing LPA5 activity can provide long-term neuroprotection to mice with brain ischemic stroke.

The Effect of Systemic Hypertension on the Pediatric Brain (중추신경계에 미치는 소아 고혈압의 영향)

  • Hur, Yun-Jung
    • Childhood Kidney Diseases
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    • v.15 no.1
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    • pp.22-28
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    • 2011
  • Hypertension is one of the most common chronic diseases in childhood and adolescence. Untreated hypertension adversely affects many organs including heart, brain, kidney and peripheral arteries. We reviewed the complication of central nervous system caused by pediatric hypertension. Cerebral blood flows are maintained constantly in response to changes in blood pressure by cerebral autoregulation. Severe hypertension which destructs cerebral autoregulation results in acute hypertensive encephalopathy syndrome, ischemic or hemorrhagic stroke. Chronic pediatric hypertension induces learning disability and cognitive defect which are subclinical symptom prior to brain damage caused by severe hypertension. We should consider the effect of hypertension on pediatric brain because appropriate antihypertensive drugs could prevent these complications.

Clinical characterization of a Korean case with 3p25 deletion

  • Lee, Hye Jin;Kim, Ja Hye;Cho, Ja Hyang;Lee, Beom Hee;Choi, Jin-Ho;Yoo, Han-Wook
    • Journal of Genetic Medicine
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    • v.11 no.1
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    • pp.36-39
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    • 2014
  • Chromosome 3 (3p) deletion syndrome is a rare genomic disorder caused by a deletion at the terminal end of the short arm of chromosome 3. The primary characteristics of the syndrome are delayed development, dysmorphic features, and several other congenital anomalies. Here, we describe the case of a 2-year-old Korean girl with typical features of 3p deletion syndrome, including dysmorphic facial features, low birth weight, developmental delay, growth and cognitive retardation, and congenital heart disease. This case represents the first report of 3p deletion syndrome in Korea. Although phenotypes can be variable among patients, a clinically recognizable pattern has been described for this genetic defect, and our report helps to identify other cases with 3p deletion syndrome from a clinical and genetic perspective.