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Palliative Care Practitioners' Perception toward Pediatric Palliative Care in the Republic of Korea (소아완화의료에 대한 호스피스 완화의료 전문기관 종사자의 인식)

  • Moon, Yi Ji;Shin, Hee Young;Kim, Min Sun;Song, In Gyu;Kim, Cho Hee;Yu, Juyoun;Park, Hye Yoon
    • Journal of Hospice and Palliative Care
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    • v.22 no.1
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    • pp.39-47
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    • 2019
  • Purpose: This study was performed to investigate the current status of pediatric palliative care provision and how it is perceived by the palliative care experts. Methods: A descriptive study was conducted with 61 hospice institutions. From September through October 2017, a questionnaire was completed by experts from the participating institutions. Data were analyzed using SPSS 21.0. Results: Among 61 institutions, palliative care is currently provided for pediatric cancer patients by 11 institutions (18.0%), all of which are concentrated in Seoul, Incheon and Gyeonggi and Gyengsang provinces; 85.2% of all do not plan to provide specialized pediatric palliative care in the future. According to the experts, the main barriers in providing pediatric palliative care were the insufficient number of trained specialists regardless of the delivery type. Experts said that it was appropriate to intervene when children were diagnosed with cancer that was less likely to be cured (33.7%) and to move to palliative care institutions when their conditions worsened (38.2%); and it was necessary to establish a specialized pediatric palliative care system, independent from the existing institutions for adult patients (73.8%). Conclusion: It is necessary to develop an education program to establish a nationwide pediatric palliative care centers. Pediatric palliative care intervention should be provided upon diagnosis rather than at the point of death. Patients should be transferred to palliative care institutions after intervention by their existing pediatric palliative care team at the hospital is started.

Single or Dual Infection with Respiratory Syncytial Virus and Human Rhinovirus: Epidemiology and Clinical Characteristics in Hospitalized Children in a Rural Area of South Korea (호흡기세포융합바이러스와 라이노바이러스의 단독 혹은 동시감염의 역학 및 임상적 특성: 강원 지역 단일 기관의 후향적 연구)

  • Kwon, Yerim;Cho, Won Je;Kim, Hwang Min;Lee, Jeongmin
    • Pediatric Infection and Vaccine
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    • v.26 no.2
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    • pp.99-111
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    • 2019
  • Purpose: Respiratory syncytial virus (RSV) and human rhinovirus (hRV) are the most common causes of child respiratory viral infections. We aimed to investigate epidemiological and clinical characteristics of RSV and hRV single infections and coinfections. Methods: Nasopharyngeal aspirates of hospitalized children aged <5 years were tested using multiplex reverse transcription polymerase chain reaction (RT-PCR) from October 2014 to April 2017. Their medical records were retrospectively reviewed. Results: RSV or hRV was detected in 384 patients who divided into 3 groups: patients with RSV (R group, n=258); patients with hRV (H group, n=99); and patients with both (RH group, n=27). The R group (median age, 6 months) consisted of 248 (96.1%) patients with lower respiratory tract infection (LRTI), and 14 (5.4%) needed oxygen inhalation. Infants aged <12 months (63.2%) had respiratory difficulty and were supplied oxygen more often. The H group (median age, 16 months) consisted of 56 (56.6%) patients with LRTI, 4 (4%) required oxygen inhalation, and 1 (1.0%) required mechanical ventilation. Infants (40.4%) showed longer hospitalization compared to patients aged ${\geq}12$ months (5 vs. 4 days, P<0.05). The RH group consisted of 24 (88.9%) patients with LRTI, and 2 (7.4%) needed oxygen inhalation. Hospitalization days and oxygen inhalation and mechanical ventilation rates did not differ between single infections (R and H groups) and coinfections (RH group). Conclusions: RSV was detected more often in younger patients and showed higher LRTI rates compared to hRV. Single infections and coinfections of RSV and hRV showed no difference in severity.

A Study on the Rational Improvement of the Regulation and System about Embryo Preservation (배아 보존에 관한 합리적 제도 개선을 위한 연구)

  • Baik, Sujin;Moon, Hannah;Park, Inkyoung;Cha, Seunghyun;Park, Joonseok;Lee, Gyeonghun;Park, Chun-seon;Cho, Heesoo;Kim, Myung-Hee
    • The Korean Society of Law and Medicine
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    • v.22 no.3
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    • pp.57-95
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    • 2021
  • Korea's period for preservation of embryos is up to five years (the Bioethics Act). However, the study reviewed domestic and foreign laws and drew issues due to the recent demand that the development of related science and technology and the period limitation limit the rights of consent holder for embryo production. the first issue is that preserved embryos are intended for pregnancy, and it is important to ensure that the autonomy of the consent holder is protected through careful consideration based on information such as scientific evidence. the second is that regulations regarding the obligation to manage embryonic preservation institutions are needed. the third is to create a social atmosphere in which embryo creation, preservation, and disposal take place in a minimum range, considering the special status of embryos. based on this issue, the first of the proposals for rational improvement of the regulation and system about embryo preservation is the introduction of an environment in which sufficient explanation and appropriate consent can be exercised and to extend the reasons for the extension of the period, rather than specifying the specific period in law. the second is that institutionalization is necessary considering not only the obligation to manage preservation institutions but also the overall site, such as concerns that may arise as a result. lastly, we propose the introduction of a management method considering the future use of embryos, such as transfer to provide research purposes and donation of pregnancy purposes by others. this process should be a method of sufficient social discussion and consensus, as well as a general consideration of the family relationship with the born child.

Clinical Utility of the MMPI-A-RF's Internalization and Externalization Higher-Order Scales: Comparison With the K-CBCL's Internalization and Externalization Scales (MMPI-A-RF의 내재화 및 외현화 상위 척도의 임상적 유용성: K-CBCL의 내재화 및 외현화 척도와의 비교)

  • Eun-Bin, Shin;Eun-Hee, Park;Hyun-Joo, Hong
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.119-126
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    • 2022
  • Objectives : The purpose of this study was to examine the clinical utility of the internalization and externalization higher-order scales of the Minnesota Multiphasic Personality Inventory-Adolescent Restructured Form (MMPI-A-RF), compared with those scales of the Korean Child Behavior Checklist (K-CBCL). Methods : 43 adolescents with internalizing disorders and 44 adolescents with externalizing disorders and their parents were administered the MMPI-A-RF and K-CBCL each. To verify the difference between the internalization and externalization scales of the MMPI-A-RF and K-CBCL for each group, independent-sample t test was performed. To compare the agreement between the MMPI-A-RF and K-CBCL, correlation analysis was also conducted. Lastly, to identify which scales significantly best predict each of the internalizing and externalizing disorder, logistic regression analysis was conducted. Results : Internalization scales of the MMPI-A-RF and K-CBCL were significantly higher in the internalizing disorder group, and the externalization scales were significantly higher in the externalizing disorder group. The positive correlation was significant only for internalization problems between the two evaluation measures in both groups (each r=0.360, p<0.05, r=0.572, p<0.05). In addition, the scales significantly predicted internalizing and externalizing disorders were the internalization and externalization scales of the MMPI-A-RF, followed by the externalization scale of the K-CBCL (R2=0.407, p<0.05). Conclusions : The internalization and externalization higher-order scales of the MMPI-A-RF were found to reliably reflect the characteristics of each disorder in adolescents and be useful evaluative scales to differentiate disorders. Moreover, if adolescents show externalization problems, additional information from the K-CBCL can be more useful to differentiate disorders.

A Case of Urologic Manifestation of IARS2-associated Leigh Syndrome (IARS2 유전자 연관 리 증후군(Leigh syndrome) 여아에서 방광기능장애 증례)

  • Hyunjoo Lee;Ji-Hoon Na;Young-Mock Lee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.1
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    • pp.25-30
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    • 2023
  • Leigh syndrome is a rare progressive neurodegenerative mitochondrial disorder with clinical and genetic heterogeneity. Recently, balletic IARS2 variants have been identified in a number of patients presenting broad clinical phenotypes from Leigh and West syndrome to a rare syndrome CAGSSS characterized by cataracts, growth hormone deficiency, sensory neuropathy, sensorineural hearing loss, and skeletal dysplasia syndrome (OMIM#616007). We describe a child with Korean Leigh syndrome with urologic manifestations resulting from a compound heterozygote mutation in IARS2. A 5-year-old girl visited the emergency room with a complaint of abdominal pain accompanied by abdominal distension. Abdominal-pelvic CT showed a markedly distended urinary bladder without definite obstructive lesions. She was diagnosed with neurogenic bladder dysfunction based on a urodynamic study. She had global delayed development due to neurologic regression after 6 months of age and a history of bilateral cataract surgery at the age of 2 years. Her brain magnetic resonance imaging showed symmetrically increased signal intensities in the bilateral putamen and caudate nuclei with diffuse cerebral atrophy. No gene variants were identified through whole-mitochondrial genome analysis. Whole exome sequencing was performed for diagnosis, and compound heterozygous pathogenic variants were identified in IARS2: c.2446C>T (p. Arg816Ter) and c.2450G>A (p. Arg817His). To the best of our knowledge, this is the first case report of bladder dysfunction manifestation in a patient with IARS2-related Leigh syndrome. Thus, it broadens the clinical and genetic spectrum of IARS2-associated diseases.

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The basis of trust in relationships: Indigenous psychological analysis of adolescents and their parents (청소년과 부모의 인간관계를 통해 본 신뢰의식: 토착심리학적 접근)

  • Uichol Kim;Young-Shin Park
    • Korean Journal of Culture and Social Issue
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    • v.10 no.2
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    • pp.103-137
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    • 2004
  • This study examines the basis of trust in relationships by adolescents and their parents using the indigenous psychological approach. Using the indigenous methodology, adolescents were asked the reasons why they trusted their mother, father, friends, and teachers. Parents were asked why they trusted their children, spouse and their children's teachers. A total of 1,737 participants completed an open-ended survey: 579 adolescents (274 middle school and 305 high school students) and their parents (579 fathers) and (579 mothers). The results indicate that adolescents trust their parents because of their sacrifice, followed by consanguinity (i.e., blood relationship), respect, their trust in me, dependability, and their advice and counseling. The reasons why adolescents trust their teachers is because of the academic guidance they provide, unconditional trust of teachers, their concern and care, respect for teachers, advice and counseling they provide, they are like parents, and because of their sacrifice for the students. The reasons for trusting their friends are as follows: Dependability, closeness, unconditional trust of friends, their understanding of me, and their emotional support. The reasons why parents trust their children are: Children's sincerity, honesty, consanguinity, parents' expectation and communication with the children, children's obedience, and since they are diligent in their schoolwork. The reasons for trusting one's spouse are reported to be sincerity, their sacrifice for the family, honesty, unconditional trust of a spouse, and because of mutual support. The reasons why parents trust their children's teachers are reported as follows: Unconditional trust of teachers, their sacrifice for the students, and their sincerity. There were no significant differences across the type of school and academic grades in terms of trust of parents. However, middle school students are more likely to trust their teachers, and high school students are more likely trust their friends. The male students rather than female students and those students with higher academic grades are more likely to trust their parents, friends, and teachers. For parents, there were no significant differences across age, sex, and educational status concerning the trust of their children, spouse, and children's teachers. There was a positive correlations between parents' trust of their spouse and children and their children's trust of their parents. There was also a positive correlations of mothers' trust of children's teachers and the children's trust of their teachers.

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Analysis of Research on Christian Infant Parents (기독교 영아기 부모 관련 연구 분석)

  • Minjung Kim
    • Journal of Christian Education in Korea
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    • v.77
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    • pp.47-62
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    • 2024
  • Purpose of the study : The purpose of this study was to analyze research on Christian infant parents in terms of research period, research content, and research method, and seek directions for research projects related to Christian infant parents. Research content and methods : For this study, domestic master's and doctoral dissertation published from 1995 to 2023 by the national assembly library and the research information sharing service (RISS) were collected under the categories 'Christianity', 'infant', 'infancy', and 'parent'. A total of 40 studies were extracted by searching with these keywords and excluding redundant studies. In addition, the frequency and percentage were calculated by classifying and analyzing the results into three criteria: research period, research content, and research method. Conclusions and Recommendations : Research on Christian infant parents increased significantly between 2016 and 2020, with 10 studies (25%) conducted during this period, indicating a more active engagement in this area compared to other times. Master's theses accounted for 39 studies (97.5%), while doctoral dissertation comprised 1 study (2.5%), suggesting a predominance of research at the master's level. Regarding the content of the research on Christian infant parents, practice studies accounted for 34 studies (85%), while basic research accounted for 6 studies (15%). Field-related studies such as the development of parental education programs and materials for infants continued to be carried out steadily, but there was a lack of theoretical, philosophical, perceptual, and factual investigation research on Christian infant parents. Methodologically, literature reviews were prevalent, with 27 studies (67.5%), followed by quantitative studies with 10 studies (25%), and qualitative studies with 3 studies (7.5%). Various types of research, including quantitative, qualitative, and literature reviews, were conducted between 2016 and 2020. Based on the research findings, in-depth qualitative studies conducted through observation and interviews, as well as mixed-method studies complementing single studies, should be conducted for a long-term perspective on research involving Christian infant and child parents.

Evaluation of Dosimetry and Image of Very Low Dose CT Attenuation Correction for Pediatric PET/CT: Phantom Study (팬텀을 이용한 소아 PET/CT 검사 시 감쇄보정 CT 선량과 영상 평가)

  • Bahn, Young-Kag;Kim, Jung-Yul;Park, Hoon-Hee;Kang, Chun-Goo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.2
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    • pp.53-59
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    • 2011
  • Purpose: To evaluate the dosimetry and image of very low does CT attenuation correction for phantom using pediatric PET/CT. Materials and methods: three PET / CT scanners (Discovery STe, BiographTruepoint 40, Discovery 600) as a child-size acrylic phantom and ion chamber dosimeter (Unfous Xi CT, Sweden) using a CT image acquisition parameters (10, 20, 40, 80, 100, 160 mA; 80, 100, 120, 140 kVp) by varying the depth dose and evaluate $CTDI_{vol}$ value. And each attenuation corrected PET/CT images used NEMA PET Phantom$^{TM}$ (NU2-1994) was evaluated by SUV. Results: Abdominal diagnosis CT dose in general pediatric (about 10 ages) parameter (100 kVp, 100 mA) than very low dose CT parameter (80 kVp, 10 mA) at the depth dose was reduced approximately 92%, $CTDI_{vol}$ was reduced to about 88%. Each CT attenuation corrected parameters PET images showed no change in the value of SUV. Conclusion: for pediatric patients, PET/CT scan can be obtained with very low dose attenuation correction CT (80 kVp, 10 mA), and such attenuation correction CT dose was reduced 100 fold than diagnosis CT dose. PET / CT scan used very low dose CT attenuation correction in pediatric patients can be helpful in reducing radiation dose.

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A Study on Actual Conditions of Preschool Education for Activation of Public Education (공교육 활성화를 위한 유아교육 현황 분석)

  • Jeong, Kyoung Hwa;Kwon, Eun Joo
    • Korean Journal of Childcare and Education
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    • v.2 no.1
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    • pp.65-88
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    • 2006
  • This study intended to activate public education, researched and analyzed real conditions of preschool education to know desirable directions of public education and help parents recognize public education. The final purpose is to offer basic materials to reestablish preschool education in the public education system. First, parents' recognition concerning preschool education in the public education system was much different from that of teachers. As for definitions of preschool education as a public education, parents understood that it means 'the nation and self-governing bodies manage aid both the public and private kindergartens', and teachers recognized that it means that 'the nation and self-governing bodies not only found operate public kindergartens but also aid manage educational funds of private kindergartens. Second, the examination of educational environments of kindergartens told that teachers and parents thought that opportunity to enter the kindergarten is not equal for all children in our country, and quality of kindergarten teachers is satisfactory. Also, they thought that curriculums of preschool educational organs have been set well according to children's developmental stages, education quality is different according to preschool education organs' foundation-types. They recognized that facilities and apparatus of preschools are satisfactory, security and neatness of preschools are satisfactory, too. Third, the examination of developmental directions of preschool education as a public education proved following facts; as for foundation-types of kindergartens in the future when promoting preschool education as a public education, parents answered financial support and supervision by the government, teachers answered aid and management of operational fees as well as support for teacher personnel expenses.

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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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