• Clinical and Experimental Pediatrics
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• 제49권4호
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• pp.341-353
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• 2006

Learning disorders are diagnosed when the individual's achievement on standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling, and level of intelligence. Subtypes of learning disorders may be classified into two groups, language-based type learning disorders including reading and writing disorder, and nonverbal type learning disorder (NLD) such as those relating to mathematics & visuospatial skills, and those in the autism spectrum. Converging evidence indicates that reading disorder represents a disorder within the language system and more specifically within a particular subcomponent of that system, phonological processing. Recent advances in neuroimaging technology, particularly the development of fMRI, provide evidences of a neurobiological basis for reading disorder, specifically a disruption of two left hemisphere posterior brain systems, one parieto-temporal, the other occipito-temporal. The former is the reading system for beginner reading, the latter for skilled reading. Compensatory engagement of anterior systems around the inferior frontal gyrus(Broca's area) and a posterior(right occipito-temporal) system is noted in persistent poor readers in long-term follow up study. The theoretical model proposed to explain NLD's source is not right hemisphere damage, but rather the white matter model. The working hypothesis of the white matter model is that the underdevelopment of, damage to, or dysfunction of cerebral white matter(long myelinated fibers) is the source of this disorder. The role of an evidence-based effective intervention in the remediation of children with learning disorder is discussed.

• 보건행정학회지
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• 제25권3호
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• pp.207-220
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• 2015

Background: The purpose of this exploratory study is to explain where, when and how the introduction of user fee system works in low and middle income countries using context, mechanism, and outcome configuration. Methods: Considering advanced research in realist review approach, we made a review process including those following 4 steps. They are identifying the review question, initial theory and mechanism, searching and selecting primary studies, and extracting, analyzing, and synthesizing relevant data. Results: User fee had a detrimental effect on medical utilization in low and middle income countries. Also previous and current interventions and community participation were critical context in user fee system. Those contexts were associated with intervention initiation and recognition and coping strategies. Such contexts and mechanisms were critical explanatory factors in medical utilization. Conclusion: User fee is a series of interventions that are fragile and dynamic. So the introduction of user fee system needs a comprehensive understanding of previous and new intervention, policy infrastructure, and other factors that can influence on medical utilization.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.141-146
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• 2021

Objective: This study was at investigated the effects of manual lymphatic drainage (MLD) on stress and pain in patients with postoperative breast cancer. Design: A randomized controlled trial. Methods: A total of twenty-two patients with postoperative breast cancer voluntarily participated in the study. Subjects were randomly assigned to the MLD groups (n=12) and rest groups (n=12). The intervention was conducted in each group for twenty minutes a day, five times a week, for four weeks. Before and after the intervention, the participants measured sympathetic nerve, parasympathetic nerve, and pain by using a sphygmograph and short-form McGill pain questionnaire.An independent t-test was used to analyze pretest and posttest changes between the groups, a paired t-test was used to analyze pre-posttests within each group. Results: After analyzing, the MLD group has been shown a significant decrease in the sympathetic nervous system (p<0.05), a significant increase in the parasympathetic nervous system (p<0.05), and a significant increase in pain (p<0.05). However, the rest group was no significant difference between pre and post. Conclusions: The results of this study confirmed that MLD techniques are an effective method in reducing stress and pain in patients with postoperativebreast cancer. And it is thought that can be used as basic data and to develop programs on stress and pain management reduction for patients with breast cancer.

• 한국사회복지학
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• 제58권4호
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• pp.291-312
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• 2006

본 연구는 행동심리학의 견고한 이론적 기반을 가지고 북미에서 약물남용자에게 효과성이 실증적으로 입증된 접근방법인 인센티브치료를 국내 지역사회기관에서 두 명의 알코올남용클라이언트에게 실시하고 그 효과성을 알아보는 것을 목적으로 한 탐색적 조사이다. 이를 위해 ABA단일체계설계를 활용하여 총 12주간의 기초선 단계, 인센티브치료 개입단계, 개입철회단계동안 표적행동으로 클라이언트의 음주여부를 음주측정기로 측정하였다. 시행결과 음주사용의 감소가 인센티브치료 개입단계 중반 무렵부터 발생하였다. 개입철회단계에서는 한 사례의 경우 다시 음주가 시작된 반면, 또 한 사례에서는 단주가 유지되어 일관된 결과를 발견할 수 없었다. 하지만 인센티브치료는 알코올남용자의 단주에 대한 동기를 유발시켜 지속적인 심리사회적 상담 및 사회복지개입의 기회를 제공한다는 점에서 지역사회에서 실행가능성이 높은 방법임이 제시되었다.

• Food Quality and Culture
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• 제2권1호
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• pp.55-60
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• 2008

This study examined the effects of lactic acid spray, hot water spray, or their combined treatment, as well as the effects of acidified sodium chlorite (ASC), for the decontamination of Escherichia coli on beef carcass surfaces using a commercial intervention system. With this system, the effects of 2 or 4% lactic acid (v/v), hot water ($89{\pm}1^{\circ}C$), or their combined treatment, were examined in terms of reducing inoculated E. coli. ASC (266 ppm), which was adjusted to pH 2.5 using acetic acid or citric acid, was applied using a hand-held spray system. When the beef carcasses were treated with 2 or 4% lactic acid for 10.4 s, less than 1 log reductions of inoculated E. coli were observed. A hot water spray treatment for 9.8 s resulted in a 2.1 log reduction of inoculated E. coli. However, when the hot water was followed with either 2 or 4% lactic acid, no difference in E. coli reduction was found between the hot water alone or the combined treatment with lactic acid. When ASC was adjusted to pH 2.5 with acetic acid and citric acid, 3.8 and 4.1 log reductions of E. coli were observed, respectively. Overall, the lactic acid spray treatment was least effective, and the ASC treatment was most effective, for the E. coli decontamination of beef carcasses. Therefore, these data suggest that ASC would be a more effective intervention against E. coli than most of the methods currently being used. However, more research is required to evaluate the effects of ASC on other organisms, as well as to identify application methods that will not affect meat quality.

• 한국사회복지학
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• 제62권2호
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• pp.399-420
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• 2010

최근 한국의 사회서비스 전달방식의 큰 변화 중의 하나는 바우처 방식의 도입과 확대이지만, 바람직한 바우처형 서비스 전달방식을 확립하는데 필요한 바우처 공급구조상의 서비스 작동기제에 대한 연구는 미흡하다. 바우처 작동기제에 대한 국외의 연구들은 서비스 공급구조가 소비자의 선택기회 증가에 가장 핵심적인 요인임을 밝히고 있다. 하지만 바우처 역사가 일천한 상황에서 국내의 연구들은 아직 바우처의 도입가능성, 성공가능성에 대한 이론적 논의수준에 머물러 있다. 이에 본 연구는 양적 질적 데이터를 바탕으로 한국의 바우처형 서비스 공급이 서비스 공급현장에서 실제 어떻게 작동하고 있는지를 살펴보는 것을 목적으로 한다. 분석 자료는 지역사회서비스투자사업의 지역개발형 사업에서 가장 많은 사업영역을 차지하고 있는 ADHD아동 조기개입서비스 사업의 서비스에 참석하고 있는 전국의 56개 사업의 196개 공급기관으로부터 설문조사와 인터뷰를 통해 수집하였다. 분석은 Cave(2001)의 바우처 작동기제 분석틀을 이용하여 (1) 바우처 작동기제가 공급구조를 어떻게 변화시켰으며 (2) 그 결과 소비자 선택의 기회가 증가하였는지를 중심으로 진행하였다. 분석결과 (1) 서비스 시장에 민간영리기관이 사업에 다수 참여함으로써 서비스 시장에 공급주체의 다양화라는 긍정적인 변화를 가져왔으나, (2) 아직 서비스의 질은 수요자의 욕구를 충분히 해결하는데 한계가 있고 소비자의 선택권도 제한되어 있는 부분이 많다는 것을 보여주었다. 결과를 바탕으로 향후 정책의 방향성에 대한 논의 및 제언을 하였다.

• Journal of Nutrition and Health
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• 제54권5호
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• pp.515-533
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• 2021

본 연구는 유아를 대상으로 한 영양교육의 중재효과를 평가하고, 과일·채소의 선호도 및 영양지식 향상에 효과적인 영양교육 유형을 분석하기 위해 체계적 문헌고찰과 메타분석을 수행하였다. 메타분석의 효과크기 결과에 따르면 유아 대상 영양교육은 과일·채소 선호도 및 영양지식을 유의적으로 향상시켰으며, 일반영양교육 보다는 과일·채소 중심 영양교육이 유아의 과일·채소 선호도 및 영양지식 향상에 더 효과적이었다. 또한 유아의 과일·채소 선호도 및 영양지식 향상을 위해서는 원예활동, 요리활동 및 오감활동 등의 직접 노출 활동을 포함하는 영양교육이 더욱 효과적이라는 것을 확인할 수 있었다. 본 연구는 유아대상 영양교육의 효과를 입증했을 뿐만 아니라, 유아의 과일·채소 선호도 및 영양지식 향상에 가장 효과적인 영양교육의 형태를 도출했다는 점에서 의의가 있다.

• 대한감각통합치료학회지
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• 제20권3호
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• pp.60-71
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• 2022

목적 : 본 연구는 국내 장애 및 비장애 아동에게 적용된 그룹 감각통합치료 중재에 대해 정리하고 효과를 제시하고자 하였다. 연구방법 : 검색 기간은 2010년 1월부터 2021년 12월까지로 하였으며, 자료 검색을 위하여 '대한감각통합치료학회', '대한작업치료학회', '한국학술정보(KISS)', '학술연구정보서비스(RISS)', '디비피아(DBpia)'의 데이터베이스를 이용하였다. 총 11편이 선정되었으며, PICO(Patient, Intervention, Comparison, Outcome) 방법을 적용하여 체계적으로 정리하였다. 결과 : 연구 결과 단일 집단 비무작위 연구가 11편 중 8편(72.73%)으로 가장 많았다. 대상자는 99명으로 연령은 3세에서 11세까지였으며, 평균 7.39세였다. 그 중 장애아동이 더 많았으며, 진단은 발달장애가 99명 중 40명(40.41%)으로 가장 많았다. 치료 중재 회기는 총 5회에서 45회까지였으며, 주 1회 또는 2회, 시간은 60분 제공이 가장 많았다. 평가도구는 캐나다 작업 수행 측정(Canadian Occupational Performance Measure; COPM)과 또래 놀이 상호작용 평점 척도(Penn Interactive Peer Play Scale; PIPPS)가 각 4회(12.90%)로 가장 많이 사용되었다. 치료 중재 목표로는 사회 상호작용 기술이 8편(36.36%)으로 가장 많았다. 치료 중재 결과 8편의 연구에서 유의한 결과를 보였다. 결론 : 본 연구를 바탕으로 향후에는 높은 질적 수준을 근거로 한 다양한 그룹 감각통합치료의 중재 방법을 체계적으로 제시하여 임상에서 유용한 정보로 활용될 수 있기를 기대한다.

• 간호행정학회지
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• 제6권1호
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• pp.135-146
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• 2000

The purpose of this study was to develope, based on the Nursing Intervention Classification (NIC) system. a set of standardized nursing interventions which had been validated. and their associated activities. for use with nursing diagnoses related to home health care for women who have had a caesarian delivery and for their newborn babies. This descriptive study for instrument development had three phases: first. selection of nursing diagnoses. second, validation of the preliminary home health care interventions. and third, application of the home care interventions. In the first phases, diagnoses from 30 nursing records of clients of the home health care agency at P. medical center who were seen between April 21 and July 30. 1998. and from 5 textbooks were examined. Ten nursing diagnoses were selected through a comparison with the NANDA (North American Nursing Diagnosis Association) classification In the second phase. using the selected diagnoses. the nursing interventions were defined from the diagnoses-intervention linkage lists along with associated activities for each intervention list in NIC. To develope the preliminary interventions five-rounds of expertise tests were done. During the first four rounds. 5 experts in clinical nursing participated. and for the final content validity test of the preliminary interventions. 13 experts participated using the Fehring's Delphi technique. The expert group evaluated and defined the set of preliminary nursing interventions. In the third phases, clinical tests were held at in a home health care setting with two home health care nurses using the preliminary intervention list as a questionnaire. Thirty clients referred to the home health care agency at P. medical center between October 1998 and March 1999 were the subjects for this phase. Each of the activities were tested using dichotomous question method. The results of the study are as follows: 1. For the ten nursing diagnoses. 63 appropriate interventions were selected from 369 diagnoses interventions links in NlC., and from 1.465 associated nursing activities. From the 63 interventions. the nurses expert group developed 18 interventions and 258 activities as the preliminary intervention list through a five-round validity test 2. For the fifth content validity test using Fehring's model for determining lCV (Intervention Content Validity), a five point Likert scale was used with values converted to weights as follows: 1=0.0. 2=0.25. 3=0.50. 4=0.75. 5=1.0. Activities of less than O.50 were to be deleted. The range of ICV scores for the nursing diagnoses was 0.95-0.66. for the nursing interventions. 0.98-0.77 and for the nursing activities, 0.95-0.85. By Fehring's method. all of these were included in the preliminary intervention list. 3. Using a questionnaire format for the preliminary intervention list. clinical application tests were done. To define nursing diagnoses. home health care nurses applied each nursing diagnoses to every client. and it was found that 13 were most frequently used of 400 times diagnoses were used. Therefore. 13 nursing diagnoses were defined as validated nursing diagnoses. Ten were the same as from the nursing records and textbooks and three were new from the clinical application. The final list included 'Anxiety', 'Aspiration. risk for'. 'Infant behavior, potential for enhanced, organized'. 'Infant feeding pattern. ineffective'. 'Infection'. 'Knowledge deficit'. 'Nutrition, less than body requirements. altered', 'Pain'. 'Parenting'. 'Skin integrity. risk for. impared' and 'Risk for activity intolerance'. 'Self-esteem disturbance', 'Sleep pattern disturbance' 4. In all. there were 19 interventions. 18 preliminary nursing interventions and one more intervention added from the clinical setting. 'Body image enhancement'. For 265 associated nursing activities. clinical application tests were also done. The intervention rate of 19 interventions was from 81.6% to 100%, so all 19 interventions were in c1uded in the validated intervention set. From the 265 nursing activities. 261(98.5%) were accepted and four activities were deleted. those with an implimentation rate of less than 50%. 5. In conclusion. 13 diagnoses. 19 interventions and 261 activities were validated for the final validated nursing intervention set.

• 한국정밀공학회지
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• 제20권5호
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• pp.82-91
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• 2003

Vehicle dynamics control (VDC) has been a breakthrough and become a new terminology for the safety of a driver and improvement of vehicle handling. This paper examines the usefulness of a brake steer system (BSS), which uses differential brake forces for steering intervention in the context of VDC, In order to help the car to turn, a yaw moment can be achieved by altering the left/right and front/rear brake distribution. The steering function achieved through BSS can then be used to control lateral position in an unintended road departure system. An 8-DOF non-linear vehicle model including STI tire model will be validated using the equations of motion of the vehicle, and the non-linear vehicle dynamics. Since fuzzy logic can consider the nonlinear effect of vehicle modeling, fuzzy controller is designed to explore BSS feasibility, by modifying the brake distribution through the control of the yaw rate of the vehicle. The control strategies developed will be tested by simulation of a variety of situation; the possibility of VDC using BSS is verified in this paper.