• Title/Summary/Keyword: Refusal

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A Study of the Effect of an Avatar Encouraging Drinking in Virtual Reality on Alcohol Craving (가상현실에서의 아바타 음주권유가 갈망감 유발에 미치는 영향에 관한 연구)

  • Choi, You-Kyung;Cho, Sang-Woo;Han, Ki-Wan;Ku, Jeong-Hun;Jung, Young-Chul;Kim, Jae-Jin;Kee, NamKoong;Kim, In-Yong
    • 한국HCI학회:학술대회논문집
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    • 2008.02a
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    • pp.823-828
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    • 2008
  • This study set out investigate what kind of changes would be caused to the craving of alcohol dependent patients by stimuli through virtual reality in the preparation stage for drinking refusal training. With regard to stimulation, it included alcohol exposure, a positive situation, and a negative situation on the basis of drinking encouraging situations(social pressure) known as drinking stimulating situations for alcoholics. The purpose of the study is to provide fundamental materials for the development of new training programs to refuse alcohol and for the examination of the possibility of utilizing virtual reality technology as a new treatment and training tool for alcoholics. To this end, a virtual reality program was conducted involving 12 alcoholics admitted to Severance Mental Health Hospital in Gyeonggi province from December 2006 to September 2007. The data was dealt with various statistic analyses such as frequency analysis, Wilcoxon Matched-pairs Signed-Ranks Test using SPSS/WIN 11.5 The analysis results indicate that avatars encouraging drinking caused more craving than just the background, that the scenes with alcohol exposed caused more craving than the scenes with no alcohol exposed, and that there were no significant changes to craving according to a positive or negative situation. The results confirmed that training sessions using virtual reality presented a situation and environment of drinking pressure that's similar to the actual social pressure and that the virtual reality approach had enormous potential as an effective treatment tool when combined with the existing treatment techniques.

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A Qualitative Study on Intervening Work Experiences of Hospital-Based Child Protection Team on Child Abuse Death Cases (병원 학대피해아동보호팀의 아동학대 사망사건 개입경험 연구)

  • Kim, Kyunghee;Lee, Heeyoun;Chung, Ickjoong;Kim, Jihae;Kim, Sewon
    • Korean Journal of Social Welfare
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    • v.65 no.4
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    • pp.61-88
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    • 2013
  • The aim of this study was to explore the work experiences of hospital-based child protection team staffs who had intervened the child abuse cases resulting in death. In order to gather the relevant data, all 62 child protection teams registered nationwide were contacted and 5 teams which had actually experienced at least one child abuse deaths were found. The staffs (hospital social workers and doctors) who belonged to these teams were intensively interviewed, and the interviewed materials were thoroughly analyzed by qualitative research methodology. The result showed that treatment delay was the most important obstacle to prevent unnecessary deaths of the victims. Some abused victims were sent to the hospital only after their physical condition had so gravely deteriorated. In other cases, custodians' bland denial or refusal to treatment made impossible the timely intervention to save the child lives. Nevertheless, child protection team staffs' reasonable suspicion and active intervention could sometimes uncover the hidden truth that child abuse was the actual cause of death. These incidents were regarded as a team's meaningful accomplishments by team members. Meanwhile, lack of awareness and excessive burden about the role and responsibility of mandated reporter precluded medical staffs' active involvement. Also, substantiating the abuse suspicion by securing positive evidences was found to be a facilitatory factor for the rapid public intervention. On the basis of these results, several practice and policy implications were discussed to improve the early detection process, securing evidence and uncovering the actual cause of death in child abuse deaths.

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Evaluation of Imaging Studies in Male Infants less than 3 Months after First Urinary Tract Infection (3개월 이하의 남아에서 첫 요로 감염 후 방사선학적 검사의 평가)

  • Jung Jong Su;Kwon Kyung Ho;Kim Jong Sik;Lee Young Ah;Kim Hyun Jung;Lee Gyun Woo
    • Childhood Kidney Diseases
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    • v.5 no.1
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    • pp.30-35
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    • 2001
  • Purpose : To evaluate tile frequency of urinary tract anomalies in male neonates less than 3 months old who presented with urinary tract infection(UTI) and to evaluate a appropriate imaging approach after first UTI. Materials and methods : During a period of 5 years from March 1994 to February 1999, 65 male infants less than 3months old(range: 4-92 days, mean: 43 days) with UTI were evaluated. Ultrasound(US) and Voiding cystourethrogram(VCUG) were done in 60 patients. Due to refusal and technological problem, 5 patients were missed. 99mTc-dimercaptosuccinic acid renal scan (99mTc-DMSA renal scan) was recommended to most patients but performed in 40 patients. Renal scan was performed at least 3 months later after urinary tract infection. Results : Urinary tract anomalies were found in 26 of 65 infants. Twenty-six had vesicoureteral reflux(VUR), two had both VUR and double ureter, two had both U and posterior urethral valve. In patients with VUR, eight had renal scar or renal atrophies. In case of renal scar or atrophy, grades of VUR were III or above. Conclusion : We suggest that US and VCUG should be routinely performed in infants(<3months)with first UTI. 99mTc-DMSA renal scan should be performed only when renal parenchymal damage was observed in US and VUR grade III or above in VCUG. (J. Korean Soc Pediatr Nephrol 5 : 30- 5, 2001)

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Echocardiographic Diagnosis of Intracardiac Masses in Yorkshire Terrier Dogs : 2 Cases (요크셔테리어 개에서 심장초음파를 이용하여 진단된 심장내 종괴 2 증례)

  • Han, Donghyun;Kim, Hyunji;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.483-487
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    • 2012
  • Primary and metastatic tumors involving the heart are relatively uncommon in dogs. In this study, we provide the echocardiographic diagnosis of intracardiac masses in 2 Yorksire terrier dogs. In the first case, the mass was attached between ascending aorta and pulmonary artery and caused moderate aortic regurgitation and moderate left ventricular dilation. The case was graded into ISACHC II heart failure. The dog was treated with common cardiac medications (i.e. furosemide, enalapril, pimobendan) and oral chemotherapeutic agent (i.e. lomustine). In the second case, the mass was occupied 2/3 of the left atrium and caused marked dilation of left atrium and severe mitral regurgitation (~5 m/s), but not severe congestive heart failure (ISACHC Ib). Although the nature of progression of the mass was likely to cardiac myxoma, the biopsy was not performed due to the owner's refusal. The dog was currently treated with cardiac medications (i.e. ramipril, clopidogrel) and bronchodilator (i.e. aminophylline). Those two dogs are still survived and are currently regularly checked.

A study on the toilet training and influencing factors (대소변 가리기 훈련과 영향을 주는 인자에 관한 연구)

  • Kim, Eun Ok;Yun, Sang Hyun;Jang, Young Taek
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.778-784
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    • 2009
  • Purpose : We aimed to determine the ideal age for initiating toilet training and investigate the factors influencing the training. Methods : The study population comprised 1,370 children aged 2-6 years, who visited the pediatric clinics in Jeonju, Iksan, and Gunsan. Their parents were given questionnaires in order to gather data about the types of diapers used, ages when toilet training was initiated and completed for each day and night, its adverse effects, and the educational level and employment and economic status of the mothers. Results : The toilet training initiation age was low for those living in the country, having an elder sibling(s), and using cloth diapers, and for those whose mothers were employed and had a low economic status. The training completion age was 22.9 months when the training was initiated before the age of 18 months; this was lower than the training completion ages of 25.9 and 31.0 months when the training was initiated at the age of 18-24 months and after 25 months, respectively. However, the required durations in these cases were 8.4, 5.6, and 3.8 months, respectively. Encopresis and refusal occurred more often when the training was initiated before the age of 18 months than when initiated after this age. Conclusion : Toilet training should begin at least after the age of 18 months considering the developmental status of infants. It is recommended for the future researchers to develop specific guidelines regarding toilet training.

Anemia and Iron Deficiency according to Feeding Practices in Infants Aged 6 to 24 Months

  • 김순기
    • Journal of Nutrition and Health
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    • v.31 no.1
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    • pp.96-101
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    • 1998
  • The prevalence of iron deficiency in later infancy and the toddler years(25% to 40% at 1 year of age) has not decreased remarkably , except in Western countries. The purpose of this study was to 1) determine the relationship between current feeding practices and iron status, and 2) assess compliance to infant feeding instructions. Two groupsof infants were examined. The first group of 302 infants aged 6 to 24months was seen at a well baby clinic while the second group of 135 infants of the same age group was assessed by venipuncture. Cutoff values for laboratory tests were as follows ; hemoglobin<11g/dL, mean corpuscular volume (MCV) <72fl ; red cell distribution width(RDW)>15% ; serum ferritin level<10ng/ml ; and transferrin saturation (serum iron(TIBC)<10%. The diagnosis of iron deficiency anemia (IDA) was made when a low hemoglobin level was associated with either low ferritin orlow transferrin saturation . Of the 302 children brought to the well baby clinic , 12.3%(n=37) were found to have anemia (hemoglobin<11.0/dL). In terms of children grouped according to feeding practices, it was found that children with anemial comprised 32.0% (24/75) of the prolonged breast-fed group (Group A), significantly more than the 4.0%(7/176) of the artificial milk feeding group(Group B). and 3.9%(2/51) of the switched from breast milk to iron -fortified weaning foods group(Group C).Among the 107 children with IDA , iron deficiency in 105 children(98.1%) was suggested by their dietary histories ; exclusive or prolonged breast-feeding for more than 6 months without iron fortification in 98 infants ; cow's milk consumption> 500ml/day without iron fortification during infancy(n=12), or >800ml without iron-fortified foods after infancy(n=15) ; and the use of unfortified forumula or unbalanced diets, mainly limited to rice gruel. Despite the relatively high (79.6%) motivation on the part of the infants mothers and supervison by professional personnel, the poor results in the infants receiving iron fortified foods were due to poor compliance(85.75). Among the mothers of 98 IDA patients who were contacted by telephone , it was revealed that 29% did not give the oral iron preparation for more than 2 months. Furthermore, negligence or disregard by the parents occurred in 14% of the case , discontinuance of the oral iron preparation by the parents due to side effects occurred in 6%, and the children's refusal or poor oral intake and no further trial occurred in 6%. The dietary history of a large group of infants was highly predictive of their risk for anemia . Continued consumption of breast milk until the age of 1 year is not warranted unless iron-fortified foods are given concomitantly. Because there is a problem with compliance, more successful and safe strategies for preventing iron deficiency woold included dual coverage in the from of therapeutic iron supplementation as well use of iron-fortified foods for teddlers who are at risk of iron deficiency.

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Management of Elderly Patients with Intracranial Aneurysm (고령군 뇌동맥류 환자의 치료)

  • Park, Hyeon Seon;Lee, Jae Whan;Kim, Jin Young;Shin, Yong Sam;Joo, Jin Yang;Huh, Seung Kon;Lee, Kyu Chang
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.786-793
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    • 2000
  • Objectives : A clinical analysis was performed to provide management strategy and to improve management outcome of elderly patients with intracranial aneurysm. Patients and Methods : We reviewed medical records of 746 consecutive patients with intracranial aneurysm who were admitted from July 1991 to December 1996. They were divided into two age groups : elderly(120 patients aged 65 years or older) and non-elderly(626 patients aged 64 years or younger). We investigated the differences between the two groups in clinical characteristics, management outcome and surgical results. Results : Female(80.0%), internal carotid artery aneurysm(48.9%), poor clinical grade(Hunt and Hess Grade IV, V : 39.8%), postoperative subdural fluid collection(38.2%), and postoperative hydrocephalus(39.7%) were more frequent in the elderly patients. There were no significant differences in the incidence of hypertension, multiple aneurysm, unruptured aneurysm, rebleeding, delayed ischemic neurological deficits, postoperative hemorrhage, and low density on the postoperative brain CT scan. In some cases, surgical clipping of ruptured aneurysm could not be performed due to moribund state or refusal of surgery by the elderly patient's family. Both management outcome and surgical results in elderly aneurysm patients at 3 months after rupture were worse than those of the non-elderly group. The most common reason of unfavorable outcome was poor clinical grade in both groups, while serious medical illness causing unfavorable outcome was more common in the elderly group. Conclusion : Surgical treatment of a ruptured aneurysm should not be avoided in elderly patient solely on the basis of advanced age. If the patients are in good clinical grade, early aneurysm surgery followed by early ambulation should be recommended. Further improvements in outcome may be achieved by thorough knowledge of poor resilience of brain, CSF flow dynamics, and diminished cardiopulmonary reserve in elderly patients with intracranial aneurysm.

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Sexual Behaviors and Sexual Experience of Adolescents in Korea (한국 청소년의 성 행태와 성 경험)

  • Lee, Gyuyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.12
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    • pp.71-80
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    • 2016
  • Purpose: The aim of this study was to identify sexual experiences and associated factors among middle and high school students in Korea. Methods: Data were analyzed from 74,186 participants who completed the 2012 Korea Youth Risk Behavior Web-based Survey. Descriptive statistics were used to identify the condition of sexual behavior, and a complex sample logistic regression was used to examine the factors related to sexual behavior. Results: Data showed that 4.3% of adolescents had engaged in sexual intercourse (5.9% of males and 2.6% of females). According to the logistic regression analysis for complex samples, the school level, socioeconomic status, experience of part time work, and living with parents, were all factors associated with the decision to engage in sexual intercourse among boys and girls. In particular, sex education in schools was associated with a reduced risk of sexual intercourse. Conclusion: The results of this study highlight the importance of developing a program that focuses on enhancing sex education and promoting refusal and better decision-making skills in order to effectively reduce the likelihood of sexual experience among adolescents in Korea.

EMT-Paramedic Student's Attitude to the Disabled (응급구조과 학생들의 장애인에 대한 태도)

  • Choi, Gil-Soon
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.2
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    • pp.85-99
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    • 2011
  • Purpose: The purpose of this study is to examine the EMT student's attitude to the disabled and provide the basic materials of educational program to make them have right awareness and attitude of the disabled. Methods: The subjects of this study were 348 of 339 emergency medical students at three departments of emergency medical in G metropolitan city who gave consent to take part in the research and the data were collected for 10 days from Mar. 2 to 11, 2011. It used DFS (Disability Factor Scale) developed by Siller (1967) and revised and complemented by Lee Jong Nam (1997) after validity and reliability test. Data collected were analyzed with technical statistics, t-test and ANOVA using SPSS/ PC 12.0 Results: The results of this study are summarized as follows. 1. On the question that there are the disabled around the subjects, 74.7% of the respondents answered 'none', and on the question of having concerns on the disabled problems, 61.5% of the respondents answered 'they have no concerns on them'. In addition, on the question of effective methods for improving a negative awareness of the disabled, many of subjects responded the governmental support must be a priority. 2. The subjects' attitude to the disabled scored average 3.13 and they have positive attitude to the disabled. In six sub-areas of attitude to the disabled, tension in contact with the disabled scored 2.90, inferred emotional disorder 2.79, unconditional repulsion 2.78, refusal to friendly relation 2.74, limitation of other functions undamaged 2.66 and distorted identification 2.65. 3. Variable showing a significant difference in the results of analysis according to general characteristics of subjects was age and those who are over '21' showed more positive attitude to the disabled than those who are below '20'. 4. In the results of analysis according to the subjects' disability related characteristics, those who have the disabled in their friends or family and have concerns on the disabled problems have a positive attitude to the disabled. Promotion and education through mass communication for changing the awareness of the disabled into a positive attitude will be most effective. Conclusion: Consequently, positive attitude of EMT student's to the disabled can be fostered by continuous contact with the disabled and their participation in voluntary services in the dimension of individual or school will be important and also the various practical methods such as enlightenment movement and supply of right information through mass communication should be sought.

Development and Effectiveness of a Smoking Preventive Program for Elementary Students (초등학생을 위한 흡연예방 프로그램의 개발 및 효과에 관한 연구)

  • Lee, Eun-Hye;Kim, Il-Ok
    • The Journal of Korean Academic Society of Nursing Education
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    • v.9 no.2
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    • pp.264-275
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    • 2003
  • The purpose of this study were to develop a smoking preventive education program for elementary students and evaluate it's effectiveness. This study was a quasi experimental study under the nonequivalent control group with pretest-posttest design. The subjects of this study were 62 who are attending elementary school(31 for each group), 2 different district elementary school. The subjects were matched by grade, similar in anti-smoking educational background of smoking, as well as their residence and income level of their families. The instruments used in this study was 18 criterion referenced test items modeled by Dick & Carey that were developed by researchers for evaluating the subjects' knowledge and attitude about smoking. A pretest was administered a week before treatment The program given to the experimental group is composed of the texts explaining the poisonous substances in tobacco, social and cultural harmfulness of smoking to the body and psychology, indirect smoking, smoking of pregnant women, motives of smoking, refusal skills of smoking; and for the subjects' understanding and the better results of study - pictures, role play, discussion, text through computer based multi-media, puzzle searching for hidden pictures, cross-word puzzle, and finally compensation. The data were collected for 50 days form mid- September to the end of October in the year of 2000, composed of formative evaluation, pre-test and summative evaluation via 2 sessions. Accordingly, the collected data were analysed by t-test, paired t-test, repeated measure ANOVA by the SAS program. This research summarize the findings as follows; 1. There was a significant difference in knowledge between the experimental group(after 1 wks t=10.4680, p=.0001; after 4 wks t= 9.310, p=.0001) and control group(after 1 wks t=0.0420, p= .9669; after 4 wks t= -0.378 p=.7079) in between the results of 1 and 4 week after education in summative evaluation (F=27.45, P=.0001). 2. There was non statistical significant difference in attitude between the experimental group (after 1 wks t=1.2292, p=0.2286 ; after 4 wks t=1.330, p=0.1935) and control group (after 1 wks t=0.1819, p=0.8569 ; after 4 wks t=0.2970, p=0.7685) in between the results of 1 and 4 week after education in summative evaluation(F=0.71, P=0.494). To sum up, the statistics of conclusive analysis evaluative for the children under school age of the 'knowledge acquisition' about smoking harmfulness. On the other hand, as there was already sound attitude about smoking, the evaluation of attitude was non significant difference between control group and experimental group, just there was partially significant difference.

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