• Title/Summary/Keyword: children's right

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Clinical Results of Surgical Treatment of an Isolated Complete Atrioventricular Septal Defect (완전방실중격결손증의 외과적 요법에 관한 임상적 고찰)

  • 이정상
    • Journal of Chest Surgery
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    • v.24 no.2
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    • pp.123-134
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    • 1991
  • Twenty eight patients had undergone repair of an isolated complete atrioventricular septal defect between April 1986 and September 1990 in Seoul National University Children`s Hospital. The group comprised 13 male and 15 female patients. They ranged in age from 2 months to 8 years[mean 18.6months] and in weight from 3. 4kg to 23kg[mean 9.0$\pm$4.6kg]. They were analysed as Rastelli type A in 17 patients, Rastelli type B in 2 patients, and Rastelli type C in 9 patients. Seven patients had concomitant Down`s syndrome. All patients had large left-to-right shunt[mean pulmonary to systemic flow ratio 3.5 $\pm$2.2 ranging from 0.68 to 10.0] and high pulmonary systolic pressure[mean 74$\pm$18.8mmHg, ranging from 35 to 110]. In 11 patients, one patch technique was used to close the atrial and ventricular septal defect and 16 patients were undergone by two patch technique. We urgently managed only one patient by pulmonary artery banding whose anatomy was Rastelli type C and severe mitral regurgitation was identified. Postoperative complete A - V block was noted in 3 patients, two of whom were dead in operating room due to combined LVOTO and myocardial failure, and one patient with Rastelli type C was undergone by VVI type permanent pacemaker insertion 1wk later after two patch technique, but we had to manage him by modified Konno operation and total correction due to LVOTO and VSD leakage and severe mitral regurgitation 3 years later. Another two reoperation cases due to severe mitral regurgitation after two patch technique were undergone, one of whom we managed by mitral annuloplasty 3 months later but aggravated mitral regurgitation made us to control him by MVR 3 months later. Another one case of VSD leakage and tricuspid regurgitation was managed by total correction but she died of respiratory insufficiency 14 days later. We experienced pulmonary hypertensive crisis in 3 patients, who were dead in two cases comparing with one control case. So operative mortality is 9/27[33.6%], in one patch group of 3/11[29.2%] comparing with two patch group of 6/16[37.5%]. In summary, causes of death were pump weaning failure, myocardial failure and low cardiac output syndrome and pulmonary hypertensive crisis, resp. failure, complete AV block. Mean follow up period is 15.8$\pm$10.7 months[ranging from 3months to 37 months]

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Analysis of ROX Index, ROX-HR Index, and SpO2/FIO2 Ratio in Patients Who Received High-Flow Nasal Cannula Oxygen Therapy in Pediatric Intensive Care Unit (고유량 비강 캐뉼라 산소요법을 받은 소아중환자실 환아의 ROX Index와 ROX-HR Index 및 SpO2/FIO2 Ratio분석)

  • Choi, Sun Hee;Kim, Dong Yeon;Song, Byung Yun;Yoo, Yang Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.4
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    • pp.468-479
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    • 2023
  • Purpose: This study aimed to evaluate the use of the respiratory rate oxygenation (ROX) index, ROX-heart rate (ROX-HR) index, and saturation of percutaneous oxygen/fraction of inspired oxygen ratio (SF ratio) to predict weaning from high-flow nasal cannula (HFNC) in patients with respiratory distress in a pediatric intensive care unit. Methods: A total of 107 children admitted to the pediatric intensive care unit were enrolled in the study between January 1, 2017, and December 31, 2021. Data on clinical and personal information, ROX index, ROX-HR index, and SF ratio were collected from nursing records. The data were analyzed using an independent t-test, χ2 test, Mann-Whitney U test, and area under the curve (AUC). Results: Seventy-five (70.1%) patients were successfully weaned from HFNC, while 32 (29.9%) failed. Considering specificity and sensitivity, the optimal cut off points for predicting treatment success and failure of HFNC oxygen therapy were 6.88 and 10.16 (ROX index), 5.23 and 8.61 (ROX-HR index), and 198.75 and 353.15 (SF ratio), respectively. The measurement of time showed that the most significant AUC was 1 hour before HFNC interruption. Conclusion: The ROX index, ROX-HR index, and SF ratio appear to be promising tools for the early prediction of treatment success or failure in patients initiated on HFNC for acute hypoxemic respiratory failure. Nurses caring for critically ill pediatric patients should closely observe and periodically check their breathing patterns. It is important to continuously monitor three indexes to ensure that ventilation assistance therapy is started at the right time.

Respiratory syncytial virus infection cases in congenital heart disease patients (선천성심장병 환아에서의 Respiratory syncytial virus 감염례 관찰)

  • Shim, Woo Sup;Lee, Jae Yeong;Song, Jin Yong;Kim, Soo Jin;Kim, Sung Hye;Jang, So Ick;Choi, Eun Yong
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.380-391
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    • 2010
  • Purpose : Respiratory syncytial virus (RSV) is one of the main pathogens causing lower respiratory infections (LRI) in young children, usually of limited severity. However, in congenital heart disease (CHD) patients, one of the high-risk groups for RSV infection, RSV can cause serious illnesses and fatal results. To elucidate the effects of RSV infection in CHD patients, we observed RSV infection cases among CHD patients and non-CHD patients. Methods : On admission of 343 LRI patients over 3 years, 77 cases of RSV infection were detected by the RSV antigen rapid test of nasopharyngeal secretion. We compared RSV infection cases among groups of CHD and non-CHD patients. Results : During the winter season, RSV caused 20-0% of LRI admissions in children. In patients with completely repaired simple left to right (L-R) shunt diseases such as ventricular septal defect, atrial septal defect, and patent ductus arteriosus, RSV infections required short admission days similar to non-CHD patients. In patients with repaired CHD other than simple L-R shunt CHD, for whom some significant hemodynamic problems remained, RSV infection required long admission days with severe clinical course. In children with unrepaired CHD, RSV infection mostly occurred in early infant age, with long admission days. RSV infections within a month after cardiac surgery also required long admission days and severe clinical course. Conclusion : To avoid the tragedic outcome of severe RSV infection in the CHD patients, efforts to find the subgroups of CHD patients at high risk to RSV infection are needed, and effective preventive treatment should be applied.

Minimally invasive cardiac surgery with the partial mini-sternotomy in children (소아연령군에서의 부분흉골소절개를 통한 최소침투적심장수술)

  • 이정렬;임홍국;성숙환;김용진;노준량;서경필
    • Journal of Chest Surgery
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    • v.31 no.5
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    • pp.466-471
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    • 1998
  • Purpose: The safety and efficacy of minimally invasive techniques in congenital heart surgery were tested in this study. Materal and method: Between July 1997 and November 1997, a total of 46 children were underwent minimally invasive cardiac operations at Seoul National University Children's Hospital. Age and body weight of the patients averaged 34.6${\pm}$41.8 (Range: 1∼148) months and 14.5${\pm}$9.9(Range: 3.0∼40.0) kg, respectively. Twenty eight patients were male. Preoperative surgical indications included 15 atrial septal defects, 25 ventricular septal defects, 1 foreign body in aorta, 3 partial atrioventricular septal defects, 1 total anomalous pulmonary venous connection(cardiac type), and 1 tetralogy of Fallot. After creating a small lower midline skin incision starting as down as possible from the sternal notch, a vertical midline sternotomy extended from xyphoid process to the level of the second intercostal space, where one of the T-, J-, I- or inverted C-shaped lower lying mini-sternotomy was completed with a creation of unilateral right or bilateral trap door sternal opening. A conventional direct aortic and bicaval cannulation was routine. Result: A mean length of skin incision was 6.1${\pm}$1.0(range: 4.0∼9.0) cm. A mean distance between the suprasternal notch and the upper most point of the skin incision was 4.0${\pm}$1.1 (range: 2.0∼7.0) cm. Mean cardiopulmonary bypass time, aortic cross-clamp time, and the operation time were 62.9${\pm}$20.0(range: 28∼147), 29.8${\pm}$12.8(range: 11∼79), and 161.1${\pm}$34.5 (range: 100-250) minutes. A mean total amount of postoperative blood transfusion was 71.0${\pm}$68.1 (range: 0∼267) cc. All patients were extubated mean 11.3${\pm}$13.8(range: 1∼73) hours after operation. A mean total amount of analgesics used was 0.8${\pm}$1.8(range: 0∼9) mg of morphine. The mean duration of stay in intensive care unit and hospital stay were 35.0${\pm}$32.2 (range: 10∼194) hours and 6.2${\pm}$2.0(range: 3∼11) days. There were no wound complications and hospital deaths. Conclusion: This short-term experience disclosed that the minimally invasive technique can be feasibly applied in a selected group of congenital heart disease as well as is cosmetically more attractive approach.

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A Study on the Traditional Costumes and Tattoo of the Maori (마오리族 傳統 服飾과 文身 考察)

  • 황춘섭;정현주
    • The Research Journal of the Costume Culture
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    • v.3 no.2
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    • pp.241-260
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    • 1995
  • The Maori's traditional clothing materials, basic forms of dress, and the pattern and technique of tatoo were examined in the present study in order to deepen the appreciation of the cultural heritage of the Maori. The research method employed was the analysis of written materials. And a fild-trip was also made for the study. The study was limitted to the traditional culture of body adornment of the Maori including the clothing which is preserved and practicing by them at the present day, and the origin and the process of the historical development of those are not included in the scope of the present study. Followings are the results of the study: (1) By far the most widely used fiber for Maori clothing is abtained from what is commonly called New Zealand Flax. The fiber of kiekie(Freycinetia baueriana) and cabbage trees(Cordyline spp.) may also be used. The strong, long-lasting fiber of toi(cordyline indivisa) is used for a prestige warrior's cloak. Flat strips of ti kauka(Cordyline australi) are also used as thatch on rain cloaks. (2) Regardless of technique used, Maori weaving is always worked horizontally from left to right. Traditionally the work was suspended between two upright turuturu or weaving sticks. As the work progressed a second pair of uprights was used to keep the work off the ground. These uprights were moved forward as required. Because the weaver sat on the ground, the working edge was kept at a height that was comfortable to reach. No weaving tools are used, the wefts(aho) being manipulated by the fingers. The two main Maori weaving techniques are whatu aho patahi(single-pair twining) and whatu aho rua(double-pair twining). (3) The Maori wore two basic garments - a waist met and a cloak. The cloth of commoners were of plain manufacture, while those of people of rank were superior, sometimes being decorated with feather or dyed tags and decorated borders. Children ran more-or-less naked until puberty, being dressed only for special events. Some working dress consisted of nothing more than belts with leaves thrust under them. Chiefs and commoners usually went barefoot, using rough sandals on journeys over rough country (4) The adornment of men and women of rank was an important matter of tribal concern as it was in chiefly persons that prestige of the group was centred, The durable items of Maori persons adornment were either worn or carried. Ornaments of various kinds were draped about the neck or suspended from pierced earlobes. Combs decorated the head. Personal decorations not only enhanced the appearance of men and women, but many had protective magical function. The most evident personal ornament was the hei-tiki made of jade or other material. Maori weapons were treasured by their owners. They served on bottle and were also personal regalia. A man of rank was not fully dressed without a weapon in hand. Also weapons were essential to effective oratory. (5) No man or woman of rank went without some tattoo adornment except in extremely rare instances when a person was too sacred to have any blood shed. The untattooed were marked as beeing commoners of no social standing. This indelible mark of rank was begun, with appropriate rite and ritual, at puberty. And tattoo marked the person as being of a marriageable age. Maori tattoo was unlike most traditional tattoo in that its main line were 'engraved' on the face with deep cuts made by miniature bone chisels. The fill-in areas were not tattooed with cuts but with the multiple pricks of small bone 'combs' that only lightly penetrated the skin surface. The instrument of tattoo consisted of small pots of pumice or wood into which was placed a wetted black pigment made from burnt kauri gum, burnt vegetable caterpillars or other sooty materials. A bird bone chisel or comb set at right angles on a short wooden handle was dipped into the gigment, that a rod or stick was used to tap head of this miniature adze, causing penetration of the skin surface. Black pigment lodged under the skin took on a bluish tinge. A full made facial tattoo consisted of major spirals with smaller spirals on each side of the nose and sweeping curved lines radiating out from between the brows over the forehead and from the nose to the chin. The major patterns were cut deep, while the secondary koru patterns were lightly pricked into the skin.

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Disaster and Artistic Measures: Hermann Josef Hack's Project of World Climate Refugee Camp (재난과 미술적 대응: 헤르만 조셉 하크(Hermann Josef Hack)의 기후난민 프로젝트)

  • Kim, Hyang-Sook
    • The Journal of Art Theory & Practice
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    • no.14
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    • pp.53-83
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    • 2012
  • This thesis is a study of artistic measures and climate refugees, based on Hack's World Climate Refugee Camp project. According to Hack, climate refugees appeared with the process of globalization. Hack claimed that the people who put climate refugees in danger are the industrialized nations, and therefore, their rejection of refugees is nonsense. He also stated that the fundamental solution would be the active participation of such nations. Thus, he travels around the world, encouraging participants and globalizing his project. Interestingly, the practical participation method of his climate calamity project is divided into four methods, which are all related to realizing the danger and presenting various solutions. First, the aesthetic of survival: the reason Hack focused on the warming trend and claimed that we have to accept the climate refugees as refugees comes from the thought that we are all potential refugees, and the anxiety that climate refugees may cause war in the end. The solution Hack found for surviving in such a world is to create "refugee camps" to notify people about the seriousness of climate change, and to put the "aesthetic for survival" in action. Second, a relation-oriented relationship: communication between Hack and the participants was done in various ways. They are experiencing a bond and emotions of an interrelationship through their actions in the experimental field, experiencing a new form of art, which they were not able to experience in a museum. Third, a utopian measure: Hack's utopian measure started from the fear of dystopia but Hack still believes that it is not only a dream, but that it can be realized. He claims that even though the start may be feeble, it is possible to rescue children from starvation and to treat climate refugees as proper human in the end, when communication and cooperation is done the right way and properly. Fourth, the aesthetic of global relation, the internet: the new solution Hack is trying on the internet is to make more people participate in his project. It is fate that "human are the wrongdoer and the victim at the same time", but according to Hack's opinion, social disaster can be avoided through effort and it is optimistic that we can give form to the culture revolution we are experiencing now. Hack's project illustrated the importance of daily life, compared to art inside a museum, through active participation of the people and opened up a new method of art through realistic responses to disasters. This is distinctive from the past exhibitions, where artists gave shape and form to ideals and an imaginary world, in that it shows that the artist and audience aim for creating a community-like structure, just like Bourriaud's art method. Hack's project of climate calamity illustrates that installation and action art is not only an art genre which shows installation and activities, but that it can include social and political issues and that it can be completed with the help of participants, consequently becoming a genre of modern art. Hack raises a question about art's identity through various descriptions. Artists as planners, who base their artworks on their subjectivity or the characteristics of a specific period, the people as participants, the duet of art work and play, human and human, and further, human and nature. The practical participation method, as a measure for "disaster", reveals the new art of the 21st century within Hack's artworks. Even though there are several problems with Hack's usage of art as a measure for disaster, it will actively open up a new page for the 21st century's art with the theme of disaster.

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The Effect of a Weighted Vest in Behavioral Problem for the Sensory Modulation Disorder (감각조절장애 아동의 문제행동에 무게감 있는 조끼 착용이 미치는 영향)

  • Han, Mi-Yea;Kim, Ji-Youn;Chang, Ki-Yeon;Park, Mi-Jin
    • The Journal of Korean Academy of Sensory Integration
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    • v.8 no.1
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    • pp.1-13
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    • 2010
  • Purpose : The purpose of the study is to find out the effect of wearing a weighted vest for sensory modulation disorder children. Methods : The participant of the study was an elementary school student, male, aged 7. The ABA single case study was used to design the study which was performed for 14 sessions. During the mediation period(B), the participant received the study cognitive education wearing weighted vest weighing 1.3kg. Results : Abnormal behaviors such as suddenly standing up from the chair, shaking body front and back, and left and right, sucking his thumb and putting the back of his hand to his mouth showed tendency to decrease gradually. Discussion : The participant's abnormal behaviors decreased as the sessions went by, which means the sensory integration therapy can improve the behavior of the child suffering the sensory modulation disorder. The design of the study had certain limitation to explain the influence a weighted vest to sustain the effect of the sensory integration therapy. New study design is needed for the extended studies to prove the lasting effect of a weighted vest for the sensory integration therapy and to suggest protocols incorporating wearing know-hows, proper wearing time, and the weight of a weighted vest.

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A STUDY ON THE DIRECTION OF THE FUTURE WELFARE SYSTEM (미래 복지체계의 방향성에 관한 연구)

  • Kim, Youn-Jae;Keum, Ki-Youn
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.6 no.4
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    • pp.153-171
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    • 2011
  • The welfare system and the direction of the welfare policy have been unable to escape greatly from the frame of the past against the facts that the external environments of the national economy of the world including Korea have been changing in quick and rapid speed. Such results have caused the issues related with the welfare, economy and society ended in the ideological collision in connection with the goals of the policy, the right agreement between the policies lacked, and the intervention and conflict between the interest group concerning the policy continued. Social policy of Korea in the past had the level of complementing the parts which could not be solved through the growth. Employment creation had been achieved continuously backed up by the high rate of growth. And the low aging level, the young population structure, and the high rate of childbirth had been the structures that made such achievement possible. New economic, social and welfare environment at home and abroad has been requesting new change in welfare policy. Goal of the economic and social policy is to construct the safe economic and social system. And what has been requested has been the formation of the economic and social policy orienting the welfare nation in form of social investment and welfare expansion. Also the direction in strengthening the welfare system of Korea shall have the balance between the protection and activation strength with the necessity of converting to the prevention welfare from the post welfare. Also the public part, market, the 3rd sector and the share of the role of an individual shall be achieved. And what is needed is the achievement of the transfer from the paradigm of residual welfare to the universal welfare. And such improvements of the welfare system will be able to elevate the possible continuity of the system in long term basis through the improvement of the welfare system.

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The Policies of Care Providers in the United Kingdom: Towards Emphasis On Carers Rights and Quality Employment (영국의 케어 제공자에 관한 정책 연구: 보호자 권리와 유급고용의 질 강조)

  • Rhee, Ka-Oak;Woo, Kug-Hee
    • Korean Journal of Social Welfare
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    • v.57 no.2
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    • pp.185-204
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    • 2005
  • In a period of rapid change, transition and re-definition of care concept, this study reviewed social policies on care providers in the UK. In the face of care crisis, the British government has made a radical reform of the care system and enacted new legislations. In the UK social policy, care providers are classified into carers and care workers. Carers mean informal caregivers and care workers are those who are paid for providing care as part of a contract of employment. Recently, the United Kingdom has given carers recognition and reward. To enhance the status and right of carers, the Carers (Recognition and Services) Act 1995, the strategy document Caring about Carers 1999, Carers and Disabled Children Act 2000, and Carers (Equal Opportunities) Act 2004 have been enacted. At the heart of the policy for carers is the idea of active citizenship, carers-friendly employment and work-life balance etc. In case of paid care worker, government's focus seems to be on quality of employment. The government has established a new national infrastructure for quality. The five national bodies founded on Care Standards Act 2000 has been established. The UK government has realized care work would play an important part in job creation strategy. In this article, we have presented several criticisms and issues of current care policy in UK.

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A Study on the Change of Perceptions of Child Abuse Before and After Special Law (아동학대 범죄의 처벌 등에 관한 특례법 전후의 아동학대 인식 변화에 대한 고찰)

  • Lee, Keung-Eun;Kim, Do-Hee
    • The Journal of the Korea Contents Association
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    • v.19 no.9
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    • pp.629-636
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    • 2019
  • In order to infer whether the Special Act on the Punishment of Child Abuse Crimes, etc. actually brought about a change in the social perception shared about child abuse in our society, we used big data to examine the change in the perception of child abuse by the public. This study selected 'child abuse' as the keyword and collected and analyzed. The results of this study are as follows. First, before the implementation of the Special Act in 2013, the words "china" are kindergarten, teacher, body, problem, reporting obligation and neglect compared to the following. After the implementation of the special law, daycare centers, incidents, eradication, campaigns, domestic violence and preventive education were newly introduced. Second, the interconnection of key words in the previous picture of 2013 shows that the left group focuses on measures to introduce to prevent child abuse while the right group consists of keyword intended to view child abuse in conjunction with domestic violence. They are still seen as a group of divorces, discipline, neglect and parental education, which they still perceive as a family problem. Since the implementation of the Special Act in 2013, it will be divided into four groups, and the top group will be highlighted by the keyword related to child abuse cases, part of suspected cases and awareness of child abuse. In addition, the Act on the Special Cases of Child Abuse and the Child Protection Agency clearly appear as a child protection system.