• 제목/요약/키워드: early intervention

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A Study on Health Status' Factors Affecting HRQOL in the Elderly Stroke Patients With or Without Sequela (노인 뇌졸중 환자의 후유증 유무에 따른 HRQOL 요인별 중요도 분석)

  • Kim, Souk-Boum;Kim, Dong-Hyun
    • The Journal of Korean society of community based occupational therapy
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    • v.7 no.1
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    • pp.37-47
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    • 2017
  • Objective : The main purpose of this study was to analyze factors affecting a health related quality of life(HRQOL) in the elderly stroke patients with(Group 1) or without(Group 2) sequela. Methods : This survey performed secondary analysis with 'the fifth korea national health and nutrition examination survey', and investigated 91 elderly stroke patients over 65 years. Results : The results were as followed: HRQOL and self rated health had a significantly lower in Group 1(p<.05). In all groups, HRQOL was affected by self rated health(${\beta}=0.39$), mental health, and medical health significantly(p<.05). In group 1, HRQOL was affected by mental health(${\beta}=0.45$), self rated health significantly(p<.05). In group 2, HRQOL was affected by medical health(${\beta}=0.45$), functional health, mental health significantly(p<.05). Conclusion : In order to improve the HRQOL of stroke patients during rehabilitative therapy, it is important that early detection and early intervention of depression and suicide, which affect mental health status, are important in the case of severe aftereffects. If the patient continues to support his/her current status regardless of aftereffects, he/she can improve the HRQOL with functional recovery of the stroke patient, and finally have a positive effect on the independence of the stroke patients.

Tandem Mass Spectrometric Analysis for Disorders in Amino, Organic and Fatty Acid Metabolism : 2 Years of SCL Experience in Korea

  • Yoon, Hye-Ran;Lee, Kyung Ryul
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.3 no.1
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    • pp.86-93
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    • 2003
  • Background : The SCL began screening of newborns and high risk group blood spots with tandem mass spectrometry (MS/MS) in April 2001. Our goal was to determine approximate prevalence of metabolic disorders, optimization of decision criteria for estimation of preventive effect with early diagnosis. This report describes the ongoing effort to identify more than 30 metabolic disorders by MS/MS in South Korea. Methods : Blood spot was collected from day 2 to 30 (mostly from day 2 to 10) after birth for newborn. Blood spot of high risk group was from the pediatric patients in NICU, developmental delay, mental retardation, strong family history of metabolic disorders. One punch (3.2 mm ID) of dried blood spots was extracted with $150{\mu}L$ of methanol containing isotopically labelled amino acids (AA) and acylcarnitines (AC) internal standards. Butanolic HCl was added and incubated at $65^{\circ}C$ for 15 min. The butylated extract was introduced into the inlet of MS/MS. Neutral loss of m/z 102 and parent ion mode of m/z 85 were set for the analyses of AA and AC, respectively. Diagnosis was confirmed by repeating acylcarnitine profile, urine organic acid and plasma amino acid analysis, direct enzyme assay, or molecular testing. Results : Approximately 31,000 neonates and children were screened and the estimated prevalence (newborn/high risk group), sensitivity, specificity and recall rate amounted to 1:2384/1:2066, 96.55%, 99.98%, and 0.73%, respectively. Confirmed 28 (0.09%) multiple metabolic disorders (newborn/high risk) were as follows; 13 amino acid disorders [classical PKU (3/4), BH4 deficient-hyperphenylalaninemia (0/1), Citrullinemia (1/0), Homocystinuria (0/2), Hypermethioninemia (0/1), Tyrosinemia (1/0)], 8 organic acidurias [Propionic aciduria (2/1), Methylmalonic aciduria (0/1), Isovaleric aciduria (1/1), 3-methylcrotonylglycineuria (1/0), Glutaric aciduria type1 (1/0)], 7 fatty acid oxidation disorders [LCHAD def. (2/2), Mitochondrial TFP def. (0/1), VLCAD def. (1/0), LC3KT def. (0/1). Conclnsion : The relatively normal development of 10 patients with metabolic disorders among newborns (except for the expired) demonstrates the usefulness of newborn screening by MS/MS for early diagnosis and medical intervention. However, close coordination between the MS/MS screening laboratory and the metabolic clinic/biochmical geneticists is needed to determine proper decision of screening parameters, confirmation diagnosis, follow-up scheme and additional tests.

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Analysis of Child protection system from a preventive Perspective : Focusing on the German case (예방적 관점에서 살펴 본 아동학대 대응체계 분석 - 독일 사례를 중심으로 -)

  • Hong, Moonki
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.6
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    • pp.515-522
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    • 2022
  • This study analyzed the child protection system in Germany from a preventive perspective and attempts to find the applicable implications to Korea. The research method was analyzed in terms of legal, policy and professionalism. The result is as follows. First, Child and Youth Support Act in Germany stipulated a preventive support system to restore the function of the family. Second, according to the Civil Act, it was stipulated that the family court could intervene early. Third, the federal Child Protection Act stipulated community cooperation for thd child protection system. Fourth, the Youth Agency as the general authority made it possible to provide preventive support and intervention at the same time. Firth, qualification standards were specified in the Child and Youth Support Act. Child protection specialists are granted to public officials who have worked for more than three years. The implications are as follows. First, the child protection system, which operates as a child abuse reporting system, should be expanded to a preventive support system. Second, it is necessary to expand monitoring by establishing an early warning system between networks in order to establish a support system for potentially at-risk children. Third, local governments should support children and parents flexibly and comprehensively for dysfunction caused by difficulties at home. Fourth, it is necessary to enact the Child Protection System Cooperation Act for a network cooperation system.

Psychological Well-being in Mid to Late Adulthood of American: Parent-child Relationship across the Lifespan and Generativity Development (중노년기 미국성인들의 심리적 복지감: 전생애 발달과정의 부모자녀관계와 생산감 발달의 영향)

  • An, Jeong-Shin
    • 한국노년학
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    • v.25 no.2
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    • pp.245-266
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    • 2005
  • This study examined the relationship between parent-child relationship experiences in childhood and adulthood, and individual development and psychological well-being in mid to later life using structural equation modeling with data from 1,882 parents who have at least one child over 18 years old. Findings indicated that receiving more affectionate parenting in childhood was associated with greater generativity development, more positive parental experiences with one's own children, and better psychological well-being in mid to later adulthood. In addition, the effects of received parenting in childhood on psychological well-being after midlife were partially mediated by parental experiences with adult children and generativity development. These findings suggest that early experiences with parents in childhood continuously influence psychological well-being in adulthood through their impact on concurrent family experiences. However, early influences can be redirected through adult experiences too. These findings have implications for the development of intervention programs aimed at promoting volunteer work for older adults, as well as for practitioners who work with families and individuals who are having problems.

Development of Smartphone Application for Cognitive Behavioral Therapy-Based Case Management in Patients with Schizophrenia (조현병 환자의 인지행동치료 기반 사례관리를 위한 스마트폰 애플리케이션 개발)

  • Kim, Sung-Wan;Lee, Ga-Young;Yu, Hye-Young;Park, Ji-Hyun;Lee, Yong-Sung;Kim, Ju-Wan;Park, Cheol;Lee, Ju-Yeon;Lee, Yo-Han;Kim, Jae-Min;Yoon, Jin-Sang
    • Korean Journal of Schizophrenia Research
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    • v.19 no.1
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    • pp.10-16
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    • 2016
  • Objectives : This article aims to describe the development of smartphone application for the case management of patients with schizophrenia. Methods : Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (HYM) for cognitive-behavioral case management and symptom monitoring. The development of the application involved psychiatrists, nurses, social workers, psychologists, and software technicians from a software development company (Goosl Corp.). Results : The HYM application for clients includes six main modules including Thought record, Symptom record, Daily life record, Official notices, Communication, and Scales. The key module is the 'Thought Record' for self-directed cognitive-behavioral treatment (CBT). When the client writes and sends the self-CBT sheet to the case manager, the latter receives a notification and can provide feedback in real time. 'Communication' and 'Official notices' are useful for promoting communication between case managers and clients with schizophrenia. Ratings in 'Symptom record', 'Daily life record', and 'Scales' modules are stored in graphic or table form representing changes in them and shared with case managers. Conclusion : The interactive function of this application is the key characteristics that distinguishes it from other mobile self-treatment tools. This smartphone application may contribute to the development of a youth- and customer-friendly case management system for individuals with early psychosis.

Mothers' Parenting Behaviors and School-Aged Children's Strategies and Competence of Emotional Regulation (어머니의 양육행동과 학령기 아동의 정서조절 전략 및 정서조절 능력간의 관계)

  • Park Seo-Jung;Kim Soon-Ok
    • Journal of Families and Better Life
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    • v.23 no.4 s.76
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    • pp.35-53
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    • 2005
  • In this study, the influence of mothers' parenting behaviors on children's strategies and competence of emotional regulation was examined. Further, the mediating effects of children's active-social support seeking and aggressive strategies on the above relationship were explored. The participants were W mother-child pairs. The children were 5th and 6th graders at two elementary schools in Kyunggi province and Kwangju metropolitan area The data were analyzed with descriptive statistics, factor analysis, Cronbach's alpha, Pearson correlations, standard multiple regressions and structural equation modeling analysis by LISREL 8.3. The main results of this study were as follows: (1) The more the mothers coached children with affection and reasoning, the more adaptive emotional regulation the children had; whereas children tended to have maladaptive emotional regulation in response to the mothers' rejecting and forceful parenting behaviors. Also, when children were coached by mothers with love, reasoning and consistent restriction, they used more active-social support seeking strategies, whereas they used more aggressive strategies when the mothers coached children with rejecting and forceful parenting behaviors. The more the mothers were rejecting, forceful and intervening, the more the children used passive-avoidant strategies. (2) The more the children used active-social support seeking strategies and the less the children used aggressive strategies, the more likely they had adaptive emotional regulation. The more the children used aggressive strategies, the more likely they had maladaptive emotional regulation. (3) Children's active-social support seeking strategies played a partial mediating role between mothers' affectionate and reasoned coaching and children's adaptive emotional regulation. These strategies, on the other hand, played a full mediating role between mothers' consistent restriction and children's adaptive emotional regulation. Children's aggressive strategies played a partial mediating role between mothers' rejecting and forceful parenting behaviors and children's maladaptive emotional regulation. Mothers' non-intervention had an influence on neither the children's aggressive strategies nor their maladaptive emotional regulation.

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu;Song, Hyun;Lee, Seok In;Moon, Mi Hyung;Kim, Hwan Wook;Jo, Gyun Hyun
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.106-110
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    • 2014
  • Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

A Study on Variation of Chinese-Korean's Recognition to the Local Community in their Enclave (중국동포(Chinese-Korean) 집단적 거주지에 나타난 지역사회에 대한 중국동포의 인식변화에 관한 연구)

  • Kim, Young-Ro
    • Korean Journal of Social Welfare
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    • v.63 no.3
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    • pp.133-156
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    • 2011
  • This study used the qualitative research for deeply interviewing Chinese-Koreans who live and work in Dearim-dong area, Yeongdeungpo-gu, Seoul, collectively. The variation of recognition to the local community at the migration early and the present and their response for overcoming their pending issues are studied through this, To understand the reality and conflict they encounter, the effort for overcoming the pending issues, the inner change of their own community, their fixed direction and so on becomes the core variables for integrating them to our society. They have formed the enormous cluster and have been already developed as the minority group. They are doing 'the struggle for recognition' for being recognized from the dominant group and trying to approach the politics for overcoming the inferiority of power. Accordingly, the intervention of social welfare to this minority group should be a more active working to protect the fragmentation of our society which can be resulted from the increasing influx of the foreigners and be also an approach to mutual enlightenment for making our society adapt to the phenomena of multi-nations and multi-cultures and for accepting them as the population.

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Mid-Term Results of Totally Thoracoscopic Ablation in Patients with Recurrent Atrial Fibrillation after Catheter Ablation

  • Lim, Suk Kyung;Kim, Joo Yeon;On, Young Keun;Jeong, Dong Seop
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.270-276
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    • 2020
  • Background: We investigated the impact of previous catheter ablation (CA) on the midterm outcomes of totally thoracoscopic ablation in patients with lone atrial fibrillation (AF). Methods: Between February 2012 and July 2018, 332 patients underwent totally thoracoscopic ablation for the treatment of AF (persistent AF; n=264, 80%). The patients were stratified into CA (n=47, 14%) and non-CA (nCA; n=285, 86%) groups according to their CA history. Results: All the baseline clinical characteristics and risk factors were similar between the groups except for age, percentage of male patients, prevalence of paroxysmal AF, prior percutaneous coronary intervention, and left atrial volume index (LAVI). No significant intergroup differences were observed in the incidence of early and late complications. At late follow-up, normal sinus rhythm was observed in 92% (43 of 47) of the patients in the CA group and 85% (242 of 285) of the patients in the nCA group (p=0.268). The rate of freedom from AF recurrence at 5 years was 55.3%±11.0% in the CA group, which was similar to that in the nCA group (55.7%±5.1%, p=0.690). In Cox regression analysis, preoperative brain natriuretic peptide levels and LAVI were associated with AF recurrence, but CA history was not significant. Conclusion: Totally thoracoscopic ablation was safe and effective in treating AF irrespective of CA history. A history of CA did not appear to affect the procedural complexity.

Early surgical intervention for unusually located cardiac fibroelastomas

  • Chung, Eui Suk;Lee, Jae Hoon;Seo, Jong Kwon;Kim, Byung Gyu;Kim, Gwang Sil;Lee, Hye Young;Byun, Young Sup;Kim, Hyun Jung
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.345-348
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    • 2020
  • Papillary fibroelastomas are the second most common primary cardiac tumor in adults. Over 80% of fibroelastomas occur on the cardiac valves, usually on the left side of the heart, while the remaining lesions are typically scattered throughout the atria and ventricles. Although the optimal timing for surgery is controversial and depends on tumor size and location, prompt surgical resection is warranted in patients at high risk of embolism. A tumor on the cardiac valve can be removed using the slicing excision technique without leaflet injury. Here we present two cases of papillary fibroelastomas occurring on the ventricular surface of the aortic valve and in the right ventricle.