• 제목/요약/키워드: early interventions

검색결과 295건 처리시간 0.024초

학령 전 아동의 라이프스타일과 부모의 체중인지도가 아동의 과체중위험에 미치는 영향 (Lifestyle Behaviors and Parental Perception of Children's Weight in Relation to Overweight Risk of Preschool Children)

  • 강경민;윤군애
    • 한국식생활문화학회지
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    • 제25권2호
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    • pp.170-178
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    • 2010
  • We conducted this study to determine the factors associated with childhood obesity. The subjects were 170 preschool children in Busan. Data were collected by using questionnaires which asked for information about socioeconomic status, parental perception of their child's weight status and dietary/physical activity behavior. BMI was calculated for each child and their classification was determined, according to their age and sex, as follows: "overweight" at or above the 85th percentile, "normal" for the 15th-85th percentile, and with a BMI below the 15th percentile the children were deemed as underweight. Classification according to BMI percentile showed that 23.5% ($18.25{\pm}1.33\;kg/m^2$) of the children were overweight, 62.9% ($15.51{\pm}0.76\;kg/m^2$) normal, and 13.5% ($13.23{\pm}2.86\;kg/m^2$) were underweight. Socioeconomic status, as represented by the parents' level of education, the occupation of the father and the household income, did not affect the results. However, mothers working outside the household was a factor that was more likely to affect the weight status (p<0.05). Among mothers whose children were overweight, 30% underestimated their children's weight status (believing them to be of normal weight when they were overweight), and 25% failed to recognize the necessity of weight control for their overweight children. While sedentary activity and total daily activity levels were not related to BMI, the level of physically active leisure activity was inversely correlated with BMI (p<0.05). Although there were no differences in total energy intake, dietary behavior was significantly related to weight status. Overweight children had poor eating tendancies: they eat faster (in less than 15 minutes), overeat, and eat late at night. Based on our findings where hereby recommended the following interventions to help limit weight problems in Korean pre-schoolers: early promotion of active leisure behavior and healthy eating habits, along with attempting to correct parental misperception of healthy weight status for children.

젊은 성인에서 사회불안 증상과 아동기 외상 경험 간의 관련성에서 긍정자원의 매개효과 (The Mediating Effects of Positive Resources in the Association Between Social Anxiety Symptoms and Adverse Childhood Experiences in Young Adults)

  • 정영은;오수경;정유라;김문두
    • 대한불안의학회지
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    • 제18권2호
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    • pp.65-71
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    • 2022
  • Objective : This study was to examine the impact of adverse childhood experiences on social anxiety symptoms in young adults and verify the mediating effects of positive resources. Methods : Data from 1,317 young adults aged to 18 to 29 years who took part in the university-based cross-sectional survey were analyzed. All participants completed Adverse Childhood Experience (ACE) scale, Social Avoidance and Distress Scale (SAD), and Positive Resources Test (POREST). Results : In young adults, 9.3% had severe social anxiety symptoms. Based on 10 ACE categories, 32.7% of participants reported one or more adverse childhood experience, and 4.5% reported four or more different forms of adverse childhood experiences. Young adults with higher social anxiety symptoms were likely to report more adverse childhood experiences, and less positive resources. Multivariate regression analysis indicated that positive resources moderated the association between adverse childhood experiences and social anxiety symptoms. Conclusion : Based on the results, professionals need to consider early detection of adverse childhood experiences and comorbid social anxiety symptoms. In addition, various positive psychological interventions for individuals with adverse childhood experiences are needed.

초등학교 저학년 학생의 단위 추론 수준: 개방형 수직선 과제를 중심으로 (Elementary school students' levels of quantitative reasoning of units: Using open number line tasks)

  • 박주경;여승현
    • 한국수학교육학회지시리즈A:수학교육
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    • 제62권4호
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    • pp.457-471
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    • 2023
  • 측정은 초등 수학의 핵심 영역이지만 중요도에 비하여 측정 상황에서 단위에 대한 학생들의 이해는 충분하지 않은 것으로 보고되고 있다. 이에 본 연구는 길이 측정 상황에서 초등학교 저학년 학생의 단위 추론에 대한 수준을 분석하여 이를 바탕으로 측정 영역에서 단위 추론을 지도하기 위한 방안을 모색하고자 하였다. 이를 위하여 개방형 수직선을 활용하여 길이 측정 과제를 적용한 초등학교 2학년 학생들의 응답을 수집 및 분석하였다. 연구 결과, 초등학교 저학년 학생들의 단위 추론 수준은 단위화, 단위 반복, 단위 분할 정도에 따라 1단위 반복하기, 주어진 단위 반복하기, 단위 사이의 관계 알기, 단위 변환하기의 4개의 수준으로 나타났다. 가장 많은 분포를 보인 수준은 길이 측정을 위해 단위 사이의 관계를 인식하는 수준이었으며 각 수준을 대표하는 단위 추론에 대한 학생들의 수준별 특징과 사례를 제시하였다. 본 연구 결과를 토대로 초등학교 저학년 학생들의 단위 추론 수준에 맞는 지도 방안이 요구되며, 불완전한 단위 추론 능력을 가진 친구들을 위한 추가 지도나 맞춤형 중재물의 활용이 필요함을 논의하였다.

Long-term clinical outcome of acute myocardial infarction according to the early revascularization method: a comparison of primary percutaneous coronary interventions and fibrinolysis followed by routine invasive treatment

  • Min, Hyang Ki;Park, Ji Young;Choi, Jae Woong;Ryu, Sung Kee;Kim, Seunghwan;Song, Chang Sup;Kim, Dong Shin;Song, Chi Woo;Kim, Se Jong;Kim, Young Bin
    • Journal of Yeungnam Medical Science
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    • 제34권2호
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    • pp.191-199
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    • 2017
  • Background: This study was conducted to provide a comparison between the clinical outcomes of primary percutaneous coronary intervention (PCI) and that of fibrinolysis followed by routine invasive treatment in ST elevation myocardial infarction (STEMI). Methods: A total of 184 consecutive STEMI patients who underwent primary PCI or fibrinolysis followed by a routine invasive therapy were enrolled from 2004 to 2011, and their major adverse cardiovascular events (MACEs) were compared. Results: Among the 184 patients, 146 patients received primary PCI and 38 patients received fibrinolysis. The baseline clinical characteristics were similar between both groups, except for triglyceride level ($68.1{\pm}66.62$ vs. $141.6{\pm}154.3mg/dL$, p=0.007) and high density lipoprotein level ($44.6{\pm}10.3$ vs. $39.5{\pm}8.1mg/dL$, p=0.005). The initial creatine kinase-MB level was higher in the primary PCI group ($71.5{\pm}114.2$ vs. $35.9{\pm}59.9ng/mL$, p=0.010). The proportion of pre-thrombolysis in MI 0 to 2 flow lesions (92.9% vs. 73.0%, p<0.001) was higher and glycoprotein IIb/IIIa inhibitors were administered more frequently in the primary PCI group. There was no difference in the 12-month clinical outcomes, including all-cause mortality (9.9% vs. 8.8%, p=0.896), cardiac death (7.8% vs. 5.9%, p=0.845), non-fatal MI (1.4% vs. 2.9%, p=0.539), target lesion revascularization (5.7% vs. 2.9%, p=0.517), and stroke (0% vs. 0%). The MACEs free survival rate was similar for both groups (odds ratio, 0.792; 95% confidence interval, 0.317-1.980; p=0.618). The clinical outcome of thrombolysis was not inferior, even when compared with primary PCI performed within 90 minutes. Conclusion: Early fibrinolysis with optimal antiplatelet and antithrombotic therapy followed by appropriate invasive procedure would be a comparable alternative to treatment of MI, especially in cases of shorter-symptom-to-door time.

흉부 외상 환자에서 일반흉부촬영과 비교한 흉부단층촬영의 진단적 유용성 (Diagnostic Usefulness of Computed Tomography Compared to Conventional Chest X-Ray for Chest Trauma Patients)

  • 최규일;서강석;류현욱;박정배;정제명;안재윤;강성원;이재혁
    • Journal of Trauma and Injury
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    • 제22권2호
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    • pp.142-147
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    • 2009
  • Purpose: Early diagnosis and management of therapeutic interventions are very important in chest trauma. Conventional chest X-rays (CXR) and computed tomography (CT) are the diagnostic tools that can be quickly implemented for chest trauma patients in the emergency department. In this study, the usefulness of the CT as a diagnostic measurement was examined by analyzing the ability to detect thoracic injuries in trauma patients who had visited the emergency department and undergone CXR and CT. Methods: This study involved 84 patients who had visited the emergency department due to chest trauma and who had undergone both CXR and CT during their diagnostic process. The patients' characteristics and early vital signs were examined through a retrospective analysis of their medical records, and the CXR and the CT saved in the Picture Archiving Communication System (PACS) were examined by a radiologist and an emergency physician to verify whether or not a lesion was present. Results: Pneumothoraxes, hemothoraxes, pneumomediastina, pulmonary lacerations, rib fractures, vertebral fractures, chest wall contusions, and subcutaneous emphysema were prevalently found in a statistically meaningful way (p<0.05) on the CT. Even though their statistical significance couldn' be verified, other disorders, including aortic injury, were more prevalently found by CT than by CXR. Conclusion: CT implemented for chest trauma patients visiting the emergency department allowed disorders that couldn' be found on CXR to be verified, which helped us to could accurately evaluate patients.

유아기 스마트기기 사용 문제행동에 대한 국내연구동향 내용분석 -중독경향성을 중심으로- (A Content Analysis of Domestic Research Trends on the Problematic Behavior of Smart Devices in Early Childhood -Focusing on Addiction Proneness-)

  • 강선경;차유정
    • 한국융합학회논문지
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    • 제12권5호
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    • pp.217-225
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    • 2021
  • 본 연구는 중독경향성을 중심으로 유아의 스마트기기 사용 문제행동과 관련된 국내연구 동향을 분석하였다. 연구동향 주요 결과는 다음과 같다. 첫째, 연도별 발행 논문 수는 총 79편이고, 다양한 학술지에 중독경향성 연구물이 게재된 데 비해 연구자의 전공은 교육과 복지계열 학과에 편중되었다. 둘째, 연구주제는 총 81개로, 실태(현황), 척도개발, 관련변인, 개입, 인과관계였다. 연구주제 비중은 관련변인 연구주제가 60편(74.1%)으로 가장 많았다. 셋째, 연구대상은 유아, 양육자, 교사로 구분되었고, 양육자 대상의 주된 연구대상은 어머니였다. 넷째, 연구방법은 양적연구가 73편(92.4%), 질적연구 2편, 문헌연구 1편, 혼합연구 2편, 기타 1편이었다. 다섯째, 영향요인 분석결과는 위험요인과 보호 요인으로 분류되고, 이는 구체적으로 개인요인, 가정요인, 사회·환경요인으로 구분되었다. 이를 바탕으로 논의와 실천적 제언을 덧붙였다.

생존분석을 이용한 복부마사지와 하지관절운동의 뇌병변 재활환자 배변완화시기 효과 비교 (Comparison of the Effects of Abdominal Massage and Lower Extremity Exercise using Survival Analysis in Rehabilitation Patients of Brain Injury)

  • 김영지;신동순;김성림;박규옥;도나령
    • 산업융합연구
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    • 제21권2호
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    • pp.25-32
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    • 2023
  • 뇌손상 환자는 초기 재활 단계에서 가장 흔한 소화장애로 변비가 발생하며 예후에 영향을 미친다. 본 연구의 목적은 경관영양하는 뇌손상 환자의 재활 치료 입원, 전동 직후부터 배변 습관을 사정하고 복부 마사지와 하지 관절 운동을 적용하여 효과를 알아보고자 한다. 연구 설계는 뇌손상 환자에게 배변 간호 중재(복부 마사지와 하지 관절 운동)를 적용하여 그 효과를 알아보기 위한 비 동등성 대조군 시차 연구이다. 연구결과, 배변 횟수는 실험군의 배변 횟수가 통계적으로 유의하게 높았으며 (p=.030), 좌약 사용은 대조군이 실험군보다 사용 횟수가 통계적으로 유의하게 높았다(p=.004). 변비 완화 시점은 실험군은 1.73일, 대조군은 4.61일로 두 군간 변비 완화 시점에 차이가 있는 것으로 나타났다(p<.001). 뇌손상 환자에게 재활 초기부터 배변을 완화시키고 변비를 예방을 위한 간호 중재는 복부 마사지와 하지관절 운동이 효과적임을 입증하였다.

Role of Adjunctive Tranexamic Acid in Facilitating Resolution of Chronic Subdural Hematoma after Surgery

  • Kiyoon Yang;Kyung Hwan Kim;Han-Joo Lee;Eun-Oh Jeong;Hyon-Jo Kwon;Seon-Hwan Kim
    • Journal of Korean Neurosurgical Society
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    • 제66권4호
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    • pp.446-455
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    • 2023
  • Objective : Chronic subdural hematoma (CSDH) is a common neurosurgical disease and generally treated with burr-hole surgery alone. Tranexamic acid (TXA) is an antifibrinolytic agent that potentially reduces recurrence rates and the residual hematoma volume. However, the role of postoperative TXA medication remains unclear to date. This study aimed to verify the effectiveness of adjunctive TXA in the view of early hematoma resolution. Methods : Between January 2018 and September 2021, patients with CSDH who underwent burr-hole trephination in a single tertiary institute were reviewed. The study population was divided into three groups, TXA, non-TXA, and antithrombotics (AT) groups, according to the medical history of cardio-cerebrovascular disease and TXA administration. The primary endpoint was CSDH recurrence, defined as re-appearance or re-accumulation of CSDH requiring neurosurgical interventions. The secondary outcome was CSDH resolution, defined as complete or near-complete resorption of the CSDH. The CSDH resolution time and serial changes of hematoma thickness were also investigated. Results : A total of 240 patients was included in the analysis consisting of 185 male and 55 female, with a median age of 74 years. During the median imaging follow-up period of 75 days, 222 patients were reached to the primary or secondary endpoint. TXA was administered as an adjunctive therapy in 41 patients (TXA group, 16.9%) while 114 patients were included in the non-TXA group (47.9%) and 85 were in the AT group. The recurrence rate was the lowest in the TXA group (2.4%), followed by non-TXA (7.0%) and AT (8.2%) groups. However, there was no statistical significance due to the small number of patients with recurrence. CSDH resolution was achieved in 206 patients, and the median estimated time to resolution was significantly faster in the TXA group (p<0.001). Adjunctive TXA administration was a significant positive factor for achieving CSDH resolution (p<0.001). The hematoma thickness was comparable among the three groups at the initial time and after surgery. However, CSDH thickness in the TXA group decreased abruptly in a month and showed a significant difference from that in the other groups (p<0.001). There was no TXA-related adverse event. Conclusion : The adjunctive use of TXA after CSDH surgery significantly facilitated the resorption of residual CSDH and resulted in the early CSDH resolution. Adjunctive TXA may be an effective treatment option to reduce recurrence by enhancing CSDH resolution in the selective patients.

인구변천 과정에서 본 한국과 스웨덴의 복지 상태 비교 (The Welfare Systems in Sweden and Korea with a Focus on the Demographic Transition)

  • 김성이
    • 한국인구학
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    • 제18권2호
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    • pp.51-69
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    • 1995
  • 이 연구는 한국사회에서 사회복지 정책을 어떻게 전개해 나가야 할 것인지에 관한 관심 속에서 선진복지국가인 스웨덴의 사회복지제도가 어떻게 발전해 나갔는지를 인구변천에 초점을 맞추어 살펴보고 있다. 먼저 스웨덴과 한국의 인구발전과정을 인구변천모형에 따라 분석하고, 인구변천 단계에 따라 사회복지가 어떻게 발전해 나왔는지를 주로 사회복지 법규를 통해 규명하고 있다. 다음 각 단계별 법규와 사회보장비 지출을 검토하여 스웨덴의 복지발달과정의 이념을 규명한 후, 한국의 사회복지정책이 어떤 방향을 나가야 할지를 제시하고 있다. 연구결과 스웨덴에 비해 한국의 사회보장비지출은 절대 부족상태이며, 스웨덴이 보편주의적 서비스를 강조하는데 비해 한국은 특수집단에 대한 서비스를 강조하고 있음이 부각되었다. 또 한국은 특수한 역사적, 문화적 요인에 의해 보훈계통의 비용이 지불되고 있다. 이 연구의 정책적 함의는 한국사회도 앞으로 소극적인 복지정책보다는 스웨덴에서 처럼 보편주의, 생산주의 및 가정복지를 바탕으로 한 복지민주주의 정책에 대한 적극적인 자세가 필요함을 제시하고 있다.

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정상산모의 질식분만 및 제왕절개술에 대한 표준진료지침서의 개발과 임상 적용 (Development and Clinical Application of Critical Pathways for Vaginal Delivery and Cesarean Section)

  • 박용원;배상욱;정영내;이혜우;김영란;홍순복;박현주;탁관철
    • 한국의료질향상학회지
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    • 제7권1호
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    • pp.32-45
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    • 2000
  • Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

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