Child is a being and provides the genetic continuity of parents and society, and therefore the fitness of these children for survival, growth and development towards reproduction, is of significance to parents and society. The aim of health care for high-risk children is not only to minimize or eliminate health problems, but also to optimize their fitness. Considering that the health care of children is influenced by available resources of parents and society, and sociocultural values and paradigms in a given environment of evolutionary adaptedness (EEA), child health care professionals need to understand factors affecting the optimal fitness of children with risks. This paper introduces a new integrated theory for health care in high-risk children, entitled, Health for Optimal Fitness of High-Risk Children. Five main components were identified with associate concepts or midrange theories affecting heath for optimal fitness of high-risk children; EEA, optimal fitness, health problems, investment resources, and anthropological values. It may provide an integrated perspective on health of high-risk children in both the proximately biomedical approach and ultimately evolutionary approach as optimizing their fitness. Further study is needed to develop substantial statements between components with existential examples.
Journal of The Korean Society of Inherited Metabolic disease
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v.17
no.2
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pp.63-68
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2017
Gaucher disease (GD) is caused by the deficiency of glucocerebrosidase. In pediatric patients with GD, especially Type I GD, enzyme replacement therapy (ERT) can reduce the hepatosplenomegaly and improve the hematologic finding and growth velocity. Herein, we report a 2-year-old girl with Type I GD presented with hepatosplenomegaly, bone pain and growth retardation. A 2 year-old-girl was referred to our hospital due to severe hepatosplenomegaly and growth retardation. She suffered from both leg pain and chronic fatigue. Simple x-ray showed widened distal long bones like that of an 'Erlenmeyer flask' which is associated with GD. The laboratory test showed anemia and thrombocytopenia. The enzyme activity was markedly reduced and the direct sequencing of the GBA gene showed the compound heterozygous mutations, p.G46E and p.L444P. As the G46E have been considered as the protective gene against neuronopathic genotype, we could assess the Type I GD in this patient. After one year of ERT, the growth velocity became 11 cm per year. Bone pain and fatigue disappeared. The volume of liver and spleen was reduced from $683cm^3$ and $703cm^3$ to $590cm^3$ and $235cm^3$, respectively. Although GD is an extremely rare disease in Korea, growth retardation and bone pain in children are the important signs which lead to early detection of GD and a simple radiologic finding is helpful to assess the GD at outpatient clinic. We highlight that the early diagnosis and early ERT is important for good growth and outcome for pediatric patients with GD.
Park, Ok-Jin;Lee, Min-June;Kim, Ji-Hyang;Min, Sung-Hee;Lee, Hyun-Sook
Korean Journal of Community Nutrition
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v.14
no.6
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pp.767-776
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2009
This study evaluated the effect of nutritional improvement of 0~5 year children of financially poor families after nutrition supplement of children and nutrition education in parents/guardians. The subject selected among applicants for low-income family financing of the government included 198 children (0~12 months:92, 1~5 years:106), and the average ages were 5.3 months and 2.4 years respectively. Food that includes each nutrient factor was provided to the subject for six months. Nutrition education was performed in two ways, through class and private education, once a month for both. Nutritional improvement was evaluated by body measurement and anemia prevalence rate. As to the survey on breast-feeding, complete breast-feeding accounted for 58.7%, weaning food 27.3%, and combined feeding 14.1% respectively, which shows that breast-feeding accounted for the largest percentage. The education program improved knowledge and attitude of the parents/guardians, which brings in positive effects on growth of children as well. The nutrition knowledge score was improved after nutrition education in 0~12 month children $(8.5\pm1.75\;to\;8.9\pm1.69)$ and 1~5 year children $(7.3\pm1.39\;to\;7.8\pm1.30)$. The nutrition attitude score was significantly improved in 0~12month children $(52.0\pm6.99$ to $53.5\pm5.21$, p < 0.001) and 1~5year children ($45.1\pm7.30$ to $49.0\pm5.96$, p < 0.001). In evaluation on nutritional improvement based on body measurements, it turned out that the wasting was reduced as for children in consideration of the height and weight according to the subject's age. The concentration of hemoglobin after the nutrient treatment for six months was significantly improved, and the anemia prevalence rate as well was reduced from 40.6% to 13.5%, which indicates the significant improvement. Based on the findings above, it turned out that providing quality food to children and nutrition education to the parents/guardians poorly fed in low-income families improved knowledge and attitude of the guardians and prevents anemia and improves growth, which brings in positive effects on growth of children. In the results regarding attitude and knowledge on nutrient/dietary life; however, the improvement level was relatively low when the extent before the education was too small, which indicates the need to revise and complement the contents and methods. In addition, as shown in the result of body measurement, long-term and consistent investigation is necessary since it is difficult to judge the effect on growth only based on short-term nutrient supplement.
Objectives Sleep is closely related to children's and adolescent's growth. The purpose of this cross-sectional study is to examine the frequency of symptoms associated with sleep in childhood and adolescence and the impact in their growth. Methods This study had used questionnaire targeting 1001 children and adolescents. 532 of them were visited the Department of Pediatrics, the Oriental Medicine Hospital of ${\bigcirc}{\bigcirc}$University located in Dongdaemun-gu, Seoul, during the period between May and September in 2012. 469 of them were students in the lower grades at ${\bigcirc}{\bigcirc}$Elementary School located in Gangnam-gu, Seoul, during June, 2012. We used PASW Statistics 18.0 to analyze the relation between growth and symptoms associated with sleep by using Independent samples t-test, one-way ANOVA, and ANCOVA. Results As the result of this research, snoring(54.9%), sleep bruxism(34.2%), sleep talking(31.5%), sleep terror(17.1%) were most frequently seen as symptoms associated with sleep. Group of habitual snoring($p=0.008^{**}$) and sleep terror($p=0.016^*$) had lower height percentile than other groups. Groups with sleep talking($p=0.022^*$) had lower weight percentile than group without sleep talking. Groups with sleep talking($p=0.018^*$) or sleep walking($p=0.045^*$) had lower BMI percentile, and group with habitual sleep apnea($p=0.039^*$) had higher BMI percentile. Conclusions Symptoms during sleep such as snoring, sleep bruxism, sleep talking, and sleep terror occur frequently among children and adolescents. More importantly, snoring, sleep terror, and sleep talking may be associated with growth of children and adolescents.
This study was conducted to examine the effects of physical activity programs on young children's body composition, physical fitness, blood lipids, and growth-related factors. Fourteen young male child subjects participated in this study. Experimental groups were divided into a young obese children group (OG; n=7) and a young normal weight children group (NG; n=7). The subjects performed supervised physical activity programs with moderate intensity for 12 weeks, 40 minutes per session, 3 times per week. The results of this study are as follows: HDL-C, growth hormone, and IGF-I were significantly increased in NG, but OG was showed no changes. Physical fitness was significantly increased in both NG and OG. This study demonstrated that physical activity programs have a positive effect on the prevention of obesity, as well as a positive effect on growth and development in young normal weight children. However, long-term follow-up studies are necessary to clarify the additive effect of exercise program with behavior modification in young obese children.
Transactions of the Korean Society of Mechanical Engineers A
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v.28
no.10
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pp.1451-1457
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2004
Bone density parameters of children, unlike that of adult, might reflect growth effect along longitudinal direction as well as bone mass. The clinical test was performed for 859 male/female children with age 6-16 years. Ultrasonic imaging system was used to measure bone density, and relationship of bone density to age was evaluated. The bone quality index appeared to be highly correlated with age for male/female children. It was found that bone quality index rose rapidly in the first growth period. The bone quality index was then kept almost unchanged in the period of puberty, and slowly rose after puberty. It was also found that growth of female stopped earlier than that of male. Also, if more clinical examinations are performed by applying various sizes of region of interest, relationship between bone density and age is expected to be more reliable.
Journal of Korean Academy of Fundamentals of Nursing
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v.19
no.4
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pp.493-502
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2012
Purpose: The purpose of this study was to identify the influence of hope, core beliefs, and social support on the posttraumatic growth of mothers with chronically ill children. Methods: In this study, 94 mothers who gave written consent completed the questionnaires between July 21 and July 31, 2012 when they visited a university hospital in Seoul, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression. Results: Hope, core belief and social support had positive correlations with posttraumatic growth. Models including these variables explained 64.8% (F=55.276, p<.001) of the variance for posttraumatic growth. Hope (${\beta}$=.441, p<.001) was the most influential factor. Conclusion: The findings demonstrate that it is essential for nurses to mediate and facilitate posttraumatic growth of mothers caring for chronically ill children. Furthermore, there is an need to develop and implement new strategies in clinical practice that will result in improvements in posttraumatic growth.
Stunting, a condition characterized by impaired growth and development in children, remains a major public health concern worldwide. Over the past decade, emerging evidence has shed light on the potential role of gut microbiota modulation in stunting. Gut microbiota dysbiosis has been linked to impaired nutrient absorption, chronic inflammation, altered short-chain fatty acid production, and perturbed hormonal and signaling pathways, all of which may hinder optimal growth in children. This review aims to provide a comprehensive analysis of existing research exploring the bidirectional relationship between stunting and the gut microbiota. Although stunting can alter the gut microbial community, microbiota dysbiosis may exacerbate it, forming a vicious cycle that sustains the condition. The need for effective preventive and therapeutic strategies targeting the gut microbiota to combat stunting is also discussed. Nutritional interventions, probiotics, and prebiotics are among the most promising approaches to modulate the gut microbiota and potentially ameliorate stunting outcomes. Ultimately, a better understanding of the gut microbiota-stunting nexus is vital for guiding evidence-based interventions that can improve the growth and development trajectory of children worldwide, making substantial strides toward reducing the burden of stunting in vulnerable populations.
Growth retardation is a common consequenc of chronic kidney disease (CKD) in childhood. Many recent clinical and experimental data indicate that growth failure in CKD is mainly due to a relative GH insensitivity and functional IGF-I deficiency. Glucocorticoids also glucocorticoids interfere with the integrity of the somatotropic hormone axis at various levels. Over the past 10 years, recombinant growth hormone (rhGH) has been used to help short children with chronic kidney disease. A GH dosage of 0.35 mg/kg/week (28 IU/$m^2$/week) appears efficient and safe. Some clinical trial data show that final height will be within the normal target height range when GH treatment is continued for many years without remarkable adverse events.
The purpose of this study was to identify therapeutic play need and the degree of the nurses's therapeutic play performances perceived by hospitalized children's mothers, and then to compare the difference between the degree of the need and perceived performances. The subjects of this study consist of 121 hospitalized children's mothers. A questionaire for this study was 29 item likert type 4 point scale developed on the basis of literature review, hospitalized children's mother interview and researcher's clinical experiences. Data was analyzed by Paired t-test, t-test, ANOVA & Duncan's comparison. Results of this study are summarized as follows : 1. The degree of the therapeutic play need was measured to be high (3.20). The degree of perceived therapeutic play need by five components were followed as : physiologic suffering relief & enhancing play (3.39), growth & development facilitating play (3.26), instructional play (3.24), emotional well-being promoting play (3.18) and providing play tool & environment(2.97). 2.The degree of the nurse's therapeutic play performances perceived by mothers was measured to be low (1.60). The degree of perceived performances of the therapeutic play by the five components were followed as : physiologic suffering relief & enhancing play (1.87), instructional play (1.74), emotional well-being promoting play (1.64), providing play tool & environment (1.44) and growth&development facilitating play (1.42). 3. The difference between the degree of the therapeutic play need and nurese's perfor- mances perceived by hospitalized children's mothers were significant statistically (t= 38.54, p=.0001). Also, five components of therapeutic play were significant statistically (p=.0001). Therapeutic play has unique benefits among health care intervention for children. These findings will help in building of the theoretical framework of therapeutic play and enhancing the quality of nursing care for hospitalized children. Therapeutic play program for hospitalized children according to child growth & development and physiologic status are recommended to be developed.
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