• Nutrition Research and Practice
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• 제13권3호
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• pp.247-255
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• 2019

BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

• 한국보육지원학회지
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• 제14권4호
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• pp.85-108
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• 2018

Objective: This study intended to analyze parenting characteristics, difficulties and support needs of multi-cultural families that had children under 3 years old, in order to develop their supporting resources. Methods: This study performed semi-structured interviews with 7 mothers from multi-cultural families that had their young children enrolled at child care and education centers in Gyeonggi Do. The interview data transcribed were analyzed using the successive contents analysis, and led to 4 themes and 12 sub-themes. Results: First, the mothers from multi-cultural families were married without understanding the Korean language and culture. Second, the multi-cultural mothers didn't properly respond to their children's needs in interaction and language aspects. As a result, the multi-cultural support centers and child care and education centers gave help to them. Third, in the view of the difficulties facing mothers, parenting problems caused by the lack of information concerning child education, the biased burden of parenting, and the different parenting values of Korean families were all expressed by the mothers. Fourth, regarding support needs, providing individual professional support for children and child-raising support for mothers, customized language and employment support for mothers and parenting education for fathers and family education on multi-culturalism are needed. Conclusion/Implications: Suggestions for decreasing the difficulties facing multi-cultural families that had children under 3 years old were discussed.

• 한국인구학
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• 제11권1호
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• pp.1-13
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• 1988

여기서는 많은 수의 비관측사례로부터 발생할 수 있는 표본의 편의(bias) 문제를 탐구한다. 이 연구는 본래 일본 후생성이 1989년 실시한 <가족주기와 가구형태에 대한 인구학적 조사> 자료를 이용하여 노인부보와 자녀간 근접성을 분석하는 목적에서 이루어졌다. 그런데 <가족주기와 가구형태에 대한 인구학적 조사>는 노인부모를 대상으로 한 조사가 아니라 전체 가구 일반에 대한 조사이기 때문에 노인부모에 대한 많은 정보를 손상하고 있었다. 또한 본 조사는 가구주를 통하여 가족원에 대한 정보를 획득하는 방식으로 설계되었기 때문에 가족원에 대한 정보가 완전하지 못하였다. 나아가 비관측사례의 유형을 보면 여러 항목들이 동시적으로 관측되지 않고 있었다. 이와 같이 복합적 메커니즘에서 발생한 비관측 사례는 분석의 편의를 초래할 위험이 크다. 우선, 많은 수의 비관측사례로 표준오차를 잘못 추정할 소지가 크다. 더욱이 사례들이 선택적으로 관측되지 않았다면 관측된 자료에 따른 추정을 심각한 편의를 포함할 수 있다. 이와 같이 손상된 자료로부터 발생할 수 있는 추정 편의를 개선하기 위하여 여기서는 두 가지 기법을 활용하였다. 첫째, 관측치와 공변인간의 관계에 기초하여 비관측사례를 추정하는 방법으로 EM 알고리듬을 활용하였다. 둘째, 관찰의 선택성에서 비롯된 추정 편의를 개선하기 위하여 이단계(two stage) 모형을 활용하였다.

• International Journal of Computer Science & Network Security
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• 제22권8호
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• pp.222-234
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• 2022

Background: Within the framework of the new Saudi Vision 2030, the education system is keen on developing Early Childhood (EC) curricula to meet the needs of children from diverse cultural and linguistic backgrounds, in addition to preparing teachers to be the main driving forces in this field. To achieve these strategic goals, the professional development of teachers has taken the lead in terms of their continuous professional achievements. Purpose: The recent study tended to explore the promotion of Cultural and Linguistic Competence (CLC) of teachers in preschool institutions in different sectors in the Kingdom of Saudi Arabia (KSA) include public, private and international. Method: In the current study, (n=300) of preschool female teachers, who had experience teaching children from diverse language and cultural backgrounds, participated voluntarily by filling out the exploratory questionnaire. It was designed on a five-point Likert scale. The credibility of the scale and the validity of the questionnaire were ascertained, and the content for which it was designed verified in terms of the purposes of the current investigation. Results: The results revealed that preschool female teachers in the private preschool settings have a higher level of CLC compared to those who were teaching in public and international preschools in KSA. In the private sector, preschool female teachers showed create abilities to provide culturally responsive environments for diverse students, applying various communication styles, and showing proper attitudes and values toward diversity. Implication: The current study provided key implications for policy makers regarding the promotion of CLC for all teachers, particularly preschool in government settings in KSA. It contributed to revealing the cultural awareness of preschool teachers' values and attitudes toward diversity.

• 대한영양사협회학술지
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• 제19권1호
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• pp.34-45
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• 2013

This study was conducted to obtain data and offer advice regarding dietary intake at kindergarten and to recommend dietary habits to prevent childhood obesity. The study was conducted in 85 children aged 4 to 5 years. Body weight and height, dietary intakes of lunch served at Kindergarten and questionnaires for dietary behaviors in Kyeongnam area were studied. All subjects were classified by their weight-length index (WLI). According to the standard WLI values, 41.2% of the children were within the normal value ($90{\leq}$WLI<110), 23.5% of the children were overweight ($110{\leq}$WLI<120), and 35.3% of the children were obese ($WLI{\geq}120$). The mean energy intake at lunch for kindergarteners was $287.1{\pm}13.4$ kcal in the normal group, $307.6{\pm}10.2$ kcal in the overweight group and $323.7{\pm}8.6$ kcal in the obese group. The percent energy of estimated energy requirement (EER) was 21.8%. The intake of protein, iron, zinc, vitamin A, and pyridoxine were significantly different by WLI (P<0.05). A comparison of nutrients in the lunch menu provided with those of 1/3 recommended intake (RI) showed that preschoolers took in fewer calories, calcium, and vitamin $B_2$, and that their deficiency rates were high (81.2%, 76.5% and 70.6% of recommended levels, respectively). There was a significant difference in the preference of fruits and milk and dairy products by WLI. Therefore, a nutritional education program and new guidance in the proper nutrition management for kindergarteners should be developed to enhance nutritional status during childhood.

• 한국융합학회논문지
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• 제8권4호
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• pp.49-57
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• 2017

본 연구는 소아암 환아의 조혈모세포이식 후 성장을 확인하고, 이에 영향을 미치는 요인들을 조사하고자 진행된 융합연구이다. 2009년 2월부터 3월까지 조혈모세포이식을 받은 소아암 환아 112명의 의무기록으로부터 키와 몸무게를 조사하였으며 자료 분석을 위해 혼합효과 모델을 사용하였다. 연구 결과 조혈모세포이식 후 대상자의 신장과 체중의 표준과의 평균표준편차값이 음의 값이었으며 동종이식 보다 자가이식의 경우 신장(p=0.0008)과 체중(p=0.0012)의 평균이 낮았다. 이식 후 신장에 영향을 주는 것으로 대상자의 이식 시 연령(p=0.0251)과 이식 형태(p=0.0020)가 확인되었으며. 동종이식 환아에서는 성장에 영향을 주는 것으로 스테로이드의 사용량이 확인되었다(p=0.0403). 대상자의 이식 후 체중은 이식 시 연령(p=0.0042), 이식형태(p=0.0035) 그리고 총정맥영양의 주입기간(p=0.0159)에 영향을 받는 것으로 나타났다. 본 연구 결과를 바탕으로 소아암 환아의 조혈모세포이식 후 성장이 잘 이루어질 수 있도록 성장저하의 고위험군을 식별할 수 있도록 하여야하며, 이러한 환아에게 적절한 간호중재가 수행되어야 할 것이다.

• 한국학교ㆍ지역보건교육학회지
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• 제6권
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• pp.17-34
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• 2005

The purpose of this study was to examine the sex-consciousness and sexual values of school children by geographic region. It's specifically attempted to make a comparative analysis of sex-consciousness and sexual values between urban and rural elementary schoolers to help provide efficient sex education for them to build the right sexual values. The subjects in this study were 400 elementary schoolers in their sixth year of elementary schools located in Danyang-gun and Chungju city, north Chungcheong province. After a survey was conducted, answer sheets from 387 students that were analyzable were analyzed. For data handling, SPSS program was employed, and t-test was utilized to see if there's any differences between the urban and rural elementary school youngsters in sex consciousness and sexual values. And $x^2$ test was used to make a comparative analysis of their view of sex education. The findings of the study were as follows : First, regarding sex-consciousness, they had general knowledge on sex. Especially, they were highly aware of sexual violence and the generation of baby, but many of them didn't know about where and how egg cells were produced. This indicated that systematic education should be offered in various ways. Concerning geographic gap, there was a significant difference in sexual knowledge between the urban and rural students. As to sexual attitude, they took a relatively positive attitude toward display of affection or sex-related talk on TV or in movies, as they viewed it as natural. This finding implied that the elementary schoolers were recipient toward sex and took an active attitude toward sexual expressions. Concerning geographic gap, there was no difference between the rural and urban students. As for sexual practices, the largest group of the students had a liking for the opposite sex, which showed that their needs for sex were unveiled in the course of having some trouble due to the other sex rather than through firsthand experiences or activities. As to geographic gap, there was a significant difference between the urban and rural students in that regard. Besides, the urban students put their sex-consciousness in practice more often than the rural students did. After they are educated to build the right sexual values, systematic sex-education programs should also be offered for them to be exposed to sustained sex education and to team how to apply their sex-consciousness to real life. Second, as for sexual values, the school children had relatively positive and equalitarian sexual values. Regarding geographic gap, there were significant gaps between the two groups' view of the opposite sex, sexual roles and chastity. Concerning view of the opposite sex, they attached more importance to the inner aspects of the opposite sex than his or her look, and they wanted to date in a natural manner. Regarding sexual roles, they were relatively well cognizant of gender equity and the importance of male and female roles. As to view of chastity, they looked upon sex as natural, not as what's ugly or ashamed of. Third, concerning their outlook on sex education, approximately more than half the students felt the needs for sex education, and there was a significant difference between the urban and rural students. They wanted to receive education about the prevention of sexual violence and physical changes during puberty the most, and there was a significant gap between the urban and rural students in this aspect. As to the time for sex education, they thought that students should start to be exposed to sex education in their fifth or sixth year. This finding signified that fifth or sixth graders who were in the beginning of puberty started to have a lot of interest in their own physical changes. Therefore, sex education would produce better effects when it's provided to fifth or sixth graders. Nearly half them preferred single-gender class when they received sex education, and there's no gap between the urban and rural students in that regard.

• Neonatal Medicine
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• 제25권3호
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• pp.102-108
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• 2018

Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

• 한국전문물리치료학회지
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• 제24권1호
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• pp.41-50
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• 2017

Background: The Pediatric Balance Scale (PBS) was developed to assess of balance ability in children with balance problem. The PBS was translated into Korean and its reliability had been studied. However, it had need to be verified using psychometric characteristics including item fit and rating scale. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of PBS using Rasch analysis. Methods: In total, 40 children with cerebral palsy (CP) (boy=17, girl=23) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS was performed, and was verified regarding the item fit, item difficulty, rating scale, and separation index and reliability using Rasch analysis. Results: In this study, the 'transfer', and 'turning to look behind left and right shoulders while standing still' item showed misfit statistics. in total 40 children with CP. Also, 'transfer', 'standing unsupported with feet together' and 'standing with one foot in front' items showed misfit statistics in diplegia CP group. Regardless of the classification of CP, the most difficult item was 'standing on one foot', whereas the easiest item was 'sitting with back unsupported and feet supported on the floor'. The 4 rating scale categories of PBS were acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. Conclusion: The PBS has been proven reliable, valid and is an appropriate tool, but it needs to modify the items of PBS according to CP classification.

• Korean Journal of Radiology
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• 제19권6호
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• pp.1031-1041
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• 2018

Objective: To compare image quality and radiation dose of high-pitch dual-source spiral cardiothoracic computed tomography (CT) between non-electrocardiography (ECG)-synchronized and prospectively ECG-triggered data acquisitions in young children with congenital heart disease. Materials and Methods: Eighty-six children (${\leq}3$ years) with congenital heart disease who underwent high-pitch dual-source spiral cardiothoracic CT were included in this retrospective study. They were divided into two groups (n = 43 for each; group 1 with non-ECG-synchronization and group 2 with prospective ECG triggering). Patient-related parameters, radiation dose, and image quality were compared between the two groups. Results: There were no significant differences in patient-related parameters including age, cross-sectional area, body density, and water-equivalent area between the two groups (p > 0.05). Regarding radiation dose parameters, only volume CT dose index values were significantly different between group 1 ($1.13{\pm}0.09mGy$) and group 2 ($1.07{\pm}0.12mGy$, p < 0.02). Among image quality parameters, significantly higher image noise ($3.8{\pm}0.7$ Hounsfield units [HU] vs. $3.3{\pm}0.6HU$, p < 0.001), significantly lower signal-to-noise ratio ($105.0{\pm}28.9$ vs. $134.1{\pm}44.4$, p = 0.001) and contrast-to-noise ratio ($84.5{\pm}27.2$ vs. $110.1{\pm}43.2$, p = 0.002), and significantly less diaphragm motion artifacts ($3.8{\pm}0.5$ vs. $3.7{\pm}0.4$, p < 0.04) were found in group 1 compared with group 2. Image quality grades of cardiac structures, coronary arteries, ascending aorta, pulmonary trunk, lung markings, and chest wall showed no significant difference between groups (p > 0.05). Conclusion: In high-pitch dual-source spiral pediatric cardiothoracic CT, additional ECG triggering does not substantially reduce motion artifacts in young children with congenital heart disease.