• Title/Summary/Keyword: Adherence

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When Changes Don\`t Make Changes: Insights from Korean and the U.S Elementary Mathematics Classrooms (변화가 변화를 일으키지 못할 때: 한국과 미국 초등수학 수업 관찰로부터의 소고)

  • 방정숙
    • Education of Primary School Mathematics
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    • v.4 no.2
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    • pp.111-125
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    • 2000
  • This paper presents cross-national perspectives on challenges in implementing current mathematics education reform ideals. This paper includes detailed qualitative descriptions of mathematics instruction from unevenly successful second-grade classrooms both in Koran and in the U. S with regared to reform recommendations. Despits dramatic differences in mathematics achivement between Korean and the U.S student. problems in both countries with regard to mathematics education are perceived to be very similar. The shared problems have a common origin in teacher-centered instruction. Educational leaders in both countries have persistently attempted to change the teacher-centered pedagogy to a student-centered approach. Many teachers report familiarity with and adherence to reform ideas, but their actual classroom teaching practices do not reflect the full implications of the reform ideals. Given the challenges in implementing reform, this study explored the breakdown that may occur between teachers adoption of reform objectives and their successful incorporation of reform ideals by comparing and contrasting two reform-oriented classrooms in both countries. This comparison and contrast provided a unique opportunity to reflect on possible subtle but crucial issues with regard to reform implementation. Thus, this study departed from past international comparisons in which the common objective has been to compare general social norma of typical mathematics classes across countries. This study was and exploratory, qualitative, comparative case study using grounded theory methodology based on constant comparative analysis for which the primary data sources were classroom video recordings and transcripts. The Korean portion of this study was conducted by the team of four researchers, including the author. The U.S portion of this study and a brief joint analysis were conducted by the author. This study compared and contrasted the classroom general social norms and sociomathematical norms of two Korean and two U.S second-grade teachers who aspired to implement reform. The two classrooms in each country were chosen because of their unequal success in activating the reform recommendation. Four mathematics lessons were videotaped from Korean classes, whereas fourteen lessons were videotaped from the U.S. classes. Intensive interviews were conducted with each teacher. The two classes within each country established similar participation patterns but very different sociomathematical norms. In both classes open-ended questioning, collaborative group work, and students own problem solving constituted the primary modes of classroom participation. However in one class mathematical significance was constituted as using standard algorithm with accuracy, whereas the other established a focus on providing reasonable and convincing arguments. Given these different mathematical foci, the students in the latter class had more opportunities to develop conceptual understanding than their counterparts. The similarities and differences to between the two teaching practices within each country clearly show that students learning opportunities do not arise social norms of a classroom community. Instead, they are closely related to its sociomathematical norms. Thus this study suggests that reform efforts highlight the importance of sociomathematical norms that established in the classroom microculture. This study also provides a more caution for the Korean reform movement than for its U.S. counterpart.

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Management of Diabetic Mellitus in Low-income Rural Patients (일개 농촌지역 저소득층 당뇨병환자의 관리 상태)

  • Kim, Hye-Yeon;Yun, Woo-Jun;Shin, Min-Ho;Kweon, Sun-Seong;Ahn, Hye-Ran;Choi, Seong-Woo;Lee, Young-Hoon;Cho, Dong-Hyeok;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.5
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    • pp.315-322
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    • 2009
  • Objectives : Knowledge about the management status of diabetic melitus (DM) is essential to improve diabetic management. Moreover, low income is associated with poor adherence to treatment and increased mortality. This study was performed to evaluate the management status of DM in low-income patients in a rural area. Methods : We enrolled 370 patients with type 2 DM living in Gokseong county, JeollaNamdo. A well-trained examiner measured the height, weight, waist circumference, blood pressure, total cholesterol, triglyceride, high density lipoprotein cholesterol, fasting blood sugar and glycosylated hemoglobin (HbA1c) levels. Carotid ultrasonography was used to measure carotid artery carotid artery intima media thickness (IMT) and plaque. anklebrachial index (ABI) was used to evaluate peripheral artery disease. A fundoscopic examination was performed to evaluate diabetic retinopathy. A history of diabetes complications and health-related questionnaires were also completed. Results : The age of diabetic subjects was 68.7$\pm$8.7 years and the duration of diabetes was 8.9$\pm$8.2 years. Most (63.5%) had hypertension, and 45.7% had triglycerides below 150 mg/dl, 38.1% had low density lipoprotein cholesterol (LDL) cholesterol below 100 mg/dl, 48.7% had urine albumin to creatinine ratio (UACR) below 30 mg/g. Less than half (45.9%) achieved the goal of HbA1c less than 7% suggested by the American Diabetes Association (ADA). 10.6% had peripheral vascular disease, 11.9% had retinopathy, and 60.8% had chronic kidney disease. Conclusions : DM management in low income patients is very poor and requires further work to improve.

Probiotic Potential of Indigenous Bacillus sp. BCNU 9028 Isolated from Meju (메주로부터 분리한 토착 Bacillus sp. BCNU 9028의 프로바이오틱스로서 이용 가능성)

  • Shin, Hwa-Jin;Bang, Ji-Hun;Choi, Hye-Jung;Kim, Dong-Wan;Ahn, Cheol-Soo;Jeong, Young-Kee;Joo, Woo-Hong
    • Journal of Life Science
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    • v.22 no.5
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    • pp.605-612
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    • 2012
  • Spore-forming bacteria are being used as probiotic supplements for human and animal use, due to their low pH stability and ability to survive the gastric barrier. In this study, the BCNU 9028 strain was screened from meju, a Korean fermented soybean food starter. Biochemical and physiological characteristics, as well as 16S rDNA sequence analyses, indicate that this strain belongs to the genus $Bacillus$. $Bacillus$ sp. BCNU 9028 showed a 92% survivability at pH 2.5 and could also withstand 0.3% ox bile. Furthermore, it was postulated that $Bacillus$ sp. BCNU 9028 could prevent biofilm formation and adherence of food-borne pathogens such as $Listeria$ $monocytogenes$, $S.$ $aureus$ and $E.$ $coli$ on the basis of its autoaggregation and coaggregation capacity with food-borne pathogens. It was shown that BCNU 9028 has good abilities to adhere to the intestinal tract from its hydrophobic character (63.3%). The $Bacillus$ sp. BCNU 9028 strain especially elicited antibacterial activity against both Gram-positive and -negative pathogens. These findings suggested that the $Bacillus$ sp. BCNU 9028 strain could be used as a potential probiotic.

Socio-economic Status Plays Important Roles in Childhood Cancer Treatment Outcome in Indonesia

  • Mostert, Saskia;Gunawan, Stefanus;Wolters, Emma;van de Ven, Peter;Sitaresmi, Mei;van Dongen, Josephine;Veerman, Anjo;Mantik, Max;Kaspers, Gertjan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6491-6496
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    • 2012
  • Background: The influence of parental socio-economic status on childhood cancer treatment outcome in low-income countries has not been sufficiently investigated. Our study examined this influence and explored parental experiences during cancer treatment of their children in an Indonesian academic hospital. Materials and Methods: Medical charts of 145 children diagnosed with cancer between 1999 and 2009 were reviewed retrospectively. From October 2011 until January 2012, 40 caretakers were interviewed using semi-structured questionnaires. Results: Of all patients, 48% abandoned treatment, 34% experienced death, 9% had progressive/relapsed disease, and 9% overall event-free survival. Prosperous patients had better treatment outcome than poor patients (P<0.0001). Odds-ratio for treatment abandonment was 3.3 (95%CI: 1.4-8.1, p=0.006) for poor versus prosperous patients. Parents often believed that their child's health was beyond doctor control and determined by luck, fate or God (55%). Causes of cancer were thought to be destiny (35%) or God's punishment (23%). Alternative treatment could (18%) or might (50%) cure cancer. Most parents (95%) would like more information about cancer and treatment. More contact with doctors was desired (98%). Income decreased during treatment (55%). Parents lost employment (48% fathers, 10% mothers), most of whom stated this loss was caused by their child's cancer (84% fathers, 100% mothers). Loss of income led to financial difficulties (63%) and debts (55%). Conclusions: Treatment abandonment was most important reason for treatment failure. Treatment outcome was determined by parental socio-economic status. Childhood cancer survival could improve if financial constraints and provision of information and guidance are better addressed.

Antitumor Effect of Schizandrin by Inhibiting Angiogenesis (Schizandrin의 신혈관형성억제에 의한 항암효과)

  • Yoon, Mi So;Kim, Do Yoon;Yu, Ho Jin;Park, Joo-Hoon;Jang, Sang Hee;Won, Kyung-Jong;Kim, Bokyung;Lee, Hwan Myung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.687-692
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    • 2012
  • Schizandra chinensis extract has been known to possess a variety of efficacy including antitumor. However, it remains unclear how schizandrin, which is a major biological active ingredient of Schizandra chinensis, exerts antitumor effect. This study was designed to investigate the mechanism by which schizandrin inhibits tumor growth and metastasis. In in vivo test using tumor model mice injected with B16BL6 cell line, mice treated with 10 and 100 ${\mu}g/ml$ schizandrin showed a significant inhibition by $73.79{\pm}6.43%$ and $90.46{\pm}1.72%$, respectively, compared with positive tumor controls. Schizandrin did not exert a significant toxicity for the normal cells (HUVECs) and tumor cell lines (A549, B16BL6, Du145, Huh7). Treatment with schizandrin at 10 and 100 ${\mu}g$/head significantly inhibited the tumor-induced angiogenesis by $68.04{\pm}32.21%$ and $103.8{\pm}34.99%$ compared with the positive control group, respectively. Using in vivo lung metastasis model, tumor metastasis assay revealed that 10 and 100 ${\mu}g$/head schizandrin significantly decreased the metastatic lung tumor by $37.51{\pm}8.15%$ and $75.53{\pm}4.38%$ compared with positive controls, respectively. On the other hand, schizandrin did not affect the adherence of B16BL6 cell line to extracellular matrix protein. These results demonstrate that schizandrin exerts inhibitory effect on tumor growth and metastasis by inhibiting angiogenesis. This study thus suggest that schizandrin may be a candidate molecule target for cancer drug development.

Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
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    • v.38 no.11 s.256
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    • pp.746-760
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    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Biocompatibility of porous hydroxyapatite ceramics prepared from bovine bones (소 뼈로부터 제조한 다공형 하이드록시아파타이트 세라믹스의 생체친화 특성)

  • Lee, Jong-Kook;Ko, Young-Hwa;Lee, Nan-Hee
    • Journal of the Korean Crystal Growth and Crystal Technology
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    • v.22 no.3
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    • pp.139-146
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    • 2012
  • Natural hydroxyapatite powder was obtained from the calcination of bovine bones and its porous compacts were fabricated by pressureless sintering at 1100 and $1200^{\circ}C$ for 1h. To evaluate and compare their biocompatibility with porosity, we investigated the support of osteoblast cells growth and cytotoxicity using the MG-63 cell line model in vitro. Sintered hydroxyapatite ceramics have a porous microstructure with a relative density of 65 % at $1100^{\circ}C$ and 82 % at $1200^{\circ}C$. Cells adherence to the surface of hydroxyapatite ceramics was observed in a day after the cell culture, and the spreading of cytoplasm around the nucleus was shown after 3 day cell culture. Most of cells were extended to the surface of hydroxyapatite through the wide area. Cell viability was nearly the same till 3 days culturing. But the rate of cell growth is higher in the specimen sintered at $1100^{\circ}C$ than that of $1200^{\circ}C$. It indicates that the porosity is an important factor to enhance the cell viability in the porous hydroxyapatite ceramics derived from bovine bones.

INHIBITION OF GLUCAN SYNTHESIS RELATED GENE EXPRESSION OF STREPTOCOCCUS MUTANS BY XYLITOL TREATMENT (자일리톨 섭취에 따른 Streptococcus mutans의 글루칸 생성관련 유전자 발현 억제효과)

  • Kim, Ji-Hye;Lee, Young-Eun;Ahn, Sang-Hun;Choi, Youn-Hee;Nam, Soon-Heyun;Song, Keun-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.36 no.4
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    • pp.531-538
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    • 2009
  • Xylitol has the ability to reduce the adherence of Streptococcus mutans(S. mutans), which can make it easier to remove plaque, decrease acid production and inhibit dental caries. There are few reports on the effects of xylitol on the expression of the virulence related genes in S. mutans. This study examined the inhibitory effect of chewing gum containing xylitol on glucan synthesis related gene expression of S. mutans. Participants were voluntarily recruited for a women's oral health prevention program, classified into two groups(a control and a xylitol group), and then followed for 2 years. Twenty salivary samples were randomly selected from each group. Colony count and real-time reverse transcription polymerase chain reaction were used to analyze the characteristics of S. mutans. The following results were obtained: The S. mutans counts decreased steadily in the xylitol group over the study period(p<0.05). The expression of the virulence related genes (gtfB, gtfC and gtfD) was significantly lower in the xylitol group than in the control groups (p<0.05). In conclusion, these results suggest that chewing xylitol gum for a long period of time may reduce the expression of the genes associated with S. mutans virulence, which can result in a decrease growth of S. mutans colonies as a result.

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Study Protocol for the Most Effective Recall Method in a Cervical Cancer Screening Program in Klang, Malaysia

  • Rashid, Rima Marhayu Abdul;Dahlui, Maznah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5867-5870
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    • 2013
  • Background: Cervical cancer is the second most common cancer among Malaysian women with an ASR of 17.9 and a mortality rate of 5.6 per 100,000 population in 2008 (GLOBOCAN, 2008). The 5 year prevalence was estimated to be 14.5 per 100,000 population. As the second most common cancer affecting productive females, cervical cancer imposes an impact to the socioeconomic aspect of the country. However, the poor uptake of cervical cancer screening is a major problem in detecting early pre-cancerous lesions and thus, delay in initiating treatment for cervical cancer. Realizing the urgency to increase the uptake of PAP smear, besides enhancing the promotion of PAP smear screening for women above 35 years old, the call-recall system for pap smear screening had been piloted in one of the suburban districts which aimed to improve regular participation of women for cervical and breast cancer screening. This is of public health importance as identifying the best feasible option to increase patient's respond to participate in the screening program effectively in our setting will be helpful in implementing an organized regular population based screening program tailored to our setting. The pilot program of cervical cancer screening in Klang was an opportunity to assess different options in recalling patients for a repeat pap smear to increase their participation and adherence to the program. Methods and Results: This was a population based randomized control trial. Women aged 20-65 years in the population that matched the inclusion and exclusion criteria were re-called for a repeat smear. There are four different intervention groups; letter, registered letters, short messages services (SMS) and phone calls where 250 subjects were recruited into each group. Samples were generated randomly from the same population in Klang into four different groups. The first group received a recall letter for a repeat smear similar to the one that has been given during the first invitation. The intervention groups were either be given a registered letter, an SMS or a phone call to re-call them. The socio-demographic data of the patients who came for uptake were collected for further analysis. All the groups were followed up after 8 weeks to assess their compliance to the recall. Conclusions: The study will provide recommendations about the most effective methods for recall in a population based pap smear screening program on two outcomes: i) patients response; ii) uptake for repeat pap smear.

Interpretation of Estoppel Doctrine in the Letter of Credit Transaction : Comparison between UCP 500 and 95 UCC (신용장거래(信用狀去來)에서의 금반언법리(禁反言法理)에 관한 해석(解釋) - UCP 500 제13조, 제14조와 95 UCC 제5-108조의 비교를 중심으로 -)

  • Kim, Young-Hoon
    • THE INTERNATIONAL COMMERCE & LAW REVIEW
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    • v.12
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    • pp.429-460
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    • 1999
  • The letter of credit is quintessentially international. In the absence of international legal system, a private system based on banking practices has evolved, commanding the adherence of the international letter of credit community and providing the foundation of th reputation of this instrument. To maintain this international system, it is vital that international standard banking practice should not be subject to local interpretations that misconstrue or distort it. The UCP is a formulation of international standard banking practice. It is neither positive law nor a "contract term" in any traditional sense and its interpretation must be consonant with its character as a living repositary of international understanding in this field. As a result, the interpretation and application of specific articles of the UCP must be consistent with its evolving character and history and with the principles upon which sound letter of credit practice is predicated. This study, especially, focuses on article 13 and article 14 of the UCP500. Article 13(b) of UCP500 stipulates that banks will have a reasonable time, not to exceed seven days, to examine documents to determine whether they comply facially with the terms of the credit. The seven-day provision is not designed as a safe harbor, because the rule requires the issuer to act within a reasonable time. But, by virtue of the deletion of the preclusion rule in the document examination article in UCP500, however, seven days may evolve as something of a safe harbor, especially for banks that engage in strategic behavior. True, under UCP500 banks are supposed to examine documents within a reasonable time, but there are no consequences in UCP500 for a bank's violation of that duty. It is only in the next provision. Courts might read the preclusion more broadly than the literal reading mentioned here or might fashion a common-law preclusion rule that does not require a showing of detriment. Absent that kind of development, the change in the preclusion rule could have adverse effects on the beneficiary. The penalty, strict estoppel or strict preclusion, under UCP500 and 95UCC differs from the classic estoppel. The classic estoppel rule requires a beneficiary to show three elements. 1. conduct on the part of the issuer that leads the beneficiary to believe that nonconforming documents do conform; 2. reasonable reliance by the beneficiary; and 3. detriment from that reliance. But stict preclusion rule needs not detrimental reliance. This strict estoppel rule is quite strict, and some see it as a fitting pro-beneficiary rule to counterbalance the usually pro-issuer rule of strict compliance.

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