• 제목/요약/키워드: At-risk children

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입원 아동의 낙상 위험 예측 도구 (A Pediatric Fall-Risk Assessment Tool for Hospitalized Children)

  • 신현주;김영남;김주희;손인숙;방경숙
    • Child Health Nursing Research
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    • 제20권3호
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    • pp.215-224
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    • 2014
  • 목적 본 연구는 입원 환아의 낙상위험 요인을 확인하여 낙상위험 예측도구를 개발하고 민감도와 특이도를 확인하기 위한 것이다. 방법 문헌고찰과 서울시내 1개 어린이 병원에 2006년 1월부터 2009년 8월까지 3년 8개월 동안 입원한 환아 중 낙상한 경험이 있는 환아 48명 전체와 2009년 5월 25일부터 6월 24일까지 한 달 동안 입원한 환아 중 낙상 경험이 없는 환아 149명을 비교한 자료를 바탕으로 낙상위험요인 8개를 추출하였으며, 로지스틱 회귀분석을 통해 유의한 위험요인 5개를 확인하였다. 8개 문항과 5개 문항으로 구성된 도구를 이용하여 실제 낙상을 경험한 군과 비낙상군을 비교하여 민감도, 특이도, 양성예측도, 음성예측도를 확인하였다. 결과 로지스틱 회귀분석 결과 입원 환아의 낙상 발생 위험의 유의한 예측 요인은 다음의 5가지였다. 연령은 3세 미만인 경우 3.00배, 뇌신경질환 진단이 있는 경우 2.41배, 활동 및 기능은 도움이 필요한 경우 3.18배, 신체발달은 정상인 경우에 7.09배, 위험약품 처방 수가 3개 이상인 경우 3.475배로 낙상위험이 높은 것으로 나타났다. 8개 문항의 경우 12점 이상을 고위험으로 보았을 때 민감도는 76.6%, 특이도는 30.3%였으며, 5개 문항의 경우 7점 이상을 고위험으로 보았을 때 민감도는 93.6%, 특이도는 16.2%로 나타났다. 결론 입원환아의 낙상위험예측도구로서 8개 문항과 5개 문항의 도구 모두 민감도는 높으나 특이도는 낮은 제한점을 갖고 있다. 그러나 낙상위험을 예방하기 위한 목적으로 사용됨을 감안하면 특이도는 낮지만 민감도가 높으므로 임상현장에서 사용 가능할 것으로 판단된다.

Changes in oral health knowledge and self-efficacy of parents using an application of caries management in children

  • Yeo, An-Na;Lee, Su-Young
    • 한국치위생학회지
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    • 제20권6호
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    • pp.775-786
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    • 2020
  • Objectives: The purpose of this study was to evaluate the effects that appeared to parents after conducting a dental caries management program for 12 months using a mobile application for systematic caries management of children. Methods: Parents responded to a questionnaire on oral care self-efficacy and oral health knowledge at the baseline, and received feedback on a management program suitable for their child's caries risk group for 12 months through a mobile application. At the end of 12 months, the questionnaire was re-written. Results: The self-efficacy of oral care increased in the low risk group, and oral care knowledge and program satisfaction were highest in the parents of low risk children. Conclusions: Base on the results of the this study, It was confirmed that parents' self-efficacy, knowledge, performance and satisfaction were all positively evaluated through the oral care program using a mobile application.

Prevalence of Known Risk Factors in Women Diagnosed with Breast Cancer at Inmol Hospital, Lahore, Punjab

  • Mansha, Muhammad;Saleem, Maryam;Wasim, Muhammad;Tariq, Muhammad
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.563-568
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    • 2016
  • Background: Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. Purpose: The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. Materials and Methods: A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. Results: Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (${\leq}46$) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.

소아 급성 림프모구 백혈병: 과거, 현재, 미래 (Acute lymphoblastic leukemia in children: past, present and future)

  • 강형진;신희영;안효섭
    • Clinical and Experimental Pediatrics
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    • 제50권7호
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    • pp.601-605
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    • 2007
  • The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.

Gender specific effect of major dietary patterns on the metabolic syndrome risk in Korean pre-pubertal children

  • Park, Soo Jin;Lee, Seung Min;Kim, Seon Mee;Lee, Myoungsook
    • Nutrition Research and Practice
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    • 제7권2호
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    • pp.139-145
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    • 2013
  • There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.

Environmental tobacco smoke and childhood asthma

  • Song, Dae Jin
    • Clinical and Experimental Pediatrics
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    • 제53권2호
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    • pp.121-128
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    • 2010
  • In recent years, environmental tobacco smoke (ETS) has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and worsening asthma control in children who already have the disease, even though a causal relationship with asthma onset is not yet established for asthma incidence. Mechanisms underlying these adverse effects of ETS are not clearly elucidated but e studies on this issue suggest that genetic susceptibility, impaired lung function, and augmented airway inflammation and remodeling may be involved. Children with asthma are just as likely to be exposed to ETS as children in general and there is no risk-free level of exposure. Therefore, providing a smoke-free environment may be of particular importance to the asthmatic children exposed to ETS who have adverse asthma outcomes, as well as to children with genetic susceptibility who are at increased risk of developing asthma upon exposure to ETS in early childhood.

아동용 휴대전화 중독 도구 개발 및 타당화 연구 (Development and Validation Study of a Cell Phone Addiction Scale for Korean Children)

  • 구현영;유명숙
    • Child Health Nursing Research
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    • 제18권2호
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    • pp.76-84
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    • 2012
  • Purpose: This study was done to develop a cell phone addiction scale for Korean children. Methods: The process included construction of a conceptual framework, generation of initial items, verification of content validity, selection of secondary items, preliminary study, and extraction of final items. The participants were 268 children from grades 4 to 6 in two urban elementary schools. Construct validity, internal consistence reliability, and split-half reliability were used to analyze the data. Results: Nine items were categorized into 2 factors explaining 61.29% of total variance. The factors were labeled as obsessive compulsion (6 items) and dependency (3 items). Cronbach's alpha coefficient for the 9 items was .87, and Spearman-Brown coefficient was .83. Scale scores identified children as high risk users, at risk users, or average users by standard scores. Conclusion: The above findings indicate that the cell phone addiction scale for children has good validity and reliability when used with Korean children.

Risk assessment of heavy metals in soil based on the geographic information system-Kriging technique in Anka, Nigeria

  • Johnbull, Onisoya;Abbassi, Bassim;Zytner, Richard G.
    • Environmental Engineering Research
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    • 제24권1호
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    • pp.150-158
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    • 2019
  • Soil contaminated with heavy metals from artisanal gold mining in Anka Local Government Area in Northwestern Nigeria was investigated to evaluate the human health risk as a result of heavy metals. Measured concentration of heavy metals and exposure parameters were used to estimate human carcinogenic and non-carcinogenic risk. GIS-based Kriging method was utilized to create a prediction maps of human health risks and probability maps of heavy metals concentrations exceeding their threshold limits. Hazard index calculation showed that 21 out of 23 locations are posing non-cancer risk for children. Adults and children are at high cancer risk in all locations as the total cancer risk exceeded $1{\times}10^{-6}$ (the lower limit CTR value). Kriging model showed that only a very small area in Anka has a hazard index of less than unity and cumulative target risk of less than $1{\times}10^{-4}$, indicating a significant carcinogenic and non-carcinogenic risks for children. The probability of heavy metals to exceed their threshold concentrations around the study area was also found to be high.

학령전기 아동 사고위험 지각 측정도구의 타당도 및 신뢰도 검증 (The Validity and Reliability of Injury Risk Perception in Preschool Children)

  • 김신정;강경아;김성희;김예영;이정은
    • 한국보건간호학회지
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    • 제26권2호
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    • pp.258-267
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    • 2012
  • Purpose: The purpose of this study was to examine the validity and reliability of injury risk perception in preschool children. Method: Employing a methodological research design, data were collected using questionnaires from a sample of 178 child day care center preschooler selected by convenient sampling located at Kwangwon-Do. Descriptive statistics, content analysis, and Pearson correlation coefficient were used in performance of data analysis. Results: Through conduct of validity testing, 27 items were finally selected. The internal consistency was acceptable with a Cronbach's alpha of .66 and a Guttman Split-half coefficient of .70. Conclusion: The injury risk perception scale showed adequate validity and reliability in preschool children. It can be used for assessment of injury risk and for development of injury prevention programs for preschool children.

Association of wheezing phenotypes with fractional exhaled nitric oxide in children

  • Shim, Jung Yeon
    • Clinical and Experimental Pediatrics
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    • 제57권5호
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    • pp.211-216
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    • 2014
  • Asthma comprises a heterogeneous group of disorders characterized by airway inflammation, airway obstruction, and airway hyperresponsiveness (AHR). Airway inflammation, which induces AHR and recurrence of asthma, is the main pathophysiology of asthma. The fractional exhaled nitric oxide (FeNO) level is a noninvasive, reproducible measurement of eosinophilic airway inflammation that is easy to perform in young children. As airway inflammation precedes asthma attacks and airway obstruction, elevated FeNO levels may be useful as predictive markers for risk of recurrence of asthma. This review discusses FeNO measurements among early-childhood wheezing phenotypes that have been identified in large-scale longitudinal studies. These wheezing phenotypes are classified into three to six categories based on the onset and persistence of wheezing from birth to later childhood. Each phenotype has characteristic findings for atopic sensitization, lung function, AHR, or FeNO. For example, in one birth cohort study, children with asthma and persistent wheezing at 7 years had higher FeNO levels at 4 years compared to children without wheezing, which suggested that FeNO could be a predictive marker for later development of asthma. Preschool-aged children with recurrent wheezing and stringent asthma predictive indices also had higher FeNO levels in the first 4 years of life compared to children with wheezing and loose indices or children with no wheeze, suggesting that FeNO measurements may provide an additional parameter for predicting persistent wheezing in preschool children. Additional large-scale longitudinal studies are required to establish cutoff levels for FeNO as a risk factor for persistent asthma.