• Title/Summary/Keyword: Behavior intervention

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Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Evaluation of the Nutrition Status and Metabolic Syndrome Prevalence of the Members according to the Number of Household Members based on the Korea National Health and Nutrition Examination Survey (2013-2014) (국민건강영양조사(2013-2014년) 자료에 근거한 가구원수별 구성원의 영양상태 및 대사증후군 유병율 평가)

  • Lee, Jin-Young;Choi, Soo-Kyong;Seo, Jung-Sook
    • Korean Journal of Community Nutrition
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    • v.24 no.3
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    • pp.232-244
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    • 2019
  • Objectives: This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013~2014 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: A total of 6,088 persons aged 19 years and over participated in 2013~2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects. Results: As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001). Conclusions: These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people's dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

The Effect of Teacher Support Program for the Integration of Handicapped Children on Teaching Efficacy of Daycare Center Teachers (장애 유아 통합보육을 위한 교사 지원이 어린이집 교사의 교사 효능감에 미치는 영향)

  • Park, Na Ri
    • Korean Journal of Child Education & Care
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    • v.18 no.4
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    • pp.247-265
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    • 2018
  • Objective: The purpose of this study was to investigate the effect of teacher support program for integration of handicapped children on teaching efficacy of daycare center teachers. Methods: In the study, 12 day care teachers in 4 day care centers in Seoul and Gyeonggi area were selected as experimental groups and 12 teachers in 5 day care centers were selected as control group. Teacher education is carried out through group education, such as understanding of developmental area, curriculum modification, activity-based embedded intervention, cooperative learning, direct teaching, disability understanding education, behavior support, family support. Individual teacher education provided counseling on the reality of child care for children with disabilities that reflects the needs of teachers for integrated child care for handicapped children. Teacher's Efficacy in Inclusive Practices (TEIP) was used as a pre post test to measure teacher's efficacy change. In order to analyze the results of the study, two independent sample t tests were conducted on the difference between pre-post test of teacher efficacy between the two groups. Results: As a result, There was a significant difference in the pre-post change of teacher efficacy between the two groups. Conclusion/Implications: The results of this study are as follows, teacher support program provided immediate feedback in integrated child daycare center for the handicapped children, child care teachers improved their integrated handicapped children care expertise, provided responsive teacher support program to the actual needs of the site, teacher support program reflected various variables related to integration, and emphasized the cooperative relationship between researcher and child daycare center teacher. The results of this study can be used as actual data of field where lack of support for the integration of handicapped children is lacking.

The Effect of Exercise Intensity on Changes in Neuronal Nitric Oxide Synthase Expression in the Hippocampus and Cerebral Cortex of Obese Mice (고지방식이로 유도된 비만 마우스의 해마 및 대뇌피질에서 운동강도에 따른 nNOS 발현의 변화)

  • Baek, Kyung-Wan
    • Journal of Life Science
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    • v.29 no.1
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    • pp.18-28
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    • 2019
  • Recent studies reported that obesity upregulated the expression of neuronal nitric oxide synthase (nNOS) and regulated particular behavior patterns in animal models. They also reported that ameliorated the increase in nNOS expression and decreased depression and anxiolytic effects. Thus, exercise seems to be an effective strategy for improving brain function by downregulating nNOS. However, the immune response differs greatly, depending on the exercise intensity. The aim of the present study was to investigate differences in brain nNOS expression in obese C57BL/6 mice that performed exercise of different intensities. Obesity was induced in 6-wks-old mice (n=35) by feeding a 60%-fat diet for 6-wks. A control (CON) group (n=14) was fed a normal diet. At the end of the induction 6-wks period of obesity, seven animals in the CON group and obesity-induced group were sacrificed to confirm obesity induction (preliminary experiments and confirmation of visceral fat accumulation). The remaining animals were then used in an 8-wks exercise intervention. Other than the CON (n=7), the obesity-induced animals were divided into the following groups: high-fat diet (HFD, n=7), HFD-low intensity (HFD-LI, n=7, 12 m/min for 75 min), HFD-moderate intensity (HFD-MI, n=7, 15 m/min for 60 min), and HFD-high intensity (HFD-HI, n=7, 18 m/min for 50 min). The exercise was performed on an animal treadmill. The expression of the nNOS protein in the hippocampus was significantly higher in the HFD group as compared with that in the CON group (p<0.01). However, there was no difference in the hippocampal expression of the nNOS protein in the other exercise groups as compared with that in the CON group. In contrast, nNOS expression in the HFD-HI group was significantly lower than that in the HFD-LI group (p<0.05). The expression of phosphorylated Akt (pAkt) was significantly higher in all the exercise groups as compared with that in the CON and HFD groups. There was no difference in the expression of pAkt in the cerebral cortex among groups, and the expression of pAkt in the cerebellum was significantly higher in the HFD-HI group as compared with that in the CON group (p<0.05). There were also no between-group differences in pAkt expression in the cerebellum among the various exercise groups. In conclusion, nNOS seems to be overexpressed in response to obesity, and it appears to be downregulated by exercise. Relatively high-intensity exercise may be effective in improving brain function by downregulating nNOS.

Factors Associated With Suicidal Attempt among Suicidal Ideators of Korean Adults (한국 성인 자살관념자의 자살시도 연관 요인)

  • Yuncheol, Choi;Hyunseuk, Kim;Sang-Shin, Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.127-136
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    • 2022
  • Objectives : The study aimed to identify factors associated with suicidal attempt in Korean adults experiencing thoughts of suicide. Methods : This study analyzed outcomes of suicidal behavior in the Korea National Health and Nutrition Examination Survey (KNHANES) 2015, 2017, and 2019. This survey was administered by the Korea Centers for Disease Control and Prevention (KCDC). The suicidal idea group was divided into individuals who had attempted suicide (n=92) and those who had not (n=831). Complex samples crosstabs analysis was conducted to compare the two groups' sociodemographic, psychiatric, and clinical characteristics. In addition, factors related to attempted suicide were investigated using complex samples logistic regression analysis. Results : The attempted suicide group had significantly higher rates of depression, recent psychiatric counseling, and suicidal plan (p<0.001) than the non-attempting group. In addition, the groups differed significantly in the frequency of binge drinking and smoking (p<0.05). Adjusted multivariate analysis revealed that the presence of a suicidal plan (Odds ratio [OR]=8.46, 95% Confidential Intervals [CI]=4.72-15.00), daily binge drinking (OR=3.14, 95% CI=1.26-7.84), psychiatric counseling within the past year (OR=3.03, 95% CI=1.75-5.23), low income level (OR=2.89, 95% CI=1.17-7.10), and history of depression (OR=2.39, 95% CI=1.29-4.42) were significantly associated with suicidal attempt. Conclusions : Factors associated with suicidal attempt among suicidal ideators in the general Korean population were identified across all sociodemographic, psychiatric, and clinical variables. Assessment of and intervention in suicidal plan, binge drinking, income level, and depression might prevent progression to suicidal attempt among those contemplating suicide.

Health and quality of life for Korean people in ageing society (고령화 사회에서 한국인의 건강과 삶의 질)

  • Kyung-Hyun Suh
    • Korean Journal of Culture and Social Issue
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    • v.12 no.5_spc
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    • pp.133-147
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    • 2006
  • Korean society is rapidly becoming an ageing society. The Korean may have to live longer than did their parents. Increasing life expectancy and changing social structure, Korean people are getting interested in quality of life, and well-being is becoming a matter of concern. And, the Korean is fully aware of the importance of health for well-being or good life. This concern about health may bring about specific behaviors related to health. Although health care expenditures of Korea are currently smaller than those of other developed countries, it is continuously increasing. Large portion of increased amount of health care expenditures is to spend for disease prevention and expansion of long-term care facilities. Constructs of well-being of the Korean, not living in western culture, may be different from those of people living in western society. Health is not top-ranked to importance for quality of life in previous studies. It does not mean health isn't determinant factor for good life or well-being. Health is an essential element for well-being. It has been proved in several researches which examined poor quality of life caused by certain diseases and management of health-related quality of life. Some theories relate to health-seeking behaviors suggested the health belief or the attitude toward health, intention to do health behavior, perceived behavioral control, and self efficacy as important factors which could predict health-related behaviors. With getting older, people decline in physical and physiological functions and become vulnerable to chronic diseases. Quality of life depends on how to adjust to these changes in senescence. Social supports, especially supports from offspring, are very important to quality of life in senescence, because supports from offspring have influence on pride of the older, they may be afraid of disclose the conflict with their offspring. Avoiding self-disclosure exclude other source of social supports and harm individual's health, therefore psychological intervention is needed to. Increasing life expectancy of the Korean, Korean government has to provide numerous long-term care facilities as well as psychosocial supports. The Korean, so far, does not recognize that psychologist could render great service to promoting individual or community health and improving individual's quality of life. It is highly expected that psychologists take actively interested and involve in health related to quality of life.

Comparative Study on the Actual Conditions about Hypertension and Diabetes Case Management of the Elderly at the Hall for the Aged and the D Senior's College (D 노인대학과 경로당 노인들의 건강행태 및 고혈압당뇨병 관리실태 비교조사)

  • Yoon, Young-Suk;Kwon, Yang-Ok;Jung, Young-Hee
    • Journal of dental hygiene science
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    • v.10 no.1
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    • pp.17-24
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    • 2010
  • The purpose of this study was to provide the basic data for effective intervention of oral health behaviors strategy and to compare the actual conditions about hypertension and diabetes case management of the elderly at the hall for the aged and the D senior's college. The research method was a questionnaire including hypertension and diabetes case management of the elderly and the subjects were 174 of the elderly(65 age over) at the hall for the aged(100) and the senior's college(74). The results of this study were as follows; 1. Hypertension 1)The incidence of hypertension of elderly at the hall for the aged and the senior's college were 32.2%. 2)83.9% of the hypertension cases were initially diagnosed during hospital examination(p < 0.05). 3)Regular blood pressure checks were performed more than one time monthly on 76.8% of the cases(p < 0.05). 4)Blood pressure control was well controlled on 75%(p < 0.05). 5)85.7% of the elderly at the hall for the aged took hypertension drugs daily and 42.9% of the elderly at the senior's college took no drug alternatively(p < 0.05). 2. Diabetes 1)The incidence of the diabetes of elderly at the hall for the aged and the senior's college were 14.4%. 2)80.0% of the diabetes cases were initially diagnosed during hospital examination(p < 0.05). 3)64.0% of the cases did not have blood sugar measuring instrument(p < 0.05). 4. In the quality of life, the thinking of no difficulty in walking and no anxiety/depression was more presented on the elderly at the senior's college than those at the hall for the aged(p < 0.05). 5. The subjective health condition scores were higher on the elderly at the senior's college than those at the hall for the aged(p < 0.05).

A Study on the Perceived Stress of Mothers in Neonatal Intensive Care Unit (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Choi Sung Hee
    • Child Health Nursing Research
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    • v.4 no.1
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    • pp.60-75
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    • 1998
  • The parents have much expectation upon the pregnancy and child birth, and in most cases, they expect the healthy parturient child. However, we can be placed on the high-risk conditions which have the physical, social and immature infant, due to the unexpected results, among the new-born. Accordingly, these high-risk newborn and premature infants will be mostly in NICU, which the concentrated medical treatment can be given, upon their conditions. After their birth and during these periods, they will be divided from the parents, and the nurse will accomplish the bringing-up activities which they can take care of the infant, expected by the parents after their birth. The hospitalization of high-risk newborn including these premature infants is the shocking experience to the parents of family, and thus they can feel the fear and uneasiness, and these reactions of parents are troubled in the behavior at the usual days, and cause the disorder and spiritless status, and these results break the supporting ability of parents, and cause the obstruction. Also, the unavoidable division between the parents and the children as like hospitalization of children can make the parents to feel the alienation emotionally, and this causes the results which the pride on the bringing-up ability of baby gets to be lost. These problems can cause the difficulties on the bonding or the parenting in the further days, and can be related to the neglect and abuse of children. Also, it is gradually increased to study and report which the emotional division by the physical division between the mother and the baby obstructs the normal affection course between the parent and the infant. The stress caused by the birth and the hospitalization of high-risk newborn, as like this, is important in the points which it can uncertainly affect the potential energy for the relationship of parent-child who are finally healthy. Accordingly, the significance and purpose of this study are to understand the contents and degree of stress which the parents of high-risk newborn including the immature child can be experienced from the hospitalization of ICU for their new borns, and thus to offer the basic program to the nursing intervention program for these. The subject of this study is the mother of newborn in NICU of 10 General Hospitals located at the 3one of Pusan, Korea from September 1997 to October 1997, and thus makes the subject of 95 person of parents who agreed to take part in the study and it is descriptive study related to the stress of mother having the newborn in NICU. The method is based on the preceding study related to the stress of mother having the experience of child hospitalization and chronic disease child, and then acquires the advice of specialists group as like 5 nursing professors, and then is amended and supplemented. Total number of questions is 43 items and consists of 5 factors as like medical treatment &nursing procedures, disease status & prognosis, role of parents, communication & inter-personal relationships, hospital environment, and is 5 point Likert Scale. The reliability of this study method is very highly shown to be Cronbach α=0.95. The collected data is analysed as Average, Frequency, Standard Deviation, T-test, ANOVA, Pearson Correlation Coefficient, Duncan multifulrange test by use of SPSS /PC (V7.5). The results of this study is summarized as under. 1. Every characteristics of subject is which the party of mother is 28.70age(±7.48) in the average ages, 51% in the high-school graduate, 38.5% in the christianity, total monthly income is 212.55 thousand won(±1.971), 74.5% in the housewife, 72.9% in the parents and children together living and the number of children to be 1.48person(± 0.6) in average, the recognition on the prognosis of baby is 74.0% in 'Don't know', the relationship with the husband after the hospitalization of babyis 37.3% in 'More Intimate', the relationship with the family of husband to be 48% in 'No-change', and the degree which is consulted with the husband about the baby is 55% in 'very frequently' and the visiting number per week is 4.59(±1.63) in average and the accompanying person in the time of visiting is which the number of husband is 56.3% and thus is the highest. The characteristics of baby is which the age is 21.88days(±16.47) after the birth in average, the sex to be 50 person in the female 52.1% and the order of birth to be 54.2% in the first chid, and the weight in the birth to be 2770gm(±610) and the height in the birth to be 46.26cm(±7.62) in aver age. The medical diagnosis is 37.5% in the premature infant, the career of hospitalization is 96.9% in 'None', and the operation plan is 90.6% in 'None' and the execution of operation is 88% in 'None' and the nursing of incubator is 55.2% in 'Yes', and the method of feeding is 50.5% in 'Oral' and the contents of feeding is 46.9% in the 'Milk'. 2. The total stress degree of subject is almost highly shown to be as 3.36(±0.86). If it is compared upon each cause, 'stress on disease status & prognosis' is highest 3.79(±1.28), and it is in the order of 'stress on medical treatment & nursing procedures' 3.70(±0.93), 'stress on hospital environment' 3.14(±0.86), 'stress on role of parents' 3.18(±0.92) and 'stress on communication & inter personal relationship' 2.62(± 0.77) 3. As the results of checking the notworthiness of stress degree upon each variable of subject, the variable showing the noted difference was the birth weight(γ=-0.16, P=0.04), birth height(γ=-0.23, P=0.03), nursing in the incubator(F=8.93, P=0.04), feed method(F=2.94, P=0.04). That is to say, it is shown which the smaller the birth weight is, the higher the stress degree of mother is noteworthily. Also, the smaller the birth height baby is, the higher the stress of mother is. In the incubator, it os shown which the mother whose baby is nursing in the incubator is higher in the stress degree than other mothers. Upon the feeding method of baby, that is to say, TPNis the highest, and it is shown in the order of NPO, Tube feeding, and P.O. feeding. When we review the above-mentioned results, as the status is serious, it is thought which we include the supporting nursing for coping with the stress of parents in the setting-up od nursing plan for the baby in the NICU.

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An Analysis on the Conditions for Successful Economic Sanctions on North Korea : Focusing on the Maritime Aspects of Economic Sanctions (대북경제제재의 효과성과 미래 발전 방향에 대한 고찰: 해상대북제재를 중심으로)

  • Kim, Sang-Hoon
    • Strategy21
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    • s.46
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    • pp.239-276
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    • 2020
  • The failure of early economic sanctions aimed at hurting the overall economies of targeted states called for a more sophisticated design of economic sanctions. This paved way for the advent of 'smart sanctions,' which target the supporters of the regime instead of the public mass. Despite controversies over the effectiveness of economic sanctions as a coercive tool to change the behavior of a targeted state, the transformation from 'comprehensive sanctions' to 'smart sanctions' is gaining the status of a legitimate method to impose punishment on states that do not conform to international norms, the nonproliferation of weapons of mass destruction in this particular context of the paper. The five permanent members of the United Nations Security Council proved that it can come to an accord on imposing economic sanctions over adopting resolutions on waging military war with targeted states. The North Korean nuclear issue has been the biggest security threat to countries in the region, even for China out of fear that further developments of nuclear weapons in North Korea might lead to a 'domino-effect,' leading to nuclear proliferation in the Northeast Asia region. Economic sanctions had been adopted by the UNSC as early as 2006 after the first North Korean nuclear test and has continually strengthened sanctions measures at each stage of North Korean weapons development. While dubious of the effectiveness of early sanctions on North Korea, recent sanctions that limit North Korea's exports of coal and imports of oil seem to have an impact on the regime, inducing Kim Jong-un to commit to peaceful talks since 2018. The purpose of this paper is to add a variable to the factors determining the success of economic sanctions on North Korea: preventing North Korea's evasion efforts by conducting illegal transshipments at sea. I first analyze the cause of recent success in the economic sanctions that led Kim Jong-un to engage in talks and add the maritime element to the argument. There are three conditions for the success of the sanctions regime, and they are: (1) smart sanctions, targeting commodities and support groups (elites) vital to regime survival., (2) China's faithful participation in the sanctions regime, and finally, (3) preventing North Korea's maritime evasion efforts.