• Title/Summary/Keyword: Behavioral Setting

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Psychotic Symptoms of Hashimoto's Encephalopathy: A Diagnostic Challenge

  • Savarimuthu, Monisha K;Tsheringla, Sherab;Mammen, Priya
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.1
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    • pp.42-44
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    • 2019
  • Hashimoto's encephalopathy (HE) is a rare and underdiagnosed neuropsychiatric illness. We present the case of a 17-year-old girl who was admitted to a tertiary-care psychiatric center with acute onset psychosis and fever. Her psychotic symptoms were characterized by persecutory and referential delusions, as well as tactile and visual hallucinations. Her acute behavioral disturbance warranted admission and treatment in a psychiatric setting (risperidone tablets, 3 mg/day). She had experienced an episode of fever with a unilateral visual acuity defect approximately 3 years before admission, which was resolved with treatment. Focused clinical examination revealed an enlarged thyroid, and baseline blood investigations, including thyroid function test results were normal. Abnormal laboratory investigations revealed elevated anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) levels (anti-TPO of 480 IU/mL; anti-TG of 287 IU/mL). Results of other investigations for infection, including cerebrospinal fluid examination, electroencephalography, and brain magnetic resonance imaging were normal. She was diagnosed with HE and was treated with intravenous corticosteroids (methylprednisolone up to 1 g/day; tapered and discontinued after a month). The patient achieved complete remission of psychotic symptoms and normalization of the anti-thyroid antibody titers. Currently, at the seventh month of follow-up, the patient is doing well. This case highlights the fact that in the absence of well-defined clinical diagnostic criteria, a high index of suspicion is required for early diagnosis of HE. Psychiatrists need to explore for organic etiologies when dealing with acute psychiatric symptoms in a younger age group.

A Methodology for Finding the Convergence Research Area by Measuring Convergence Index in Government Research Institutes (융합지수 측정을 통한 출연연 융합연구영역 발굴모형 연구)

  • Coh, Byoung-Youl;Kim, So-Young;Lee, Jae-Min
    • Journal of Korea Technology Innovation Society
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    • v.22 no.3
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    • pp.446-474
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    • 2019
  • In conjunction with securing R&D competitiveness through technology convergence, there is a growing interest in the strategy to derive innovation based on the measurement of convergence. In this paper, we present a data-based model that suggests convergence strategies for the research projects of government research institutes (GRIs) in Korea. The convergence characteristics of the research projects are represented by inherent attributes of technology and behavioral attributes of actors. The measuring process of the proxy variables (Rao-Stirling and Herfindahl-Hirschman Indices) for each attributes are proposed. These two indices are used to construct the convergence diagram, through which the research projects of GRIs are distributed into four areas: AllianceIntra, Alliance-Inter, Competition, Mission-Oriented. Based on the convergence diagram proposed in this study the convergence index is measured to derive 30 convergence research areas of GRIs. As a result, we expect to provide appropriate guidelines for setting the policy direction of the convergence research projects.

Psychosocial support interventions for women with gestational diabetes mellitus: a systematic review

  • Jung, Seulgi;Kim, Yoojin;Park, Jeongok;Choi, Miyoung;Kim, Sue
    • Women's Health Nursing
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    • v.27 no.2
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    • pp.75-92
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    • 2021
  • Purpose: This study aimed to analyze the content and effectiveness of psychosocial support interventions for women with gestational diabetes mellitus (GDM). Methods: The following databases were searched with no limitation of the time period: Ovid-MEDLINE, Cochrane Library, Ovid-Embase, CINAHL, PsycINFO, NDSL, KoreaMed, RISS, and KISS. Two investigators independently reviewed and selected articles according to the predefined inclusion/exclusion criteria. ROB 2.0 and the RoBANS 2.0 checklist were used to evaluate study quality. Results: Based on the 14 selected studies, psychosocial support interventions were provided for the purpose of (1) informational support (including GDM and diabetes mellitus information; how to manage diet, exercise, stress, blood glucose, and weight; postpartum management; and prevention of type 2 diabetes mellitus); (2) self-management motivation (setting goals for diet and exercise management, glucose monitoring, and enhancing positive health behaviors); (3) relaxation (practicing breathing and/or meditation); and (4) emotional support (sharing opinions and support). Psychosocial supportive interventions to women with GDM lead to behavioral change, mostly in the form of self-care behavior; they also reduce depression, anxiety and stress, and have an impact on improving self-efficacy. These interventions contribute to lowering physiological parameters such as fasting plasma glucose, glycated hemoglobin, and 2-hour postprandial glucose levels. Conclusion: Psychosocial supportive interventions can indeed positively affect self-care behaviors, lifestyle changes, and physiological parameters in women with GDM. Nurses can play a pivotal role in integrative management and can streamline the care for women with GDM during pregnancy and following birth, especially through psychosocial support interventions.

Screening and Assessment Tools for Measuring Delirium in Patients with Cancer in Hospice and Palliative Care: A Systematic Review

  • Yang, Eun Jung;Hahm, Bong-Jin;Shim, Eun-Jung
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.214-225
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    • 2021
  • Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

The Study on the impact of optimistic bias and control illusion in COVID 19 Preventive Behavior (COVID 19 방역행동에 있어서 낙관적 편견과 통제성 편향의 영향에 관한 연구)

  • Jeong, Hyeonju
    • Journal of the Korea Convergence Society
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    • v.13 no.2
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    • pp.223-233
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    • 2022
  • In addition to optimistic bias which can be a biased phenomenon in perceived susceptibility, including illusion of control which is a distorted phenomenon, the current study attempted to demonstrate the influential relationship between these two important variables and COVID 19 personal preventive behaviors and social distancing practice. Conducting Survey utilizing online pannel from Macromill Embrain, the present study performed regression analysis, setting personal preventive behavioral variables such as mask wearing, hand washing, using hand sanitizer as independent variable, and analyzed how these independent variables influence control illusion and optimistic bias. As a result, COVID 19 personal preventive behavior didn't have direct effect on optimistic bias and control illusion except for hand washing. Finding, also, showed that control illusion affected optimistic bias, and the relation between these variables was different depending on demographic variable such as gender and age.

Effectiveness and Safety of Traditional East Asian Herbal Medicine as Monotherapy for Major Depressive Disorder: A Systematic Review and Meta-Analysis (주요우울장애에 대한 한약 단독치료의 효과와 안전성: 체계적 문헌고찰 및 메타분석)

  • Seung, Hye-Bin;Kwon, Hui-Ju;Kim, Sang-Ho
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.1
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    • pp.79-111
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    • 2022
  • Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I2=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I2=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

Service Quality, Customer Satisfaction and Customer Loyalty of Mobile Communication Industry in China (중국이동통신산업중적복무질량(中国移动通信产业中的服务质量), 고객만의도화고객충성도(顾客满意度和顾客忠诚度))

  • Zhang, Ruijin;Li, Xiangyang;Zhang, Yunchang
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.269-277
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    • 2010
  • Previous studies have shown that the most important factor affecting customer loyalty in the service industry is service quality. However, on the subject of whether service quality has a direct or indirect effect on customer loyalty, scholars' views apparently vary. Some studies suggest that service quality has a direct and fundamental influence on customer loyalty (Bai and Liu, 2002). However, others have shown that service quality not only directly affects customer loyalty, it also has an indirect impact on customer loyalty by influencing customer satisfaction and perceived value (Cronin, Brady, and Hult, 2000). Currently, there are few domestic articles that specifically address the relationship between service quality and customer loyalty in the mobile communication industry. Moreover, research has studied customer loyalty as a whole variable, rather than breaking it down further into multiple dimensions. Based on this analysis, this paper summarizes previous study results, establishes an effect mechanism model among service quality, customer satisfaction, and customer loyalty in the mobile communication industry, and presents a statistical test on model assumptions by using customer investigation data from Heilongjiang Mobile Company. It provides theoretical guidance for mobile service management based on the discussion of the hypothesis test results. For data collection, the sample comprised mobile users in Harbin city, and the survey was taken by random sampling. Out of a total of 300 questionnaires, 276 (92.9%) were recovered. After excluding invalid questionnaires, 249 remained, for an effective rate of 82.6 percent for the study. Cronbach's ${\alpha}$ coefficient was adapted to assess the scale reliability, and validity testing was conducted on the questionnaire from three aspects: content validity, construct validity. and convergent validity. The study tested for goodness of fit mainly from the absolute and relative fit indexes. From the hypothesis testing results, overall, four assumptions have not been supported. The ultimate affective relationship of service quality, customer satisfaction, and customer loyalty is demonstrated in Figure 2. On the whole, the service quality of the communication industry not only has a direct positive significant effect on customer loyalty, it also has an indirect positive significant effect on customer loyalty through service quality; the affective mechanism and extent of customer loyalty are different, and are influenced by each dimension of service quality. This study used the questionnaires of existing literature from home and abroad and tested them in empirical research, with all questions adapted to seven-point Likert scales. With the SERVQUAL scale of Parasuraman, Zeithaml, and Berry (1988), or PZB, as a reference point, service quality was divided into five dimensions-tangibility, reliability, responsiveness, assurance, and empathy-and the questions were simplified down to nineteen. The measurement of customer satisfaction was based mainly on Fornell (1992) and Wang and Han (2003), ending up with four questions. Based on the study’s three indicators of price tolerance, first choice, and complaint reaction were used to measure attitudinal loyalty, while repurchase intention, recommendation, and reputation measured behavioral loyalty. The collection and collation of literature data produced a model of the relationship among service quality, customer satisfaction, and customer loyalty in mobile communications, and China Mobile in the city of Harbin in Heilongjiang province was used for conducting an empirical test of the model and obtaining some useful conclusions. First, service quality in mobile communication is formed by the five factors mentioned earlier: tangibility, reliability, responsiveness, assurance, and empathy. On the basis of PZB SERVQUAL, the study designed a measurement scale of service quality for the mobile communications industry, and obtained these five factors through exploratory factor analysis. The factors fit basically with the five elements, indicating the concept of five elements of service quality for the mobile communications industry. Second, service quality in mobile communications has both direct and indirect positive effects on attitudinal loyalty, with the indirect effect being produced through the intermediary variable, customer satisfaction. There are also both direct and indirect positive effects on behavioral loyalty, with the indirect effect produced through two intermediary variables: customer satisfaction and attitudinal loyalty. This shows that better service quality and higher customer satisfaction will activate the attitudinal to service providers more active and show loyalty to service providers much easier. In addition, the effect mechanism of all dimensions of service quality on all dimensions of customer loyalty is different. Third, customer satisfaction plays a significant intermediary role among service quality and attitudinal and behavioral loyalty, indicating that improving service quality can boost customer satisfaction and make it easier for satisfied customers to become loyal customers. Moreover, attitudinal loyalty plays a significant intermediary role between service quality and behavioral loyalty, indicating that only attitudinally and behaviorally loyal customers are truly loyal customers. The research conclusions have some indications for Chinese telecom operators and others to upgrade their service quality. Two limitations to the study are also mentioned. First, all data were collected in the Heilongjiang area, so there might be a common method bias that skews the results. Second, the discussion addresses the relationship between service quality and customer loyalty, setting customer satisfaction as mediator, but does not consider other factors, like customer value and consumer features, This research will be continued in the future.

An Exploratory Study on Customers' Individual Factors on Waiting Experience (고객의 개인적 요소가 대기시간 경험에 미치는 영향에 대한 탐색적 연구)

  • Kim, Juyoung;Yoo, Bomi
    • Asia Marketing Journal
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    • v.12 no.1
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    • pp.1-30
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    • 2010
  • Customers often experience waiting for buying service. Managing customers' waiting time is important for service providers since customers who are dissatisfied with waiting, secede from a service place at last. Not a few studies have been done to solve waiting time problem and improve customers' waiting experience. Hui & Tse(1996) identify evaluation factors in customers' behavioral mechanism as customers wait. That is, customers experience perceived waiting time, waiting acceptability and emotional response to the wait when they wait. Since customers evaluate the wait using these factors, service provider should manage these factors in order to minimize customers' dissatisfaction. Therefore, this study explores that evaluation factors of waiting are influenced by customers' situational and experiential characteristics, which include customer loyalty, transaction importance for customer and waiting expectation level. Those situational and experiential characteristics are usually given to service providers so they can't control these at waiting point. The major findings derived from two exploratory studies can be summarized as follows. First, according to the result from the study 1 (restaurant setting), customers' transaction importance has the greatest positive influence on waiting experience. The results show restaurant service provider could prevent customers' separation effectively through strategies which raise customers' transaction importance, like giving special coupons for important events. Second, in study 2 (amusement part setting) customer loyalty has large positive impact on waiting experience as well as transaction importance. This results show that service provider could minimize customers' dissatisfaction using strategies which raise customer loyalty continuously. This results show customer perceives waiting experience differently according to characteristics of service place and service itself. Therefore, service provider should grasp the unique customers' situational and experiential characters for each service and service place. It could provide an effective strategy for waiting time management. Third, the study finds transaction importance and waiting expectation level have direct influence customers' waiting experience as independent variables, while existing studies treated them as moderators. Customer loyalty which has not been incorporated in previous waiting time research is known to affect waiting experience. It suggests that marketing strategy which builds up customer loyalty for long period of time is also quite effective, compared to short term tactics to help customers endure waiting time. Fourth, this study reveals the importance of actual waiting time along with perceived waiting time. So far most studies only focus on customers' perceived waiting time. Especially, this study incorporates the concept of patient limit on waiting time to investigate effect of actual waiting time. The results show that there were various responses to the wait depending on how actual waiting time exceeds individual's patent limit on waiting time or not, even though customers wait about the same period of time. Finally, using structural equation model, conceptual path between behavioral responses is verified. As customer perceives waiting time, then she decides whether she can endure it or not, and then her emotional response occurs. This result are somewhat different from Hui & Tse(1996)'s study. The study also includes theoretical contributions as well as practical implications.

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Improvement of Attention Span and Impulsivity of Children with Attention Deficit Hyperactivity Disorder through Structured Violin Learning (주의력결핍과잉행동장애 아동의 집중력 향상과 충동성 조절을 위한 바이올린 교습 중심의 음악치료 사례 연구)

  • Kang, Hyun Jung
    • Journal of Music and Human Behavior
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    • v.3 no.2
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    • pp.1-14
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    • 2006
  • The purpose of this study is to examine the effect of violin learning as to enhance the attention span and impulsiveness of children with Attention Deficit Hyperactivity Disorder(ADHD). Three children with ADHD, grade 2, 3, 4 were selected to participate in the research. A total of 15 session were given during 8 week time span, including a final performance session. For measurement, Korean-Child Behavior Checklist(K-CBCL), Home Situation Questionnaire-Revised (HSQ-R), Conners Teacher Rating Scale-Revised (CTRS-R) were administered before and after the implementation. Other behavioral checklist were used to record inappropriate or interruptive behaviors. The results showed that violin learning has increased attention span and reduced impulsive behaviors of all three children with ADHD. Along with these changes, the identified inappropriate behaviors reduced as sessions progressed. Also the changes observed within the music environment were generalized to non-music environment, such as family and school. These results also indicate that violin can be a therapeutic medium used in music therapy setting to bring positive changes for children with ADHD problems.

Current Barriers of Obesity Management of Children Using Community Child Care Centers and Potential Possibility of Utilizing Mobile Phones: A Qualitative Study for Children and Caregivers (지역아동센터 이용 어린이의 비만관리의 한계점과 모바일폰의 잠재적인 활용 가능성: 어린이와 보호자 대상의 질적 연구)

  • Lee, Bo Young;Park, Mi-Young;Kim, Kirang;Shim, Jea Eun;Hwang, Ji-Yun
    • Korean Journal of Community Nutrition
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    • v.25 no.3
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    • pp.189-203
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    • 2020
  • Objectives: This study was performed to identify the current barriers of obesity management for children using Community Child Care Centers and their caregivers (parents and teachers working in the Centers). Further, this study explored the possibility of utilizing a mobile phone application for tailored obesity prevention and management programs to overcome the current difficulties associated with children's obesity management. Methods: The qualitative data were collected through in-depth interviews with 20 obese and overweight children or children who wanted to participate in this study using Community Child Care Centers, 12 teachers working at the Centers, and a focus group interview with five parents of children using the Centers. Data were analyzed with a thematic approach categorizing themes and sub-themes based on the transcripts. Results: The current barriers of obesity management of obese and overweight children using Community Child Care Centers were lack of self-directed motivation regarding obesity management (chronic obesity-induced lifestyles and reduced self-confidence due to stigma) and lack of support from households and Community Child Care Centers (latchkey child, inconsistency in dietary guidance between the Center and household, repetitive pressure to eat, and absence of regular nutrition education). Mobile phone applications may have potential to overcome the current barriers by providing handy and interesting obesity management based on visual media (real-time tracking of lifestyles using behavior records and social support using gamification), environmental support (supplementation of parental care and network-based education between the Community Child Care Center and household), and individualized intervention (encouragement of tailored and gradual changes in eating habits and tailored goal setting). It is predicted that the real-time mobile phone program will provide information for improving nutritional knowledge and behavioral skills as well as lead to sustainable children's coping strategies regarding obesity management. In addition, it is expected that environmental factors may be improved by network-based education between the Community Child Care Centers and households using the characteristics of mobile phones, which are free from space and time constraints. Conclusions: The tailored education program for children using Community Child Care Centers based on mobile phones may prevent and reduce childhood obesity by overcoming the current barriers of obesity management for children, providing environmental and individualized support to promote healthy lifestyles and quality of life in the future.