• Title/Summary/Keyword: Child class

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Dose Response Relationship in Local Radiotherapy for Hepatocellular Carcinoma (원발성 간암의 국소 방사선치료 시 선량반응 관계)

  • Park Hee Chul;Seong Jinsil;Han Kwang Hyub;Chon Chae Yoon;Moon Young Myoung;Song Jae Seok;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.118-126
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    • 2001
  • Purpose : In this study, it was investigated whether dose response relation existed or not in local radiotherapy for primary hepatocellular carcinoma. Materials and Methods : From January 1992 to March 2000, 158 patients were included in present study. Exclusion criteria included the presence of extrahepatic metastasis, liver cirrhosis of Child's class C, tumors occupying more than two thirds of the entire liver, and performance status on the ECOG scale of more than 3. Radiotherapy was given to the field including tumor with generous margin using 6, 10-MV X-ray. Mean tumor dose was $48.2{\pm}7.9\;Gy$ in daily 1.8 Gy fractions. Tumor response was based on diagnostic radiologic examinations such as CT scan, MR imaging, hepatic artery angiography at $4\~8$ weeks following completion of treatment. Statistical analysis was done to investigate the existence of dose response relationship of local radiotherapy when it was applied to the treatment of primary hepatocellular carcinoma. Results : An objective response was observed in 106 of 158 patients, giving a response rate of $67.1\%$. Statistical analysis revealed that total dose was the most significant factor in relation to tumor response when local radiotherapy was applied to the treatment of primary hepatocellular carcinoma. Only $29.2\%$ showed objective response in patients treated with dose less than 40 Gy, while $68.6\%\;and\;77.1\%$ showed major response in patients with $40\~50\;Gy$ and more than 50 Gy, respectively. Child-Pugh classification was significant factor in the development of ascites, overt radiation induced liver disease and gastroenteritis. Radiation dose was an important factor for development of radiation induced gastroduodenal ulcer. Conclusion : Present study showed the existence of dose response relationship in local radiotherapy for primary hepatocellular carcinoma. Only radiotherapy dose was a significant factor to predict the objective response. Further study is required to predict the maximal tolerance dose in consideration of liver function and non-irradiated liver volume.

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A Survey on Child Battering among Elementary School Children and Related Factors in Urban and Rural Areas (도시 및 농어촌 아동의 가정내 구타발생률 및 관련요인 조사)

  • Jeon, Kae-Soon;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.232-242
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    • 1991
  • To determine the incidence rate of child battering and related factors, a questionnaire survey was Conducted on 1,255 children in 4th and 5th grades of two elementary schools (one in the upper economic class area with 519 students and the other in the lower economic class area with 504 students) in Taegu and two schools in rural areas of Kyungpook province (120 and 112 students, respectively) from 1st May to 10th May 1990. Total number of children who were battered during one-month period (1-30 April 1990) prior to the survey was 918 (73.1%). Among the battered children 87 (6.9%) were severely battered (twice or more in a month by kicking or more severe method) and 831 children (66.2%) were moderately battered (all other battering than severe battering). The percentage of battered children and degree of battering were not significantly different between two schools in Taegu and between urban and rural areas. Common reasons for battering were disobediance (61.9%), making troubles (34.9%), and poor school performance (33.3%). However, 16.1% of severely battered children responded that the perpetrators battered them to wreak their anger and 5.7% of them did not know the reason why they were battered. A majority of the battered children (65%) regretted their fault after being battered but 20.7% of the severely battered children wanted to run away and 9.2% of them had an urge to commit suicide. While most of the physical injuries due to battering were minor as bruise (52.7%) but some of them were severe, e.g., bone fracture (2.5%), skin laceration (1.5%), and loss of consciousness. (0.2%). The common psycho-behavioral complaints of the severely battered children were unwillingness to study (31%), unwillingness to live (17.2%), and reluctance to go home (13.8%). The incidence rate of severe battering was significantly higher (p=0.018) among the children living in a quarter attached to a store (14.0%) than the children living in an apartment (6.6%) and individual house (6.2%). The incidence rate of severe battering was higher among children living in a rental house (8.4%) than children living in their own house 6.3%) (p=0.005). The children of father only working (5.1%) and mother only working (4.5%) had a lower incidence rate of severe battering than the children of both parents working (9.1%) and both parents unemployed (20.7%) (p=0.006). More children were battered when there was a sick family member (80.8%) compared with the children without a sick family member (71.4%) (p=0.001). The incidence rates of severe and moderate battering increased as the frequency of quarreling between mother and father increased (P=0.000). The percentage of unbattered children was higher among children whose father's occupation was professional (39.4%) than that of the total study subjects (26.9%) (p<0.001).

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THE CLASSIFICATION OF ADOLESCENTS IN RUNAWAY SHELTERS BY THE EVALUATION OF THEIR PSYCHOPATHOLOGY (보호시설 가출청소년의 정신병리에 대한 평가와 분류)

  • Lee, Jong-Sung;Kwack, Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.2
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    • pp.192-217
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    • 2001
  • Object:This study was carried out to classify adolescents in runaway shelters by evaluating their psychopathology. And the ultimate purpose is to offer basic data for preventing adolescents‘ runaway and for diversifying runaway shelters suitable for the problem of individual adolescent. Method:128 adolescents who stay in the runaway shelters were asked to complete self-report qeustionnaires including basic sociodemographic data, Child Behavior Check List(CBCL), Minnesota Multiphasic Personality Inventory(MMPI), and Symptom Check List-90-Revised(SCL-90-R). Korean Wechsler Adult Intelligence Scale(K-WAIS)[or Korean Educational Developmental Institute-Wechsler Intelligence Scale for Children(KEDI-WISC)] and Bender-Gestalt test(BGT) were also done by clinical psychologists. Results:The most common age of the subjects were 15-year-old, and they dropped out their schools in the middle school most commonly. Mostly they were from middle class family and their parents' educational level were high school graduates. The first runaway episode was most common in the middleschool period, and their runaways were repeated. The most common frequency of runaways were more than 10 times. About 10% of them abused drugs and about 80% of them abused alcohol. One third of them had experiences of illegal problems and 10% of them engaged in sexual activity for money. 95 adolescents(83%) in CBCL, 42 adolescents(36%) in SCL-90-R, and 70 adolescents(69.3%) in MMPI showed clinical significance. In intelligence test, 22 adolescents(22%) were mentally retarded. In BGT, 35 adolescents(39.4%) manifested brain dysfunction signs. Conclusion:Runaway adolescents in the shelters have variable and severe psychopathology. Their psychopathology is classified as follows;The behavior disorder group, the mood disorder group with anxiety/depression, the somatic disorder group with somatic symptoms, and the psychosis group with possibility of severe psychopathology. Therefore it is very important to evaluate psychiatric problems of runaway adolescents, and specific therapeutic interventions according to their problems are required.

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Predictors of Latent Class of Longitudinal Medical Expenses of Older People and the Effects on Subjective Health (노인 의료비 변화궤적의 잠재계층 유형: 예측요인과 주관적 건강에 대한 영향)

  • Song, Si Young;Jun, Hey Jung;Choi, Bo Mi
    • 한국노년학
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    • v.39 no.3
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    • pp.467-484
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    • 2019
  • The purpose of this study is to explore latent classes of longitudinal medical expenses of older people and to analyze its predictors and its effects on subjective health. Among participants of the Korean Health Panel, the sample of this study includes 1,119 people who is 65-year-old or older and reported their medical expenses for nine consecutive years. The analyses were conducted in three steps. First, Growth Mixture Model (GMM) was applied to find distinct subgroups showing similar patterns in medical expenses. The results showed four groups which were classified as high medical expenditure maintenance group, medical expenditure increase group, low medical expenditure maintenance group, and medical expenditure reduction group. Second, the multinominal logistic regression found that the presence of spouse, economic participation, the number of chronic diseases, and the type of health insurance were significant predictors of latent classes in medical expenses. In particular, the greater the number of chronic diseases, the higher the likelihood of belonging to the high medical expenditure maintenance group. In addition, medical benefit recipients are more likely to belong to the low medical cost maintenance and medical cost reduction groups. Third, multiple regression analysis revealed that the older people in the groups with low or reducing expenses reported better subjective health than people with higher expenses. This study has its meanings in exploring the heterogeneity in longitudinal medical expenses among older people and its predictors and its associations with health outcome. The results of this research provide background information in establishing public health policy for older people.

Podiatric Clinical Diagnosis using Decision Tree Data Mining (결정트리 데이터마이닝을 이용한 족부 임상 진단)

  • Kim, Jin-Ho;Park, In-Sik;Kim, Bong-Ok;Yang, Yoon-Seok;Won, Yong-Gwan;Kim, Jung-Ja
    • Journal of the Institute of Electronics Engineers of Korea CI
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    • v.48 no.2
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    • pp.28-37
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    • 2011
  • With growing concerns about healthy life recently, although the podiatry which deals with the whole area for diagnosis, treatment of foot and leg, and prevention has been widely interested, research in our country is not active. Also, because most of the previous researches in data analysis performed the quantitative approaches, the reasonable level of reliability for clinical application could not be guaranteed. Clinical data mining utilizes various data mining analysis methods for clinical data, which provides decision support for expert's diagnosis and treatment for the patients. Because the decision tree can provide good explanation and description for the analysis procedure and is easy to interpret the results, it is simple to apply for clinical problems. This study investigate rules of item of diagnosis in disease types for adapting decision tree after collecting diagnosed data patients who are 2620 feet of 1310(males:633, females:677) in shoes clinic (department of rehabilitation medicine, Chungnam National University Hospital). and we classified 15 foot diseases followed factor of 22 foot diseases, which investigated diagnosis of 64 rules. Also, we analyzed and compared correlation relationship of characteristic of disease and factor in types through made decision tree from 5 class types(infants, child, adolescent, adult, total). Investigated results can be used qualitative and useful knowledge for clinical expert`s, also can be used tool for taking effective and accurate diagnosis.

Education Needs for Home Care Nurse (가정간호 교육요구도 조사 연구)

  • Kim Cho-Ja;Kang Kyu-Sook;Baek Hee-Chon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.2
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    • pp.228-239
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    • 1999
  • In 1990 Home Care Education Programs started when legislation established certification for Home Care Nurses. The Ministry of Health and Welfare proposed a home care education curriculum which has 352 class hours and 248 hours of 'family nursing and practice'. Though Home Care Education Programs have been offered in 11 home care educational institutes, there has been no formal revision for the home care education programs. Also a first and second home care demonstration projects have been carried out, but there has been no research on outcomes for home care education as applied in home care practice. The purposes of this study were to identify the important content areas for home care nursing as perceived by home care nurses, and to identify their clinical competence in each of these areas, and from these to identify the education needs. The sample was 107 home care nurses who were working in home care demonstration hospitals and community-based institutions which have been offering home care services. Responses were received from 88 nurses, comprising a 82.2% return rate, and 86 were included in the final analysis. The instrument used was a modification of the instrument developed by Caie-Lawrence et(1995) and Moon's(1991) instrument on home care knowledge. The instrument's Cronbach's coefficient was 0.982. Among the respondents, 64% were working at home care demonstration hospitals and 36% were working at community-based institutions. Their home care experiences were from one month to six years, with a mean of 20.6 months. The importance rating for home care education content was 3.42 0.325, which means importance was rated relatively high. Technical aspects of home care were identified the most important. Five items 'education skill', 'counseling skill', 'interview skill', 'wound care skill', 'bed sore care skill' received 100% importance ratings. The competency rating was 2.87 0.367 and 'technical aspects of home care' was the highest, and 'application to home care skill' was the lowest. Home care nurses' education needs were identified and compared to the importance ratings and competency ratings. Eleven items were identified as the highest in the importance areas and eleven items were in the lowest competency areas. High importance ratings matched with low competency ratings determined training needs, but there was no matching items in this study. In the lowest competency areas four items were excluded, because of not being applicable in current home care practice. Therefore total eighteen items were identified as home care education needs. These items are 'bed sore care skill', 'malpractice', 'wound care skill', 'general infection control', 'change and management of tracheostomy tubes', 'CVA patient care', 'Hospice care', 'pain management', 'urinary catheterization and management', 'L-tube insertion and managements', 'Respirator use and management skill', 'infant care', 'prevention to burnout', 'child assessment', 'CAPD', 'infant assessment', 'computer literacy', and 'psychiatry patient care'.

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The effects of balanced English approach program on five-year-old children's English reading and writing Ability (균형적 영어접근 프로그램이 만5세 유아의 읽기와 쓰기능력에 미치는 영향)

  • Cha, Kyong Na;Bae, Jae Jung;Chung, Chung Hee
    • Korean Journal of Childcare and Education
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    • v.6 no.2
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    • pp.57-81
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    • 2010
  • The purpose of this study is to examine the balanced English approach program on five-year-old children's English reading and writing ability. For this study, two classes consisting of five-year-old children in HATBEAT kindergarten in D city were selected. One class was designated as the experimental group and the other as the control group. The balanced English approach program was performed on the experimental group but not on the control group. The balanced English approach program was carried out for 8 weeks. The experimental procedures were in the order of pre-test, the experimental treatment, and post-test. The result of the experiment was evaluated by comparing the pre-test and post-test results. Analysis of data was performed by ANCOVA. The result of the study are as follows. First, in the English reading ability, the experimental group was more enhanced than the control group. Also, for sub-factors of English reading such as alphabet and English word reading ability, the experimental group was more enhanced than the control group. However, in the English book reading ability as a sub- factor of the English reading, there was not much difference in the result between the experimental group and the control group. Second, in the English writing ability, the experimental group were more enhanced than the control group.

A Pre-school Teacher's Educational Meaning of an Activity : 'Discourse between Children through Books' in 3-year-old Children's Classroom (유아교사가 생각하는 만 3세 교실에서 '책을 통한 유아들 간의 의견나누기' 활동에 대한 교육적 의미)

  • Suh, Hye Jeong;Yoon, Koung Ok
    • Korean Journal of Childcare and Education
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    • v.9 no.6
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    • pp.339-368
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    • 2013
  • This study aims to discover how three-year-old children to search for existence and its meaning, while they participate a programme, 'discourse among children through books' as a way of resolving curiosities. Data were collected between April 2, September 10, 2010 and the collected data included teacher's class records, pictures, discussion notes and interview materials. The results showed that 'discourse among children through books' follows steps in a process. The steps include: Deciding a topic that children should search for, choosing an appropriate book to resolve children's curiosities, spending some time for discoursing among children by using pictures in the book, and sharing what they had understood. Through this process, a pre-school teacher met with children who were full of abilities, ideas and motivation to explore with a little assistance. The pre-school teacher was able to overcome preconceived ideas that informational books could be difficult for children, and experienced various lessons, while the children led their own learning. It represents that the activity, 'discourse among children through books' can be a children centered inquiry learning teaching strategy, because the informational books ensure that the children gain knowledge and are actively in cogitation.

Oral Features in a Child with Noonan Syndrome : A Case Report (누난 증후군 환자의 구강 내 특징 : 증례 보고)

  • Hwang, Inkyung;Lee, Yeonju;Sim, Dohee;Mah, Yonjoo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.1
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    • pp.115-122
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    • 2018
  • Noonan syndrome is characterized by distinctive facial features, short stature, and congenital heart disease. It is a congenital genetic disorder with a prevalence of between 1/1,000 and 1/2,500 in both genders. An 11-year-old boy with Noonan syndrome visited the hospital with an ectopically positioned tooth. A pulmonary stenosis was diagnosed and his growth and development were delayed. In many cases of this diseases there is obvious hemostasis, which he was not experiencing. His facial appearance showed characteristic features of Noonan syndrome. The patient showed a dental class II relationship, labioversion of the upper anterior teeth, and a shallow overbite. Radiographic examination revealed that the upper right canine was ectopically positioned, which led to root resorption of the upper right lateral incisor. A lateral cephalometric radiograph revealed a craniofacial pattern that was within normal limits. Surgical opening and button attachment on the impacted upper right canine were performed and traction was applied on the impacted tooth using a removable appliance. This patient was mildly affected by Noonan syndrome and showed some dental problems. However, few studies have reported the oral characteristics of Noonan syndrome despite its high incidence. Thus, this case report describes the oral features and management of Noonan syndrome.

A Study on Curriculum Development for CHPs (보건진료원 직무교육 교과과정개선을 위한 연구)

  • Kwon Myung-Soon
    • Journal of Korean Public Health Nursing
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    • v.13 no.2
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    • pp.26-44
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    • 1999
  • The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.

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