The Journal of the Convergence on Culture Technology
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v.8
no.2
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pp.69-75
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2022
The purpose of this study is to present the direction of the development and utilization of remote class content for infants in a future educational environment through the analysis of remote class content for childhood. The analysis targets are 148 kindergarten [play ON] contents, and the analysis results according to "easy to use," "interest," "educational," "conformity of content," and "technicality" are as follows. Except for the 'conformity of content', there was a large variation in the score of content for each sub-area. In the case of "conformity of content," almost all of them received high scores for content production by incumbent teachers. With this in mind, we have drawn the following conclusions: First, it should be produced at an appropriate speed in consideration of the induction and understanding of childhoods' participation in play in the search and progress process, and it should be possible to play according to the challenges and levels using various strategies under the theme that all childhoods can be interested in. In addition, it was found that it was necessary to select topics, edit videos, and voice support so that childhoods can participate in the process of discovery and search, supporting childhoods' imagination, curiosity, and creative experiences.
Based on the Kohut's theory, this study carries out an investigation into the counselor's self object role in pathological narcissism. The theological understandings deal with narcissism, pathology, and self object. Narcissism and pathology can be seen as the failure of the formation of cohesive self. Early infant self, by feeling proper sympathy and love, usually forms integrated cohesive self. In other words, narcissistic personalities, when failing to receive sympathy and accommodation, can result in forming helpless and vulnerable self, which is filled with resentment. In addition, narcissistic characters are afraid of the world and maintain the grandiose image of self to protect themselves from feeling helplessness and emptiness. On the other hand, when they experience accommodation and admiration provided by self object, they can strengthen the image of grandiose self and demonstrate creative abilities as well. An infant remains as a fragmented self, when his or her relationship experience with self object is to be damaged. This study suggests the following conclusions: The counselor's self object role for pathological narcissism should be sympathetic self object so that the counselee will be able to form his or her own healthy cohesive self. Additionally, self object should play a kind role to guide infant desires for ideal models, which eventually help infants to pursue healthy ideas and maintain early states of narcissistic balances.
The purpose of this study is to examine the experiences of new teachers in the process of preparing and implementing the 2019 revised Nuri curriculum, and to find ways to support novice teachers. For these, Data were collected through telephone interviews with 12 first-time teachers with less than 2 years of experience at private kindergartens and daycare centers in Chungnam and Daejeon, and the collected data was analyzed through text network analysis. The results are as follows. First, teachers were worried that they did not know the details of the curriculum while preparing for the 2019 revised Nuri curriculum. To supplement this, they were preparing to observe infants, share information with fellow teachers, and refer to the Nuri curriculum commentary. Also, teachers thought that they were getting help in terms of indirectly experiencing actual play cases through training. Second, the first-time teachers were providing various support by focusing on children's play while implementing the Nuri curriculum. The teachers emphasized that the good point of implementing the Nuri curriculum is that children's interests and thoughts are taken into consideration, and that children-centered play can be carried out, and that the teachers can support children's play while thinking about it. And teachers mentioned the difficulties of reading children's thoughts in children's play, grasping the topic and proceeding with the play, and the lack of time to play. In addition, starting teachers were referring to internet resources and sharing opinions with fellow teachers, and mentioned that direct experience helped them to implement the play. Lastly, teachers' interest in and observation of play, creative thinking, quickness, and willingness to support play were considered important as the competency required for teachers.
The Journal of the Convergence on Culture Technology
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v.10
no.5
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pp.473-483
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2024
This study attempted to explore the operational experience of teachers in the extended class and the difficulties of teachers in the extended class for the implementation of play-oriented education in the extended class. The results of the interview analysis are as follows. First, I had a perception that the extended class teacher was an assistant teacher rather than a regular teacher. Second, since there is no separate classroom for extended classes, it helps teachers in charge of their absence rather than recognizing it as a sense of belonging and regular responsibility and cares for children without getting hurt. Third, teachers in the extended class put children's safety first with the care of mixed classes and the inconsistent return time of infants and toddlers. Fourth, most teachers were aware of the play-based curriculum and did not receive training, and most teachers said that it was impossible to implement the play-based curriculum in extended childcare. As a result, teachers in charge of the extended class need a guidebook for the extended class and an education and guidebook on the activity connection of the extended childcare class on what is the role of the teacher in charge of the extended class.
Pulmonary artery banding (PAB) in the functional univentricular heart (UVH) is a palliative procedure for staging toward the Fontan procedure; however, it is known to be a risk factor. Material and method: The records of all 37 patients with functional UVHs who underwent surgical palliation using PAB between September 1989 and August 1999 were reviewed retrospectively. We investigated the aortic arch obstruction, the development and progression of subaortic stenosis after PAB, and risk factor of mortality according to surgical method. Result: In 37 neonates and infants with single ventricular physiology, aortic arch obstruction was combined in 7. There were 6 early deaths (16.2%) after PAB and 3 late deaths (8.1%) after Fontan operation. The actuarial overall survival including early mortality at 3 and 5 years were 80.7$\pm$6.6%, 72.2$\pm$8.2% respectively. Among 31 patients who survived PAB, 27 patients (87.1 %) could become candidates for Fontan operation; 22 patients (71.0%) completed Fontan operation with 3 deaths and 5 were waiting bidirectional cavopulmonary shunt(BCPS) or Fontan operation (follow-up mean 4.5 year, minimal 2 year). Subaortic stenosis developed in 8 patients after PAB (8/29, 27.6%); 3 cases in the patients without arch anomaly (3/22, 13.6%) and 5 in those with arch anomaly (5/7, 71.4%). The subaortic stenosis was managed with Damus-Kaye-Stansel procedure (DKS) in 6 patients without operative mortality and conal septum resection in 2 without long-term survivor. Analysis of risk factors established that aortic arch obstruction was strongly associated with subaortic stenosis (p<0.001). The only risk factor of late mortality was Fontan procedure without staged palliation by BCPS (p=0.001). Conclusion: PAB is effective as an initial palliative step in functional UVH. And the high risk group of patients with aortic obstruction can undergo effective short-term PAB as an initial palliative step, with subsequent DKS for subaortic stenosis. This strategy, initial PAB and careful surveillance, and early relief of subaortic stenosis can maintain acceptable anatomy and hemodynamics for later Fontan procedures.
Yoo, Hye Soo;Kim, Ji Eun;Park, Soo Kyoung;Seo, Hyun Ju;Jeong, Yoo Jin;Chio, Seo Heui;Jeong, Soo In;Kim, Sung Hoon;Yang, Ji Hyuk;Huh, June;Chang, Yun Sil;Jun, Tae Gook;Kang, I Seok;Park, Won Soon;Park, Pyo Won;Lee, Heung Jae
Clinical and Experimental Pediatrics
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v.52
no.4
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pp.481-487
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2009
Purpose : This study investigated the clinical course and prognostic factor of very low birth weight infants (VLBWI) with hemodynamically significant congenital heart defects (CHDs). Methods : Medical records of 1,098 VLBWI with birth weight <1,500 g who had been admitted to the neonatal intensive care unit of Samsung Medical Center from October 1994 to December 2007 were reviewed retrospectively. The data for these patients with hemodynamically significant CHD (n=33) were compared with those without CHD (n=1,065). Results : The incidence of CHD was 3.0% (33 patients) 7 patients (21%) had CHD combined with the congenital abnormalities or chromosomal disorders. The most common CHD was a ventricular septal defect. The incidence of intrauterine growth retardation was higher in patients with CHD than in patients without CHD (34% vs. 20%), but there were no significant differences in gestational age, birth weight, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, severe intraventricular hemorrhage (${\geq}$Gr III), and periventricular leukomalacia. Cardiac surgery was performed on 13 patients (39%). Nine patients received staged operations, and 10 patients received early intervention. The overall mortality in patients who had CHD was higher than in the patients who did not have CHD (27% vs. 16%). In patients with CHD, congenital abnormalities or chromosomal disorders were more important factors for increased mortality (86% vs. 11%) than the degree of complexity of CHD (19% vs. 42%). Conclusion : The most important prognostic factors of VLBWI with CHD are the associated congenital abnormalities or chromosomal disorders.
Background: Since Ross and Sormeville first reported the use of aortic homograft valve for correction of pulmonary atresia in 1966, homograft valves are widely used in the repair of congenital anomalies as conduits between the pulmonary ventricle and pulmonary arteries. On the basis of these results, we have used it actively. In this report, we describe our experience with the use of cryopreserved valved homograft conduits for infants and children requiring right ventricle to pulmonary artery connection in various congenital cardiac anomalies. Material and Method: Between January, 1996 and December 2001, 27 infants or children with a median age of 16 months(range 9days to 18years) underwent repair of RVOTO using homograft valved conduit by two surgeons. We studied 22 patients who have been followed up at least more than one year. The diagnosis at operation included pulmonary atresia with ventricular septal defect (n=13), truncus arteriosus (n=3), TGA or corrected TGA with RVOTO (n=6). Homograft valved conduits varied in size from 15 to 26 mm (mean, 183.82 mm). The follow-up period ranged from 12 to 80.4 months (median, 48.4 months). Result: There was no re-operation due to graft failure itself. However, early progressive pulmonary homograft valve insufficiency developed in one patient, that was caused by dilatation secondary to the presence of residual distal pulmonary artery stenosis and hypoplasia after repair of pulmonary atresia with ventricular septal defect. This patient was required reoperation (conduit replacement). During follow-up period, there were significant pulmonary stenosis in one, and pulmonary regurgitation more than moderate degree in 3. And there were mild calcifications at distal anastomotic site in 2 patients. All the calcified homografts were aortic in origin. Conclusion: We observed that cryopreserved homograft conduits used in infant and children functioned satisfactorily in the pulmonic position at mid-term follow-up. To enhance the homograft function, ongoing investigation is required to re-establish the optimal strategy for the harvest, preservation and the use of it.
Background: Recent advances in understanding the anatomy of the complete atrioventricular septal defect(including right-dominant unbalanced atrioventricular septal defect) have led to alternative methods of repairing these defects. Material and Method: From May 1997 to July 1998, 8 consecutive infants(age range, 2 to 28 months, mean body weight 6.0$\pm$2.2 kg) received a single-stage intracardiac repair of the complete atrioventricular septal defect with modified surgical methods. Depending on the specific anatomic structure, the procedure was simplified in 3 patients by a direct closure of the ventricular element of the defect(Group I). Two patients judged unsuitable for direct closure due to a potential left ventricular outflow tract obstruction had received a standard two-patch repair(Group II). The remaining 3 patients with right-dominant unbalanced complete atrioventricular septal defect underwent biventricular repair; to enlarge the orifice of the left atrioventricular valve, the ventricular septal patch was placed slightly more to the right of the ventricular crest, a left sided bridging leaflet was augmented with an autologous pericardial patch, and the leaflet was repaired with a double- orifice(Group III . Result: In all 8 patients, the postoperative echocardiography demonstrated good hemodynamics. Seven patients were weaned from the ventilators after a mean 3$\pm$1 days, and 1 patient was weaned after 24 days due to a reoperation and emphysematous lung problem. A reoperation was performed in 1 patient for progressive left atrioventricular valve regurgitation due to leaflet tearing. There were no early and late mortalities. At the time of the latest review, judging from the echocardiographic criteria, left atrioventricular valve stenosis was mild in 1 patient(mean pressure gradient 6.5 mmHg, 13.5%), left atrioventricular valve regurgitation was absent or grade I in 7 patients(87.5%). The right atrioventricular valve regurgitation was absent or grade I in all 8 patients(100%). Conclusion: Infants with complete atrioventricular septal defect were treated with either a simplified approach with direct closure of the ventricular element of the defect or a modified surgical technique for a right-dominant unbalanced atrioventricular septal defect, depending on the anatomic structure. The results were no operative mortalities and low morbidity.
Infantile hypertrophic pyloric stenosis(IHPS), which occurs three of 1,000 live births, is a major cause of nonbilious vomiting of early infancy but its etiology and pathogenesis are still obscure. The operation of pyloromyotomy as described by Ramstedt in 1912 remains the standard of care for the treatment of IHPS. From January 1993 to October 1996, 35 infants with IHPS were surgically treated and the following results were obtained. 1. Thirty-five patients comprised 32 males and 3 females, and the ratio of male to female was 10.7:1. 2. The most prevalent age group was between 2 weeks and 8 weeks. 3. Of 35 infants, first born babies were 23 cases(65.7%). 4. Breast feeding was in 23 cases(65.7%). 5. The body weight percentile at admission was lower than 50 percentile in all 35 cases. 6. Onset of symptoms was predominantly between 1week and 2 weeks in 11 cases(31.4%). 7. All had a history of nonbilious vomting, generally projectile in nature. 8. In the measured serum electrolytes, hypokalemia was noted in 9 cases(25.7%), hypochloremia was observed in 14 cases(40.0%). 9. In the preoperative ultrasonography, the average muscle thickness, diameter, and length of the pylorus were 6.2mm, 12.1mm, and 17.9mm, respectively. 10. Among 35 cases, significant sonographic criteria of IHPS, muscle thickness of 5mm or more, were noted in 26 cases(83.9%). 11. A total of seven associated anomalies were noted in six patients. 12. All 35 cases were treated with Fredet-Ramstedt pyloromyotomy. 13. There were postoperative complications of wound infection in 2 cases. Intermittent nonprojectile vomiting was presented in 8 cases(22.9%) after operation, but one of them was relieved in 13 days and the rest were relieved within one week by adjustment of oral intake.
The purpose of this study was to classify risk groups according to Caries Risk Assessment (CRA) and to investigate the effect of caries prevention program after 1 year of caries prevention intervention program in 6-year-old infants with high caries risk. The subjects were selected based on responses to CRA questionnaires. At the first visit, oral examination, Cariview, bacteria and saliva flow test were performed. The caries risk group was classified accordingly. The subjects were given fluoride application and oral health education every four months and evaluated the same as the first visit after 1 year. As a result of classifying the risk level according to CRA, more than 80% of the subjects were in the high or extreme high risk. The dft index was increased in all risk groups after the intervention. There was a significant difference between the before and after intervention (p<0.05). The Cariview score showed a slight decrease after the intervention in the moderate and high risk groups. As a result of the evaluation of bacteria test, Streptococcus mutans were decreased to ${\geq}10^5CFU/ml$ saliva after intervention in all groups. Lactobacilli were decreased after intervention in high risk and extreme high risk groups. As a result of saliva flow, there was significant difference between caries risk groups before and after intervention (p<0.05). In conclusion, regular caries management has been shown to influence caries risk factors in high-caries risk children. Also, it is necessary to find out periodical dental risk management system which is suitable for domestic situation through the related studies.
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