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Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder: A Retrospective Study (주의력결핍 과잉행동장애 아동의 약물치료 순응도에 영향을 미치는 요인 : 후향적 연구)

  • Kim, Yoon-Jung;Oh, So-Young;Lee, Ji-Ah;Moon, Su-Jin;Lee, Won-Hae;Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.174-181
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    • 2010
  • Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

The Trend and Prospect of the Nursing Intervention Classification (간호중재분류의 동향과 전망)

  • Park, Sung-Ae
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.75-85
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    • 1996
  • Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.

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A Study on the Dominant Driving Force of Plate Movement presented in the High School Earth Science Textbooks (고등학교 지구과학 교과서에 제시된 판 이동의 주된 원동력에 대한 고찰)

  • Jeon, Taehwan;Seo, Ki-Weon;Lee, Gyuho
    • Journal of the Korean earth science society
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    • v.37 no.1
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    • pp.62-77
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    • 2016
  • In the early model of plate tectonics, the plate was depicted as a passive raft floating on the convecting mantle and carried away by the mantle flow. At the same time, ridge push at spreading boundaries and drag force exerted by the mantle on the base of lithosphere were described as the dominant driving forces of plate movements. However, in recent studies of plate tectonics, it is generally accepted that the primary force driving plate motion is slab pull beneath subduction zones rather than other forces driven by mantle convection. The current view asserts that the density contrast between dense oceanic lithosphere and underlying asthenosphere is the substance of slab pull. The greater density of oceanic slab allows it to sink deeper into mantle at trenches by gravitational pull, which provides a dominant driving force for plate motion. Based on this plate tectonics development, this study investigated the contents of plate tectonics in high school Earth Science textbooks and how they have been depicted for the last few decades. Results showed that the early explanation of plate movement driven by mantle convection has been consistently highlighted in almost all high school textbooks since the 5th curriculum, whereas most introductory college textbooks rectified the early theory of plate movement and introduced a newly accepted theory in revised edition. Therefore, we suggest that the latest theory of plate tectonics be included in high school textbooks so that students get updated with recent understanding of it in a timely manner.

A Study on the Erasure of Japanese National Flag in Dong-A Ilbo (["동아일보"]의 일장기 말소 사건 연구)

  • Chae, Baek
    • Korean journal of communication and information
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    • v.39
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    • pp.7-39
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    • 2007
  • This study tried to revaluate the Erasure of Japanese National Flag in Dong-A Ilbo. In spite of its historical significance, this event was not explored thoroughly by researchers. While it was known as Chosunjoongang-Ilbo erased the Japanese National Flag earlier than Dong-A Ilbo on August 13 1936, but this study found out that Dong-A Ilbo erased the Japanese National Flag in the local morning edition of the same day. With the victory of Kijeong Son in the Berlin Olympic Marathon the nationalistic coverage of Dong-A Ilbo seemed to be revived. And this change caused the severe suppression by the colonial Japanese government. The government intended to eliminate the influences of Seongsu Kim and Jinwoo Song to make Dong-A Ilbo more cooperative partner. But because the intention of the government was not acceptable to two men, Dong-A Ilbo posed a noncooperative stance. This resulted in the longest suspension over 9 months. Finally with the change of stance to a compromising one, Dong-A Ilbo could be released from the longest suspension on June 3rd, 1937.

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Prognostic Significance of Group 2 Lymph Node Metastasis in pT3pN1 Gastric Cancer Patients (제5판 UICC TNM림프절 분류에 따른 pT3pN1 위암 환자에서 림프절의 해부학적인 위치에 따른 2군 림프절 양성의 의의)

  • Kim Yong Jin;Kim Byung Sik;Choi Won Yong;Yook Jung Hwan;Oh Sung Tae;Park Kun Choon
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.32-35
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    • 2004
  • Purpose: The most important prognostic factors in gastric cancer is the depth of invasion of the primary tumor and lymph node metastasis. The nodal staging of the 5th edition of the Union Internationale Contrala Cancrums (UICC) TNM classification in 1997 was changed based on the number of metastatic lymph node. We attempted to evaluate the prognostic significance of N2 group metastasis in pT3pN1 gastric cancer patients by comparing two different nodal staging systems. Materials and Methods: A retrospective analysis was made for 352 gastric cancer patients who underwent curative resection, including D2 dissection, from 1991 to 1997 at Asan Medical Center. A clinicopathologic comparison between two groups by using a nodal staging systems was summarized into a table. Cumulative survival rates were calculated by using the Kaplan-Meier method. The difference between the two groups was evaluated by using the log rank test with SPSS 11.5 for Windows Results: There were no statistical differences in clinicopathologic factors. However, there was a significant difference in survival rate between the two groups (P=0.0009). This suggests that N2 group metastasis in pT3pN1 gastric cancer patients has a clinical significance for predicting prognosis. Conclusion: Our results suggest a possibility of prognostic significance of N2 group metastasis. Therefore, anatomical location of the lymph node should be described.

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The Effect of CYP2D6/3A5 Genotypes on Plasma Concentrations of Haloperidol after Adjunctive Treatment of Aripiprazole

  • Shim, Joo-Cheol;Ahn, Jung-Mi;Jung, Do-Un;Kong, Bo-Geum;Kang, Jae-Wook;Liu, Kwang-Hyeon;Shin, Jae-Gook
    • Korean Journal of Biological Psychiatry
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    • v.18 no.2
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    • pp.95-100
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    • 2011
  • Objectives To evaluate the drug interactions between aripiprazole and haloperidol, authors investigated plasma concentrations of those drugs by genotypes. Method Fifty six patients with a confirmed Diagnostic and Statistical Manual of Mental Disorders 4th edition diagnosis of schizophrenia were enrolled in this eight-week, double blind, placebo-controlled study. Twenty-eight patients received adjunctive aripiprazole treatment and twenty-eight patients received placebo while being maintained on haloperidol treatment. Aripiprazole was dosed at 15 mg/day for the first 4 weeks, and then 30 mg for the next 4 weeks. The haloperidol dose remained fixed throughout the study. Plasma concentrations of haloperidol and aripiprazole were measured by high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) at baseline, week 1, 2, 4 and 8. $^*1$, $^*5$, and $^*10$ B alleles of CYP2D6 and $^*1$ and $^*3$ alleles of CYP3A5 were determined. The Student's T-test, Pearson's Chi-square test, Wilcoxon Rank Sum test and Logistic Regression analysis were used for data analysis. All tests were two-tailed and significance was defined as an alpha < 0.05. Results In the frequency of CYP2D6 genotype, $^*1/^*10$ B type was most frequent (36.5%) and $^*1/^*1$ (30.8%), $^*10B/^*10B$ (17.3%) types followed. In the frequency of CYP3A5 genotype, $^*3/^*3$ type was found in 63.5% of subjects, and $^*1/^*3$ type and $^*1/^*1$ were 30.8% and 5.8% respectively. The plasma levels of haloperidol and its metabolites did not demonstrate significant time effects and time-group interactions after adjunctive treatment of aripiprazole. The genotypes of CYP2D6 and 3A5 did not affect the plasma concentration of haloperidol in this trial. No serious adverse event was found after adding aripiprazole to haloperidol. Conclusion No significant drug interaction was found between haloperidol and aripiprazole. Genotypes of CYP2D6 and 3A5 did not affect the concentration of haloperidol after adding aripiprazole.

Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study (조현병 환자에서 장기지속형 항정신병 주사제 팔리페리돈 팔미테이트의 효능과 안전 : 24주 개방형 연구)

  • Kang, Hyun-Ku;Hahm, Woong;Shon, In-Ki;Paik, In-Ho
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.111-117
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    • 2013
  • Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

Development of Korean Version of the Dementia Eating Evaluation Tool based on Behavioral Observation (행동관찰 기반 치매 식이 평가 도구의 한국판 개발)

  • Seo, Sang-Min;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.9 no.1
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    • pp.56-68
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    • 2020
  • Objective : This study introduces domestic and overseas systematic assessment tools that can identify eating problems of dementia patients based on abnormal behavior observations and turns them into Korean through the verification of content placement by expert groups. Methods : Three types of assessment tools were selected for final development in Korean version through several meetings based on a wide range of relevant literature searches. The 3 selected assessment tools were first translated by the researchers, and a 9-person expert team was used to verify the Content Validity Index. Results : The EBS content equivalence calculation shows that all 6 questions and 1 response item had a CVI value 0.9, and all items were included in Korean EBS without modification. The EdFED content equivalence calculation showed that all 11 questions had CVI value 0.9, which was included in the Korean edition of EdFED without modification. The content equivalence calculation of the FDI showed that all 19 questions had a CVI of 0.8 or higher, and all items were included in the Korean version of the FDI without modification of the item. Conclusion : Korean versions of the EBS, EdFED and FDI, which are based on behavioral observation and diet tools for people with dementia, have been developed. Early determination of problems related to diet in dementia patients and providing proper intervention through observational Korean version assessment tools is vital in terms of strengthening patient nutrition and reducing caregivers' burden.

A Study on Optimum Allocation and Risk Assessment of Recognition Devices Intended for the Mobility Handicapped in Terms of the Guardian Services (지킴이 서비스를 위한 교통약자 인식장치 적정배치 및 위험도 평가에 관한 연구)

  • Han, Woong-Gu;Kim, Hyun-Myung;Choi, Kee-Choo;Sohn, Sang-Hyun
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.11 no.2
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    • pp.67-76
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    • 2012
  • In this study, we established objective appraisal standard by applying newly made appraisal standard to those areas equipped with the protection system targeted to the Mobility handicapped announced in this edition (issue 5, volume 9(Oct., 2010)) beyond simple evaluation related to protector satisfaction. Additionally, we achieved efficient budget execution by conducting the preliminary estimation assessment regarding those areas on which recognition devices should be newly deployed. Through the assessment of the system coordination, the maximum safety distance is proved to be 72.2m. On the basis of this result, we applied dangerous grade to the deployment of recognition devices considering both psychological and accidental risk. With this, we proposed valuation basis to enable us to do future business. Based on this assessment standard, the degree of risk is proved to decrease by 35.2% compared to before conducting the demonstration project in terms of evaluation of comprehensive risk regarding intended areas. Additionally, we confirmed the fact that the degree of risk can decrease by 33.1% totally after having recognition devices built according to the deployment standard within budget. Furthermore, comprehensive risk can decrease up to 94% compared to the level of the demonstration project even though we spend 21.9% less of the existing budget. Hence, we can say that the deployment method of recognition devices related to the degree of risk is applied efficiently in the near future in terms of controlling comprehensive risk and cutting down budget through this study.

Emotional Availability of working mothers and their 24~48 month-olds in child care centers (취업모와 자녀의 정서적 가용성에 관련된 변인 연구:보육시설에 다니는 24-48개월 아동을 중심으로)

  • Han, Sung Hee;Lee, Young
    • Korean Journal of Childcare and Education
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    • v.6 no.1
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    • pp.23-45
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    • 2010
  • The purposes of this study were to explore the level of emotional availability of working mothers and their 24~48month-olds (67 dyads: 33 boys and 34 girls) in child care centers and to examine the relationship between the mother-child emotional availability and the related variables of working mothers and their children. Emotional Availability Scales (EA, 3rd edition) developed by Biringen, Z., Robinson, J., & and Emde, R.N. (1998) was used. Mother's work-family conflict, maternal parenting stress, and maternal depression, temperament of child, personal background were measured. The results of this study were as follows: The level of mother-child emotional availability was above in the middle level. There were significant differences in the mother-child emotional availability by maternal educational level and family income level, and significant negative correlation between maternal parenting stress and mother-child emotional availability. There was significant difference in the mother-child emotional availability by the starting point of child care experience. Mother-child emotional availability were significantly explained by family income level, maternal parenting stress, and the starting point of child care experience.