• Journal of Dental Anesthesia and Pain Medicine
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• 제22권2호
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• pp.155-159
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• 2022

Cohen syndrome is a rare genetic disorder associated with mutations in the VPS13B gene. Individuals with this disorder present with diverse clinical manifestations, including muscle hypotonia, intellectual disabilities, and typical facial characteristics, such as prominent upper central incisors and micrognathia. General anesthesia was administered to a 23-year-old man with Cohen syndrome. Although we observed prominent upper central incisors, an overjet of 10 mm, micrognathia, and thyromental distance of 4 cm, hypotonia was not observed in the patient. Intubation was rendered difficult when performing a direct laryngoscopy. However, smooth intubation was achieved using a video laryngoscope. The patient's train of four (TOF) count remained zero close to 60 min after rocuronium administration, suggesting that the drug's muscle-relaxant effect may have been prolonged. A TOF ratio of 0.79 was confirmed 130 min after rocuronium administration, and a TOF ratio of 1.0 was confirmed after administration of 150 mg of sugammadex. The patient's respiration remained stable after extubation, and no recurarization of muscle relaxation was observed. As demonstrated in this case report, it is important to closely monitor recovery from muscle relaxation and prepare multiple techniques for airway management in general anesthesia management of patients with Cohen syndrome.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.127-131
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• 2021

Autosomal recessive spinocerebellar ataxia 20 (SCAR20; OMIM #616354) is a recently described disorder that is characterized by ataxia, intellectual disability, cerebellar atrophy, macrocephaly, coarse face, and absent speech. It is caused by loss-of-function mutations in SNX14. To date, all cases with homozygous pathogenic variants have been identified in consanguineous families. This report describes the first Korean cases of SCAR20 family caused by homozygous variants in SNX14. Two siblings were referred to our clinic because of severe global developmental delay. They presented similar facial features, including a high forehead, long philtrum, thick lips, telecanthus, depressed nasal bridge, and broad base of the nose. Because the older sibling was unable to walk and newly developed ataxia, repeated brain magnetic resonance imaging (MRI) was performed at the age of 4 years, revealing progressive cerebellar atrophy compared with MRI performed at the age of 2 years. The younger sibling's MRI revealed a normal cerebellum at the age of 2 years. Whole-exome sequencing was performed, and homozygous variants, such as c.2746-2A>G, were identified in SNX14 from the older sibling. Sanger sequencing confirmed homozygous SNX14 variants in the two siblings as well as a heterozygous variant in both parents. This report extends our knowledge of the phenotypic and mutational spectrum of SCAR20. We also highlight the importance of deep phenotyping for the diagnosis of SCAR20 in individuals with developmental delay, ataxia, cerebellar atrophy, and distinct facial features.

• 지역사회간호학회지
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• 제11권1호
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• pp.245-261
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• 2000

Based on the literature, status and role the music therapist in America was reviewed for this study. The process of developing a music therapy program in America suggests to us many things: In America, music therapists have sustained a mutually beneficial status with their clients for, over fifty years. Excellence in academic education and clinical training enable music therapists to continue to provide quality music therapy. The magnitude of change in to music therapy in the United States, however creates the challenge of providing real access to music therapy continues in the future. Music therapy is the use of music in the accomplishment of therapeutic aims: the restoration, maintenance, and improvement of mental and physical health. Music therapists work with individuals of all ages who require special services due to behavioral. social. learning, or physical disabilities. Employment may be in hospitals, clinics, day care facilities, schools, community mental health centers, substance abuse facilities, nursing homes, hospices, rehabilitation centers, correctional facilities, or private practices. The American Music Therapy Association (AMTA) was founded in 1998 as a result of a union between the American Association for Music Therapy (founded in 1971) and the National Association for Music Therapy(founded in 1950). Music therapists are highly qualified professionals who have completed approved degree programs and had clinical training in order to receive Board Certification(MT-BC), with the designation of Registered, Certified, or Advanced Certified Music Therapist(RMT. CMT - or ACMT). AMTA provides several mechanism for monitoring the quality of music therapy programs: Standards of Practice. a Code of Ethics, a system for Peer Review, a Judical Review Board, and an Ethics Board. According to the results of this study, the suggestions were as follows: 1. It is concluded that music therapy as a nursing intervention can be effective for the clients. 2. It is a great challenge to develope a music therapy program for nursing intervention however, it is also task and responsibility to further the development of nursing.

• Safety and Health at Work
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• 제10권4호
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• pp.393-399
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• 2019

Objective: This study investigates the impact of multimorbidity on work through a literature review of longitudinal studies. Methods: A systematic review was carried out in the databases Lilacs, SciELO, PAHO, PubMed/Medline, Scopus, Web of Science, and Cochrane. There were no restrictions regarding the year of publication or language to maximize the identification of relevant literature. The quality of studies was assessed by the protocol STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). Results: An initial database search identified 7522 registries, and at the end of the analysis, 7 manuscripts were included in the review. Several studies have demonstrated direct and indirect impacts of multimorbidity on the health of workers. For this, the number of missed days due to health-related issues was evaluated, as well as the reduction in work productivity of the unhealthy worker, vulnerability of the worker with multimorbidity regarding higher indices of dismissal and recruitment difficulties, and incidence of early retirement and/or receipt of benefits due to disabilities. Conclusions: Multimorbidity has a negative impact on work, with damages to quality of life and work productivity, worsening the absenteeism/presenteeism indices, enhancing the chances of temporary or permanent leaves, and lowering employability and admission of individuals with multimorbidity.

• The Korean Journal of Pain
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• 제35권3호
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• pp.280-290
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• 2022

Background: This study aimed to determine the impact of complex decongestive therapy applications on upper extremity function in breast cancer patients who developed adhesive capsulitis after lymphedema. Methods: Thirty patients who developed adhesive capsulitis due to lymphedema were divided into two groups as study (n = 15) and control (n = 15) groups. Both groups received 20 minutes of exercise five days a week for three weeks using a Biodex isokinetic dynamometer, as well as a hot pack and TENS (Transcutaneous Electrical Nerve Stimulation) treatment to the shoulder joint. The study group received 45 minutes of intensive decongestive therapy along with the adhesive capsulitis treatment. The visual analogue scale was used to assess pain, circumference, and volumetric measurements were used to assess edema, and the Arm, Shoulder, and Hand Problems Questionnaire (DASH: Disabilities of the Arm, Shoulder, and Hand) was used to assess upper extremity functionality. The shoulder range of motion was evaluated. Results: Both groups had improvements in pain (P < 0.001), shoulder joint range of motion (P < 0.001), and upper extremity functionality (P < 0.001) after the treatment. There was a significant decrease in circumference and volumetric measurements in the study group (P < 0.001). However, no differences were seen in measurements in the control group. Conclusions: The results showed that complex decongestive therapy was beneficial in reducing lymphedema in breast cancer patients who acquired adhesive capsulitis due to lymphedema. Consequently, the authors believe that supplementing conventional physiotherapy with complex decongestive therapy will benefit patients.

• 한국빅데이터학회지
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• 제8권1호
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• pp.11-22
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• 2023

본 연구는 대중들이 '심신장애를 사유로 하는 형량 감경 비율'에 대해 어떻게 생각하고 있는지 분석하고, 여론의 방향과 실제 법원의 판단이 합치되는지 확인하기 위해 수행되었다. 이를 위해, 대법원 코트넷 판결문 검색시스템과 기관별 정신감정 의뢰 건수, 네이버 뉴스에서 '심신장애'를 키워드로 하는 기사의 개수와 댓글 개수, 댓글 내용을 크롤링한 결과를 활용하였다. 데이터 분석 결과, 여론은 심신장애에 따른 형량 감경에 대해 부정적이었으며 그 기준의 모호성에 대해 불만을 나타냈다. 그러나 실제 판결문 분석과 기관별 정신감정 의뢰 건수 분석 결과 법원은 「형법」제10조(심신장애)에 규정된 정신장애인의 책임 조각 및 책임 감경에 대해 엄격하게 판단하고 있음을 확인할 수 있었다. 즉, 가해자의 정신장애에 대한 인정 사례는 줄어들고 있지만 여론은 이를 인지하지 못하고 있다. 공권력이 국민 수호의 의무를 충분히 수행하고 있지 못하다는 여론의 형성은 국가기관에 대한 국민의 신뢰를 떨어뜨리는 부정적 효과를 갖고 있다. 따라서 국민의 안전을 보장하는 경찰과 검찰은 국민의 신뢰를 얻기 위해 명확한 기준에 따라 법집행을 할 필요가 있으며 사법부도 심신장애에 대한 감형 기준에 대해 엄중한 판단은 물론 그 적용 결과를 국민들에게 인식시켜줄 필요가 있다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권2호
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• pp.7-14
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• 2016

Purpose: Caring for weak person in society, which increases the population of the elderly and people with disabilities is essential. By increasing along with the increase of the use of passenger facilities for travelers and pedestrian is increasing the demand for convenient and secure facilities for everyone. The emerging importance of the passenger-related facilities, but a representative study of the bus terminal facilities is lacking. Bus terminals are the most popular passenger facility. Thus, the bus terminal can be conveniently used by anyone in everyday life, however, the applied elements considering the use of the transportation Poor are not sufficient. Methods: This study was conducted to evaluate BF certification standards targeting bus terminals across the country to determine the availability of the transportation Poor in bus terminal. Result: As a result of the bus Terminal possibility BF certified it appeared to be very low. Also, items received the lowest rating of each item was evaluated in the informative facilities and items. Bus terminal is a facility used by the unspecified individuals, the proportion of first-time user is high, but there is a lack of consideration for the transportation Poor bus terminals. Implications: In the future, this study can guide the next research on the application of BF certification standards in bus terminal. Further studies can be presented to the improvement of the BF certification indicator in bus terminal.

• 사회복지연구
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• 제41권1호
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• pp.39-63
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• 2010

본 연구는 영국에서 태동한 장애에 대한 사회적모델과 미국에서 발현된 자립생활모델을 이론적으로 비교함으로써 각 모델이 갖는 정체성을 뚜렷하게 부각시키는데 있다. 연구결과, 상이점으로 사회적모델은 거시적인 이념적 수준에서 장애의 원인에 대한 패러다임의 변화를 추구한 반면, 자립생활모델은 자조모임과 활동보조서비스라는 구체적인 사회변화 양상을 요구하는 자립생활실천의 미시적 관점에서 당사자의 서비스에 대한 통제권을 강조한다. 유사성으로서는 당사자주의, 장애에 대한 사회적 책임, 초기단계에서의 지적장애인의 소외, 장애인차별금지법 제정에의 추동력 제공 등을 들 수 있다. 이러한 연구결과는 양 모델의 정체성을 보다 뚜렷하게 하는 장점과 함께, 향후 서비스 실천현장에서, 장애운동계에서 어떻게 이들을 이해하고 있으며 실제 관련 법률의 개정, 장애인장기요양제도 등의 도입·전개에 있어 실제 어떠한 영향을 미쳤는지를 살펴볼 수 있는 이론적 틀을 제시했다는데 그 의의가 있다.

• 한국사회복지학
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• 제62권4호
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• pp.171-192
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• 2010

본 연구는 장애인의 직업재활성과에 영향을 미치는 개인적, 조직적 특성을 밝힘으로써 장애인 직업재활사업의 발전을 위한 실천적 함의를 제공하는데 목적이 있다. 분석을 위해 2009년 서울시에서 운영비를 지원하고 있는 장애인 직업재활시설 내 장애인과 시설에 대한 조사결과를 활용하였으며, 임금수준을 장애인의 직업재활성과로 간주하여 분석하였다. 분석방법으로는 직업재활성과의 개인효과와 조직효과를 구분하기 위해 위계선형모형(Hierarchical Linear Model)을 사용하였다. 분석결과, 장애인 직업재활시설 간 차이가 장애인의 임금수준을 설명하는 비중이 유의하게 높았으며, 개인특성과 조직특성의 상호작용효과를 분석한 결과 장애유형과 조직특성 변수 간의 상호작용효과가 유의한 것으로 나타났다. 정책적으로 장애인 직업재활사업의 성과를 높이기 위해 직업재활시설 간 격차를 줄이기 위한 노력이 필요하며, 장애유형 및 특성에 따라 시설운영에 있어 각별한 관심이 요구된다.

• 한국컴퓨터정보학회논문지
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• 제29권8호
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• pp.77-84
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• 2024

본 논문에서는 장애인 예술인의 예술 작품을 전시할 수 있는 안드로이드 플랫폼 기반의 온라인 전시 애플리케이션을 설계하고 구현한다. 이 애플리케이션은 장애인 예술인을 위한 사용자 편의성을 고려한다. 특히 시각 및 청각 장애인을 위한 STT, TTS 기능을 제공한다. 또한, 장애인 예술인의 전시 작품을 위해 회원가입 시 장애 등록증과 등록번호를 활용하여 장애인 인증이 가능하도록 구현함으로써 인증된 장애 예술인만 작품을 전시할 수 있도록 구현한다. 장애인 예술인에 대한 개인정보와 예술 작품에 대한 정보를 저장하는 데이터베이스는 MySQL로 구현한다. 서버 모듈은 RestAPI를 활용하여 JSON 형태의 데이터를 전송하도록 구현한다. 예술 작품에 대한 정보는 데이터 용량이 크기 때문에 서버에 직접 저장하지 않고 Firebase Storage를 활용하여 데이터 용량 제한 없이 저장하도록 구현한다. 이 애플리케이션은 장애 예술인의 전시 공간 부족과 일반 대중과의 소통 부족 문제를 완화할 수 있다.