• Child Health Nursing Research
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• v.19 no.3
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• pp.159-167
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• 2013

Purpose: The purpose of this study is to find out preschool children's health status and their mothers' health management in the vulnerable classes. Methods: The assessment tool was developed, taken into consideration existing studies, materials produced by the customized visiting health care system, and review of visiting nurses of health centers and related experts. Data were collected January to February 2010 from 259 mothers by visiting nurses, and analyzed using SAS program for descriptive statistics. Results: Body weight less than 3 percentile was found for 5.0% children and over 97 percentile for 7.7%. Atopy was found in 17.8% children, no hand-washing after toileting and before meal in 30.9% and 36.7% respectively, no breakfast in 15.8%, and irregular meal in 32.0%. Sex education was made by 45.7% mothers, regular dental check by 56.6%, and hearing and eyesight test by 61.1% and 66.8% respectively. Home environment for upbringing is 34.3 in the scale of 41, and accident prevention 17.5 in the scale of 22. Conclusion: It is necessary to make an intervention on children's weight, personal sanitation and meal time in the vulnerable classes. Mothers need to be educated for appropriate health care, and home environments to improve upbringing and accident prevention.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.73-82
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• 2008

Dental caries is an infectious disease caused by mutans streptococci, and is a primary etiologic agent of dental caries in humans. The molecular pathogenesis of mutans streptococcal-associated dental caries occurs in three phases. Firstly, S. mutans attaches to tooth surface via a cell surface adhesion termed antigen I/II. In the second phase, the glucosyltransferase(GTFs) synthesize polymers like glucans in the presence of sucrose. In the third phase, the multivalent glucans interacts with glucan binding proteins (GBPs) and they make dental plaque and accumulation of microorganisms. Many studies and clinical trials have indicated that a mucosal immune response to these antigens(Ag I/II, GTFs, GBPs) of S. mutans can influence the pathogenesis of dental caries. So these antigens can be important vaccine candidates for immunologic intervention against dental caries. In this study, we cloned the genes for GTFb, GTFc, GTFd from S. mutans GS-5 and did the nucleotide sequence analysis. And the recombinant proteins of GTFd and N-terminus of GTFd were expressed. Intact GTF which we get from this experiment can be used for antibody production specific for any GTF activity domain through animal experiment.

• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.111-120
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• 2016

Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

• Journal of muscle and joint health
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• v.11 no.2
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• pp.187-198
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• 2004

Purpose: The purpose of this study was to identify differences of BMI, pain, depression, self-esteem and self-efficacy between rheumatoid arthritis and osteoarthritis patients. Method: The study subjects were 135 persons having chronic arthritis at rheumatology clinic and the department of orthopedic surgery of the C university hospital in D city. The data were collected from February 19th to April 7th, 2003. The data analysis consisted of $X^{2}-test$, t-test, Pearson Correlation Coefficient, and multiple regression using SPSSWIN 10.0 program. Result: 1. There were significant differences in age(p=0.000), occupation(p=0.015), marriage(p=0.028), duration of illness(p=0.000), BMI(p=0.006) and Self-efficacy(p=0.017) between rheumatoid arthritis and osteoarthritis patients. 2. In rheumatoid arthritis, the BMI and self-esteem(r=-0.239, p=0.05) were significantly correlated and also pain and self-esteem(r=-0.402, p=0.01), pain and self-efficacy(r=-0.455, p=0.01) were significantly negatively correlated. The self-esteem and depression(r=-0.622, p=0.01), self-efficacy and depression(r=-0.729, p=0.01) were significantly negatively correlated and also pain and depression(r=0.432, p=0.01), self-esteem and self-efficacy(r=-0.476, p=0.01) were significantly positively correlated. In osteoarthritis, the pain and self-esteem(r=-0.225, p=0.01) were significantly negatively correlated and also pain and self-efficacy(r=-0.493, p=0.01), self-esteem and depression(r=-0.692, p=0.01), self-efficacy and depression(r=-0.566, p=0.01) were significantly negatively correlated. The pain and depression(r=0.290, p=0.05), self-esteem and self-efficacy(r=0.383, p=0.01) were significantly positively correlated. 3. The factors influenced by the self-efficacy, the depression and age in rheumatoid arthritis explained 56.2%, the depression and pain in osteoarthritis explained 43.9%. The factors influenced by the BMI, the self-esteem in rheumatoid arthritis explained 5.7%, but there was no significantly variable in osteoarthritis. Conclusion: The results support the importance of different nursing intervention focused on BMI and self-efficacy in patients with rheumatoid arthritis and osteoarthritis. There is a need for further studies to identify relation of variables in different diseases related to arthritis.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.5-26
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• 2001

Many studies have reported that regular aquatic exercise can lead to improvement of health for patients suffering from arthritis. In spite of these benefits, the adherence rate has shown as few as 26% of patients with arthritis who had completed the aquatic exercise education program. Moreover, when patients with arthritis begin an aquatic exercise, 47% withdraw within the first 6 month. No study has been found that constructs model to explain aquatic exercise adherence of patients with arthritis. The purpose of this study were to identify the factors influencing exercise adherence and to construct and test a structural model to explain aquatic exercise adherence of patients with arthritis. Hypothesized model was constructed on the basis of Bandura's social cognitive theory and literature review. Exogenous latent variables included in this model are group cohesion and barrier, endogenous latent variables are self-efficacy, outcome expectancy and self-evaluation. Empirical data used was collected through individual interviews with the structural questionnaire on 249 patients with arthritis who had completed the 6-week aquatic exercise education program of Korean Rheumatology Health Professionals Academy. The interviews were performed from September 6, 1999 through October 8, 1999. A model tested by the covariance structural analysis with LISREL 8.12a program and by descriptive statistics and correlation with SAS 6.12 program. The results are summarized as follows: First, hypothesized model showed a good fit to the empirical data. In the modified model added one new path showed a much better fit. Second, group cohesion had a direct, indirect positive effects, self-efficacy and self evaluation had a direct positive effects on exercise adherence. Barrier had a direct, indirect negative effects on exercise adherence. Outcome expectancy had a direct negative effect, indirect positive effects through self-evaluation on exercise adherence, but total effects was not significant. Total effect size of the variables were group cohesion, self-efficacy, barrier and self evaluation in order. All variables accounted for 54% of the total variance of exercise adherence in the model. In conclusion, this model confirmed to be proper in explaining of aquatic exercise adherence. Group cohesion, self-efficacy, outcome expectancy, self-evaluation, barrier contributed to the aquatic exercise adherence of patients with arthritis. The results of this study suggested that improvement of group cohesion, self-efficacy and self-evaluation, motivation of outcome expectancy through self-evaluation, and reduction of the barrier should be included in the strategy of nursing intervention for the aquatic exercise adherence of patients with arthritis.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Journal of Gifted/Talented Education
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• v.25 no.4
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• pp.649-667
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• 2015

This study handled underachievement issue of gifted students by developing and validating educational programs as a solution, or relief, of their academic underachievement problems. The proposed educational program was designed to enhancing reading comprehension ability of gifted students with underachievement. Based on comprehensive literature review, this study found that key issues of underachievement have to do with learning strategy, and also that learning strategy was established as 'reading comprehension strategy.' Considering diverse reading comprehension models and strategies suggested by preceding studies, the reading comprehension strategy program in Korean was customized for underachieving gifted students on the middle school level. The effectiveness of the reading comprehension strategy program as a solution to underachievement of gifted students was explored by applying the developed program to 36 identified students after school twice a week for 6 weeks, conducting pre- and post-tests that were selected to measure their reading comprehension abilities, collecting their academic achievement data before and after the intervention by this study, and interviewing students. As the results of this study, reading metacognition ability, reading comprehension skills, and school grades of gifted students with underachievement were meaningfully improved as a group. On the individual level, 12 identified students, exactly one third of the whole group of underachieving gifted students, showed so improved academic achievement as we can say they overcame underachievement based on the Supplee's definition.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.7
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• pp.4053-4056
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• 2013

Background: Colposcopy is the gold standard procedure for evaluating cervical cytological abnormalities. Although it is essentially a minimally invasive intervention, referral for colposcopy may cause significant distress on patients. In this study, we aimed to determine if pre-procedural anxiety levels have a significant association with procedure related pain and discomfort in women undergoing colposcopy for evaluation of abnormal cervical cytology. We also assessed the impact of various clinical factors on anxiety, pain and discomfort in these patients. Materials and Methods: This prospective study was performed at the gynecologic oncology department of Zekai Tahir Burak Women's Health Education and Research Hospital in Ankara, Turkey between January and June 2013. After taking informed consent, State-Trait Anxiety Inventory (STAI) form and a 14-item questionnaire were filled for women who were admitted to our outpatient colposcopy unit for evaluation of abnormal cervical cytology. STAI scores were calculated for each participant. Immediately after the procedure, visual analog scale (VAS) scores for procedure-related pain and discomfort were obtained. Associations between STAI and VAS scores were investigated using correlation analyses. The effect of various contributing factors on anxiety, pain and discomfort were evaluated with linear regression analysis. The p values less than 0.05 were considered statistically significant. Results: A total of 222 women met the inclusion criteria within the study period. Mean patient age was $38.5{\pm}9.6$. Median state and trait anxiety scores were 47 and 46, respectively. Median VAS scores for pain and discomfort were 4 for both variables. State anxiety had a significant correlation with procedure related discomfort (p=0.02). Colposcopy related pain VAS scores were significantly affected by state anxiety level, marital status and prior gynecological examination (p<0.05). Colposcopy related discomfort VAS scores were significantly affected by state anxiety level, marital status, prior gynecological examination and educational status. Conclusions: Additional measures should be implemented in women that carry higher risk for experiencing pain and discomfort. Social, cultural and lifestyle issues may also affect women's experiences during colposcopy, therefore further studies are needed to define specific determining factors in various populations.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4335-4340
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• 2016

Background: Bone metastasis is a single condition but presents with various patterns and severities. Skeletal-related events (SREs) deteriorate overall performance status and reduce quality of life. However, guidelines for early detection and management are limited. This study includes a survey of the prevalence of bone metastasis in cases with common cancers in Thailand as well as a focus on survival patterns and SREs. Materials and Methods: A retrospective cohort analysis was conducted using a database of the Chiang Mai Cancer Registry and the Musculoskeletal Tumor Registry of the OLARN Center, Chiang Mai University. The prevalence of bone metastasis from each type of primary cancer was noted and time-to-event analysis was performed to estimate cancer survival rates after bone metastasis. Results: There were 29,447 cases of the ten most common cancers in Thailand, accounting for 82.2% of the entire cancer registry entries during the study period. Among those cases, there were 2,263 with bone metastases, accounting for 7.68% of entries. Bone metastasis from lung, liver, breast, cervix and prostate are common in the Thai population, accounting for 83.4% of all positive cases. The median survival time of all was 6 months. Of the bone metastases, 48.9% required therapeutic intervention, including treatment of spinal cord and nerve root compression, pathological fractures, and bone pain. Conclusions: The frequency of the top five types of bone metastasis in Thailand were different from the frequencies in other countries, but corresponded to the relative prevalence of the cancers in Thailand and osteophilic properties of each cancer. The results of this study support the establishment of country specific guidelines for primary cancer identification with skeletal lesions of unknown origin. In addition, further clinical studies of the top five bone metastases should be performed to develop guidelines for optimal patient management during palliative care.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.315-326
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• 2000

Objectives : Health behaviors that contribute to the leading cause of mortality, morbidity, and social problems among youth and adults are mostly established during youth, extend into adulthood, and are interrelated. The purpose of this study is to investigate health behavior, juvenile delinquent behavior, mental status and to understand related factor to health behavior. Methods : The study items of life style were health related habit including smoking, drinking, breakfast, regular diet, regular exercise, sleeping time and weight status. Also, sexual evidence, violence, suicidal perceptions were surveyed. Questionnaire survey was conducted from January to February, 2000 by adolescence living in Kyunggi-Do. Data were collected by self-administered questionares. The collected data were analyzed using PC-SPSS 9.0 version. Results : Most students perceived to be healthy themselves but just two thirds students had concern for health. 64.9% ever drank alcohol, 26.4% ever smoked, and also and 2.9% had attempted suicide during preceding the survey. The rate of sleeping over 8 hours is 31.8%, 65.6% had breakfast. Multiple regression analysis to find related factor with adolescents health behavior were conducted. As a results, concern for health, sex, grade, spending money and attempt to suicide were related to health behavior. Conclusion : These results showed that many efforts to improve the health-concern are necessary and suggest the need for further studies including follow-up study, intervention study on the relationship of life style.