• Title/Summary/Keyword: Standard of Care

Search Result 1,361, Processing Time 0.029 seconds

Long-term follow-up of Fanconi anemia: clinical manifestation and treatment outcome

  • Yoon, Byung Gyu;Kim, Hee Na;Han, Ui Joung;Jang, Hae In;Han, Dong Kyun;Baek, Hee Jo;Hwang, Tai Ju;Kook, Hoon
    • Clinical and Experimental Pediatrics
    • /
    • v.57 no.3
    • /
    • pp.125-134
    • /
    • 2014
  • Purpose: The aim of this study was to characterize Korean patients with Fanconi anemia (FA), which is a rare but very challenging genetic disease. Methods: The medical records of 12 FA patients diagnosed at Chonnam National University Hospital from 1991 to 2012 were retrospectively reviewed. Results: The median age at diagnosis was 6.2 years. All patients showed evidence of marrow failure and one or more physical stigmata. Chromosome breakage tests were positive in 9 out of 11 available patients. The median follow-up duration was 69.5 months. The Kaplan-Meier (KM) survival of all patients was 83.3% at 10 years and 34.7% at 20 years, respectively. Seven patients underwent 9 stem cell transplantations (SCTs). Among them, 5 were alive by the end of the study. Ten-year KM survival after SCT was 71.4% with a median follow-up of 3.4 years. All 5 patients treated with supportive treatment alone died of infection or progression at the median age of 13.5 years, except for one with short followup duration. Acute leukemia developed in 2 patients at 15.4 and 18.1 years of age. Among 6 patients who are still alive, 3 had short stature and 1 developed insulin-dependent diabetes mellitus. Conclusion: We provide information on the long-term outcomes of FA patients in Korea. A nation-wide FA registry that includes information of the genotypes of Korean patients is required to further characterize ethnic differences and provide the best standard of care for FA patients.

A Study on the Degree of Depression and Death Orientation of Some Students Majoring in Dental Hygiene (일부 치위생과 학생의 우울수준과 죽음의식에 관한 연구)

  • Han, Se-Young;Jung, Ui-Jung;Cheon, Seok-Yeon
    • Journal of dental hygiene science
    • /
    • v.13 no.3
    • /
    • pp.230-237
    • /
    • 2013
  • In this research, the degree of depression and death orientation of the 332 female students majoring in dental hygiene at colleges located in Gyeongsangbuk-do Province were examined and analyzed through a structured self-administered questionnaire from May to July, 2012, for the purpose of improving their mental health. The results are as follows: 1. The degree of depression of the subject students majoring in dental hygiene was shown that 59.9%, 36.8%, 3.0%, and 0.3% of the students were in the normal group, mild depression group, moderate level of depression group, and severe depression group, respectively. 2. The grand mean and the standard deviation of the subjects'death orientation was $2.09{\pm}0.62$ points. 3. The degree of depression of the subjects whose family's economic level was low, whose satisfaction with their family background was low, whose satisfaction level with their major was low, whose school records was low, who frequently thought about death, and who attempted suicide was high in a meaningful way, and death orientation was meaningfully low. In addition, those in the group with the experience of feeling suicidal were proved to have a significantly high degree of depression, and those without the experience of education about death had a low level of death orientation. 4. The degree of depression and death orientation had a positive correlation. When the study results above are combined, follow-up research needs to be conducted so that differentiated programs linked with the care for mental health for the formation of proper attitudes toward depression and death will be established to help students lead a positive life.

A Study on Actual Conditions and Curriculum Analysis of the Preschool Private Education Program of Cultural Centers (영유아 문화센터 프로그램 실태와 교육내용 분석)

  • Lee, Young Joo;Gil, Hyo Jeong
    • Korean Journal of Childcare and Education
    • /
    • v.9 no.3
    • /
    • pp.273-289
    • /
    • 2013
  • The goal of this study was to analyze the demands of parents of an after-school program. In order to do this, we looked at cultural centers and their curriculums. Cultural centers are one of the most popular private education centers for preschoolers, and are used for the operation of special activities. The research was conducted on preschool curriculums of 300 cultural centers, including cultural centers of department stores and supermarkets. The curriculum analysis was conducted for 400 preschool curriculums of three cultural centers, which had the most programs of all. The scope of the curriculum analysis was based on the 3rd Childcare Standard Curriculum for infants and Nuri Curriculum for preschoolers. As a result of the analysis, there were 12,286 programs for infants. The most popular topics for programs were comprehensive activity, physical activity, and music activity. There were 15,310 programs for preschoolers. Physical activity was the most popular topic among them. It was followed by drawing activity and number and operating activity. Analyzing the contents of these programs, we found that 'participating in physical activity' of physical exercise, and 'expressing artistically' of artistic experience were the most popular contents of infants. 'Expressing artistically' of artistic experience and 'control of body and basic exercise' of physical exercise were most popular contents for preschoolers. The results show that parents demand physical activity programs for infants and artistic activity programs for preschoolers. The results of the research should be considered when childcare centers try to make a special after-school program.

The Influence of Early Childhood Preservice Teachers' Aptitude of ChildCare Teacher on their Perception of Teacher Professionalism (예비보육교사의 보육교사 적성이 교사전문성 인식에 미치는 영향)

  • Kim, Young-Tae
    • Journal of the Korea Academia-Industrial cooperation Society
    • /
    • v.20 no.7
    • /
    • pp.317-324
    • /
    • 2019
  • The purpose of this study is to find how the childcare teacher aptitude of students majoring in childcare and education influences their perception of teacher professionalism. To achieve that, a questionnaire survey was conducted with 216 early childhood preservice teachers living in A city. For data processing and analysis, SPSS program was used so as to conduct frequency analysis and calculate the mean and standard deviation. In addition, to test reliability and find relations between variables, Cronbach's ${\alpha}$, correlation analysis, and multiple regression analysis were conducted. As a result, firstly, in terms of the childcare teacher aptitude perceived by the students majoring in childcare and education, they highly perceived an affinity with young children and a sense of calling of their job; in terms of their perception of teacher professionalism, they highly perceived social necessity and vocational ethics. Secondly, early childhood preservice teachers' childcare teacher aptitude had a statistically significant correlation with their perception of teacher professionalism. Thirdly, the sub factors of early childhood preservice teachers' childcare teacher aptitude all positively influenced the sub factors of the perception of teacher professionalism. Given the study results, the students majoring in childcare and education perceived the importance of their aptitude of childcare teacher. In order to provide high-quality childcare service and create the positive aptitude of childcare teacher, it will be necessary to conduct a variety of basic research.

A study on the optimum range of reinforcement in tunneling adjacent to structures (구조물 근접 터널시공시 최적의 보강범위에 관한 연구)

  • Lee, Hong-Sung;Kim, Dae-Young;Chun, Byung-Sik;Jung, Hyuk-Sang
    • Journal of Korean Tunnelling and Underground Space Association
    • /
    • v.11 no.2
    • /
    • pp.199-211
    • /
    • 2009
  • Development of underground space is actively performed globally for better life in the surface, and the scale of the space is increasing. Extreme care should be taken in the construction of the underground space in urban areas in order to avoid damage of adjacent structures and interference with existing underground space. In case of shallow tunnels, reinforcement of ground and structures is necessary to minimize the damage to structures due to excavation but any standard for optimum range of the reinforcement has not been established yet. In this paper, a series of numerical analyses have been performed for a 20 m diameter tunnel excavated underneath a structure to investigate the degree of damage of the structure according to vertical and horizontal spacing between the tunnel and structure. In addition to that, optimum range of reinforcement is presented for each case where reinforcement is required. It has been observed that the reinforcement is necessary for the ground condition adapted in the analyses as follows: (1) if horizontal spacing ($S_{H}$) approaches to 0D (D: equivalent diameter of tunnel) for vertical spacing (Sv) of 0.5D, and (2) if tunnel exists underneath the structure for vertical spacing (Sv) of 0.75D. The reinforcement is not necessary for Sv of 10 regardless of $S_{H}$. It also has been obtained that the optimum ranges of the reinforcement around structure foundation are 7 m in depth and whole width of the structure and 5 m beyond tunnel sidewall. These reinforcememt ranges have been confirmed to be enough for stability of the structure if types of reinforcement method is appropriately selected.

SELF-INJURIOUS BEHAVIOR IN A PATIENT WITH AUTISM : A CASE REPORT (자폐 환자의 자해로 인한 구강 내 손상 : 증례 보고)

  • Ji, Eun-Hye;Lee, Hyo-seol;Choi, Hyung-Jun;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
    • /
    • v.8 no.1
    • /
    • pp.10-14
    • /
    • 2012
  • Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

A Review on Stress and Coping Level at Dysmenorrhea Perceived by Middle School Girls in Seoul (월경곤란시 여자중학생이 지각하는 스트레스 및 그 대응에 관한 소고)

  • Jung Moon-Hee
    • Journal of Korean Public Health Nursing
    • /
    • v.5 no.2
    • /
    • pp.45-51
    • /
    • 1991
  • The purpose of this study is to investigate the stress and coping level as a result of dysmenorrhea which was experienced by girls. For the collection of data, the girls from the 1st to the 3rd grade in middle school in Seoul were selected through a random sampling technique. The survey was conducted from the 1st. to the 14th of June, 1991 by the use of questionnaires made after a pilot study. The final subjects for analysis were restricted to only those who had experienced me~arche, the number of which totaled 1,131. The stress, coping level, and other variables, were tested and analysed by descriptive statistics (eg, frequency, percentage, mean and standard deviation), t-test, ANOVA and Pearson's correlation coefficients. The obtained results are summarized as follows. 1. The chronological start for menarche was at a mean age of 13.1 The respondents who had experienced menarche numbered $70.9\%$ of the 1st grades and $96.2\%$ of the 2nd grades in middle school, otherwise the starting age for menarche was in the 4th grade in primary school. 2. Their menstrual cycle and period were longer than adult's one. The number of students studied who had experienced dysmenorrhea during their menstrual cycle were 860, and 650 of those revealed that their mothers or sisters had experienced similar problems. 3. The subjects who were late or head left early rather than being absent from school every menstruation cycle were more stressful. The results are thought to show that the girl's perception of dysmenorrhea seems to be more sensitive than adult's one. 4, A significant negative correlation was found between the perception of menstrual flow and strees level. It means that an increase in the stress of dysmenorrhea was associated with decreased menstrual bleeding. The degree of hypochondrical concern assessed by the girls was significantly correlated to stress and coping level. When the girls perceived high stress as a result of dysmenorrhea, they worried about their physical health more. The above results lead us to the suggestion that the starting point of early education with a school program is appropriate for the 4th grade in primary school. Especially if the girls in middle school should be required to give the information about correct knowledge and sufficient self -care management of menstruation monthly, if this could be implemented the loss in school days among the students due to dysmenorrhea would be minimized with more ease.

  • PDF

Conventional versus Doxorubicin-Eluting Beads Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma: a Tertiary Medical Centre Experience in Malaysia

  • Rahman, F Abdul;Naidu, J;Ngiu, CS;Yaakob, Y;Mohamed, Z;Othman, H;Jarmin, R;Elias, MH;Hamid, N Abdul;Mokhtar, N Mohd;Ali, RA Raja
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.17 no.8
    • /
    • pp.4037-4041
    • /
    • 2016
  • Background: Hepatocellular carcinoma (HCC) is a common cancer that is frequently diagnosed at an advanced stage. Transarterial chemoembolisation (TACE) is an effective palliative treatment for patients who are not eligible for curative treatment. The two main methods for performing TACE are conventional (c-TACE) or with drug eluting beads (DEB-TACE). We sought to compare survival rates and tumour response between patients undergoing c-TACE and DEB-TACE at our centre. Materials and Methods: A retrospective cohort study of patients undergoing either treatment was carried out from January 2009 to December 2014. Tumour response to the procedures was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Kaplan-Meier analysis was used to assess and compare the overall survival in the two groups. Results: A total of 79 patients were analysed (34 had c-TACE, 45 had DEB-TACE) with a median follow-up of 11.8 months. A total of 20 patients in the c-TACE group (80%) and 12 patients in the DEB-TACE group (44%) died during the follow up period. The median survival durations in the c-TACE and DEB-TACE groups were $4.9{\pm}3.2$ months and $8.3{\pm}2.0$ months respectively (p=0.008). There was no statistically significant difference noted among the two groups with respect to mRECIST criteria. Conclusions: DEB-TACE demonstrated a significant improvement in overall survival rates for patients with unresectable HCC when compared to c-TACE. It is a safe and promising approach and should potentially be considered as a standard of care in the management of unresectable HCC.

Availability of the Time and Change Test in Screening for Dementia in the Elderly (노인에서 치매 조기선별을 위한 시각.금전계산 검사의 유용성)

  • Chung, Eun-Kyung;Shin, Min-Ho;Rhee, Jung-Ae
    • Journal of Preventive Medicine and Public Health
    • /
    • v.36 no.2
    • /
    • pp.101-107
    • /
    • 2003
  • Objectives : Dementia has emerged as a leading public health problem in elderly persons, and its early detection is important for the treatment of curable cases, and in the educational support for other family members. Although dementia screening tests are available, they have not gained widespread use in community or primary care settings. Our goal was to validate the Tine and Change (T&C) Test, -including its validity and reliability in patients, and to assess it as a simple, standardized method for the screening of dementia in the rural elderly. Methods : The participants in this study comprised of 59 patients from an urban hospital and 405 persons from a rural community aged 65 years or older. The time test evaluated the understanding of clock hands indicating 11:10, and the change test the ability to make 1,000 Won from a group of coins, consisting of one 500, seven 100, and seven 50 Won coins. The T&C ratings were validated against a reference standard based on the physician's diagnosis of the patients. The convergent validity in relation to other cognitive measure, test-retest agreement, and inter-observer reliability were assessed. To assess the relationship between the Korean Mini-Mental State Exam (K-MMSE) and the T&C Test, the mean K-MMSE scores were compared with the results of the T&C Test in the elderly from a rural community. Results The T&C Test had a sensitivity and specificity of 73.0, and 90.9%, and positive and negative predictive values of 93.1, and 66.7%, respectively. The test-retest and inter-observer agreement rates were both 95%. The K-MMSE scores and T&C Test were significantly related in the elderly from a rural community (p<0.01), The T&C Test was not influenced by the educational status. The Time and Change Tests took a mean of 6.3 and 12.7 seconds, respectively, to complete Conclusion : The T&C Test is a simple, accurate and reliable, performance-based tool in the screening for dementia. Because it is quick, and easy-to-use, it is hoped the T&C Test will be used for the widespread cognitive screening of aging populations.

A Study on Clothing Buying Pattern of Korean High School Girls by their Self-concept (여고생의 자아개념에 따른 의복구매행동 특성)

  • 황춘섭
    • Journal of the Korean Society of Costume
    • /
    • v.43
    • /
    • pp.169-186
    • /
    • 1999
  • The objectives of the present study were to investigate the relationship between self-concept and clothing buying pattern in accordence with their self-concept. The method employed to conduct this study was normative-descriptive survey using questionnaires. Subjects were 438 high school girls in Seoul and the survery was implemented from the begining of May 1998 to the end of June 1998. The questionnaires were completed by students during class. Mean Standard Deviation Chi-Squeare and t-test were employed to analize the data gathered. The results are summarzed as follows: (1) The group who has the higher score in total positive self, self identity self satisfacton self behavior physcial self moral ethical self personal self and family self cares more about economical efficiency of clothing than the group who has the lower score. (2) The group who has the higher score in total positive self, self satisfaction personal self and family self attachs greater importance to the practical use of clothing than those who scored lower with in said categories of self concept. (3) The group who has the higher total positive self score cares originality more than the group who has the lower score when they purchase outdoor garment. (4) The group who has the lower social self score cares modesty and ostentation more than the group who scored higher in social self. (5) The group who has the higher score in positive self behavior personal self and family self cares about convenence in care and maintenance of the clothing than the group has the lower score. (6) Friends buying and use experiences of herself and the observation of other's attire are the main source of fashion information for the present Korean high school girls. The group who has the higher score in total positive self personal self family self, self identity self satisfactio self behavior used their own experiences more often as a source of fashion information than those who scored lower with in said categories of self concept. The group who has the higher score of total positive self personal self family self, self identity self satisfaction self behavior uses family members more often as a source of fashion information than those who scored lower with in said categories of self concept. The group who has the higher score in self identity and self behavior uses store displays more often than the group who scored lower. (7) Bonded processing goods stores or fancy goods shops(haberdashery) located in trendy shopping district discount stores and outlet stores of the famous manufactures are main places where Korean high school girls buy their outdoor garments. The group who has the higher score in social self, self identity and personal self uses department stores more often and rerely shops at bonded processing goods stores of fancy goods shops located in thendy shopping district compared to those who scored lower with in said categories of self concept.

  • PDF