Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.35
no.1
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pp.22-28
/
2024
Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual "niche construction" by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.
Lee, Gyungjoo;McCreary, Linda;Kim, Mi Ja;Park, Chang Gi;Yang, Soo
Journal of Korean Academy of Nursing
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v.42
no.7
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pp.1039-1049
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2012
Purpose: From the holistic environmental perspective, individual and environmental influences on low-income children's questionable development were identified and examined as to differences in the influences according to the child's developmental stage of infancy (age 0-35 months) or early childhood (age 36-71 months). Methods: This study was a cross-sectional comparative design using negative binominal regression analysis to identify predictors of questionable development separately for each developmental stage. The sample was comprised of 952 children (357 in infancy and 495 in early childhood) from low-income families in South Korea. Predictors included individual factors: child's age and gender; proximal environmental influences: family factors (family health conditions, primary caregiver, child-caregiver relationship, depression in primary caregiver) and institution factors (daycare enrollment, days per week in daycare); and distal environmental influences: income/resources factors (family income, personal resources and social resources); and community factors (perceived child-rearing environment). The outcome variable was questionable development. Results: Significant contributors to questionable development in the infancy group were age, family health conditions, and personal resources; in the early childhood group, significant contributors were gender, family health conditions, grandparent as a primary caregiver, child-caregiver relationships, daycare enrollment, and personal resources. Conclusion: Factors influencing children's questionable development may vary by developmental stage. It is important to consider differences in individual and environmental influences when developing targeted interventions to ensure that children attain their optimal developmental goals at each developmental stage. Understanding this may lead nursing professionals to design more effective preventive interventions for low-income children.
Background: Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. Materials and Methods: Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. Results: Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. Conclusions: Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.
Seo, Hye Kyung;Hwang, Joo-Hee;Shin, Myoung Jin;Kim, Su young;Song, Kyoung-Ho;Kim, Eu Suk;Kim, Hong Bin
Journal of Korean Medical Science
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v.33
no.45
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pp.280.1-280.9
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2018
Background: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. Methods: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). Results: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Nontunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. Conclusion: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.
Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (${\leq}8$ hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.
[Purpose] Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity. [Methods] We enrolled 70 male children (age 9-17 years [sumo group, n = 14] and 9-14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels). [Results] The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups. [Conclusion] Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.
Objectives: This study aimed to develop evaluation criteria for the elementary-school-based health promotion program using the RE-AIM framework and to examine their feasibility. Methods: Previous evaluation studies on health interventions for elementary-school students using the RE-AIM framework were reviewed systematically to identify appropriate evaluation criteria. A diet and physical activity intervention based on the transtheoretical model was implemented in a pilot study using the "Happy Me" application. The feasibility of using the RE-AIM framework to evaluate it was examined. Results: The review yielded the following evaluation criteria: "reach," the ratio of participants out of the total target population; "efficacy/effectiveness," the difference in outcomes between the intervention and control groups, or between a pre- and post-test; "adoption," the rate of use of the program and participation in the next stage of the program; "implementation," the progress on the program components; "maintenance," the participants' and teachers' intention to continue using the program. The pilot study reached 76.6% of the targeted population. The intake of sugar-sweetened beverages decreased (P < 0.0001), and the duration of walking increased (P < 0.0001). Other indicators could not be evaluated; therefore, potential indicators were suggested. Conclusions: This study produced feasible evaluation criteria for elementary-school-based health promotion using the RE-AIM framework. Nevertheless, the feasibility needs to be validated with a broader range of studies and long-term interventions.
Purpose: This study investigated hand-washing practice among community-dwelling older adults during the coronavirus disease 2019 (COVID-19) pandemic and aimed to identify the impact of COVID-19-related concerns and depression on hand-washing practice. Methods: This was a secondary analysis of data extracted from the 2020 Community Health Survey. The primary data were collected through self-reporting from August 10 to September 8, 2020 in a cross-sectional study. The subjects comprised of 1,350 adults aged 65 or older living in Jeju Province who participated in the 2020 Community Health Survey. Results: The factors affecting hand-washing practice among older adults were male older adults (β = -.18, p < .001), age (β = -.07, p = .001), no education (β = -.20, p < .001) and elementary, middle, and high school graduation (β = -.15, p < .001) compared to a college or higher education, poor health perception (β = -.13, p < .001), COVID-19-related concerns (β = .08, p = .005), and depression (β = -.07, p = .001). To summarize, the factors negatively affecting hand-washing practice included male gender, lower education level, poor health perception, and depression. In contrast, factors positively associated with hand-washing practice included COVID-19-related concerns. Conclusion: These findings show the importance of considering these multifaceted determinants when designing targeted interventions and educational programs to promote hand-washing among older adults. Additionally, based on the relationship between hand-washing practice and COVID-19-related concerns and depression, interventions that can alleviate mental problems along with providing proper education are required.
The purpose of this study was to find out the recent trend of high-tech AAC intervention studies for individuals with disabilities. Electronic database searches were completed to identify studies published between 2009 and 2016. 46 studies were identified for inclusion in this review. The studies were classified as participants, research design, intervention settings, independent variables, dependent variables, communication skills by High-tech device, type of high-tech AAC device. Across these studies, intervention was provided to total of 126 participants. Most participants are aged 6-11 and the most common diagnosis was autistic spectrum disorder. Most common study designs were multiple probe design and multiple treatment design. The majority of studies implemented interventions in a special education school(classroom) setting. The majority of studies implemented interventions to compare the effect of high-tech and low-tech AAC device interventions. The majority of targeted behavioral outcomes were communication skills. Tablet PC was the most frequently used for intervention in both domestic and foreign studies. The most common softwares were 'My talky' in domestic studies and 'Proloquo2Go' in foreign studies. The synthesis of evidence describing views of users and providers and the implementation of high-tech AAC device can provide valuable data to inform intervention studies and functional outcome measures. Suggestions for the future research are discussed.
A number of studies have been conducted to prevent obesity due to the worldwide increasing rate of obesity and its adverse effects on our health. Recently, a relationship between obesity and gut microbiome has been reported. Fecal and cecal microbiota are generally targeted for examining the gut microbiome during dietary interventions. There is, however, no common understanding on which microbiota and how results elucidated from the data would differ. In this study, we conducted dietary induced obesity study and compared fecal and cecal microbiota affected by dietary interventions. Normal Diet and high fat diet were fed to 6 weeks old mice for 12 weeks, and 16 S rRNA genes amplified from fecal and cecal DNA were sequenced using MiSeq. Our results show that the 𝛼-diversity showed significant differences between the dietary interventions as well as cecal and fecal microbiota. The difference in the taxonomic compositions between cecal and fecal microbiota had become clearer at the family and genus level. At the genus level, Faecalibaculum and Lactobacillus were more abundant in the cecal and fecal microbiota, respectively. In general dietary intervention studies, dietary effects are more significant than type difference. However, the microbiota analysis results should be interpreted carefully, considering both diet and samples (feces/caecum).
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