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Clinical Outcome and Long Term Follow-up of Chronic Functional Constipation in Children (소아 만성 기능성 변비의 치료 성적과 장기적 예후)

  • Ahn, Yoon Jin;Park, Jae Ock
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.200-209
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    • 2006
  • Purpose: The purpose of this study was to evaluate the long term outcome and the factors contributing to treatment outcome for chronic functional constipation in children. Methods: Sixty three children were enrolled who had chronic functional constipation and could be followed by telephone contact. They were treated at the Bucheon Soonchunhyang Hospital for more than 1 month and observed from March 2001 to June 2005. We analyzed the clinical features, symptoms and signs, as well as the course and results of treatment. Results: The male to female ratio was 35 (55.6%) : 28 (44.4%). The mean age at the onset of symptoms and diagnosis was $21.1{\pm}23.5$ (1.9~84.0) months and $47.1{\pm}34.2$ (6.9~138.0) months, respectively. The mean defecation frequency before treatment was $3.2{\pm}2.3$ (0.5~10.0) times per week. The symptoms associated with constipation were as follows: soiling 34 (54.0%) which was more common in males than females, large stools in 30 (47.6%), decreased bowel movements less than three times a week in 20 (31.7%), straining during defecation in 19 (30.2%) and retentive posturing 19 (30.2%). The mean duration of follow-up was $34.2{\pm}14.6$ (3.6~60.0) months and 44 (69.8%) patients had their symptoms resolve ("success") and 19 (30.2%) were not resloved ("fail") from the constipation. The time for recovery from soiling, straining during defecation and retentive posturing after treatment was $4.3{\pm}2.4$ (1.0~36.0), $5.0{\pm}1.4$ (0.8~36.0) and $5.0{\pm}3.1$ (1.0~36.0) months, respectively. A relapse of the constipation occurred in 15 (23.8%) patients, 9 (60%) boys and 6 (40%) girls. The time to relapse after cessation of treatment was $2.9{\pm}1.9$ (1.0~6.0) months and the only risk factor associated with relapse was the initial duration of treatment. Conclusion: Most of the patients had resolution of symptoms within five months after treatment; relapse occurred within three months after the interruption of treatment. The duration of treatment was important for recovery and for the prevention of relapse in the constipated children. Thus a long term maintenance of therapy and follow-up is necessary for chronic functional constipation in children.

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Analysis of the types of eating behavior affecting the nutrition of preschool children: using the Dietary Behavior Test (DBT) and the Nutrition Quotient (NQ) (유아의 영양상태에 영향을 미치는 식행동 유형 분석 : 어린이 식행동 검사 (DBT)와 어린이 영양지수 (NQ) 활용)

  • Sim, Hyeon Mi;Han, Youngshin;Lee, Kyung A
    • Journal of Nutrition and Health
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    • v.52 no.6
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    • pp.604-617
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    • 2019
  • Purpose: To investigate the effect of eating behavior on nutritional status according to temperament type. Methods: One thousand one hundred three preschool children aged 2 to 6 years in Gyeongsan, Gyeongsangbuk-do from April to June 2018 were surveyed about their eating behavior and nutritional status using DBT (Dietary Behavior Test) and NQ (Nutrition Quotient) which are proven tests. The dietary behaviors of the children were classified into four categories: approach avoidance, sensory sensitivity, hyperactivity, and irregularity. NQ scores were divided into five categories: balance, diversity, moderation, regularity, and practice. Results: The mean of the children's age was 3.42 ± 1.4 (596 boys and 507 girls). The percentage distribution of the NQ grade was as follows: 5.5% (highest), 12.5% (high), 47.1% (medium), 22.2% (low), and 12.6% (lowest). The risk group of approach avoidance and sensory sensitivity had significantly (p < 0.001) lower scores than the normal group in balance factor (51.9 ± 12.0 vs. 57.8 ± 15.9 in approach avoidance type, 52.6 ± 17.6 vs. 57.7 ± 15.9 in sensory sensitivity type) and diversity factor (32.5 ± 24.4 vs. 50.1 ± 22.4 in approach avoidance type, and 32.5 ± 24.0 vs. 50.7 ± 22.2 in sensory sensitivity type). The scores of the hyperactivity risk group were significantly lower in moderation factor (78.2 ± 12.1 vs. 81.2 ± 11.9), and those of the irregular risk group were significantly lower in variety (35.9 ± 24.5 vs. 48.8 ± 23.2), regularity (57.6 ± 37.1 vs. 66.1 ± 17.6), and practice (57.1 ± 19.4 vs. 65.1 ± 22.5) factors than the normal group (p < 0.001). Especially, the risk group of approach avoidance and sensitivity type had significantly (p < 0.001) lower intakes of whole grain, fruit, bean and bean products, vegetables, and Kimchi. Conclusion: This present study suggested that the eating behavior based on temperament of demanding preschool children affected food choice resulting in food consumption diversity of children. Therefore, it is important to provide customized nutrition education programs based on temperament type.

Differences in Sleep Patterns are Related to Behavior, Emotional Problems, Attention and Academic Performance in Elementary School Students of a South Korean Metropolitan City (일 도시의 초등학교 학생의 수면습관과 행동, 정서, 주의력, 학습과의 관계)

  • Tak, Hee-Jong;Lee, Ji-Ho;Lee, Chang-Myung;Chung, Seok-Hoon;Lee, Jae-Won;Sim, Chang-Sun;Yoon, Jae-Goog;Sung, Joo-Hyeon;Bhang, Soo-Young
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.22 no.3
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    • pp.182-191
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    • 2011
  • Objectives: The aim of this study was to investigate the sleep patterns of South Korean elementary school children and whether the differences in sleep patterns were related to behavior, emotional problems, attention and academic performance. Method: This study included a community sample of 268 boys and girls from fourth-, fifth- and sixth-grade classes in a South Korean metropolitan city from November to December 2010. The primary caregivers completed a questionnaire that included information on demographic characteristics, as well as the Child's Sleep Habit Questionnaire (CSHQ), the Korean version of Child Behavior Checklist (K-CBCL), the Korean version of the Learning Disability Evaluation Scale (K-LDES), the Korean version of ADHD Rating Scale (K-ARS) and the Disruptive Behavior Disorder Scale (DBDS). We conducted analyses on the CSHQ individual items, between the subscales, on the total scores and on the K-CBCL, the K-LEDS, the K-ARS and the DBDS. Results: Based on the findings from the CHSQ, the subjects had significantly higher scores for bedtime resistance ($9.18{\pm}2.17$), delayed sleep onset ($1.32{\pm}0.62$), the sleep duration ($4.19{\pm}1.52$) and daytime sleepiness ($14.10{\pm}3.55$) than the scores from the previous reports on children from western countries. The total CHSQ score showed positive correlations to all subscales of the K-CBCL : withdrawn (r=0.24, p<.005), somatic complaint (r=0.24, p<.005) and anxious/depressive (r=0.38, p<.005). Bedtime resistance was associated with oppositional defiant disorder (r=0.15, p<.05) and a positive correlation was demonstrated between sleep anxiety and the oppositional defiant disorder score (r=0.13, p<.05), night waking and the conduct disorder score (r=0.16, p<.05). Delayed sleep onset was related with low performance on the K-LDES with respect to thinking (r=-0.17, p<.05) and mathematical calculation (r=-0.17, p<.05). Conclusion: The results of this study reconfirm Korean children's problematic sleep patterns. Taken together the results provide that the reduced sleep duration and disruption of sleep pattern can have a significant impact on emotion, behavior, performance of learning in children. Further studies concerning more diverse psychosocial factors affecting sleep pattern will be helpful to understanding of the sleep health in Korean children.

Evaluation of dietary behavior and nutritional status of elementary school students in Jeju using nutrition quotient (어린이 영양지수 (nutrition quotient)를 이용한 제주 지역 일부 초등학생의 식습관 및 영양 상태 평가)

  • Boo, Mi Na;Cho, Su Kyung;Park, Kyong
    • Journal of Nutrition and Health
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    • v.48 no.4
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    • pp.335-343
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    • 2015
  • Purpose: The aim of this study was to evaluate the food behavior and nutritional status of elementary school students in the Jeju area using Nutrition Quotient (NQ). Methods: The subjects were 440 students (235 boys and 205 girls) in the fifth and sixth grade at four elementary schools located in Jeju. Demographic, lifestyle, and environmental information was collected using a self-reported questionnaire. The food behavior checklist for children's Nutrition Quotient (NQ), consisting of 19 items, and nutrition education related information were also obtained. Results: The mean score of the children's NQ was poor, reaching 60.3 points. The percentage distribution of NQ grade was 19.8% (lowest), 18.6% (low), 45.0% (medium), 10.7% (high), and 5.9% (highest) and the factor scores for balance, diversity, abstinence, regularity, and practice were 56.6, 68.4, 71.3, 57.4, and 54.8 points, respectively. Compared with the NQ cut-off points for defining malnutrition (balance; 57, diversity; 87, abstinence; 66, regularity; 69, and practice; 67 point), average score of abstinence factor was only above the cut-off point and scores of the other factors were below the cut-off point. Subjects with higher NQ scores tended to have higher levels of exercise activity (p < 0.001), frequency of family meals (p < 0.01), and father's educational levels (p < 0.01) compared to those with lower NQ score. NQ score showed positive association with nutrition education experience and practice (p < 0.001). Conclusion: NQ score of elementary school students residing in Jeju was lower than the national average. More opportunities should be provided for participation in nutrition education, which incorporates a range of program strategies, as well as communication and education activities.

A Study on Health Aspects of Daily Life of Elementary School Children in an Urban Area (일부도시국민학교취학아동의 보건생활에 관한 실태조사연구)

  • 구외행
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.36-49
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    • 1973
  • This study was carried out for the objectives to collect the basic informations on the health behaviors of the elementary school children in an urban area in Korea. Seven hundred students were drawn to fill in the designed questionnaire which carries variety of Questions on health re-lated behaviors in general, eating habits, disease history, mental health, and sex education. Questionnaire were filled in by their parents. Major findings are as follows: ① 55.7% had habits of washing the hands before eating whereas 59.8% trashing their hands after toilet. The others had no idea of washing hands before eating and after toilet. ② 26,5% had habits of brushing the teeth twice a day 54.7% only once in the morning, and 2.6% once only in the evening. Thus, the idea of prevention from decayed teeth seems to be lacking among the school children. ③ Bathing habits were also inquired to get 40.3% of bathing more than once a week, 43.1% once every two weeks, and the rest of 16.6% once every one to three months. ④ 41.7% keep the regular bedding time whereas 58.3% irregular. Physical exercises were con-ducted by 76.6% on the ground while 23.5% did not practice any physical exercises at all. Of those physical exercises, rope skipping occupied 37.5%, and the other 66.9% consisted of 14 different kinds of individual type physical exercises such as gymnastic exercise. The main reasons for not enjoying exercises were different by sex; boys largely complained the inadequacy and lack of gymnastic facilities and girls felt in short of friends who could join the exercises. ⑤ 31.9% of the school children had been taking not much of food while 28.3% had unbalanced diets. Of these unbalanced diets, meat occupied 33.2% to be the priority to have an order of the following items such as vegetables, bread or noodle, and fishes as next to each. For eating habits, 88.5% take simple snack such as bread (38.4%, cookies, fruits, and candies in order. 25.8% of the children were provided such snacks or their parents regularly. Breakfast was sufficiently taken by 45.0% whereas 8.4% had never sufficiently. As to the lunch, 63.6% had sufficiently while 16.8% insufficiently. 70.6% take breakfast with all family members together and 30.4% separately. Correlation of sufficient taking of breakfast and eating together of tile family member's seems to be significant when we compare 72.5% of sufficient takers who enjoy breakfast together with the family members with 55.6% of insufficient takers who enjoy it with the family. This finding allows the investigator to point out the importance of table circumstances for children's eating. ⑥ The most common disease was catching a cold (38.8%), and the second was stomach trouble to be followed by the frequency of car sickness, headache, and skin infection. Doctors are consulted only by 23.9% when they are sick whereas 59.7% resorted to the drug stores. The lower the educational attainment of the parents, the lower the rate of visiting clinics. ⑦ 36.7% of their parents pointed out the problems of personality guidance as the most difficult thing at home 71.3% of their parents worried about and unsatisfied with their children's personality traits. Of these complains of the parents, impatience stood at the top to be tabulated at 24.1%, and 21.1% indicated narrow-mindedness. In line with this primary socialization at home, the most crucial problem seems to be related with the lack or recognition of the parents'own role when we find only 43.1% of the parents understood the importance of their own role for the home education of children; the latter group attributed tile responsibility of personality formation to the children themselves. ⑧ As to the sex educational aspects, 30.9% of children have ever asked about the physiology of reproduction or sexual matters to their parents, of those parents only 17.0% could give the constructive responses to the inquiries of the children. In companies on with these data, 25.6% recognized their own role in sex education for their own children while the large segments of the parents (51.1%) attributed the responsibility of sex education to tile low level of 38.3% who recognized the importance of sex education in the school curriculum and 25.1% of the parents insisted to wait until they get to know naturally about sex. 38.1% of the parents said they had some knowledge on sex from books while 16.9% through mass media. The next groups had common senses of sex from their own parents, school friends and other sources.

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Perceptions of school meal services of middle school students and dieticians/dietetic teachers in Gwangju area according to the conversion of free meal services (무상급식 전환에 따른 광주지역 중학생과 영양(교)사의 학교급식에 대한 인식)

  • Kim, Sook-Wha;Heo, Young-Ran;Ro, Hee-Kyong
    • Journal of Nutrition and Health
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    • v.48 no.1
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    • pp.113-121
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    • 2015
  • Purpose: The purpose of this study was to investigate satisfaction with and perception of the school meal service according to middle school students and dieticians/dietetic teachers in Gwangju area who experienced change to the free meal service and the main contents were as follows. Methods: The research subjects were 197 students (99 boys and 98 girls) and 42 dieticians/dietetic teachers were recruited. Results: Compared to the free meal service before, satisfaction of students was high (53.8%), and 69.9% of students said there was no change in the school meals, however a significant difference was observed between gender. Overall 80.2% of middle school students said that there was no change in menu, 70.6% were no change in the frequency of food with high preference, and 64.0% were no change in leftover of meals. 85.7% of dieticians/dietetic teachers said that there was no change in the student's satisfaction according to the conversion of free meal services; 59.5% of dieticians/dietetic teachers said that there was no change in the frequency of foods with high preference, the variety of vegetables was increased in the qualitative change item of food materials, and 95% of them were not aware of change in the amount of students' leftover foods. Dieticians/dietetic teachers had limitations in selecting menus with purchase and costs of food materials (26.2%) by conversion of the free meal service and their priority considered was the food cost (45.2%) when they selected menus. Change in feeding affairs was office work management (26.2%) and recipe research and development (19.0%). Conclusion: With the results of this study, the satisfaction with the school meal service was not changed in the awareness of students and dieticians/dietetic teachers. Therefore further study is needed to determine the middle school's satisfaction with school meals based on a variety of factors including the environmental food meal services.

Evaluation of short-term cardiac function by tissue Doppler imaging in pre and postoperative period of congenital heart disease (조직 도플러 영상을 이용한 선천성 심장병 수술 전후의 단기 심기능 평가)

  • Lee, Jun-Hwa;Kim, Yeo-Hyang;Hyun, Myung-Chul;Lee, Sang-Bum
    • Clinical and Experimental Pediatrics
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    • v.50 no.5
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    • pp.476-483
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    • 2007
  • Purpose : The objective of this study was to assess ventricular function by tissue Doppler imaging (TDI) in children with congenital heart disease (CHD) who have been undergoing open heart surgery (OHS) using cardiopulmonary bypass. We tried to compare the parameters of tissue Doppler imaging before and after OHS in patients with congenital heart disease. Methods : This study was conducted on 32 patients with CHD after OHS from January 2005 to December 2005 at Kyungpook National University hospital. Patients who underwent 2-D echocardiography before and after their OHS. All patients were divided into three groups, left ventricular volume overloading group (group 1), and right ventricular volume overloading group (group 2), and right ventricular pressure overloading group (group 3). The TDIs were examined before and 1 to 3 months after OHS. Peak early diastolic (E), and peak late diastolic (A) velocity of transmitral flow were measured by pulsed wave Doppler examination. Peak systolic (Sm), peak early diastolic (Em), and peak late diastolic (Am) velocity in apical 4-chamber and 2-chamber views were measured by TDI. The author calculated E/Em ratio. Results : The patients were 14 boys and 18 girls and the average age of patients was 2 years and 3 months. The congenital heart diseases which have to get OHS were ventricular septal defect (13 cases), atrial septal defect (7), atrioventricular septal defect (3), isolated pulmonary stenosis (2) and tetralogy of Fallot (7). There were significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view (P<0.05). Conclusion : This study showed significant decrease of Sm, Em, Am measured on tricuspid annulus and E/Em measured on mitral annulus in apical 4 chamber view after OHS. These changes might be due to the effects of cardiopulmonary bypass in OHS and/or hemodynamic changes after correction of congenital heart disease. To clarify these changes, further study on more patients is needed.

The Relationship of between Anxiety Tendency and Recurrent Abdominal Pain in Elementary School Children (학동기 소아에서 반복성 재발성 복통과 불안 성향과의 관련성)

  • Moon, Ji-Young;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.129-137
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    • 2007
  • Purpose: It has been reported that children with chronic pain have higher levels of anxiety than age-matched controls. Therefore, this study was designed to determine the relationship between anxiety and recurrent abdominal pain in elementary school children. Methods: In 2005, we surveyed 1,254 elementary school children (592 boys and 662 girls) whose ages ranged from 7 to 12 years. The degree of trait and state anxiety was compared between agroup suffering from intermittent abdominal pain, a group suffering from recurrent abdominal pain and a normal control group following the Korean version of Spielberger's State-Trait Anxiety Inventory YZ form (STAI-YZ). Results: 709 (56.5%) and 69 (5.5%) of the patients reported intermittent abdominal pain and and recurrent abdominal pain, respectively, during the 12 month period before this study was conducted, and trait and state anxiety values for each of these groups was 116 (9.3%) and 63 (5.0%), respectively. In addition, the State-Trait Anxiety score was significantly higher in the group with intermittent abdominal pain and RAP than the anxiety score of the normal control group. Additionally, the STAI-YZ score increased in proportion to the severity of abdominal pain, but was not correlated with the duration, frequency, onset time or location of abdominal pain. Furthermore, the proportion of the group with abdominal pain in the group that had trait or state anxiety was significantly higher than the proportion of the group that did not have trait and state anxiety. Conclusion: Recurrent abdominal pain during childhood is correlated with state and trait anxiety, therefore, psychological factors, such as anxiety duringtreatment, must also be considered when determining the cause of recurrent abdominal pain.

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The Relationship between Beverage Consumption, Nutrient Intake and Body Mass Index in Elementary School Students in Gyeongnam Area (경남지역 초등학생들의 음료수 섭취와 영양소 섭취량 및 BMI와의 관련성)

  • Kim, Seok-Young;Ryu, Seon-A
    • Journal of Nutrition and Health
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    • v.41 no.6
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    • pp.530-538
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    • 2008
  • This study was performed to assess the effects of beverage consumption on nutrient intake and anthropometric measurements. Beverage intake and dietary intake were measured by a beverage frequency and quantity questionnaire and three 24-hour dietary recalls in 160 elementary school students in the Gyeongnam area. The number of drinking moments per month was 93.5 and drinking amount of all beverages was 626.6 mL per day. The amount of milk intake was 253.8 ml per day, which was the highest in all types of beverage consumption, followed by juice(133.6 mL), and carbonated beverage(77.7 mL). The amount of sweetened beverage which was defined as all beverages except milk and soy milk was 359.7 mL per day. Energy intakes from all kinds of beverages and sweetened beverages accounted for 20.3% and for 10.5% of the daily energy intake, respectively. The contributions of sweetened beverage intake to the daily energy intake in girls accounted for 13.5%, whereas in boys it was 7.7% and significantly lower. The number of drinking moments and the contribution of sweetened beverage intake to daily energy intake were negatively correlated with protein, vitamin A and niacin intake, respectively. The consumption of milk and soybean milk combined showed a significant negative correlation with the body fat ratio(%) and it also negatively correlated with waist-hip girth ratio(WHR). However, the sweetened beverage intake was not related any of the anthropometric measurement. In conclusion, consumption of the sweetened beverage dropped the nutritional quality of diet. However it was not related with anthropometric measurements in elementary students.

An Analysis of the Competency Exam for College Education : Area of Science Inguiry (대학수학능력시험 실험 평가 문제의 분석 : 과학 탐구를 중심으로)

  • Kim, Eun-Jin;Kim, Young-Soo
    • Journal of The Korean Association For Science Education
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    • v.12 no.1
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    • pp.75-92
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    • 1992
  • The purpose of this study was to point out the problems of the competency exam for college education, a new college entrance exam, and to suggest the improvement ideas for it For this purpose, the test items of science inquiry were taken from the first, the second and the third pilot studies of the competency exam for college education which National Institute of Educational Evaluation had done. These tests were administered to 1,223 students of the general high school(422 for the 1st 400 for the 2nd, and 401 for the 3rd test). Also, those students' and the high school science teacher's opinions about the tests and the new college entrance exam were surveyed. The evaluation objectives of those test items were analyzed and the test item analyses were done. The results were as follows; (1) The evaluation objective analysis showed that most of the test The purpose of this study was to point out the problems of the competency exam for college education, a new college entrance exam, and to suggest the improvement ideas for it For this purpose, the test items of science inquiry were taken from the first, the second and the third pilot studies of the competency exam for college education which National Institute of Educational Evaluation had done. These tests were administered to 1,223 students of the general high school(422 for the 1st, 400 for the 2nd, and 401 for the 3rd test). Also, those students' and the high school science teacher's opinions about the tests and the new college entrance exam were surveyed. The evaluation objectives of those test items were analyzed and the test item analyses were done. The results were as follows; (1) The evaluation objective analysis showed that most of the test items were constructed based on the evaluation framework which was composed of scientific inquiry thinking ability, science concept, and scientific inquiry context dimensions. But, those items were unevenly distributed into a few areas of the evaluation framework. (2) The boys had higher mean scores than the girls in all of the tests, but these differences were not statistically significant. The natural science course students had significantly higher mean than the humanities course students in all of the test:(1st, F=12.643, p=0.0004 ; 2nd, F=45.757, p=0.0001 ; 3rd, F=36.162, p=0.0001). A significant interaction of sex and course was found in only 1st test( F=11.352. p=0.0008). (3) Most students answered the test was difficult and they needed more time to finish it Also, they added they had to study in a different way from the traditional one in order to prepare the new college entrance exam. Science teachers answered that those evaluation objectives of the tests corresponded well with the educational objectives of high school science and that the tests were suitable as measuring instruments of the scientific thinking abilities. But they pointed out it would be very difficult for them to teach students for preparing the exam under the exsting educational conditions. To carry out successfully the competency exam for college education, the following improvements were suggested. (1) Good evaluation methodology should be developed. (2) In-service science teacher training models on evaluation should be put in force. (3) Effective teaching models and strategies should be developed.(4) The high school science curriculum should be revised.

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