• 제목/요약/키워드: child's development

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급성장염으로 인한 탈수 환아에서 혈청 요산의 염상적 유용성 (Clinical Usefulness of Serum Uric Acid in Gastroenteritis Patients with lJehydration)

  • 송준호;장명완;유황재;김철흥
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권1호
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    • pp.23-30
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    • 2006
  • 목 적: 급성 장염은 소아의 유병률과 사망률의 중요한 원인이기 때문에, 탈수 정도를 정확하게 평가하여 교정하는 것이 매우 중요하다. 이러한 탈수평가에서 임상적 척도들과 검사실 지표들의 효용성이 비교 연구되어 왔고, 검사실 지표들의 효용성이 비교 연구되어 왔고, 검사실 지표들 중 BUN, creatinine, 중탄산엽, 혈당, 요비중 등이 쉽게 검체를 얻을 수 있고 신속하게 결과를 알 수 있어 많이 연구되어 왔다. 본 연구는 이러한 검사실 지표들과 함께 요산을 체중 변화에 의한 탈수의 정도와 비교하고자 하였다. 방 법: 2002년 6월부터 2003년 12월까지 관동대학교 명지병원에 장염으로 인한 탈수증세로 입원한 환자 90명을 대상으로 하였다. 수액치료를 하기 전에 각각의 환자의 체중을 측정하였고, 퇴원 전에 다시 체중을 측정하여, ([최종 체중-초기 체중/최종체중]${\times}100$)으로 환아의 체중 감소량을 측정하여 각각 경증, 중등도, 중증 탈수군으로 분류하여, BUN, creatinine, 혈청 중탄산염, 혈당, 혈청 요산, 요비중과 비교하였다. 결 과: 경증 탈수군은 54명으로 전체의 60%, 중등도 탈수군은 24명으로 전체의 26%, 중증 탈수군 12명으로 전체의 14%에 해당하여 경증 탈수군이 가장 많은 비율을 차지한 것으로 나타났다. BUN, creatinine, 혈청 중탄산염, 혈당, 요비중은 탈수 정도와 통계학적으로 유의하지 않았으나, 요산은 통계학적으로 유의한 결과를 보였다. 혈청 요산 7 mg/dL을 기준으로 중등도 이상의 탈수 예측치의 민감도와 특이도를 조사한 결과 민감도는 66.6%, 특이도는 87.1%, 양성 예측도는 77.4%, 음성 예측도는 79.6%이었다. 결 론: 본 연구에 혈청 요산이 탈수 정도와 연관이 있었다. 따라서 임상적 지표와 함께 혈청 요산을 탈수 판단의 지표로 사용했을 경우 소아장염 환아에서 조기에 탈수 정도를 파악하는데 도움을 줄 수 있을 것으로 생각되나 이에 대해서는 좀 더 광범위한 연구가 필요할 것으로 사료된다.

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초등학교 아동의 개인위생에 대한 조사 (A Study on Personal hygiene of Primary School Students)

  • 김재삼;남철현;강희양
    • 한국학교보건학회지
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    • 제9권1호
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    • pp.109-123
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    • 1996
  • The study was designed to gain necessary basic data, in order to grasp the actual condition on personal hygiene of primary school students and to help school health education and child health education data development of parents of students, the survery was carried out through this reporter's interview for mothers who have primary school pupil in KyungBug area during the period of a month from 14 the April to 30 the April 1994. The results of this study can be summarized as follows. 1. As for general characteristics, the percent of answer mothers with 30~34 years 44.9%, and the percent of answer mothers with 35~39 years was 37.6%, 14.6% of answer mother was 40 years and over. The most house types was apartment house, that is 64.8% and independence house was 18.9%, 13.7% of answer mothers was multivalent house residents. As for level of school career, the percent of high school was 64.2% and the percent of university was 20.5%, 10.1% of answer mothers was finishment of middle school. As for religion a lack of religion was 38.4% and a Buddhist was 36.8%, a christian was 13.4%, 10.4% of answer mothers was a catholic. As for jobs, the percent of office was 33.9%, specialist and expert skiller was 17.3%, self-management was 16.0%, fishing and agrarian villiages was 11.6%, public service personnel and shool personnel was 9.1%. As for the number of sons and daughters, the percent of two was 70.5%, the percent of one was 16.0%, and the percent of male students was 54.1%. As for level of economic life middle level was 59.9%. 2. The percentage of washing hand after school hours was 66.8% and not washing hand after school hours was 33.2%. In washing hand after school hours family of independence house, mothers that have schoolcareer of university, female students, three and over of sons and daughters was high individually (p<0.05). 3. As for paring one's nails, once a ten days was 52.9% once a five days was 22.5% once a fifteen days was 19.0%, once a twenty and over was 5.6%. 4. 54.7% of primary school students of answer mother's take a bath once a few days and 31.6% take a bath once a week, 10.1% take a bath once a tendays. 5. The percentage of changing of underwear once a day was 60.9%, once a few days was 37.1%, once a week was 2.0%, as for changing of underwear, sons and daughters that has mothers with 29 years and downward, one number of sons and daughters, females students was high individually (p<0.01). 6. The percentage of haircut once a 20~30 days was 59.9%, once a 31~40 days was 17.9%, once a 40 days and over was 16.6%. As for the percentage of haircut once a 20~30 days apartment house residents, male students was high (p<0.01). 7. The percentage of experience in taking nutrition was 79.8% and the percentage of experience in taking restorative was 72.3%. As for taking nutrition, apartment house residents, one number of sons and daughters, male students was high individually (p<0.01). As for taking restorative apartment house residents, on number of sons and daughters, male students was high individually (p<0.05). 8. The percentage of habit of unbalanced diet was 44.0%, sons and daughters that have mother with 40 years and over apartment house residents, male students, one number of sons and daughters was high indivdually (p<0.05). 9. As for hygiene condition of sons and daughters, the percentage of good state of health was 65.2%, middle state of health was 3.5% bad state of health was 11.4%. In good state of health sons and daughters that have mothers with 29 years and downward, multivalent house residents, three numbers of sons and daughters, female students, high birth was high individually. 10. As for fattness of sons and daughters, existence was 18.2%. No existence was 81.8%. in existence sons and daughters who have mothers with 40 years and downward, independence house resident, special job and expert skill job, three and over number of sons and daughters, female students, low birth was high individually. 11. As for use aspect of medical facilities of sons and daughters, hospital doctors was 53.1%, drugstore was 42.3%, chinese medicine hospitals or health organization was 4.6%. In usage of drugstore, sons and daughters of mothers with 29 years, 40 years and over was 55.6%, 61.4% individully, inusage of hospital doctors 30~34 years, 34~39 tears was 64.5%, 49.1% individully (p<0.01), apartment house residents, one or two numbers of sons and daughters, male students was high individually. In the percentage of using drugstore, school career of middle school and downward, in occupation, three and over numbers of sons and daughters, low birth was high individually (p<0.05). According to the results mentioned above. An actual condition and a related matters on personal hygiene of primary school students must be used as the basis data of a health education program and a health data of a health education program and a health data related, a teaching materials development and must be helped to the health life education of parents of students and childs.

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거제도(巨濟島) 주민(住民)의 영양실태조사(營養實態調査) (Nutrition Survey in Koje Island)

  • 오승호;장수경;박명윤
    • Journal of Nutrition and Health
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    • 제10권4호
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    • pp.43-58
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    • 1977
  • Kojedo is the second largest island in Korea and a total population of 115,500 is living on the island of 394.69 sq. km. Under the direction of three nutrition professors, nutrition surveys in two villages in Kojedo, namely Siljun Ri in Hachung Myon and Soowol Ri in Shinhyun Myon, were carried by 30 college senior students majoring in nutrition from August to 20 August 1977. From a total of 176 households of the two villages, 67 households were randomly selected and 390 family members of the households were subjcets of the nutrition surveys. The precise weighing method was used in evaluating the kinds of foods and nutrient intakes of the subjects for three consecutive days. Thirty-seven pre-school children aged between 3 to 6 years and 27 fertile women were examined for biochemical findings and physical status. The main purposes of the surveys are to provide baseline data on nutrition in Kojedo Island for the Kojedo Community Development Project and to compare the nutritional status of the villages of Siljun Ri and Soowol Ri. Siljun Ri is located in the pilot project area of the Koiedo Community Health Project sponsored since December 1970 by the Christian Medical Commission of the World Council of Churches. While Soowol Ri is a control village for comparison. The results obtained are summarized as follows: Food Intake The average food intake per person per day in Siljun Ri, 1064 grams (91.7% in vegetable foods and 7.6% in animal foods) was 90 grams more than that of Soowol Ri, 974 grams (92.8% in vegetable foods and 5.9% in animal foods). However, the food intake per pre-school child in Siljun Ri, 485 grams (92.6% from vegetable foods and 6.4% from animal foods) was 21 grams lower than that of the Soowol Ri, 506 grams (88.5% from vegetable foods and 6.5% from animal foods). The average intake of beans was 16 grams(1.5% out of the total food intake) in Siljun Ri and 21 grams(2.2% of the total food intake)in Soowol Ri. The villagers should be guided for more consumption of soybeans to improve the quality of protein intake from vegetable foods. Nutrient Intake The adult intake in Siljun Ri and Soowol Ri were 2,529 kcal and 2,511 kcal respectively. The average energy intake of pre-school childen in Siljun Ri was 948 kcal and that for adult and 1,500 kcal for childen aged between 4 to 6 years-given by the Korea FAO Association, the diets in both villages were not adequate. Average daily protein intake of the subjected adult in Siljun Ri was 78.4 grams and that of Soowol Ri was 76.2 grams, while pre-school children took 30.7 grams in the former village and 31.7 grams in the latter village per child per day. The protein intake in both villages were lower than the recommended allowances, 80 grams for adult and 45 grams for $4{\sim}6$ years childen, and animal protein intake of the all subjects was very much lower than the RDA. The main charecter of the diet has been found low in quality of protein and high in carbohydrate. The calcium intakes of the pre-school children in both villages, 251.9 milligrams in Siljun Ri and 218.8 milligrams in Soowol Ri, were very much lower than the recommended allowance of 500 milligrams per day. It is apparent that the diet for children should be supplemented with calcium. Among the vitamin group, the daily average intakes of vitamin A and $B_{2}$(thiamine), $B_{2}$(riboflavin), C(ascorbic acid), and niacin were not adequate for the children in both villages. Especially the intake of riboflavin, 0.4 milligrams in both village children, was much lower than the RDA, 0.9 milligrams per day. Physical Characteristics Average height, weight, chest and head circumference of the pre-school children in both villages were similar to those of the Korean standard given by the Korean Paediatrics Association except that the average height of pre-school boys in Siljun Ri was 8 cm higher than the Korean standard of 105 cm. The mean values of upper arm circumference and skinfold thickness of pre-school boys in both villages were the same, 15.4 cm for upper arm circumference and 6.8 mm for skinfold thickness, but the mean values of those of the girls in Siljun Ri were higher than those of pre-school grils in Soowol Ri. Biochemical Findings Avera ge hemogobin value of boys and girls in both villages was the same, 11.1 grams per 100 ml of blood. The incidence of anemia (Hb value below 11g/100ml) was similar in both viltagesr 36.4% for boys and 50% for girls in Siljun Ri and 37.5% for boys and 50% for girls in Soowol Ri. Average hemoglobin values of fertile women were 10.7g% in Siljun Ri and 10.8% in Soowor Ri. The incidences of anemia(Hb valre brlow 12g/100ml) were 100% in Siljun Ri and 86.7% in Soowol Ri. The anemia of these subjects may be caused mainty low intake of good quality protein and iron intake from vegetable food. Recommendation In general, the nutritional status of a community health pilot village is not higher than that of control village due to the lack of nutrition improvement guldance services. Nutrition education should be delivered to the villagers as a main part of the health education artivities. The emphasis should be on building better health through bttter food habits and better food production as well as on preventing malnutrition and diseasrs. It can be an invaluable part of community developnent. Since nutrition is considered to be at least one-half of MCH care, no village or home visits should be made without careful provision for teaching and demoastrating something simple and practical on nutrition. The nurse, midwife, and village health worker should be the chief promoters of nutrition.

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농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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오디에이션 음악활동이 유치원 아동의 음악소질 향상에 미치는 영향 (Effect of Music activitics using audition on Music Aptitude development for Kindergarten Children)

  • 노주희
    • 인간행동과 음악연구
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    • 제1권1호
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    • pp.11-32
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    • 2004
  • 에드윈 고든(Edwin E. Gordon)에 의하면 음악소질은 선천적인 자질과 후천적인 환경이라는 두 가지 요인의 상호 작용에 의하여 결정되며 만 9세 이전에는 환경의 영향에 따라 유연하게 반응하여 환경이 좋으면 발달되고 환경이 나빠지면 수그러드는 유동음악소질의 시기에, 또한 9세 이후에는 환경의 영향에 대하여 민감하게 반응하지 않는 고정음악소질의 시기에 놓인다. 본 연구는 유동음악소질의 시기에 경험하는 풍부한 음악적 교육환경의 제공시기가 이를수록, 또한 교육의 제공기간이 길수록 소질의 향상에 미치는 효과가 더욱 크다는 음악학습이론의 가설을 증명하고자 하였다. 그리고 미국의 템플 대학의 음악학습이론 수업을 모델로 하여 설립된 유아음악감수성계발프로그램 "오디"가 계발한 오디에이션 음악활동이 음악소질에 미치는 교육효과를 검증하고자 하였다. 교육은 매주 30분 씩 연구자와 연구자 외 1인의 협력교사가 함께 아이들을 가르치는 Co-teaching 형식으로 음악지도의 형태가 아닌 음악안내의 교육방법으로 진행되었다. 다양한 조성, 가사 없는 선율노래와 리듬노래, Free-Flowing Movement를 중심으로 한 다양한 동작, 개별적 반응활동인 패턴학습 등 음악학습이론의 원칙이 지켜졌으며 대그룹 수업을 위하여 오디가 발전시킨 새로운 수업전개방식과 기술이 적용되었다. 실험집단은 각각 1년간 오디수업을 받은 만 5세 유치원 아동과 만 4세 때부터 2년간 오디수업을 받은 만 5세 유치원 아동으로서 두 집단 모두 만 5세 때 고든의 오디에이션기초평가 Primary Measures of Music Audiation(Gordon, 1979)을 사용하여 학년초, 중, 학년말 등 3회에 걸쳐 음악소질을 측정하였다. 연구의 결과는 첫째, 오디의 활동을 5세 동안 1년 교육받은 실험집단 1의 음악소질검사결과를 4세부터 2년 동안 교육받은 실험집단 2의 음악소질검사와 비교할 때 음감소질은 유의미한 차이가 없었으나 리듬소질에서는 유의미한 차이가 발생하였다. 둘째, 오디의 활동을 교육받은 실험집단과 오디의 음악수업을 받지 않은 비교집단의 학기초 음악소질검사 결과는 유의미한 차이를 보이지 않았으나 학기말 검사결과에서는 유의미한 차이를 보였다.

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소금민감성 SLC12A3 유전자 다형성에 따른 나트륨섭취가 소아비만에 미치는 영향 (Effects of interaction between SLC12A3 polymorphism, salt-sensitive gene, and sodium intake on risk of child obesity)

  • 정주현;이명숙
    • Journal of Nutrition and Health
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    • 제50권1호
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    • pp.32-40
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    • 2017
  • 소아기의 과체중 혹은 비만은 성인기의 만성질환의 onset 위험을 증가시키는 대사이상을 야기하므로 관련된 obesogenic 환경 (나트륨 섭취 등)을 제어할 필요가 있다. 본 연구에서는 소아기의 과도한 소금섭취가 신장의 재흡수 기능을 조절하는 SLC12A3기능장애로 이어져 고혈압 및 비만을 야기하는지를 확인하고자 하였다. 서울 구로구에 소재한 8~9세 초등학생 752명 (남학생: 379명 여학생: 373명)을 대상으로 BMI가 85 percentiles이상을 비만군으로, 이하를 정상군으로 분류하였다. SLC12A3 rs11643718 유전자형은 GG (wild)와 GA + AA로 분류하여 신체계측, 혈액검사, 식이조사 등을 비교분석하였다 대상자의 남아가 여아보다, 비만군이 정상군보다 신체지수, 혈액지수, 식사섭취량이 여아보다 높았다. 남녀 모두 비만군에서 높은 TG와 낮은 HDLc를 보여주었지만 비만한 남아는 혈압에, 비만한 여아는 인슐린저항성에 더 민감한 반응을 보였다. 비록 남녀차이는 있지만 비만군 및 정상군 모두에서 SLC12A3의 GA + AA형이 GG형보다 혈압과 체중이 높았다. GG 유전자형을 가지고 있는 소아는 혈중 LDLc, FBS, insulin등이 높거나 식이 콜레스테롤섭취가 증가할수록 비만이 될 위험도가 증가하였고 엽산의 섭취가 증가할수록 비만위험도는 감소하였다. 반면, GA + AA 유전자형을 가지고 있는 소아는 고나트륨 (> 4,000 mg/day)섭취시 비만위험도 (odd ratio)가 15.57배 증가하였고 남아 (22.84배)에서 더욱 위험도가 높았다. HDLc의 경우는 유전자형에 관계없이 증가할수록 비만위험도가 감소하였다. 결론적으로 SLC12A3 (rs11643718) 유전자의 A allele를 가진 형이 나트륨에 특이적으로 반응하여 과체중위험을 증가시키는 것으로 생각된다.

치매노인의 삶의 질과 시설 환경 요인에 관한 연구 (A Study on the Quality of Life of Elderly People with Dementia and the Environmental Factor of Facilities)

  • 박세정;김한곤
    • 한국노년학
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    • 제29권4호
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    • pp.1361-1381
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    • 2009
  • 최근 우리 사회는 급격한 사회변동으로 다양한 사회문제를 경험하여 왔다. 특히 치매노인이 접근하기 쉽지 않은 대상이라는 특성 때문에 치매노인의 삶의 질에 대한 심층적인 연구가 제대로 이루어지지 않고 있다. 이 연구의 목적은 치매노인의 삶의 질을 조사하고, 치매노인의 삶의 질과 시설 환경과의 관계 분석을 통해 치매노인의 시설 환경에 적합한(compatible) 프로그램 개발이나 다양한 정책적 및 실천적 방안을 구성하는 데 필요한 기초 자료를 제시하고자 하며, 이를 통하여 치매노인의 삶의 질 향상과 시설 환경적 문제해결 방안을 모색하는 것이다. 이를 위하여 대구 및 경북지역의 노인주거복지시설 및 노인의료복지시설의 치매노인을 대상으로 하였으며 수집된 자료는 SPSS 12.0 통계 프로그램을 이용하여 빈도 및 교차분석과 다항로지스틱회귀분석을 하였다. 그 결과 시설의 환경이 치매노인의 삶의 질에 유의한 영향을 미치는 변인으로 밝혀졌다. 이를 위한 방안으로는 첫째, 치매노인이 만족하는 삶의 질을 위해서는 치매노인의 특성을 충분히 고려한 환경을 마련하고 치매노인의 잠재능력에 대한 인식전환이 필요하다. 둘째, 주수발자가 치매노인의 삶의 질에 영향을 주는 것으로 나타난 결과를 미루어 볼 때, 주수발자와의 관계 향상을 위한 프로그램이 필요하다. 셋째, 시설환경의 변화가 필요하다. 시설들이 치매노인의 증상에 잘 대처해 나갈 수 있도록 준비하고 시설의 접근성이 다소 떨어지는 것에 대해서는 오프라인(off-line)보다는 온라인(on-line)을 통해 치매노인요양시설과 전담인력 등 인프라를 확충하고, 지역사회가 긴밀히 협력하여 요양보호를 필요로 하는 어르신께 양질의 요양보호서비스를 제공할 수 있도록 해야 한다.

미술교육에 있어서 시각적 미디어를 통한 조형교육에 관한 연구 (Visual Media Education in Visual Arts Education)

  • 박지숙
    • 조형예술학연구
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    • 제7권
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    • pp.64-104
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    • 2005
  • Visual media transmits image and information reproduced in large quantities, such as a photography, film, television, video, advertisement, or computer image. Correspondence to the students' reception and recognition of culture in the future. arrangements for the field of studies of visual culture. 'Visual Culture' implies cultural phenomena of visual images via visual media, which includes not only the categories of traditional arts like a painting, sculpture, print, or design, but the performance arts including a fashion show or parade of carnival, and the mass and electronic media like a photography, film, television, video, advertisement, cartoon, animation, or computer image. In the world of visual media, Image' functions as an essential medium of communication. Therefore, people call the culture of today fra of Image Culture', which has been converted from an alphabet convergence era to an image convergence one. Image, via visual media, has become a dominant means for communication in large part of human life, so we can designate an Image' as a typical aspect of visual culture today. Image, as an essential medium of communication, plays an important role in contemporary society. The one way is the conversion of analogue image like an actual picture, photograph, or film into digital one through the digitalization of digital camera or scanner as 'an analogue/digital commutator'. The other is a way of process with a computer drawing, or modeling of objects. It is appropriate to the production of pictorial and surreal images. Digital images, produced by the other, can be divided into the form of Pixel' and form of Vector'. Vector is a line linking the point of departure to the point of end, which organizes informations. Computer stores each line's standard location and correlative locations to one another Digital image shows for more 'Perfectness' than any other visual media. Digital image has been evolving in the diverse aspects, such as a production of geometrical or organic image compositing, interactive art, multimedia art, or web art, which has been applied a computer as an extended trot of painting. Someone often interprets digitalized copy with endless reproduction of original even as an extension of a print. Visual af is no longer a simple activity of representation by a painter or sculptor, but now is intimately associated with a matter of application of media. There is some problem in images via visual media. First, the image via media doesn't reflect a reality as it is, but reflects an artificial manipulated world, that is, a virtual reality. Second, the introduction of digital effect and the development of image processing technology have enhanced a spectacle of destructive and violent scenes. Third, a child intends to recognize the interactive images of computer game and virtual reality as a reality, or truth. Education needs not only to point out an ill effect of mass media and prevent the younger generation from being damaged by it, but also to offer a knowledge and know-how to cope actively with social, cultural circumstances. Visual media education is one of these essential methods for the contemporary and future human being in the overflowing of image informations. The fosterage of 'Visual Literacy' can be considered as a very purpose of visual media education. This is a way to lead an individual to the discerning, active consumer and producer of visual media in life as far as possible. The elements of 'Visual Literacy' can be divided into a faculty of recognition related to the visual media, a faculty of critical reception, a faculty of appropriate application, a faculty of active work and a faculty of creative modeling, which are promoted at the same time by the education of 'visual literacy'. In conclusion, the education of 'Visual Literacy' guides students to comprehend and discriminate the visual image media carefully, or receive them critically, apply them properly, or produce them creatively and voluntarily. Moreover, it leads to an artistic activity by means of new media. This education can be approached and enhanced by the connection and integration with real life. Visual arts and education of them play an important role in the digital era depended on visual communications via image information. Visual me야a of day functions as an essential element both in daily life and in arts. Students can soundly understand visual phenomena of today by means of visual media, and apply it as an expression tool of life culture as well. A new recognition and valuation visual image and media education is required to cultivate the capability of active, upright dealing with the changes of history of civilization. 1) Visual media education helps to cultivate a sensibility for images, which reacts to and deals with the circumstances. 2) It helps students to comprehend the contemporary arts and culture via new media. 3) It supplies a chance of students' experiencing a visual modeling by means of new media. 4) There are educational opportunities of images with temporality and spaciality, and therefore a discerning person becomes to increase. 5) The modeling activity via new media leads students to be continuously interested in the school and production of plastic arts. 6) It raises the ability of visual communications dealing with image information society. 7) An education of digital image is significant in respect of cultivation of man of talent for the future society of image information as well. To correspond to the changing and developing social, cultural circumstances, and the form and recognition of students' reception of them, visual arts education must arrange the field of studying on a new visual culture. Besides, a program needs to be developed, which is in more systematic and active level in relation to visual media education. Educational contents should be extended to the media for visual images, that is, photography, film, television, video, computer graphic, animation, music video, computer game and multimedia. Every media must be separately approached, because they maintain the modes and peculiarities of their own according to the conveyance form of message. The concrete and systematic method of teaching and the quality of education must be researched and developed, centering around the development of a course of study. Teacher's foundational capability of teaching should be cultivated for the visual media education. In this case, it must be paid attention to the fact that a technological level of media is considered as a secondary. Because school education doesn't intend to train expert and skillful producers, but intends to lay stress on the essential aesthetic one with visual media under the social and cultural context, in respect of a consumer including a man of culture.

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Ceftriaxone 사용후 발생된 Pseudolithiasis (Ceftriaxone Associated Biliary Pseudolithiasis)

  • 김재영;고재성;이환종;고영률;서정기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제1권1호
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    • pp.100-106
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    • 1998
  • 목 적: ceftriaxone은 제 3세대 반합성 cephalosporin제제로 강력한 항균작용이 있어 중증 감염성질환의 치료에 널리 사용되고 있으며, 합병증으로 항생제로서는 유일하게 담낭오니를 형성할 수 있다. 최근의 보고들에 의하면 ceftriaxone의 사용으로 발생된 담낭오니는 약제투여를 중단하면 자연 소실되는 양성경과를 취하는 것으로 알려져 있으나, 드물게 담낭절제술이 시행된 경우도 있었다. 이에 저자들은 ceftriaxone 투여로 발생된 담낭오니의 발생빈도, 유발위험인자, 예후 등을 알아보기 위해 본 연구를 시행하였다. 방 법: 1997년 3월부터 1998년 2월까지 서울대학교병원 소아과에 세균성감염이 의심되어 입원하여 ceftriaxone으로 치료 받으면서 복부 초음파검사가 가능했던 21례 중에서 담낭오니의 발생이 확인된 8명의 환자들을 조사대상으로 하였으며 추적관찰 초음파검사는 6례에서 시행되었다. 선행하는 간질환이나 신기능이 떨어져 있는 경우는 본 조사 대상에서 제외하였다. 결 과: 1) 총 21례의 환자에서 ceftriaxone으로 치료 도중에 복부 초음파검사가 가능했으며, 38%(남아 4례, 여아 4례)에서 담낭오니의 발생이 확인되었다. 2) 담낭오니가 발생된 군의 나이가 $6.3{\pm}2.9$세로 발생하지 않은 군의 나이 $2.2{\pm}3.1$세보다 의미있게 많았으며(p<0.05), 24개월 이후의 연령군에서 이전의 연령군에서보다 더 잘생겼다(p<0.05). 3) 담낭오니는 8례 모두에서 고음영의 에코를 보였으며, 5례에서 후벽음영이 동반되었다. 4) 추적관찰 초음파검사가 가능했던 6례 중 2례는 약제의 투여가 끝난 때로부터 14일째, 2례는 30일째, 나머지 2례는 80일째 시행한 복부초음파검사에서 각각 정상 담낭소견을 보였다. 5) 담낭오니의 발생과 ceftriaxone의 투여용량, 투여기간, 금식, 원인질환 등은 의미있는 상관관계를 보이지 않았다. 결 론: ceftriaxone 투여로 인한 담낭오니의 발생은 나이가 가장 중요한 위험인자로 24개월 이상의 연령군에서 의미있게 발생빈도가 높았다. 그러므로 나이가 24개월 이상의 환자에게 고용량($60{\sim}100\;mg{\cdot}Kg^{-1}{\cdot}day^{-1})$의 ceftriaxone을 투여한 경우와 약제 투여 후에 간담도계 증상이 발생된 모든 경우에는 기본적으로 담낭 초음파검사를 시행하는 것이 바람직하다고 사료된다.

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산후우울증의 심리사회적 위험요인 (Psychosocial Risk Factors of Postpartum Depression)

  • 박시성;한귀원
    • 정신신체의학
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    • 제7권1호
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    • pp.124-133
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    • 1999
  • 연구목적 : 산후우울증은 여러 요인이 관여하여 발생하며, 이들 위험요인에는 다양한 심리사회적 요인이 포함된다. 이전의 여러 연구결과들을 통해 산후우울증의 위험요인이 알려지고 있지만 아직까지 국내에서 산후우울증을 대상으로 위험요인을 연구한 경우는 별로 없다. 본 연구는 국내에서 산후우울증의 심리사회적 위험요인으로는 어떤 것이 있는지를 알아보기 위하여 시행되었다. 방법 : 일신기독병원을 방문한 출산 후 약 6~8주에 있는 산모 119명을 대상으로 하였다. 설문지를 이용하여 산후우울증의 위험요인에 대하여 조사하고 산후우울의 정도를 측정하였다. 설문지는 이전 연구들을 통해 알려진 위험요인들을 참고하고 산모들의 스트레스와 관계되는 요인들을 추가하여 작성하였다. 산후 우울증을 평가하기 위해 EPDS(Edinburgh postnatal depression scale)를 번안해서 사용하였고, 산후우울의 정도는 측정된 EPDS 접수에 따라 판단하였다. 결과 : 총 대상 산모 119명 중 EPDS에 의해 산후우울증으로 진단될 수 있는 고위험군은 16명으로, 13.45%의 빈도를 보였다. 고위험군에서는 과거 우울증상을 경험한 경우와 결혼생활에 대한 만족도가 낮은 경우가 저위험군에 비해 유의하게 많았다, 또 과거 우울증상을 경험하였던 군, 임신중 우울과 불안증상을 경험한 군, 임신 및 산욕기동안 스트레스 생활사를 경험하였다고 보고한 군, 결혼생활에 대한 만족도가 낮은 군, 그리고 나이가 많을수록 EPDS 접수가 유의하게 높았다. 반면, 산모의 교육수준, 종교, 직업의 유무, 임신과 출산에 따른 직업중단 희망임신 여부 분만방법 수유방법, 유아의 입원여부, 그리고 기대했던 유아의 성별 및 실제 유아의 성별은 우울증상에 영향을 미치지 않았다. 결론 : 이상의 결과로 볼 때 산후우울증은 산후에 비교적 높은 빈도로 발생 가능하며, 우울증의 과거력, 임신동안 우울과 불안증상의 경험, 스트레스 생활사, 결혼생활에 대한 낮은 만족도, 그리고 산모의 연령과 같은 요소들이 산후우울증의 위험요인이었다. 임신과 산욕기 동안 산모에 대하여 적절히 정신의학적으로 개입함으로서 조기에 산후우울증을 발견하고 치료할 수 있으며, 산후우울증으로 인하여 산모와 유아에게 미치는 다양한 손실을 예방할 수 있을 것으로 생각된다.

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