• Title/Summary/Keyword: cost of children

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Diagnostic Evaluation of the BioFire® Meningitis/Encephalitis Panel: A Pilot Study Including Febrile Infants Younger than 90 Days (BioFire® Meningitis/Encephalitis Panel의 진단적 유용성 평가: 90일 미만 발열영아에서의 예비 연구)

  • Kim, Kyung Min;Park, Ji Young;Park, Kyoung Un;Sohn, Young Joo;Choi, Youn Young;Han, Mi Seon;Choi, Eun Hwa
    • Pediatric Infection and Vaccine
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    • v.28 no.2
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    • pp.92-100
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    • 2021
  • Purpose: Rapid detection of etiologic organisms is crucial for initiating appropriate therapy in patients with central nervous system (CNS) infection. This study aimed to evaluate the diagnostic value of the BioFire® Meningitis/Encephalitis (ME) panel in detecting etiologic organisms in cerebrospinal fluid (CSF) samples from febrile infants. Methods: CSF samples from infants aged <90 days who were evaluated for fever were collected between January 2016 and July 2019 at the Seoul National University Children's Hospital. We performed BioFire® ME panel testing of CSF samples that had been used for CSF analysis and conventional tests (bacterial culture, Xpert® enterovirus assay, and herpes simplex virus-1 and -2 polymerase chain reaction) and stored at -70℃ until further use. Results: In total, 72 (24 pathogen-identified and 48 pathogen-unidentified) CSF samples were included. Using BioFire® ME panel testing, 41 (85.4%) of the 48 pathogen-unidentified CSF samples yielded negative results and 22 (91.7%) of the 24 pathogen-identified CSF samples yielded the same results (enterovirus in 19, Streptococcus agalactiae in 2, and Streptococcus pneumoniae in 1) as those obtained using the conventional tests, thereby resulting in an overall agreement of 87.5% (63/72). Six of the 7 pathogen-unidentified samples were positive for human parechovirus (HPeV) via BioFire® ME panel testing. Conclusions: Compared with the currently available etiologic tests for CNS infection, BioFire® ME panel testing demonstrated a high agreement score for pathogen-identified samples and enabled HPeV detection in young infants. The clinical utility and cost-effectiveness of BioFire® ME panel testing in children must be evaluated for its wider application.

Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection (급성 감염성 질환을 가진 영유아에서 철결핍 진단 지표로서의 망상적혈구혈색소량)

  • Kim, Jon Soo;Choi, Jun Seok;Choi, Doo Young;You, Chur Woo
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.827-833
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    • 2008
  • Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

Optimum Population in Korea : An Economic Perspective (한국의 적정인구: 경제학적 관점)

  • Koo, Sung-Yeal
    • Korea journal of population studies
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    • v.28 no.2
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    • pp.1-32
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    • 2005
  • The optimum population of a society or country can be defined as 'the population growth path that maximizes the welfare level of the society over the whole generations of both the present and the future, under the paths allowed by its endowments of production factors such as technology, capital and labor'. Thus, the optimum size or growth rate of population depends on: (i) the social welfare function, (ii) the production function, and (iii)demographic economic interrelationship which defines how the national income is disposed into consumption(birth and education of children included) and savings on the one hand and how the demographic and economic change induced thereby, in turn, affect production capacities on the other. The optimum population growth path can, then, be derived in the process of dynamic optimization of (i) under the constraints of (ii) and (iii), which will give us the optimum population growth rate defined as a function of parameters thereof. This paper estimates the optimum population growth rate of Korea by: specifying (i), (ii), and (iii) based on the recent development of economic theories, solving the dynamic optimization problem and inserting empirical estimates in Korea as the parametric values. The result shows that the optimum path of population growth in Korea is around TFR=1.81, which is affected most sensitively, in terms of the size of the partial elasticity around the optimum path, by the cost of children, share of capital income, consumption rate, time preference, population elasticity of utility function, etc. According to a survey implemented as a follow up study, there are quite a significant variations in the perceived cost of children, time preference rate, population elasticity of utility across different socio-economic classes in Korea, which implied that, compared to their counterparts, older generation and more highly educated classes prefer higher growth path for the population of Korea.

Development and Evaluation of the Supplementary Foods for Korean Infants and Children (지역 식품을 이용한 이유 보충식의 개발과 이의 영양학적 검토 및 저장성에 관한 연구)

  • Ahn, Kyung-Mi;Moon, Soo-Jae;Choi, Hong-Sik;Kwak, Tong-Kyung
    • Journal of Nutrition and Health
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    • v.18 no.4
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    • pp.259-271
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    • 1985
  • The purpose of this study was to develop supplementary foods for infants and young children in order to improve their nutritional status. Three formulas composed of rice, soybeans, fish, dry skim milk and sesame in varying proportions were studied. The three formulas, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$, were consisted of Rice(R), Soybean$(S_{1})$, Sesame$(S_{2})$ (60 : 35 : 5) , Rice, Fish(F), Soybean, Sesame (60 : 10 : 25 : 5) , and Rice, Dry Skin Milk (M), Soybean, Sesame (60 : 10 : 25 : 5), respectively. A proximate analysis and amino acid determination were made on the developed formulas. In the animal assay, growth rate, PER and FER were evaluated and biochemical analyses were also carried out. A storage test and the cost evaluation were also conducted. The summarized results are as follows : 1) The proximate composition of the three formulas were 7.3-7.4% of moisture, 15.9-21.5% of crude protein, 7.8-9.6% of crude fat and 2.5-2.8% ash. 2) The result of amino acid analysis showed that the 1st limiting amino acids of $RS_{1}S_{2}$ and $RFS_{1}S_{2}$ were lysine (amino acid score, 76.6) and threonine (amino acid score, 93.3), and that of $RMS_{1}S_{2}$ and the commercially prepared formula were sulfur containing amino acids (amino acid score, 82.0 and 54.4). When the contents of the amino acids of the three formulas were compared with mother's milk and cow's milk, the balance of the amino acid of each formula was superior to mother's milk but inferior to cow's milk. 3) In the animal assay, the growth rate of all groups increased gradually during the experimental period. 4) The C- PER, which was corrected on the basis of the casein PER of 2.5 was 2.99, 3.38 and 3.10 in the $RS_{1}S_{2}$, $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ respectively. The C- PER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were Significantly (P<.05) higher than that of the casein. 5) The FER of the casein, $RS_{1}S_{2}$, $RFS_{1}S_{2}$, and $RMS_{1}S_{2}$ were 0.37, 0.39, 0.43 and 0.39, respectively. The FER of $RFS_{1}S_{2}$ and $RMS_{1}S_{2}$ were also significantly (P<.05) higher than that of the casein. 6) The concentrations of hematocrit, hemoglobin, total protein and albumin in the serum of the rats of all groups were not significantly different among groups. 7) The storage stability test showed that the total plate count (TPC), the coliforms count and the bacterial spore count in the ingredients were quiet low. However, after 30 and 60 days storage, the count in $RFS_{1}S_{2}$ increased and were higher at room temperature than refrigerated temperature. 8) In the cost evaluation, the cost of the developed formulas was \1,826-2,626 / kg. This was less than that of the commercially prepared formula (\3,300-4,073 / kg) and that of the imported formula (\4,250-8,720 / kg).

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한국 농촌지역의 임신효율 (Reproductive Efficiency)에 관한 연구 : 충남 서산지역을 중심으로

  • An, Mun-Yeong
    • Journal of agricultural medicine and community health
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    • v.7 no.1
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    • pp.74-79
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    • 1982
  • Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

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Differences in Health, Economic Status, and Social Relations of Female Elderly Living Alone - A Comparative Analysis of Residental Areas including Urban, Rural, Fishing, and Island Communities in Chungcheong Province - (여성 독거노인의 건강, 경제상태, 사회적 관계의 지역적 차이에 관한 연구 - 도시, 농촌, 어촌, 도서지역의 비교 -)

  • Kim, Yun-Jeong
    • The Korean Journal of Community Living Science
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    • v.18 no.3
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    • pp.417-431
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    • 2007
  • This study investigates the differences among residental areas in the health, standard of living, and social relationships of female elderly living alone. The total of 501 subjects(185 from rural areas, 159 from fishing communities, 77 from the islands, and 80 from urban areas) were questioned from May to July, 2006. The research area was confined to Chungcheong Province. The female elderly living alone of this study were an average of seventy-three years old, had a low cost of living, and received little formal school education. Over sixty percent(60.3) of them lived on less than thirty dollars a month which was the recognized Korean poverty level in 2006. The female elderly living alone were evaluated as being in good health, but they themselves perceived their health as being poor. Observed by residential areas, the subjects in urban areas were lower in ADL, and both the urban dwellers and the islanders appeared to be higher in their satisfaction with medical services as compared to those in rural areas and fishing communities. The fishing villagers showed the lowest standard of living for female elderly living alone. The analysis of social relationships as seen in the different residental areas revealed that the female elderly living alone g in urban areas tended to be receiving social supports rather than providing for others, and subjects living in fishing areas and the islands proved to be relatively higher in the exchange of social supports. In relation to offspring, the female elderly living alone in urban areas had a lower frequency of meeting with their children and also a lesser degree of intimacy with them because they lived at a distance. On the other hand, subjects living in rural areas and fishing communities had a higher frequency of meeting with their children and a greater degree of intimacy with them even if they lived at a distance. The study also showed that the female elderly living alone in the islands had a higher frequency of once meeting per three week with their offspring and a higher degree of intimacy with them because they all live in the same islands. In conclusion, the subject living in urban areas appeared to be isolated from their offspring as compared to the other seniors in the study. The female elderly living alone in urban areas suffered from an insufficient network of relatives and neighbors, and they experienced a poor quality of relationships to their offspring. Almost all of the lone seniors in the study had a low score in social activities; however, the female elderly living alone in urban areas revealed a higher level of participation in volunteer activities, group activities, and educational activities. Nevertheless, the lone seniors living in urban areas were not satisfied with their participation in social activities. The subjects living in rural in fishing communities and the islands showed more participation in money-making activities. This study suggests that the policies for female elderly living alone should reflect the differences of regional characteristics.

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Is it Impossible to Replace Chloral Hydrate in Dental Sedation of Pediatric Dentistry in Korea? (진정법에서 클로랄 하이드레이트의 대안은 무엇일까?)

  • Han, Miran;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.47 no.2
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    • pp.228-234
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    • 2020
  • Chloral hydrate (CH) has been used in sedation for over 100 years. CH was first synthesized in 1832, the sedative properties were observed in 1861. Because of its easy synthesis, its use was widespread since 1869. There is a record of the use of CH in children as early as 1894. Recently there have been many controversies about safety of CH. Because of the low cost and relatively safe experience CH has still been used for dental sedation in children. After the US FDA recommendation in 2006, US pharmaceutical companies no longer produce commercial CH. However, CH has been used in the form of suspensions prepared from raw materials in many areas of the United States, and reports of adverse events related to death have continued. CH is the most commonly used drug for sedation in Korea, and there have been some reports of side effects. Dexmedetomidine, propofol and midazolam were introduced as an alternative for CH. There are various limitations in using them in the pediatric dentistry area and there are many things to consider. The purpose of this review is to analyze the complications of CH and status of use in Korea, and to introduce alternatives to CH.

Role of Korean Society of Pediatric Infectious Disease during the Middle East Respiratory Syndrome (MERS) Outbreak in Korea, 2015 (2015년 우리나라에서 발생한 중동호흡기증후군과 대한소아감염학회의 역할)

  • Kim, Kyung-Hyo
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.136-142
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    • 2015
  • The Korean Society of Pediatric Infectious Diseases (KSPID) has participated in the task force team consisting of government authorities as well as civil medical experts and facilities to block the spread of Middle East Respiratory Syndrome in 2015. KSPID posted the "Middle East Respiratory Syndrome (MERS) Pop-up" in the homepage of The Korean Pediatric Society and The Korean Society of Pediatric Infectious Diseases. KSPID also released the "Guidelines for testing for MERS in children and adolescents" and the "Instructions for the Operation of National Safe Hospital" for children and adolescents in a timely manner. Such actions were aimed to prevent unnecessary anxieties, studies and isolation of pediatric patients with respiratory symptoms and signs caused by other common microbial etiologies as being suspected for MERS patients. This strategy relieved the doctors and parents from unnecessary fear and prevented the loss of unnecessary health care costs, and has proven to be a well-judged guideline and management protocol as evaluated after the final end of MERS outbreak. KSPID and its members should support the presence of pediatric infectious disease (PID) specialists in every medium size hospitals in Korea by developing the need for consultation fees for PID consultation in the hospital based practice and promoting the potential for cost savings related to prevention of health care associated infections and optimal prescription of antimicrobial agents. KSPID and its members need to approach and develop a communication plan to political decision makers to demonstrate and convince them of the importance of a PID specialist service.

Drawbacks of Teacher Training System and Improvement Plan for Performance of Nuri-educators (누리과정 담당교사의 직무능력 향상을 위한 유아교사 양성체계의 문제점과 개선방안)

  • Kwon, Eun Hee;Sung, Young Hye
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.7 no.4
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    • pp.187-200
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    • 2012
  • Korean government imposed a free education policy called "Nuri-Curriculum program" available for children under age of 5 ever since march 2012 due to consolidation of national responsibility. The policy presents providing of cost-free and high-quality education/childcare services to people. Nuri program services will expand to applied age of 3-5 children from march 2013. however, because to gain successful outcomes from the program requires well-trained professional educator, it is necessary to standardize education infrastructure in order to improve employees' professionality. Therefore study suggests followings: fisrt, establishment of desirable role-model. second, unification of the training process. third, unifications of administration system and qualification standard. fourth, readjust curriculums to focus on basic knowledge of human life. fifth, clarify the duty of educator and systematize curriculums. sixth, consolidate base criteria.

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An Exploratory Research on Social Workers' Attitude and Related Factors about Indoor Air Quality Management of Social Welfare Facilities (사회복지시설 종사자의 실내공기질 관리에 대한 태도와 관련 요인에 관한 탐색적 연구)

  • Bae, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.17 no.5
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    • pp.273-284
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    • 2017
  • As these days people spend most of time at inner space, indoor air quality affect human life seriously. Government manage indoor air quality of various facilities based on different laws. Government released that they would try to protect environment for vulnerable people such children and seniors from indoor air pollutants in 2015. But social welfare facilities are exception under current legal systems. Clients of social welfare residential facilities are the disables, the elderly, homeless and children and they usually stay inner space very long time. The purpose of this study is explore workers' attitude and related factors about indoor air quality management of social welfare facilities. 69.5% of respondents agree to government's indoor air quality management, 80.9% of respondents think social welfare facilities must be included in legal system for indoor air quality management. Environmental awareness and law awareness were related with attitude to indoor air quality management. Based on the results of the analysis, I propose the amendment of law on indoor air quality of the Ministry of Environment, cost burden of central or local government and the necessity of education and research on indoor air quality management in social welfare facilities.