• Title/Summary/Keyword: type of anxiety

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Investigation of False Positive Rates Newborn Screening using Tandem Mass Spectrometry (TMS) Technology in Single Center (단일기관에서 이중 질량 분석법(tandem mass spectrometry technology)을 이용한 선천성 대사이상 검사의 위양성율에 대한 연구)

  • Kim, Hyunsoo;Shin, Son Moon;Ko, Sun Young;Lee, Yeon Kyung;Park, Sung Won
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.18-23
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    • 2016
  • Objective: Newborn screening leads to improved treatment and disease outcomes, but false-positive newborn screening results may impact include parental stress and anxiety, perception of child as unhealthy, parent-child relationship dysfunction, and increased infant hospitalizations. The purpose of this study was to investigate of the false positive rates and the causative factors of false positive results in Tandem Mass Spectrometry (TMS) in single center. Methods: Records were reviewed for all 18,872 subjects who were born in Cheill General Hospital, during January 1st, 2012 to December 31st, 2014. 17,292 neonates (91.62%) were tested for tandem mass screening almost in 2-5th day of life. Newborn babies whose first results were abnormal had been tested repeatedly by same methods in 7-14 day. If the results were abnormal again, further evaluation was performed. TMS analysis included data for the 43 disorders screened for using TMS broken down into three categories: fatty acid oxidation disorders, organic acidurias, and aminoacidopathies. The impact of several factors on increased false positive rates was analyzed using a multivariate analysis: time from birth to sample collection, birth weight, birth height, BMI, gender, gestational age, delivery type. Results: Males of the subjects were 8942 (51.7%), female 8350 (48.3%), the mean gestational age was $38.6{\pm}1.7$ weeks, the average birth weight $3,155.6{\pm}502.4g$, the average birth height $49.1{\pm}2.9cm$, and the average BMI $13.0{\pm}3.8(kg/m^2)$. Vaginal delivery cases were 9713 (56.2%), caesarean section 7,579 (43.8%). The average date of the inspection was $2.8{\pm}1.1$ days. 224 cases were identified as TMS positive. All the subjects were false positive (222/17,292, 1.30%) except 2 cases (1 male; benign phenylketonuria and 1 female; Short chain acyl-CoA dehydrogenase deficiency). The false positive rates were 0.61% in fatty acid oxidation disorders, 0.25% in organic acidurias, and 0.45% in aminoacidopathies. In our study, the date of inspection got late, the false positive rates got higher. Because almost the cases of late test date were in treatment in neonatal intensive care unit so their test date was affected by their medical conditions. False positive rate was higher in extreme immaturity${\leq}27$ weeks than newborns of gestational age >27 weeks [OR=6.957 (CI=1.273-38.008), p<0.025] and extremely low birth weight<1,000 g than newborns of birthweight ${\geq}1,000g$ [OR=5.616 (CI=1.134-27.820), p<0.035]. Conclusion: False positive rate of TMS was 1.30% in Cheil General Hospital. Lower gestational age and birth weight impacted on increased false positive rates. Better understanding of factors that influence the reporting of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting. of screening tests, and the ability to modify these important factors, may improve the screening process and reduce the need for retesting.

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A Study on the Perceived Stress Level of Mothers in the Neonatal Intensive Care Unit Patients (신생아 중환자실에 입원한 환아 어머니의 스트레스)

  • Kim Tae Im
    • Child Health Nursing Research
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    • v.6 no.2
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    • pp.224-239
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    • 2000
  • This descriptive study was conducted to understand the contents and degree of parental stress level in the NICU patients, and to give a baseline data in developing nursing intervention program. Subjects were the 62 mother of hospitalized newborn in NICU of 1 University Hospital in Taejon City from May 1st, 1999 to November 30th, 1999, who agreed to take part in this study. The instrument used in this study were Parental Stressor Scales : NICU(PSS:NICU) developed by Miles et al. and validated by 3 NICU practitioners and 3 child health nursing faculties. The questionnaire has 4 dimensions and 45 items; sight and sounds of NICU(5 items), babies' appearance and behavior(19 items), parental role alteration and relationship with their baby(10 items), communication with health team(11 items). The questionnaire asks parents to rate each item on a five-point Likert type scale that ranges from (1) to (5). Total scores representing overall stress from the NICU environment are calculated by summing response to each item. A high score indicates high stress. A subscale score is calculated by summing the responses to each item in the subscale. Cronbach's α coefficients were .93. The data was analyzed as average, Frequency, Standard deviation, t-test, ANOVA, Pearson correlation coefficient by use of SPSS/PC+. The results of this study is summarized as follows ; 1. The total perceived stress level score of mothers was slightly high(3.6±.7). The highest scored dimension was 'appearance and behavior of the baby'(3.9±1.5), and next were 'relationship with their baby and parental role change'(3.5±1.4), 'communication with health team'(3.4±.9), 'sight and sounds of NICU'(3.2±.8). 2. Two variables were statistically significant with PSS:NICU total scale ; mother's perceived severity of the baby's condition (r=.482, P=.002) and mother's religious attendance(t=2.83, P=.01). The more the mother perceive their baby's condition severe, the higher the total stress score. There were high stress score noted in the mother of no religious attendance. 3. Four variables were statistically significant with NICU environment subscale ; mother's educational background(F=3.45, P=.04), religious attendance(t=2.28, P=.04), sex of the baby(t=2.83, P=.01) and NICU patients' hospital day(r=.359, P=.004). That is mother with high educational background and girl baby were high NICU environment subscale score. 4. Four variables were statistically significant with appearance and behavior of the baby subscale ; when first saw baby(F=3.52, P=.04), incubator care(t=2.83, P=.01), mother's perceived severity of the baby's condition(r=.303, P=.017), number of NICU visit(r=.441, P=.002). That is, seeing the baby first in the NICU and recieved incubator care was very stressful. Also, the more the mother perceive their baby's condition severe and more NICU visit, the higher the appearance and behavior of the baby subscale stress score. 5. Four variables were statistically significant with relationship with their baby and parental role change subscale ; when first saw baby(F=3.37, P=.04), sex of the baby(t=2.36, P=.03), incubator care(t=5.60, P=.00), mother's perceived severity of the baby's condition(r=.401, P=.001). That is, seeing the baby first in the NICU and girl baby was very stressful. Also, the more the mother perceive their baby's condition severe, the higher the relationship with their baby and parental role change subscale stress score. 6. Three variables were statistically significant with communication with health team subscale ; mother's educational background (F=3.63, P=.04), incubator care(t=4.24, P=.00), gestational age(r=-.394, P=.047), and birth weight(r=-.460, P=.004). That is, mother with high educational background and receiving incubator care were high communication with health team subscale score. Also, the shorter the gestational age and smaller the baby's birth weight, the higher the communication with health team subscale score. In conclusion, information about physical environment of NICU, the mother's perceived severity of baby's illness state, maternal role change related variables and the knowledge of characteristics of NICU patients must be included in nursing intervention program of mother's of NICU patients in reducing the maternal stress and anxiety level.

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A Study on Setup for Preliminary Decision Criterion of Continuum Rock Mass Slope with Fair to Good Rating (양호한 연속체 암반사면의 예비 판정기준 설정 연구)

  • Kim, Hyung-Min;Lee, Su-gon;Lee, Byok-Kyu;Woo, Jae-Gyung
    • The Journal of Engineering Geology
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    • v.29 no.2
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    • pp.85-97
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    • 2019
  • It can be observed that steep slopes ($65^{\circ}$ to $80^{\circ}$) consist of rock masses were kept stable for a long time. In rock-mass slopes with similar ground condition, steeper slopes than 1 : 0.5 ($63^{\circ}$) may be applied if the discontinuities of rock-mass slope are distributed in a direction favorable to the stability of the slope. In making a decision the angle of the slope, if the preliminary rock mass conditions applicable to steep slope are quantitatively setup, they may be used as guidance in design practice. In this study, the above rock mass was defined as a good continuum rock mass and the quantitative setup criterion range was proposed using RMR, SMR and GSI classifications for the purpose of providing engineering standard for good continuum rock mass conditions. The methods of study are as follows. The stable slope at steep slopes ($65^{\circ}$ to $80^{\circ}$) for each rock type was selected as the study area, and RMR, SMR and GSI were classified to reflect the face mapping results. The results were reviewed by applying the calculated shear strength to the stable analysis of the current state of rock mass slope using the Hoek-Brown failure criterion. It is intended to verify the validity of the preliminary criterion as a rock mass condition that remains stable on a steep slope. Based on the analysis and review by the above research method, it was analyzed that a good continuum rock mass slope can be set to Basic RMR ${\geq}50$ (45 in sedimentary rock), GSI and SMR ${\geq}45$. The safety factor of the LEM is between Fs = 14.08 and 67.50 (average 32.9), and the displacement of the FEM is 0.13 to 0.64 mm (average 0.27 mm). This can be seen as a result of quantitative representation and verification of the stability of a good continuum rock mass slope that has been maintained stable for a long period of time with steep slopes ($65^{\circ}$ to $80^{\circ}$). The setup guideline for a good continuum rock mass slope will be able to establish a more detailed setup standard when the data are accumulated, and it is also a further study project. If stable even on steep slopes of 1 : 0.1 to 0.3, the upper limit of steep slopes is 1 : 0.3 with reference to the overseas design standards and report, thus giving the benefit of ensuring economic and eco-friendlyness. Also, the development of excavation technology and plantation technology and various eco-friendly slope design techniques will help overcome psychological anxiety and rapid weathering and relaxation due to steep slope construction.

Effects of the Comfort Promotion Program for Prevention of Delirium among Elderly Patients Hospitalized in Long-term Care Hospital (요양병원 입원 노인환자의 섬망예방을 위한 안위증진 프로그램 개발 및 효과 검증)

  • Hwang, Hye-Jeong;Shin, Yeonghee;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.9
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    • pp.203-215
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    • 2017
  • Delirium is an acute confused state associated with poor outcomes among hospitalized long-term care hospital elderly patients. This study was conducted to examine the effects of acomfort promotion program based on Kolcaba's comfort theory for prevention of delirium among elderly patients who have been hospitalized in long-term care hospitals. The study used was a quasi-experimental type, with two groups of patients; those who received their usual care plus comfort nursing intervention (n=34) and those who only received usual care methods. Using the IBMSPSS/PC (Version 21), the homogeneity of the control and intervention group wereevaluated by the chi-squared test and an independent t-test, and all collected data wereanalyzed. Hypotheses were tested by independent t-tests and repeated measures of ANOVA. Delirium occurred at a rate of 2.9% (1/34) in the intervention group and 14% (5/34) -in the control group ($x^2=3.98$, p=0.047). The severity of the delirium in theintervention group was lower than that of the control (t=2.27, p=.027). The duration of delirium was 2days in the intervention group and 2-10days in the control group, indicating delirium in the intervention group lasted for a significantly shorter period ($x^2=3.22$, p=0.048). According to the change of time, the intervention group showed improvement in all areas including comfort scores (F=108.85, p<0.001), anxiety scores (F=63.39, p<0.001), depression scores (F=89.78, p<0.001), quality of sleep scores (F=63.63, p<0.001), and pain scores (F=93.64, p<0.001). In conclusion, elderly patients who were admitted to nursing homes were advised to participate in nursing intervention,which effectivelyprevented delirium based on the Kolcaba's comfort theory of physical, psychological, spiritual, social, cultural and environmental approaches to prevent delirium. Therefore, it is necessary to extend the program for prevention of delirium in the physical, psychological, spiritual, social, cultural, and environmental contexts to prevent delirium in geriatric hospitalized elderly patients.

Death Recognition, Meaning in Life and Death Attitude of People Who Participated in the Death Education Program (죽음교육 프로그램 참여자의 죽음인식, 생의 의미 및 죽음에 대한 태도)

  • Kang, Kyung-Ah;Lee, Kyung-Soon;Park, Gang-Won;Kim, Yong-Ho;Jang, Mi-Ja;Lee, Eun
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.169-180
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    • 2010
  • Purpose: This study was to identify the death recognition, meaning in life, and death attitude of participants in the death education program. Methods: A survey was conducted, and 205 data were collected. Descriptive statistics, ${\chi}^2$-test, ANOVA, and Duncan test were used. Results: 1) The followings were the characteristics of death recognition shown by the participants. Over half of the participants said that they had given some thoughts on their deaths, that they had agreeable view on death acceptance, and that diseases and volunteer works made them think about their deaths. Moreover, suffering, parting with family and concerns for them, etc. were the most common reasons for the difficulty of accepting death. As for 'the person whom I discuss my death with', spouse, friend, and son/daughter were the most chosen in this order. Lastly, the funeral type that most of the participants desired was cremation. 2) The means of meaning in life and death attitude were $2.92{\pm}0.29$ and $2.47{\pm}0.25$, respectively. There were significant differences between health status, meaning in life and death attitude. 3) A significant positive corelationship was found between meaning in life and death attitude (r=0.190, P=0.001). Conclusion: For an effective death education program that would fit each individual's situation, an educational content that can make a person understand the meaning of his or her life and death, includes knowledge to lessen the fear and anxiety of death, and helps a person heal from the loss of a family member is absolutely necessary.

A Study on Perception Change in Bicycle users' Outdoor Activity by Particulate Matter: Based on the Social Network Analysis (미세먼지로 인한 자전거 이용객의 야외활동 인식변화에 관한 연구: 사회네트워크분석을 중심으로)

  • Kim, Bomi;Lee, Dong Kun
    • Journal of Environmental Impact Assessment
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    • v.28 no.5
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    • pp.440-456
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    • 2019
  • The controversy of the risk perception related to particulate matters becomes significant. Therefore, in order to understand the nature of the particulate matters, we gathered articles and comments in on-line community related to bicycling which is affected by exposure of the particulate matters. As a result, firstly, the government - led particulate matter policy was strengthened and segmented every period, butthe risk perception related to particulate matters in the bicycle community has become active and serious. Second, as a result of analyzing the perception change of outdoor activities related to particulate matters, bicycle users in community showed a tendency of outdoor activity depending on the degree of particulate matters ratherthan the weather. In addition, the level of the risk perception related to particulate matters has been moved from fears of serious threat in daily life and health, combined with the disregard of domestic particulate matter levels or mask performance. Ultimately, these risk perception related to particulate matters have led some of the bicycling that were mainly enjoyed outdoors to the indoor space. However, in comparison with outdoor bicycling enjoyed by various factors such as scenery, people, and weather, the monotonous indoor bicycling was converted into another type of indoor exercise such as fitness and yoga. In summary, it was derived from mistrust of excessive information or policy provided by the government or local governments. It is considered that environmental policy should be implemented after discussion of risk communication that can reduce the gap between public anxiety and concern so as to cope with the risk perception related to particulate matters. Therefore,this study should be provided as an academic basis for the effective communication direction when decision makers establish the policy related to particulate matters.

A study on the effect of collimator angle on PAN-Pelvis volumetric modulated arc therapy (VMAT) including junction (접합부를 포함한 PAN-전골반암 VMAT 치료 계획 시 콜리메이터 각도의 영향에 관한 고찰)

  • Kim, Hyeon Yeong;Chang, Nam Jun;Jung, Hae Youn;Jeong, Yun Ju;Won, Hui Su;Seok, Jin Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.32
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    • pp.61-71
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    • 2020
  • Purpose: To investigate the effect of collimator angle on plan quality of PAN-Pelvis Multi-isocenter VMAT plan, dose reproducibility at the junction and impact on set-up error at the junction. Material and method: 10 adult patients with whole pelvis cancer including PAN were selected for the study. Using Trubeam STx equipped with HD MLC, we changed the collimator angle to 20°, 30°, and 45° except 10° which was the default collimator angle in the Eclipse(version 13.7) and all other treatment conditions were set to be the same for each patient and four plans were established also. To evaluate these plans, PTV coverage, coverage index(CVI) and homogeneity index (HI) were compared and clinical indicators for each treatment sites in normal tissues were analyzed. To evaluate dose reproducibility at the junction, the absolute dose was measured using a Falmer type ionization chamber and dose changes at the junction were evaluated by moving the position of the isocenter in and out 1~3mm and setting up the virtual volume at the junction. Result: CVI mean value was PTV-45 0.985±0.004, PTV-55 0.998±0.003 at 45° and HI mean value was PTV-45 1.140±0.074, and PTV-55 1.031±0.074 at 45° which were closest to 1. V20Gy of the kidneys decreased by 9.66% and average dose of bladder and V30 decreased by 1.88% and 2.16% at 45° compared to 10° for the critical organs. The dose value at the junction of the plan and the actual measured were within 0.3% and within tolerance. At the junction, due to set-up error the maximum dose increased to 14.56%, 9.88%, 8.03%, and 7.05%, at 10°, 20°, 30°, 45°, and the minimum dose decreased to 13.18%, 10.91%, 8.42%, and 4.53%, at 10°, 20°, 30°, 45° Conclusion: In terms of CVI, HI of PTV and critical organ protection, overall improved values were shown as the collimator angle increased. The impact on set-up error at the junction by collimator angle decreased as the angle increased and it will help improve the anxiety about the set up error. In conclusion, the collimator angle should be recognized as a factor that can affect the quality of the multi-isocenter VMAT plan and the dose at the junction, and be careful in setting the collimator angle in the treatment plan.

Analysis of Latent Classes and Influencing Factors According to the Love Types of Korean Adults (한국 성인의 사랑유형 잠재집단 및 영향요인 분석)

  • Ha, Moon-Sun;Song, Yeon-Joo
    • Korean Journal of Culture and Social Issue
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    • v.27 no.4
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    • pp.561-584
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    • 2021
  • This study was conducted to classify 601 Korean adults into latent classes according to their love types and identify the differences in depression and find variables that affect the latent classes classification. As a result of the latent class analysis, the latent group for love types of Korean adults were classified into the L-H (7.7%) group, which showed the highest level of all three factors of intimacy, passion, and commitment, and the L-MH (33.6%) group, which all three factors were higher than the average, the L-M (39.8%) group with the mean of all three factors, the L-ML (14.6%) group with all three factors lower than the mean, and the L-L (4.3%) group with the lowest all three factors. Also, as a result of ANOVA, the L-MH group was psychologically healthier and more adaptive than the L-ML group. As a result of multinomial logistic analysis, females were more likely to belong to L-M, L-ML and L-L groups than males. In addition, singles were more likely to belong to the L-M and L-ML groups than those who were married. Also, the higher the anxiety attachment level, the higher the likelihood of belonging to the L-M, L-ML, and L-L groups than the L-H and L-MH groups, the L-ML and L-L groups than the L-M groups, and the L-L group rather than the L-ML groups. However, age, neuroticism, and emotional regulation did not affect the classification of latent classes. This study is meaningful in that it identified the various latent classes for the love types of Korean adults more three-dimensionally and suggested the possibility of differential interventions according to the characteristics of each group.

Relationship between Stress and Eating Habits of Adults in Ulsan (울산지역 성인 남녀의 스트레스와 식습관)

  • Kim, Hye-Kyung;Kim, Jin-Hee
    • Journal of Nutrition and Health
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    • v.42 no.6
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    • pp.536-546
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    • 2009
  • This study was done to investigate the effect of stress on appetite and eating habits, and other health-related behaviors. The subjects of this study consisted of 188 males and 224 females in Ulsan area. The results were as follows: When stressed, 56% (n = 231) of the subjects experienced a change in appetite and of these, 32% (n = 132) experienced an increased appetite. Stress-induced eating may be one factor contributing to the development of obesity. There was a gender-specific response to stress in which women are more likely to use food to deal with stress, whereas men are more likely to use alcohol consumption or smoking. It was found that types of stressors were individual (52.9%), social (50.7%), family relations (34.5%), work demands (34.2%) and physical environment (32.3%). Stress-induced symptoms of the subjects were anxiety (38.3%), headache (36.7%) and neck or shoulder aches (36.2%), and females experienced those symptoms more than males. Those older than 50 years had a higher eating habit score and lower stress score compared with younger subjects. There were significant differences between sex, age, occupation, family type, BMI, exercise, sleeping hours and eating habits or stress level. This study may be helpful in advancing findings in this area to better provide health professionals with appropriate counseling tools to improve the health of all individuals.