A study of the impact of pre-pregnancy body mass index and dietary intakes during pregnancy on gestational weight gain

학위논문 (석사)-- 서울대학교 보건대학원 : 보건학과(보건영양학전공), 2014. 2. 정효지.임신 전 체질량지수와 임신 중 식이요인은 임신 중 체중증가의 주요 결정요인으로 알려져 있으나, 한국인 여성을 대상으로 연구된 바가 드물고, 임신 전 BMI와 임신 중 식사요인을 동시에 고려한 체중증가에 미치는 영향에 대한 연구가 드물다. 따라서 본 연구는 임신 전 모성의 비만도 및 영양섭취 수준이 임신 중 체중증가에 미치는 영향에 대하여 살펴보고자 하였으며 이를 위하여 2009년부터 2011년까지 서울시에 소재한 여성전문병원의 산부인과를 내원한 260명의 산모를 대상으로 연구를 수행하였다. 대상자는 임신 전 BMI에 따라 저체중군(BMI <18.5), 정상 체중군(BMI 18.5≦BMI<23), 과체중․비만군(BMI≧23)으로 분류하였다. 임신 전 체질량지수에 따른 체중증가는 저체중군 14.5±5.0kg, 정상체중군14.4±4.6kg, 과체중․비만군 12.1±5.2kg로 저체중 산모에서 체중증가가 높았다(p=0.0045). 과체중․비만군에서 산모나이, 저소득(200만원 미만), 임신 전 흡연경험이 있는 산모가 유의하게 많았다(p=0.0210, p=0.0171, p=0.0140). 임신결과의 경우 제태기간은 과체중·비만군에서 37주 미만인 대상자가 가장 많았다(p=0.0468). 영양소 섭취수준은 저체중군 임신부가 정상체중, 과체중․비만군에 비해 열량을 더 많이 섭취하는 경향을 보였다. 한국인 영양섭취기준과 비교하였을 때, 칼슘은 모든 BMI군에서 70%이상, 철, 엽산의 경우 90%이상의 임신부가 평균필요량 미만으로 섭취하고 있었고, 나트륨은 100%의 임신부가 목표섭취량의 이상을 섭취하고 있었다. 임신 중 체중증가에 영향을 주는 요인을 회귀분석한 결과 BMI가 낮을수록 임신 중 체중이 증가하였으며(β=0.7362, p=0.0005β=-0.2788, p=0.0004), 영양소의 경우 탄수화물, 인 섭취가 증가할수록 임신 중 체중이 증가하였다(β=0.0164, p=0.0034β=0.0047, p=0.0014). 식이요인 외 변수를 보정한 후에는 열량, 칼슘 섭취가 증가할수록 임신 중 체중이 증가하였다(β=0.0026, p=0.0041β=0.0034, p=0.0466). 본 연구결과 임신 중 체중증가에 영향을 미치는 요인은 임신 전 BMI와 제태기간, 식이요인은 열량 탄수화물, 인, 칼슘으로 나타났다. 따라서 임신 전 체질량지수에 따른 올바른 산전관리 및 임신 중 영양소섭취를 통해 임신 중 적정 체중증가를 유도하여 비정상적인 임신체중증가와 관련된 부정적 임신결과예방을 위한 기초자료로 활용할 수 있을 것이다.Pre-pregnancy Body Mass Index (ppBMI) and dietary intakes have been reported as major determinants for gestational weight gain(GWG), however the associations were not elucidated among Korean pregnant women. The aim of the study was to investigate the impact of ppBMI and dietary intakes during pregnancy on GWG. The 260 pregnant women with singleton were recruited from the woman's hospital from 2009 to 2011. The subjects were classified as three groups: underweight group(ppUW, BMI<18.5), normal weight group(ppNW, 18.5≦BMI<23) and overweight group(ppOW, BMI≧23). Mean GWG of ppUW, ppNW, and ppOW was 14.5±5.0kg, 14.4±4.6kg and 12.1±5.2kg, respectively. The average mother age, frequency of gestational age, house income level and smoking experience of ppOW were higher than other groups(p=0.0468, p=0.0210, p=0.0171, p=0.0140, respectively). Based on the multivariable linear regression analysis, was negatively associated with ppBMI (β=-0.2788, p=0.0004), and positively associated with carbohydrate(β=0.0164, p=0.0034), phosphate(β=0.0047, p=0.0014), and calcium intake(β=0.0034, p=0.0466). The results indicate that the ppBMI and dietary intakes especially carbohydrate and phosphate and calcium might be major determinants of GWG among Korean pregnant women.제 1 장 서론 1 1. 연구배경 및 필요성 1 2. 연구목적 4 제 2 장 연구방법 5 1. 연구대상 5 2. 조사방법 5 3. 분석방법 8 제 3 장 연구결과 9 1. 임신 전 BMI에 따른 임신 특성과 사회·경제적 특성 9 2. 임신 전 BMI에 따른 임신부의 신체 계측치 11 3. 임신 전 BMI에 따른 임신결과 12 4. 임신 전 BMI에 따른 임신 중 영양소 섭취수준 14 5. 임신 중 체중증가의 결정요인 20 제 4 장 고찰 22 제 5 장 요약 및 결론 28 참고문헌 29 Abstract 35Maste

The relationship between Terminal Care Stress and Knowledge and Perception of Hospice-Palliative Care among Pediatric Nurses

이 논문은 제1저자 박은영의 석사학위논문의 일부를 발췌한 것임This article is based on a part of the first authors masters thesis from Seoul National UniversityPurpose: This study examined the knowledge and perception of hospice-palliative care and terminal care stress among pediatric nurses, and the relationships among these variables. Methods: In this descriptive research study, 154 pediatric nurses who experienced terminal care at least once were surveyed. This study used three scales, including the Palliative Care Quiz for Nursing (PCQN), Perception of Hospice-Palliative Care, and Terminal care stress. Data analyses using SPSS 22.0 included descriptive statistics, independent t-test, one-way ANOVA, Mann-Whitney U test, Pearsons correlation coefficient, and stepwise multiple linear regression. Results: Terminal care stress experienced by the pediatric nurses was significantly related to the perception of hospicepalliative care; the hospice-palliative care education program enhanced the knowledge and perception of hospicepalliative care. Conclusion: Hospice-palliative care education programs should be developed and provided for pediatric nurses to improve pediatric hospice-palliative care. Additionally, further research on this topic is required because the present results are inconsistent with previous and current researches

An Exploration of the Dynamics Between CEO Status and Firm Status

학위논문 (석사)-- 서울대학교 대학원 : 경영학과, 2017. 2. 조승아.Although research on individual and organizational status has deepened our understanding of each, to date, little attention has been paid to the interlinkages between the two. Drawing from the status literature, we suggest that how organizations value the status of CEOs will differ depending on their organizational context, namely organizational status. To address this, we develop a notion of status disparity, which refers to the relative dominance of CEO status over firm status. Specifically, we explore how the relative standing of the CEO with respect to the firm may affect CEO valuation and examine the impact of such status disparity on CEO-level outcomes: CEO power, compensation, and dismissal likelihood. Empirical results from the panel data set of CEOs in S&P 500 firms supported that the CEOs with greater status disparity are more likely to have higher power and receive greater compensation. The findings indicate that the perceived value of CEO status is linked to organizational status, thus exhibiting how stakeholders perception and attribution can be explained through the idea of status disparity.1.Introduction 1 2.Theory and Hypotheses 4 2.1.Status in a Business Context 4 2.2.Status in a CEO-Firm Relationship 7 2.3.The Conceptual Framework of CEO Status and Firm Status 10 2.4.Hypotheses 15 3.Methods 21 3.1.Sample 21 3.2.Measures 21 3.3.Data Analysis 26 4.Results 27 5.Discussion and Conclusion 36 References 41 국문초록 50Maste

두 개의 국경을 넘어 - 소냐 나자리오,『엔리케의 여정』

『엔리케의 여정』(하정임 역, 다른, 2007)은 원래 《LA 타임스》 지에 기획기사 연재물로 실렸던 것으로, 이 연재물은 퓰리 처 상, 조지 포크 상, 로버트 케네디 저널리 즘 그랑프리 상 등 12개의 상을 수상했다. 이를 바탕으로 2006년에 책으로 엮었으며, 우리말로는 2007년에 번역되었다. 20년 이상 빈곤, 이민, 마약 등 사회문제 에 대한 기사를 써온 저자 소냐 나자리오 (Sonia Nazario)는 현대판 이민의 진정한 모습을 생생하게 전달 하는 기사를 쓰기로 결심한다. 이 작업을 위해 소냐 나자리오는 한 소년이 중앙아메리카에서 출발해 엄마가 있는 미국에 도착까 지 밟아야 했던 경로를 직접 체험했다..

An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units

Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databasesa total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea

The Optimal Angle of Needle Insertion for Caudal Block in Adults

BACKGROUND: This study was conducted to investigate the optimal angle of needle insertion during caudal epidural injection in chronic low back pain patients using ultrasound imaging. METHODS: One hundred eight patients (40 male and 68 female patients) with low back pain and sciatica were studied.Soft tissue ultrasonography was performed to identify the sacral hiatus. The optimal angle of the needle to the skin was measured with an imaginary line drawn parallel to the sacral base using a protractor on a longitudinal plane. A 22-gauge caudal epidural needle was inserted and was guided by ultrasound to the sacral hiatus and into the caudal epidural space. RESULTS: The mean +/- SD for the intercornual distance, depth of the caudal space and the thickness of the sacrococcygeal membrane were 19.0 +/- 3.2 mm, 3.6 +/- 0.9 mm and 1.8 +/- 0.8 mm, respectively. The optimal angle showed a significant correlation with the depth of the caudal space and the thickness of the sacrococcygeal membrane. The mean +/- SD for the optimal angle of the needle insertion was 23.5 +/- 6.9 degrees. CONCLUSIONS: We conclude that the needle should be inserted at an angle of approximately 23.5 degrees to the skin in order to avoid injury to the periosteum and an inadvertent intra-osseous injection.ope

Lethal Aspergillus Endocarditis After Heart Transplantation

We report a case of a 21-year-old male who died from lethal Aspergillus endocarditis 3 months after heart transplantation. He underwent heart transplantation in other country. He was treated with hemodialysis for acute renal failure due to cyclosporine and then transferred to our hospital. When he complained high fever, follow-up echocardiography showed a large mobile echogenic mass attached to posterior mitral valve leaflet. The result of serum Aspergillus galactomannan antigen assay was positive. He was empirically treated with intravenous amphotericin B and antibiotics. However, he was rapidly deteriorated and died on hospital day 3.ope

Postradiation Malignant Fibrous Histiocytoma of the Colon: A Case Report

Post-radiation soft tissue sarcomas are recognized as rare complications of radiation therapy. The most common type of post-radiation soft tissue sarcoma is a malignant fibrous histiocytoma (MFH), which originates from mesenchymal cells with a predominance of histiocytes and fibroblasts. The two most common sites of occurrence for post-radiation soft tissue sarcomas are the chest wall and pelvic cavity. Post-radiation colorectal MFHs are extremely rare and all of the reported cases of post-radiation sarcomas have occurred ＞3 years after radiation therapy. Recently, we managed a case of colorectal MFH which developed in a 48-year-old male who had undergone a low anterior resection for rectal adenocarcinoma and had received chemoradiotherapy as adjuvant treatment. Twelve months after radiotherapy, a 4 cm mass was detected 8 cm superior to the anastomosis site on colonoscopic examination. A soft tissue sarcoma was suspected on pathologic examination of the biopsy specimen. Therefore, he underwent a Hartmann’s operation and the final pathologic finding revealed MFH with a storiform pattern of tumor cells composed of pleomorphic, multinucleated giant cells. This is the first case of MFH that had a latency period ＜3 years (i.e., 1 year) between the time of radiotherapy and diagnosisope

Recurrent Coccidioidomycosis Manifesting as Osteomyelitis in Korea

Coccidioidomycosis is a fungal infection that results from inhaling the airborne arthroconidia of the Coccidioides species. It is an endemic disease in the southwest part of North America and rarely diagnosed in Korea. As tourism to endemic areas and the number of immunocompromised patients have been increasing, the incidence of this infection has increased in non-endemic areas. Treatment is usually successful with antifungal agents; however, recurrence is common. It is difficult to decide when to discontinue the antifungal treatment especially in non-endemic areas where doctors are not familiar with the disease. We report a case of recurrent coccidioidomycosis manifesting as osteomyelitis after the treatment of the patient for disseminated coccidioidal infection. The complement fixation test was a useful tool for the assessment of patient response and to evaluate suspected recurrenceope

(The) effects of involvement in sport and physical activity in self-evaluations of high school students

본 연구에서는 자신의 정체를 탐색하고 자기에 대한 개념을 형성해 가는 시기인 청소년기에있는 고등학생의 자기평가에 대하여 스포츠 및 신체활동 참가가 어떠한 영향을 미치는지를 규명하는데 목적을 두고 있다. 본 연구의 대상은 층화군집표집(Cluster sampling combined with stratification : 3cluster sampling with 1strata)방법에 의하여 추출된 서울시 소재 고등학교에 다니는남녀 고등학생 642명이었다. 본 연구에서는 정종훈 외(1994), Hillary Commission(1990), William &amp;amp; James(1990), Butcher(1985), Schutz et al.(1981), Snyder &amp;amp; Spreitzer(1974).Marsh et al.(1994a, 1994b), 구정화(1994)의.「청소년의 자기평가에관한 조사 연구」 등에서 사용된 설문 또는 설문지를 기초로하여 설문지 문항을 작성하였고, 사전검사를 통하여 수정, 완성된 설문지를 사용하였다. 수집된 자료를 X&amp;apos; 검정, 검정, 일원분산분석(one-way ANOVA), 상관관계 분석, 다중회귀분석을 적용하여 분석한 연구결과를 토대로 다음과 같은 결론을 유도할 수 있었다. 첫째, 청소년들의 스포츠 및 신체활동 참가는 성별, 부모수입에 따라 통계적으로 유의한차이가 있었으며 남학생, 공학의 여학생, 그리고 상층 · 중층 학생집단은 여학생, 비공학의 여학생, 그리고 하층 학생집단에 비하여 참가율이 높았다. 자기평가에 있어서는 남학생, 비공학의 여학생, 그리고 상층 · 중층 학생집단이 여학생, 공학의 여학생, 그리고 하층 학생집단에 비하여 자신을 더욱 긍정적으로 평가하였다. 둘째, 각 집단별 스포츠 및 신체활동 참가는 자기평가와 정적인 상관이 있다. 세째, 스포츠 및 신체활동 참가는 신체영역의 총변화량의 10.45%, 사회영역은 7.48%,또래평가는 4.42%, 학업영역은 3.83%, 가치영역은 3.66%, 부모평가는 3.48%, 교사평가는 2.54%를 설명하였고, 사회적 인 자기평가(5.06%)보다는 주관적 인자기평가(11.82%)에 더 많은 영향을 미친다. 네째, 스포츠 및 신체활동의 일차적 참가 집단은 비참가 집단에 비하여 자기평가의 모든 영역에 있어서 자신을 긍정적으로 평가하며, 특히 사회영역, 신체영역, 교사평가, 또래평가에 있어서 더욱 긍정적으로 평가하고 또한 평가받을 것이라고 생각한다. 이상을 종합해 볼 때, 스포츠 및 신체활동 참가는 청소년의 자기평가에 영향을 미치는한 변인이며, 이에 긍정적인 자아관 확립을 고양시킬 다양한 노력의 일환으로 스포츠 및 신체활동 참가는 반드시 요청되어야 할 것이다. 본 연구에서 보여지는 청소면의 자기평가에 대하여 스포츠 및 신체활동 참가가 미치는 영향력이 최고 11.82%에 불과한 것에 대해서는, 청소년의 자기평가에 영향을 줄 수 있는 사회적 삶의 다른 측면들과 비교해 볼 때, &amp;apos;입시위주의 교육현실&amp;apos;에서 우리의 청소년이 얼마나 적은 시간과 관심을 할애할 수 밖에 없는지를 고려해야 할 것이며 성, 부모의 수입과 같은 기타 매개변인들에 대한 변화를 기대하는 것보다 스포츠나 신체활동에 대한 기회를 제공하는 것이 훨씬 쉽다는 사실을 기억해야 할 것이다.;The purpose of this study was to examine the effect of involvement in sport and physical activity on self-evaluations of high school students. The sudjects were 308 males and 334 females in 6 high schools located in Seoul metropolitan area and selected by cluster sampling combined with stratification. Data were collected by means of a self-administered questionnaire. The measures of sports involvement and self-evaluations were adopted from surveys conducted by Kuh. Jung-Hwa(1994). Chung, Jong-Hun (1994). Marsh et a1.(1994a, 1994b). Hillary Commission(l990). William &amp;amp; James (1990). Butcher(1985). Schutz et a1.(1981). Snyder &amp;amp; Spreitzer(l974). This questionnaire has considerable reliability and validity. The data were analyzed by x^(2) test, t-test. one-way ANOVA. correlation analysis, and mutiple regression analysis. From the findings of this study the following conclusions were made: 1. It was found that involvement in sport and physical activity is unequally distributed across gender, school characteristics, socioeconomic groups: males, females in co-ed schools, and students from higher income levels are more involved in sport and physical activity. It was also found that males and students from higher income levels had more positive self perception in terms of self-evaluations while females from single sex schools more than those in co-ed schools consider themselves positively. 2. There were significantly positive correlation between sports involvement and self-evaluations. 3. The study revealed that involvement in sport and physical activity can be one of the important variables contributing to self-evaluations. The results of the regression analysis showed that 10.45% of physical self, 7. 48% of social self, 4.42% of peer relation, 3.83% of academic self, 3.66% of self-worth, 3.48% of parents relation, and 2.54% of teacher relation were accounted for by sports involvement and the effects on subjective self-evaluations (11.82%) were stronger than on objective self-evaluations (5.06%). 4. Students who were involved in sports on a regular basis tended to have higher self-evaluations than the others. Considering those modest effects of involvement in sport and physical activity upon self-evaluations shown the above, it might not be said that sports involvement has strong consequences for self-evaluations . However, it is better understood when we consider how little time each day is devoted to sports and physical activities in comparision to other aspects of social life that seem to affect self-evaluations.목차 = ⅲ 表目次 = ⅳ 論文槪要 = ⅶ Ⅰ. 서론 = 1 A. 연구의 필요성 및 목적 = 1 B. 연구문제 및 가설 = 3 C. 용어의 정의 = 4 Ⅱ. 이론적 배경 = 5 A. 청소년기의 자기평가 = 5 B. 스포츠 및 신체활동 참가 = 13 Ⅲ. 연구방법 = 19 A. 연구대상 = 19 B. 연구도구 = 20 C. 조사절차 및 자료처리 = 26 Ⅳ. 결과 및 논의 = 28 A. 스포츠 및 신체활동 참가와 자기평가에 대한 집단별 차이검정 = 28 B. 자기평가에 대한 스포츠 및 신체활동 참가의 영향 = 57 Ⅴ. 결론 및 제언 = 80 참고문헌 = 84 부록 = 94 ABSTRACT = 10