(A) comparison of smoking prevention effect with role play and lecture education for adolescence.

지역사회 간호학과/석사[한글] 우리나라 성인 남자의 흡연율은 점차적으로 감소하고 있으나 여성과 청소년층의 흡연인구는 빠른 속도로 증가하고 있다. 특히 청소년들의 흡연이 최근 10여년간에 급속하게 증가하고 있으며 남학생의 경우 고등학교 3학년의 흡연율은 41.6%로 보고 되고 있다. 미국학생(28.2%), 일본학생(26.2%), 영국학생(20.5%), 러시아(19.4%), 이스라엘(9.3%의 경우보다 심각한 실정이다. 이에 본 연구에서는 역할극과 기존의 강의식 흡연예방교육의 효과를 비교하여, 역할극이 청소년에 흡연에 대한 지식, 태도, 흡연량에 어떠한 영향을 미치는 가를 파악하고자 시도되었다. 연구의 대상자는 서울시 중랑구에 위치한 1개 인문계고등학교 1학년 10개반중 4개반을 임의로 선정하여 2개반 97명은 실험군 나머지 2개반 96명은 대조군으로 나누었다. 본 연구의 자료수집은 2001년 3월 9일∼2001년 4월16일 까지 이루어졌다. 자료수집 과정은 실험군과 대조군 모두 실험 중재 전에 제 종속변수(지식, 태도, 흡연량)에 대한 사전조사를 실시한후 실험군에는 역할극을 대조군에는 강의식 흡연예방교육을 실시 하였다. 사후조사는 2차례에 걸쳐( 실험직후, 실험후 4주 )이루어 졌다. 수집된 자료는 SAS통계프로그램을 이용하여 분석하였으며 연구대상자의 일반적 특성은 빈도와 백분율을 실험군과 대조군의 동질성검증을 파악하기 위하여 χ ²－ 검증 , t -test를 사용하였고, 흡연량, 지식, 태도의 관련성을 알아보기 위하여 상관분석을 실시하였 다. 실험군과 대조군의 사전, 사후 프로그램의 효과를 알아 보기 위하여 Two-way Anova를 적용하였다. 본 연구의 결과는 다음과 같다. 첫째, 두 그룹의 사전 동질성 비교에서 대조군이 실험군보다 학교생활만족도가 낮고 고민.스트레스정도가 높은 것으로 나타났으나 이들 변수와 흡연량, 흡연지식, 흡연태도 관계를 분석한 결과 통계적으로 유의한 관계로 나타나지 않아 두 그룹의 교육효과를 비교할때 통제하지 않았다. 둘째, 두 그룹의 사전 동질성 비교에서 흡연량(t=-1.3945,p=.169), 흡연태도는(t=-1.8881,p=.060) 통계적으로 유의한 차이가 없었지만 흡연지식에(t=3.1175,p=.0021) 있어서는 통계적으로 유의한 차이가 있었다. 셋째, 흡연량과 흡연지식, 흡연태도의 상관관계 분석결과 흡연지식은 흡연량과, 흡연태도에 유의한 상관관계를 보이지 않았으나 흡연태도는 흡연량과 유의하게 역상관 관계를 나타내고 있는 것으로 나타났다.(r=-0.1978,p=.0058) 그러므로 흡연지식은 흡연량, 흡연태도에 관련이 없으므로 두 그룹간으 흡연지식의 차이는 두 그룹의 교육효과를 비교할 때 통제하지 않았다. 넷째, 프로그램 전후 흡연량의 변화는 실험군과 대조군 간의 통계적으로 유의한 차이가 없는 것으로 나타났다.(F=1.04,P=.3130) 다섯째, 프로그램 전후 흡연태도의 변화는 실험군과 대조군 간의 통계적으로 유의한 차이가 있는 것으로 나타났다.(F=10.87,P=.0012) 역할극이 또래들의 흡연태도를 바꾸는 데 강의식 흡연예방교육보다 효과가 있는 것으로 나타났다. 여섯째, 프로그램 전후 흡연지식의 변화는 실험군과 대조군 간의 통계적으로 유의한 차이가 없는 것으로 나타났다.(F=3.51,P=.0626) 그러나 강의식 흡연 예방교육을 시행한 대조군에서 흡연지식이 프로그램전 보다 프로그램후 흡연지식의 변화의 폭이 상당히 증가한 것으로 나타났다. 본 연구결과를 종합해 볼때 흡연태도의 변화는 흡연지식 변화 보다 흡연량에 영향을 미치는 것으로 나타났는데 역할극은 청소년 흡연태도를 변화시키는 데 유의한 효과가 있었다. 또한 강의식 흡연예방교육은 흡연지식의 변화에 역할극 보다 효과적 이었다. 그러므로 흡연지식, 태도를 변화시켜 흡연율을 낮추기 위해서는 기존의 강의식 흡연예방교육에 역할극을 병행할 것을 제언한다. [영문] The smoking rate of Adult Korean has decreased each year, but the smoking rate of wamen & adolescents has increased rapidly. Especially adolescence smoking has increased rapidly for the last 10 years and it is reported that the smoking rate of the boy students in the third grade of high school is 41.6%. This situation is serious and worse than those of U.S.(28.2%), Japan(26.2), England(20.5%), Russia(19.4%), and Israel(9.3%). So the purpose of this article is to compare the effectiveness of role play with that of and existing smoking prevention lecture education and it to analyze what influence role play has on the adolescence knowledge, attitude and quantity about smoking. The research subject students are selected at random from 4 classes among the 10 classes of the first graders of an academic high school which is located in Joongrang-Gu Seoul Korea. And they are divided into two groups of an experimentation group of 2 classes with 97 students and a contrast group of 2 classes with 96 students. This research data were collected from May 9th 2001 to April 16th 2001. The data collection was implemented from March 9th, 2001 to April 16th, 2001. On the data collection progress, pre research was performed first about knowledge, attitude and quantity of smoking for experimentation and contrast group before intervention. After that role play was performed on experimentation groups and smoking prevention education was performed on contrast groups. Post researches are formed twice(immediately after the experimentation, 4 weeks later after the experimentation). Collected data are analyzied by using the SAS program. Analysis on general characteristics of research subject students used frequency and percentage. And it used x²-test and t-test for analysis on homogeneity character inspection between experimentation group and contrast group. And the Two-way Anova was used for analyzing effectiveness of pre and post program. And correlation analysis was used to see the correlation of smoking quantity, knowledge and attitude. The results of the study were as follow; 1. On comparison to pre research homogeneity character contrast group school life satisfaction is less than experimentation group, stress more higher than experimentation group. School life satisfaction, stress is relationship smoking quantity, attitude, knowledge show no statistically difference significant. 2 On comparison of pre research homogeneity character of experimentation and contrast group, there is no statistically difference significant smoking quantity(t=-1.3945,p=.169)and attitude(t=-1.8881,p=.060). But smoking knowledge(t=3.1175,p=.0021)is statiscally difference significant. 3. According to correlation analysis on smoking quantity, knowledge and attitude, the smoking knowledges is no statistically difference significant by smoking quantity and attitude. On the other hand smoking attitude is statistically difference significant by smoking quantity.(r=-0.1978,p=.0058) Because of smoking knowledge has no connection with smoking quantity and attitude, the difference of smoking knowledge on experimentation and contrast group has no controlled when compare to effectiveness of smoking education. 4. For context of program performance the change of smoking quantity is no statistically difference significant by between experimentation and contrast group(F=1.04, P=.3130). 5. For context of program performance the change of smoking attitude is statistically difference significance by between experimentation and contrast group(F=10.87, P=.0012). For the changing smoking attitude of the peer, the role plays was more effective than lecture smoking prevention education. 6. For context of the program performance, the changes of smoking knowledge is no statiscally difference significance by between experimentation and contrast group(F=3.51, p=.0626). But on the contrast group which performed smoking prevention lecture education are expressed fairly increasing of the smoking knowledge after program performed. As a conclusion, the change of smoking attitude was more effective in reducing the smoking quantity than the change of smoking knowledge. So role play was effective in changing the smoking attitude. smoking prevention lecture education was more effective in the change of smoking knowledge than role play. For that reason, in order to make decrease of smoking rate by the change of smoking knowledge and attitude, this article suggest that the role play should be used with the existing smoking prevention cture education at the same time.ope

Changes in Peripapillary and Macular Vessel Densities and Their Relationship with Visual Field Progression after Trabeculectomy

he aim of this study was to determine the factors associated with visual field (VF) deterioration after trabeculectomy, including the peripapillary vessel density (pVD) and macular vessel density (mVD) changes assessed by optical coherence tomography angiography (OCT-A). Primary open-angle glaucoma patients with more than two years of follow-up after trabeculectomy were included. pVD was calculated in a region defined as a 750 μm-wide elliptical annulus extending from the optic disc boundary. mVD was calculated in the parafoveal (1-3 mm) and perifoveal (3-6 mm) regions. VF deterioration was defined as the rate of mean deviation (MD) worse than -1.5 dB/year. The change rates of pVD and mVD were compared between the deteriorated VF and non-deteriorated VF groups. The factors associated with the rate of MD were determined by linear regression analyses. VF deterioration was noted in 14 (21.5%) of the 65 eyes that underwent trabeculectomy. The pVD (-2.26 ± 2.67 vs. -0.02 ± 1.74%/year, p ≤ 0.001) reduction rate was significantly greater in the deteriorated VF group than in the non-deteriorated VF group, while that of parafoveal (p = 0.267) and perifoveal (p = 0.350) VD did not show a significant difference. The linear regression analysis showed that the postoperative MD reduction rate was significantly associated with the rate of pVD reduction (p = 0.016), while other clinical parameters and preoperative vascular parameters did not show any association. Eyes with greater loss of peripapillary retinal circulation after trabeculectomy tended to exhibit VF deterioration. The assessment of peripapillary vascular status can be an adjunctive strategy to predict visual function after trabeculectomy

Implications of the Relationship Between Refractive Error and Biometry in the Pathogenesis of Primary Angle Closure

PURPOSE. The purpose of this study was to investigate the relationship between refractive error and ocular biometry and its implication in the pathogenesis of primary angle closure (PAC). METHODS. We have retrospectively recruited 119 PAC eyes and 388 non-PAC eyes with an axial length (AL) of <= 25.0 mm and a spherical equivalent (SE) of >=-6.0 diopters (D). Stepwise multiple regression was performed for keratometry value (K), AL, anterior chamber depth (ACD), and SE. RESULTS. PAC eyes were more likely to be in women and have a higher IOP and shorter AL than non-PAC eyes. In a multiple regression analysis, SE was not associated with PAC. The associations between AL and SE or AL and ACD were not different in PAC eyes compared with non-PAC eyes. However, the cornea was flatter in PAC eyes (beta = -0.448, P < 0.001), and a flatter cornea was associated with more hyperopic refraction (beta = -0.454, P < 0.001) and shallower ACD (beta = 0.073, P < 0.001) in PAC eyes. ACD was not associated with SE in non-PAC eyes, but shallower ACD was associated with greater myopic refraction in PAC eyes (beta = 1.117, P = 0.006). CONCLUSIONS. PAC eyes seem to have flatter cornea compared with non-PAC eyes. A shallower ACD seems to be associated with greater myopic refraction in PAC eyes, but not in non-PAC eyes

Comparison of the Prevalence and Clinical Characteristics of Epiretinal Membrane in Pseudoexfoliation and Primary Open-angle Glaucoma

Purpose: The purpose of this study was to investigate and compare the prevalence and clinical characteristics of epiretinal membrane (ERM) in patients with pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG). Methods: In this retrospective observational study, 211 PXG eyes, 210 age-matched normal eyes, and 220 POAG eyes were included. The presence and staging of ERM (stage 1, 2, and 3 or greater) were independently assessed by 2 observers. Univariate and multivariate linear regression analyses were performed to assess the factors associated with visual field (VF) mean deviation (MD) in PXG eyes. Results: Among 211 PXG eyes, 40 (19.0%) had an ERM, while 4.1% of POAG and 2.4% of normal eyes had an ERM (P<0.001). Retinal nerve fiber layer thickness (69.4 vs. 70.4 mu m, P=0.477) and VF MD (-7.7 vs. -10.4 dB, P=0.098) were not different between POAG and PXG eyes but macular thickness was greater (259.5 vs. 271.5 mu m, P=0.006) in PXG eyes than in POAG. Both lower retinal nerve fiber layer thickness (beta=0.337, P<0.001) and the presence of an ERM (beta=-4.246, P=0.002) were independently associated with worse VF MD in PXG eyes. Conclusions: The prevalence of ERM was significantly greater in PXG eyes than in age-matched normal or POAG eyes. The presence of ERM affected VF in PXG eyes

Longitudinal Macular Ganglion Cell-Inner Plexiform Layer Measurements to Detect Glaucoma Progression in High Myopia

PURPOSE: To investigate whether progressive macular ganglion cell-inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (RNFL) thinning are predictive for detecting visual field (VF) progression in eyes with high myopia. DESIGN: Cohort study. METHODS: A total of 104 primary open-angle glaucoma (POAG) eyes with high myopia and 104 age-and VF severity-matched POAG eyes without high myopia (mean follow-up, 5.4 years) were included. High myopia was defined as a spherical equivalent <-6.0 diopters or axial length >26.5 mm. Progressive GCIPL, RNFL, and VF deterioration were determined by Guided Progression Analysis (GPA) in optical coherence tomography and standard automated perimetry. The risk of VF progression was evaluated using Cox proportional hazard models. RESULTS: Highly myopic eyes with progressive GCIPL thinning had a significantly higher risk of developing VF progression after adjusting for the baseline intraocular pressure (HR 4.00; P = .001) or peak intraocular pressure (HR 3.11; P = .011) in the multivariable Cox proportional hazard model, whereas highly myopic eyes with progressive RNFL thinning were not significantly associated with VF progression. In eyes without high myopia, both progressive GCIPL (HR 4.67 or 3.62; P = .008 or .037, respectively) and RNFL (HR 6.60 or 3.97; P = .001 or .016, respectively) thinning were associated with a significantly higher risk of developing VF progression after adjusting for the baseline or peak intraocular pressure. CONCLUSIONS: Monitoring macular GCIPL thickness was effective for predicting glaucoma progression regardless of the presence of high myopia nbsp

Comparison of Lamina Cribrosa Curvature in Pseudoexfoliation and Primary Open-Angle Glaucoma

PURPOSE: To compare lamina cribrosa curvature (LCC) in pseudoexfoliation glaucoma (PXG) and primary open-angle glaucoma (POAG) and to elucidate the factors associated with LCC in both groups. DESIGN: Retrospective, cross-sectional study. METHOD: Forty eyes with PXG and visual field mean deviation-matched 40 eyes with POAG were included. Spectral domain optical coherence tomography enhanced depth imaging was used to acquire LC images. The LCC index (LCCI) was calculated as LCC depth/LCC width 3 100. Calculated LCCI values were compared between the PXG and POAG groups. Logistic regression analysis was performed to investigate the factors related to the presence of PXG. Factors associated with LCCI were determined by uni- and multivariable linear regression analyses in both groups. RESULT: Visual field mean deviation (L11.7 +/- 9.7 dB vs -1.0 +/- 8.5 dB, P = .731) and retinal nerve fiber thickness (647.4 +/- 22.7 mu m vs 68.3 +/- 19.9 mu m, P = .857) did not differ between the 2 groups. However, the mean (8.8 +/- 2.9 in PXG, 6.6 +/- 1.9 in POAG) and sectoral LCCIs assessed at 0, 30, 60, 90, and 120 degrees were significantly greater in the PXG than in the POAG group (all, P < .05), but not at 150 degrees (P = .113). Logistic regression analysis revealed that higher average LCCI (odds ratio [OR] = 1.509 [95% confidence interval 1.180-2.047], P = .003) and older age (OR = 1.074 [95% confidence interval 1.017-1.147], P = .019) were associated with the presence of PXG. IOP was associated with mean LCCI only in the POAG group (beta = 0.150 [95% confidence interval 0.018-0.281], P = .027) while none of the factors showed association with LCCI in PXG. CONCLUSION: PXG eyes had more steeply curved LC than POAG eyes with a similar level of glaucoma severity. The clinical implication(s) of steeper LCC in PXG should be investigated in a forthcoming study. ((C) 2020 The Authors. Published by Elsevier Inc.