609 research outputs found

    Teacher Beliefs and Practices Survey: operationalizing the 1997 NAEYC guidelines

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    This study examined the psychometric properties of a revised measurement, the Teacher Beliefs and Practices Survey, devised for teachers of 3- to 5-year-old children. The measure was designed to reflect the concepts of DAP (developmentally appropriate practices) as presented in the revised 1997 NAEYC guidelines and consisted of 2 scales. Three hundred seventy five surveys completed by public kindergarten teachers in Southeast Louisiana were utilized in the study. Reliability was examined using internal consistency method. Cronbach¡¯s ¥á was .858 for the Beliefs Scale and .787 for the Instructional Activities Scale. Validity of the measure was examined in its content, criterion, and construct (Carmines & Zeller, 1979). Content validity was enhanced by reflecting the feedback from the nationwide experts in early childhood education on the survey before administering the measure to the targeted teachers. Criterion-related validity was supported when the findings showed that one of the sub-measures, the measure of the developmentally inappropriate practices, showed a high correlation with the score from the observed classroom practices. The following results support construct validity: first, the factors uncovered in the survey matched the important concepts of DAP in the guidelines; second, predictors of DAP found to be significant from previous studies were also significant in both of the subscales; third, the low but significant correlation between the Teacher Beliefs and Practices Survey score and a theoretically related measure, the Teacher Educational Attitude Scale (Rescorla et al., 1990) was found. Considering the psychometric properties, the Teacher Beliefs and Practices Survey appears to be a promising measure for critically examining teachers¡¯ beliefs about and practices of DAP

    The Morphologic Assessment of Rectal Neuroendocrine Tumors

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    AbstractBackground and aimsThe histopathologic features of rectal neuroendocrine tumors (NETs), including size, lymphovascular invasion, invasion of proper muscle, and mitotic rate, have a limited role to play in determining a treatment plan preoperatively. We aimed to investigate the morphologic parameters associated with metastasis, and to evaluate their predictive value.MethodsBetween January 2000 and May 2011, the medical records and endoscopic findings of 468 patients presenting with rectal NETs at the Samsung Medical Center were analyzed retrospectively. All tumors were classified according to size and endoscopic features such as color, shape, contour, and surface change.ResultsTwenty-one of the 468 patients (4.5%) with rectal NETs had lymph node (LN) metastasis and 11 patients (2.4%) had distant metastasis. Risk factors for metastasis included tumor size (≥10mm in diameter), hyperemic change, polypoid lesions, irregular contours, and surface ulceration (p=0.000). Independent risk factors that were predictive of metastasis on multivariate analysis included tumor size (≥10mm in diameter), hyperemic change, and surface ulceration. As the number of independent risk factors for metastasis increased, the risk of metastasis rose.ConclusionsEndoscopic features such as hyperemic change, polypoid lesions, irregular contours, and surface ulcers with tumor size ≥10mm in diameter are associated with metastasis in rectal NETs. In particular, atypical endoscopic features including hyperemic change, and surface ulcer with tumor size ≥10mm in diameter may help to predict the risk of metastasis of rectal NETs

    Management of Complications of Colorectal Submucosal Dissection

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    Endoscopic submucosal dissection (ESD) is a useful procedure for the treatment of superficial gastrointestinal neoplasm. Compared with endoscopic mucosal resection (EMR), ESD has several benefits, which include resectability of various difficult lesion, accurate histologic assessment of specimen, and lower recurrence rate. However, the risk of procedure- related complications is higher with ESD than with EMR. Moreover, because the colon has a thin wall and limited endoscopic maneuverability, ESD is considered a more challenging and risky procedure when performed in the colon than in the stomach. ESD-related complications are more likely to occur. The significant complications associated with ESD are bleeding, perforation, coagulation syndrome and stenosis, most of which can be treated and prevented by endoscopic intervention and preparation. Therefore, it is important to know how to occur and manage the ESD related complication

    How to Detect Sessile Serrated Adenoma/Polyps

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    Analysis of Inflammatory Markers and Electroencephalogram Findings in Pediatric Patients with COVID-19: A Single-Center Study in Korea

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    Purpose The Omicron variant wave spread rapidly from February 2022 in South Korea following the initial management of the coronavirus disease 2019 (COVID-19) outbreak. This study examined electroencephalogram (EEG) findings and serological inflammatory markers in pediatric patients with COVID-19 (Omicron variant). Methods We retrospectively reviewed the medical records of 41 patients who presented at Gyeongsang National University Changwon Hospital between March and May 2022 and were diagnosed with COVID-19. All serological tests were performed within 24 hours of fever or seizure onset. Results The median patient age was 3.6 years (range, 0.08 to 14.00), and the average hospital stay was 3.7 days (range, 1.0 to 7.0). Interleukin-6 (IL-6) levels were elevated above the normal range in all patients (median, 43.18 pg/mL; range, 7.0 to 190.0) and were higher among those who experienced seizures. Of the 41 total patients, 17 (41.5%; mean age, 5.4 years) visited the clinic for seizure. Three patients experienced prolonged seizures (lasting longer than 30 minutes) and received intravenous lorazepam, while eight presented with complex febrile seizures. Nine patients underwent EEG, of whom five exhibited abnormal initial findings. Linear regression demonstrated correlations between prolonged seizure duration and both serum IL-6 level and blood lymphocyte count. Conclusion Numerous serological markers associated with the immune cascade were found to be elevated in children with COVID-19. Nevertheless, febrile seizures represent a relatively common neurological presentation among pediatric patients infected with Omicron variants. Consequently, COVID-19 infection exhibits both familiar and distinct characteristics regarding the mechanisms inducing seizures and fever in children

    Psychotic Features as the First Manifestation of 22q11.2 Deletion Syndrome

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    The 22q11.2 deletion is a genetic disorder which is characterized by abnormalities in cardiac functioning, facial structure, neurobehavioral development, T cell functioning, and velopharyngeal insufficiencies. In the presented case study, 22q11.2 deletion was found in a patient who has psychotic symptoms only. A 25-year-old woman with a history of hypoparathyroidism and hypothyroidism presented with auditory hallucinations and persecutory delusions. After three months of treatment with antipsychotic medications, the patient was readmitted with generalized tonic-clonic seizures. The following week, the patient went into sepsis. A fluorescent in situ hybridization (FISH) analysis revealed the presence of a 22q11.2 microdeletion. This case study suggests that psychotic symptoms can develop prior to the typical symptoms of a 22q11.2 deletion. As such, psychiatrists should test for genetic abnormalities in patients with schizophrenia when these patients present with seizures and immunodeficiencies

    pneumonia in pediatric patients: an analysis of 15 confirmed consecutive cases during 14 years

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    PurposePneumocystis jirovecii pneumonia occurs in various immunocompromised patients. Despite the prophylaxis strategies in clinical practice, certain patients develop P. jirovecii pneumonia. This study was performed to investigate pediatric cases with P. jirovecii pneumonia in a single center.MethodsWe identified pediatric patients younger than 19 years with microbiologically confirmed P. jirovecii pneumonia from January 2000 to February 2014. A retrospective chart review was performed.ResultsFifteen episodes of P. jirovecii pneumonia in 14 patients were identified with median age of 8.3 years (range, 0.4–18.6 years). Among these patients, 11 patients had hematology-oncology diseases, 2 had primary immunodeficiency disorders (one with severe combined immunodeficiency and the other with Wiskott Aldrich syndrome), 1 had systemic lupus erythematosus and 1 received kidney transplant. Four patients were transplant recipients; 1 allogeneic and 2 autologous hematopoietic cell transplant and 1 with kidney transplant. The median absolute lymphocyte count at the diagnosis of P. jirovecii pneumonia was 5,156 cells/mm3 (range, 20–5,111 cells/mm3). In 13 episodes (13 of 15, 86.7%), patients were not receiving prophylaxis at the onset of P. jirovecii pneumonia. For treatment, trimethoprim/sulfamethoxazole was given as a main therapeutic agent in all 15 episodes. Steroid was given in 9 episodes (60%). Median treatment duration was 15 days (range, 4–33 days). Overall mortality at 60 days was 35.7% (5 of 14).ConclusionMajority of our patients developed P. jirovecii pneumonia while not on prophylaxis. Continuous efforts and more data are needed to identify high risk patients who may get benefit from P. jirovecii pneumonia prophylaxis

    Relationship between Physical activity and Cardiovascular Outcomes in the Korean Elderly: Review of Experimental Studies

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    PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes

    Etiology and clinical characteristics of fever of unknown origin in children: a 15-year experience in a single center

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    PurposeFever is one of the most common symptoms in children. In previous studies, infectious disease was the most common cause of pediatric fever of unknown origin (FUO). The aim of this study is to investigate the etiology, clinical characteristics and prognosis of pediatric FUO in 21 century with more diagnostics available and to analyze the factors for certain disease categories.MethodsAmong the children under 18 years old who were hospitalized at Samsung Medical Center from January 2000 to December 2014, the patients who met the criteria including fever of ≥38.0℃ for longer than ≥14 days and failure to reach a diagnosis after one week of investigations were included.ResultsTotal 100 patients were identified. Confirmed diagnosis was achieved in 57 patients (57%). Among them, infectious diseases (n=19, 19%) were most common, followed by connective tissue diseases (n=15, 15%), necrotizing lymphadenitis (n=8, 8%), and malignancies (n=7, 7%). Children with fever duration over 28 days had a trend for higher frequency of connective tissue diseases (28.3%) except undiagnosed etiology. The symptoms such as arthritis, lymph node enlargement and only fever without other symptoms were significantly related with connective tissue diseases, necrotizing lymphadenitis and undiagnosed respectively (P<0.001). Ninety-two patients have become afebrile at discharge and 1 patient died (1%).ConclusionAlmost half of our patients were left without diagnosis. Although it has been known that infectious disease was most common cause of pediatric FUO in the past, undiagnosed portion of FUO have now increased due to development of diagnostic techniques for infectious diseases
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