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나효진,성인영,최경효,김정훈 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.2
Objective: To investigate neurodevelopmental long-term outcome in children born after in-vitro fertilization (IVF). Method: We performed retrospective study in which we investigated development of neurodevelopmental disability in 254 childern (113 twins, 28 singletons) born after in vitro fertilization between Janurary 1995 and December 1999. We obtained neurodevelopmental status on a certain date and disability of children from medical records or phone interviews of parents. We assessed developmental status, congenital malformation, cerebral palsy and seizure, speech disorder, other neurologic problems, prematurity, low birth weight, maternal age, intraventricular hemorrhage (IVH), retinopathy and congenital anomaly. Results: Six children (2.3%) were diagnosed as cerebralpalsy, three children (1.2%) as developmental delay and 11 had IVH, 6 had retinopathy, 10 had congenital anomaly (esp. abdominal wall defect). The mean maternal age was 30±2.8 years old and gestational age was 35±3.0 weeks. One hundred one children (39.7%) were born prematurely, 66.5% low birth weight. Conclusion: High prevalence of neurodevelopmental disabilities like cerebral palsy compared to population controls (cerebral palsy: 1.9/1000 live birth) was revealed. Therefore, we should know mild high risk of developmental disability and do developmental examination carefully in children born after IVF and long-term follow up.
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경기도혁신학교 운영에 따른 학교체제 변화 연구 : 초등학교 사례를 중심으로
나효진,안선회 한국교육정치학회 2015 敎育政治學硏究 Vol.22 No.4
This research is for investigating school system changes according to operation of Gyeonggi-do innovation school. To investigate school system change, a school system change model modified from that of Hoy and Miskel was used. A public elementary school in Gyeonggi-do assumed to have many school system changes was selected as a subject of research. Depths interview was a main research method. Also materials revealed from School-info, internal documents in the school, etc were complemented. The research results showed innovation school operation made notable school system changes. These changes could be the motive power that drew excellent educational attainments. Thus, educational authorities should make features suggested as Gyeonggi-do innovation school indexes elaborate. In addition, institutional strategies should be provided to be free of the superintendent of schools' inclination and ideas. To build the self management system from principal's leadership, autonomy of the compilation and execution of a budget, recognition of diverse organization of curriculum and demonstraion of flexible authority over human resources should be devised. Lastly, the educational authorities have to provide conditions, circumstances for Gyeonggi-do innovation school that reflect the school's distinct characteristic and the local community's anticipation. 이 연구는 경기도혁신학교 운영에 따른 학교체제 변화를 알아보기 위한 것이다. 이를 위해 Hoy와 Miskel의 학교체제 모형을 수정하여 개발한 학교체제 변화 모형을 활용하여 학교체제 변화를 분석하였다. 연구 대상은 혁신학교 운영 등으로 학교체제의 변화가 많을 것으로 추정되는 경기도 소재 공립 초등학교이고, 연구방법은 문헌연구와 심층면접을 병행하였으며,‘학교알리미’에 공개된 자료, 학교의 내부문서 등 양적 자료들을 통해 보완하였다. 연구결과 경기도혁신학교 운영 전과 후‘혁신초’의 학교체제 변화는 눈에 띄게 나타났으며, 학교장이 교감과 함께 주도하고 교사들이 적극 참여한 학교체제의 변화는 높은 교육적 성과를 도출해 내는 원동력이 되었다. 따라서 교육정책 당국은 혁신학교가 성공적으로 확산되고 정착될 수 있도록 경기도혁신학교 지표로 제시한 특성들을 정교화 하여 교육감의 교육적 성향이나 이념에 따라 혁신학교 지정이나 운영이 좌우 되지 않도록 하기 위한 제도적 장치를 마련하여야 한다. 또한, 학교장이 충분한 리더십을 가지고 자율경영체제가 구축될 수 있도록 예산 편성·집행의 자율권 부여, 교육과정 편성·운영의 다양성 인정, 경직된 인사권의 융통성 발휘 등 행·재정적 지원이 강구되어야 한다. 그리고 학교의 특색과 지역사회의 요구가 반영된 경기도혁신학교가 운영될 수 있는 여건과 환경을 제공하여야 한다.
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장기간의 기관 내 삽관 환자에 대한 발관 전 연하 자극
황창호,최경효,나효진,고윤석,임채만,양경순 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.2
Objective: To evaluate the effect of preemptive swallowing stimulation on the recovery of swallowing function in long-term intubated patients. Method: Patients in the intensive care unit intubated for at least 48 hours due to respiratory distress from March to August 2003 were randomly assigned to two groups. Fifteen patients were stimulated (experimental group), and 18 patients were not stimulated (control group). The duration of intubation was 15.5±6.7 days in the experimental group and 15.7±6.5 days in the control group. Duration of stimulation in the experimental group was 7.3±3.6 days. After extubation, we compared the severity of dysphagia via video-fluoroscopic swallowing study. Results: There was no difference in percentage of aspiration and swallowed volume between two groups. Oral transit time of the experimental group (0.37±0.07 sec) was significantly shorter than that of the control group (0.83±0.10 sec), and the oropharyngeal swallowing efficiency of the experimental group (73.3±17.4%/sec) was significantly higher than that of the control group (50.1±13.0%/sec). Conclusion: Preemptive swallowing stimulation in long term intubated patients may facilitate recovery of dysphagia.
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송우현,황창호,나효진,성인영,안세현 대한재활의학회 2005 Annals of Rehabilitation Medicine Vol.29 No.1
Objective: To investigate whether early postmastectomy rehabilitation program could improve shoulder function and upper limb edema. Method: 40 patients who underwent either a breast conserving procedure or a modified radical mastectomy were included. Among 40 patients, 20 patients recieved early postmastectomy rehabilitation program and 20 patients were recieved only instruction for exercise. The patinets were assessed on the three days after surgery and one month after surgery. The range of motion (ROM) of shoulder, pain onmobility of shoulder and arm circumference were evaluated. Results: One month after surgery, both groups showed improvements in shoulder motion range, pain and edema. But there were significantly better in early rehabilitation group than control group (p<0.05). Conclusion: We concluded that early postmastectomy rehabilitation program was beneficial in regaining the shoulder motion and in reduction of pain and edema.
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