Preschool Children's Imagenative Behavior during Free Play

유아기 어린이의 놀이는 대부분이 상상놀이 이다. 상상놀이란 사실이 아닌 것을 가장해서 행동하거나 다른 사람의 동작이나 활동을 모방하여 사물이나 도구를 사용하여 가작화(make-believe) 하는 놀이이다. 본 연구은 자유놀이 시간 동안 유아가 상상놀이에 참여하는 빈도와 상상놀이의 종류 및 내용과 상상놀이에 사용된 놀이감을 분석하는 것을 목적으로 하였다. 연구대상은 서울 시내에 위치한 대학 부속 유치원의 원아 만 3세, 4세, 5세로 총 89명이었다. 연구방법은 자연관찰로 각 유아를 30초씩 75회로 총 37.5분 관찰하였다. 관찰된 상상놀이의 참여빈도와 상상놀이의 종류 및 내용에 따른 연령 및 성별 차이를 알아보기 위하여 상상놀이 빈도를 점수화하여 일원변량분석과 t검증을 하였고, 사용된 놀이감의 종류는 사용빈도와 백분율을 산출하였다. 수집된 자료를 통해 얻어진 결과는 다음과 같다. 1. 자유놀이 시간동안 유아의 상상놀이 참여 빈도는 전체 놀이중 45%를 차지한다. 참여 빈도는 연령별로 유의한 차이를 보이지 않으며 성별로 남아가 여아보다 상상놀이를 더 많이한다. 2. 유아가 참여한 상상놀이 종류는 개인상상놀이가 41%, 집단상상놀이가 59%이다. 연령별로 3세가 4세와 5세보다 개인상상놀이를 많이 하며 5세가 3세와 4세보다 집단 상상놀이를 많이 한다. 성별로 남아가 여아보다 개인상상놀이를 모두 더 많이 한다. 3. 유아들이 주로 참여한 상상놀이 내용는 11종류로 이중 소꿉놀이와 군인·경찰놀이를 가장 많이 한다. 상상놀이 내용은 대부분 연령에 따라 유의한 차이가 없다. 성별로는 유의한 차이를 보이는데 여아는 소꿉놀이, 극화놀이를 많이 하는 반면 남아는 군인·경찰놀이, 자동차·교통놀이, 선장·해적놀이, 로보트·우주놀이, 공사·수선놀이를 많이 한다. 4. 유아는 상상놀이의 93%를 놀이감을 사용한다. 사용된 놀이감은 13종류이고 조작놀이감, 소꿉그릇류, 의상류를 주로 많이 사용한다. 성별로 보면 남아는 조작놀이감, 교통기관류를 많이 사용하는 반면 여아는 밀가루반죽, 소꿉그릇류, 의상류를 많이 사용한다.;The purpose of this study was the analysis of the frequency of participation, types, themes and playthings related to the imaginative play of preschool children during free play activities. The subject were 89 nursery school children three, four and five years of age. The methodology used in data collection was time sampling in the natural setting during free play. The observers used a behavioral checklist to record the children's imaginative play and playthings. Each subject was observed 75 times for 30 seconds on each observation for a total of 37.5 minutes per child. Mean frequencies of behavior and play materials were computed and the data was analyzed with one way analysis of variance and t-test. The results of the study were as follows; a) Frequency in participation of children in imaginative play during free play activities was 45% of observed free play activities, there was no significant difference between age levels. Boys exhibited imaginative play more than girls. b) 41% of the imaginative play was individual play and 59% was group imaginative play. Three-year-olds exhibited significantly more individual imaginative play than four- and five-year old children. Five-year-olds exhibited significantly more group imaginative play than three-and four-year-old children c) Children mainly exhibited I1 kinds of imaginative themes. Girls prefered housekeeping; boys prefered role playing police- man and soldier, pirate captain, robot space construction repair and transportation play. d) Children used 13 kinds of playmaterials in imaginative play, blocks, doll dishes and dress-up cloths were used most frequently. Children used structured materials in 49% and open-ended materials in 51% of their imaginative play.목차 = ⅲ 논문개요 = ⅴ Ⅰ. 서론 = 1 A. 연구의 필요성 및 목적 = 1 B. 연구문제 = 3 Ⅱ. 이론적 배경 = 4 A. 상상놀이의 개념 = 4 B. 상상놀이의 발단단계 및 유형 = 6 C. 상상놀이에 영향을 주는 변인 = 11 D. 상상놀이의 가치 = 16 Ⅲ. 연구방법 = 21 A. 연구대상 = 21 B. 연구절차 = 21 C. 도구 및 관찰변인 = 22 D. 자료분석 = 25 Ⅳ. 결과 및 해석 = 26 Ⅴ. 논의 및 결론 = 38 A. 논의 = 38 B. 결론 = 40 참고문헌 = 41 부록 = 45 ABSTRACT = 4

The effect of calcium antagonist and potassium concentrations in the cardioplegic solution on the recovery of myocardial function after ischemic cardiac arrest

의학과/석사[영문] [한글] 심장 질환에 대한 개심술과 관련되어 발생하는 심근의 손상으로부터 심근을 보호하는 방법들 중 현재 가장 보편적으로 시행되고 있는 것은 심근을 냉각시키는 것과 고 농도의 K**+를 포함한 용액을 대동맥 차단 중에 관상 동맥계로 부여하는 것이다. 이와 같은 심근 보호를 위하여 투여하는 용액에 현재 여러 가지 물질이 첨가되고 있는데 칼슘 길항제를 첨가하여 사용하면 저산소증 상태하의 심근의 보호와 기능회복에 도움을 줄 가능성이 있 다. 본 연구는 적출된 흰쥐의 Langendorf식 역관류 심장표본에서 St. Thomas 병원 심근 마 비액의 조성을 기본으로 K**+의 농도와 verapamil의 첨가 여부를 변화시킨 심근 마비액을 사용하여 그 기능을 일시적으로 정지시키고 일정 시간 후 다시 정상 Krebs-Heneleit용액 으로 재관류시켜 그 심장 기능의 회복을 관찰한 것인데 다음과 같은 결론을 얻었다. 즉 심근마비액내의 K**+의 농도와 verapamil의 첨가 여부가 대동맥 차단과 관련하여 발 생하는 심근손상으로부터 심근을 보호하는데 도움이 되는지 여부를 조사할 경우, 심근을 7℃나 23℃로 냉각시킬 때는 대동맥 차단시간을 적어도 120분 이상 유지하여야 심장소생 율이나 기능회복의 차이를 관찰할 수 있으며, 심근을 냉각시키지 않고 38℃에서 관찰할 경우에는 대동백 차단시간을 60분 이내로 유지하여야 한다는 것을 발견하였다. 심근 냉각 온도를 7℃로 하고 대동맥 차단을 120분간 유지한 후 재관류하여 심근 마비 액 조성의 차이에 따른 각 실험군의 심장 소생율을 비교하였는데 verapamil을 첨가하지 않고 저농도(4mEq/L)의 K**+용액을 사용한 경우에 소생율이 가장 높았고, 소생된 심장에 서 재관류 30분 후에 측정한 심장기능의 회복율은 verapamil을 첨가하지 않고 고농도(16m Eq/L)의 K**+용액을 사용한 실험군에서 가장 높았다. 이상의 결과로 verapamil첨가가 심 근보호에 도움이 되지 못한다는 결론 얻었다. The effect of calcium antagonist and potassium concentrations in the cardioplegic solution on the recovery of myocardial function after ischemic cardiac arrest EUN GI KIM Department of Medical Science, The Graduate School, Yonsei University (Directed by Professor DOO HEE KANG, M.D., Ph.D.) High potassium cardioplegia is a widely accepted procedure to enhance myocardial protection from ischemic injuries associated with open heart surgeries. To determine whether addition of verapamil to the cardioplegic solution and high concentration of potassium in the solution can produce satisfactory myopcardial protection during ischemia, 105 isolated rat hearts perfused by modified Langendorff technique were studied. St. Thomas hospital cardioplegic solution was selected as a standard high potassium(16 mEq/L of K**+) cardioplegic solution. Four kinds of cardioplegic solutions were made by modifying the composition. i.e. high potassium, low potassium, and in the presence or absence of verabamil. By changing the cooling temperature of myocardium and aorta-cross-clamp time, we found that at least 120 min of aorta-cross-clamp time was necessary at cooling temperature of 7℃ or 23℃ for maximizing the differences of survival rate between the groups. When aorta-cross-clamp was carried out for 120 min at cooling temperature of 7℃, the measured functional parameters(heart rate, left ventricular pressure, maximum dp/dt of LVP) showed some but non-significant difference of recovery rate between the groups. The survival rate was best when low K**+ solution was used without verapamil. The high K**+ solution without verapamil showed best recovery of the measured functional parameters. From the above results, it may be said that addition of verapamil was not helpful for myocardial protection from ischemic injury during myocardial arrest.restrictio

스마트폰 기반 환자 중심 혈당 관리 시스템의 효과 연구

학위논문 (박사)-- 서울대학교 대학원 : 의학과, 2017. 2. 조영민.The prevalence of diabetes mellitus is 8.3% worldwide, and the number of patients is continuously increasing. Medical costs related to diabetes, largely due to the treatment costs of diabetic complications resulting from poor glycemic control, represent a significant socioeconomic burden. Diabetes is a chronic disease that requires life-long managementtherefore, it is important that strategies focus on the education of patients towards self-management and the support of daily activities. Various information technology (IT)-based interventions have been developed for chronic diseases including diabetes. However, the efficacy and safety of these interventions have not been established through well-designed randomized controlled clinical trials. Furthermore, current IT-based systems for disease management have limited functionalities for diabetes self-management. This study aimed to develop a multifunctional diabetes management system and assess its efficacy and safety. The patient-centered smartphone-based diabetes care system (PSDCS) contained 4 modules on glucose monitoring, diet, physical activity, and social network service. Each module collected data via a Bluetooth glucometer and activity tracker and gave appropriate feedback or a reminder according to preset algorithms. The system also incorporated a web site allowing medical staff to monitor individual input data. A single-arm pilot study aimed to test the feasibility of HbA1c reduction with the PSDCS over 12 weeks. Twenty-nine patients completed the pilot study. The HbA1c and fasting plasma glucose levels decreased significantly from baseline (7.7 ± 0.7% to 7.1 ± 0.6%, p < 0.0001140.9 ± 39.1 mg/dL to 120.1 ± 31.0 mg/dL, p = 0.0088, respectively) after 12 weeks of intervention. The number of glucose measurement correlated with the extent of reduction in HbA1c levels (r = －0.53, p = 0.0013). The scores of the Summary of diabetes self-care activities including diet, exercise, and glucose monitoring, showed a significant improvement, particularly in the patients in the upper tertile of HbA1c reduction. No severe adverse event occurred during the intervention. Based on the results of the pilot study, we upgraded the system and conducted to a multicenter, randomized controlled study over 24 weeks. The upgraded system had an insulin dosing algorithm for basal insulin and premixed insulin, a rescue therapy protocol, and an improved user interface. A total of 172 patients, excluding the patients who missed the primary endpoint or did not fulfill the inclusion/exclusion criteria, were included in the analysis (full analysis set). After 24 weeks, HbA1c reduction relative to baseline was greater in the mHealth group (－0.4 ± 0.1%) compared to the standard care group (－0.1 ± 0.1%). The difference between the adjusted mean changes was 0.35% (95% CI: 0.14-0.55, p = 0.001). The reduction in HbA1c levels was more evident among patients with a baseline HbA1c of 8.0% or higher (－0.9 ± 0.2% vs. －0.3 ± 0.2%, p = 0.016) and who used insulin (－0.7 ± 0.2% vs. －0.2 ± 0.2%, p = 0.014). The proportion of patients achieving HbA1c levels below 7.0% was 41.1% for the mHealth group and 20.7% for the standard care group (OR = 2.01, 95% CI: 1.24-3.25, p = 0.003). The proportion of the patients achieving HbA1c levels of 6.5% or lower was 14.4% and 2.4%, respectively (OR = 5.78, 95% CI: 1.40-23.86, p = 0.004). Overall, 31.1% of patients in the mHealth group and 17.1% of patients in the standard care group achieved HbA1c levels below 7.0% without hypoglycemia (OR = 1.82, 95% CI: 1.03-3.21, p = 0.024). Among insulin users, the range of glucose fluctuation in the mHealth group was significantly reduced compared to that in the standard care group (－50.8 ± 60.6 mg/dL vs. 4.4 ± 62.0 mg/dL, p = 0.017). There was no difference in numbers of hyper- and hypoglycemic events between the groups. No patient was treated with rescue therapy, and system-related adverse events did not occur during the study. In conclusion, our smartphone-based PSDCS improved glucose control with a tolerable safety profile, and can be applied to patients with type 2 diabetes.1. Introduction 1 1.1. Computer-Assisted System in Diabetes Management 2 1.1.1. Early studies using computer-based system in patients with diabetes 2 1.2. u- and m-Healthcare System in Diabetes Management 4 1.2.1. Internet-based diabetes care system 4 1.2.2. Development of u-healthcare system 6 1.2.3. Converting from u-healthcare to m-healthcare 8 1.2.4. The effect of computerized decision support system (CDSS) on diabetes care 9 1.3. Smartphone-based Diabetes Care System 11 1.3.1. Introduction of smartphones to healthcare 11 1.3.2. Smartphone-based diabetes healthcare systems 12 1.3.3. Studies using smartphone-based diabetes healthcare systems 13 2. Pilot study 18 2.1. Methods 18 2.1.1. Study participants 18 2.1.2. Study design 19 2.1.3. Patient-Centered Smartphone-Based Diabetes Care System 21 2.1.4. Statistical analysis 24 2.2. Results 25 3. Main study 31 3.1. Methods 31 3.1.1. Health-On G program 31 3.1.2. Study participants 37 3.1.3. Study design 40 3.1.4. Endpoints and post-hoc analysis 45 3.1.5. Management of severe hyper- and hypoglycemia 46 3.1.6. Statistical analysis 48 3.2. Results 50 3.2.1. Study population 50 3.2.2. Efficacy endpoints 52 3.2.3. Subgroup analysis for efficacy endpoints 69 3.2.4. The change in insulin dose in group D patients 77 3.2.5. The use of Health-On G program 79 3.2.6. Safety endpoints 85 4. Discussion 90 5. Summary 105 References 106 국문 초록 119Docto

A Legal study on the information disclosure system in the EU company law

학위논문(박사)--서울大學校 大學院 :法學科 商法專攻,1995.Docto

황산을 이용한 2단계 가수분해에 의한 목재의 당화에 관한 연구

학위논문(석사) - 한국과학기술원 : 화학공학과, 1982.2, [ [iii], 73 p. ]In wood hydrolysis, the hydrolytic degradation of cellulose is affected disadvantageously by the hydrolysis products of the hemicellulose that are formed simultaneously. In view of this point, a two-stage process, that the hemicellulose is hydrolyzed in the pretreatment step and then the cellulose is hydrolyzed, would be desirable. The purpose of this research is to investigate the effect of reaction parameters on sugar yields and evaluate the kinetic parameters by using pine sawdust as raw material and sulfuric acid for catalyst. It was found that the overall rate of the prehydrolysis depends upon acid concentration, non-hemicellulose concentration, temperature and the concentration of hemicellulose in the reaction mixture, and that of the main hydrolysis depends upon acid concentration, temperature, and the concentration of cellulose. The reaction rate was found to be represented by : Decomposition of hemicellulose to simple sugars in the prehydrolysis. $r_H=2.275 × 10^{10}C_A^{1.011}C_N^{-0.856} exp (-20860/RT)C_H$ Decomposition of cellulose to glucose in the main hydrolysis. $r_1=1.242 × 10^{19}C_A^{1.284} exp(-42570/RT)C_C$ Decomposition of glucose in the main hydrolysis. $r_2=3.945 × 10^{14}C_A^{0.985} exp(-32880/RT)C_G$ According to the result of the scale-up and cost estimation for a plant capacity of 10 ton/day sawdust, total product cost is about 544,000 dollars. Annual total sugar production is 1146 tons and unit cost for sugar solution is 0.474 dollars/kg sugar.한국과학기술원 : 화학공학과