Hyponatremia can be a life-threatening illness among hospitalized children. The aims of this study were to evaluate the incidence and risk factors of hyponatremia in 3938 children who were admitted to the Cheil General Hospital and Women’s Health Care Center with respiratory infections. Clinical data were collected, and multiplex RT-PCR analyses were done for various microorganisms. Hyponatremia was observed in 531 (13.5%) patients. The incidence of hyponatremia differed according to the respiratory tract infection (P < 0.0001) and microorganism (P = 0.001). In children with hyponatremia, the age at admission was significantly older (P < 0.0001), male gender was more frequent (P = 0.019), CRP was higher (P < 0.0001), and coinfection with multiple organisms was more common (P = 0.001) than in children without hyponatremia. In multivariate analyses, an older age at admission (P = 0.006), male gender (P = 0.004), and increased CRP (P < 0.0001) were independent risk factors. Sodium levels correlated negatively with WBC (P = 0.037), CRP (P < 0.0001), and number of hospital days (P = 0.020). The AUC values of age (0.586, P < 0.0001), CRP (0.599, P < 0.0001), and blood urea nitrogen (0.559, P < 0.0001) were all significant predictors of hyponatremia. This study is the first to show that the incidence of hyponatremia differs according to infecting microorganism and radiological findings.
The experience and play activities in forest spaces have played an effective role in children's growth and development, therefore, many studies and projects related to forest activity space have progressed actively. However, the focus of previous research has been merely on the effectiveness of forest activity but little on providing the basis for the spatial design of these types of forest activity spaces. Thus, this study aims to identify the relationship between children's developmental play activity and the physical characteristics of forest activity spaces for evidence-based design. First of all, indicators for Cognitive-Social play(CSP) was selected and forest spaces were categorize into play facility spaces and forest spaces. More detailed environmental characteristics of each space were 'play area' and 'paving materials' for play facilities and 'density of tree and shrub', 'slope', 'paving materials' and 'fixing and type of natural loose parts'for forest space. Through environmental inventory and behavior observation, the types of play behaviors and the occurrence frequency of children aged four to five were collected and analyzed.The results were as follows: 1) In play facility spaces, play behaviors occurred at a high frequency at the facility playground with play facilities and sand area. In terms of CSP, functional-solitary and functional-parallel plays occurred predominantly. 2) In forest spaces, various play behaviors occurred at high frequency in the environment with low density planting and various natural loose parts. For CSP, functional-group and symbolic-group plays occurred at a high frequency.3) Symbolic-group play appeared to be highly affected by environmental characteristics like tree area of scatter density or less, 10~20 degree slope, and the presence of fixed large stumps. In conclusion, this study provides standards of physical environmental characteristics for forest activity space design through direct observation and analysis of children's play behaviors.
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