According to trends in scientific technical competition, many countries around the world are interested in and focused on the STEAM integrated education. By observing the fact that the goal of our country's science education is to cultivate creative workers who have scientific knowledge, the need for STEAM integrated education cannot be denied. Therefore, the purpose of this study was to develop the STEAM integrated program focused on themes that considered activities and interest in the grade 6 science subject in order to identify its influence on the creativity and interest levels of elementary students. The STEAM integrated education program in this study was developed so that it can be applied as a unit review or reinforcement activities in the closing activities per unit in grade 6. The focus was placed on heightening students' creativity and interest in science subject learning through a program focused on activities per theme. As a result of applying the developed STEAM integrated program in prior and post conditions on 3 elementary school's students in J Province, it was discovered that significant improvement was found in the creativity and scientific interest of elementary students in the experimental group, compared to the control group. Therefore, continuous and systematic development of the STEAM integrated education program is required, and moreover, it must be developed for all elementary grade levels and efforts should be put into actively applying the program in the field of education.
BackgroundDexmedetomidine as a sole agent showed limited use for painful procedures due to its insufficient sedative/analgesic effect, pronounced hemodynamic instability and prolonged recovery. The aim of this study was to compare the effects of dexmedetomidine-ketamine (DK) versus dexmedetomidine-midazolam-fentanyl (DMF) combination on the quality of sedation/analgesia and recovery profiles for monitored anesthesia care (MAC).MethodsFifty six patients undergoing chemoport insertion were randomly assigned to group DK or DMF. All patients received 1 μg.kg−1 dexmedetomidine over 10 min followed by 0.2–1.0 μg.kg−1h−1 in order to maintain 3 or 4 of modified Observer's Assessment of Analgesia and Sedation score checked every 3 min. At the start of dexmedetomidine infusion, patients in group DK or DMF received 0.5 mg.kg−1 ketamine or 0.05 mg.kg−1 midazolam + 0.5 μg.kg−1 fentanyl intravenously, respectively. When required, rescue sedatives (0.5 mg.kg-1 of ketamine or 0.05 mg.kg-1 of midazolam) and analgesics (0.5 mg.kg-1 of ketamine or 0.5 μg.kg-1 of fentanyl) were given to the patients in DK or DMF group, respectively. The primary outcome of this study was the recovery parameters (time to spontaneous eye opening and the length of the recovery room stay). The secondary outcomes were parameters indicating quality of sedation/analgesia, cardiorespiratory variables, and satisfaction scores.ResultsThere were no significant differences in the onset time, time to spontaneous eye opening, recovery room stay, the incidences of inadequate analgesia, hypotension and bradycardia between the two groups. Despite lower infusion rate of dexmedetomidine, more patients in the DMF group had bispectral index (BIS) < 60 than in the DK group and vice versa for need of rescue sedatives. The satisfaction scores of patients, surgeon, and anesthesiologist in the DMF group were significantly better than the DK group.ConclusionsThe DK and DMF groups showed comparable recovery time, onset time, cardiorespiratory variables, and analgesia. However, the DMF group showed a better sedation quality and satisfaction scores despite the lower infusion rate of dexmedetomidine, and a higher incidence of BIS < 60 than the DK group.Trial registrationClinical Trial Registry of Korea KCT0000951, registered 12/12/2013
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