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Doctor's Perception and Referral Barriers toward Palliative Care for Advanced Cancer Patients (말기암환자의 완화의료에 대한 의사들의 인식과 완화의료 의뢰 시 장애요인)

  • Lee, Jae-Ri;Lee, Jung-Kwon;Hwang, Sun-Jin;Kim, Ji-Eun;Chung, Ji-In;Kim, Si-Young
    • Journal of Hospice and Palliative Care
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    • v.15 no.1
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    • pp.10-17
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    • 2012
  • Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.

Functional analysis of seaR protein identified from Saccharopolyspora erythraea (희소방선균의 seaR 단백질 발현을 통한 기능 분석)

  • Ryu, Jae Ki;Kwon, Pil-Seung;Lee, Hyeong Seon
    • Korean Journal of Microbiology
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    • v.51 no.1
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    • pp.39-47
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    • 2015
  • Secondary metabolism in actinomycetes has been known to be controlled by a small molecule, ${\gamma}$-butyrolactone autoregulator, the binding of which to each corresponding receptor leads to the regulation of the transcriptional expression of the secondary metabolites. We expected that expression of an autoregulator receptor or a pleiotropic regulator in a non-host was to be gained insight of effective production of new metabolic materials. In order to study the function of the receptor protein (seaR), which is isolated from Saccharopolyspora erythraea, we introduced the seaR gene to Streptomyces coelicolor A3(2) as host strains. An effective transformation procedure for S. coelicolor A3(2) was established based on transconjugation by Escherichia coli ET12567/pUZ8002 with a ${\varphi}C31$-derived integration vector, pSET152, which contained int, oriT, attP and $ermEp^*$ (erythromycin promotor). Therefore, the pEV615 was introduced into S. coelicolor A3(2) by conjugation and integrated at the attB locus in the chromosome of the recipients by the ${\varphi}C31$ integrase (int) function. Exconjugant of S. coelicolor A3(2) containing the seaR gene was confirmed by PCR and transcriptional expression of the seaR gene in the transformant was analyzed by RT-PCR. In case of S. coelicolor A3(2), a phenotype microarray was used to analyze the phenotype of transformant compared with wild type by seaR expression. After that, in order to confirm the accuracy of the results obtained from the phenotype microarray, an antimicrobial susceptibility test was carried out. This test indicated that sensitivity of the transformant was higher than wild type in tetracycline case. These results indicated that some biosynthesis genes or resistance genes for tetracycline biosynthesis in transformant might be repressed by seaR expression. Therefore, subsequent experiments, analysis of transcriptional pattern of genes for tetracycline production or resistance, are needed to confirm whether biosynthesis genes or resistance genes for tetracycline are repressed or not.

The Change of Cortical Activity Induced by Visual Disgust Stimulus (시각혐오자극으로 유발된 대뇌 피질 활성도 변화)

  • Jung, Wook;Park, Doo-Heum;Yu, Jae-Hak;Ryu, Seung-Ho;Ha, Ji-Hyeon;Shin, Byoung-Hak
    • Sleep Medicine and Psychophysiology
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    • v.20 no.2
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    • pp.75-81
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    • 2013
  • Objectives: There are a lot of studies that analyze the interaction between the emotion of disgust and the functional brain images using fMRI and PET. But studies using sLORETA (standardized low resolution brain electromagnetic tomography) almost do not exist. The aim of this research is to explore the relationship of the emotion of disgust and the cortical activation using sLORETA analysis. Methods: Forty five healthy young adults ($27.1{\pm}2.6$ years) participated in the study. While they were watching 4 neutral images and 4 disgusting images associated with mutilation selected from the international affective picture system (IAPS), participants' EEGs were taken for 30 seconds per one picture. Through these obtained EEG data, sLORETA analysis was performed to compare EEGs associated with neutral and negative images. Results: During looking for visual disgusting stimulus, all participants reported unpleasantness, arousal and stress. In sLORETA analysis, the decrease of current density in theta wave was shown at left frontal superior gyrus (BA10) and middle gyrus (BA10, 11). This voxel cluster consists of a total of 11 voxels and the threshold of t value indicating statistically significant decreases in the current density (p<0.05) was -1.984. There were no differences between male and female in the degree of being disgusted by the stimuli. Conclusion: This finding may suggest that the activation of dorsolateral prefrontal cortex might be associated with regulating disgust emotion.

The Effectiveness of Buprenorphine Transdermal Patch on Patients with Shoulder Pain: Short-Term Follow-up Study (견관절 통증을 동반한 동결견 환자에게서 Buprenorphine transdermal patch의 효과: 단기 추시 결과)

  • Hong, Jin Ho;Park, Yong Bok;Ryu, Ho Young;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.1
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    • pp.7-12
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    • 2014
  • Purpose:The effectiveness of transdermal buprenorphine patch on the patients with frozen state of frozen shoulder was evaluated. Materials and Methods: Between March and September in 2013, 127 patients with pain and limited range of motion in shoulder joint over 6 months were included. Every patient was confirmed the diagnosis through MRI or ultrasonogram and each patient received intra-articular injection of steroid once. After 2~4 weeks, every patient was interviewed via telephone survey and finally 105 patients were included, 54 patients received only oral NSAIDs (NP group) while 51 patients received additional transdermal buprenorphine patch (BP group). Pain and functional visual analog scale (PVAS, FVAS), American Shoulder Elbow Society (ASES) score was checked. Results: Generally, every outcome variables showed improvements in both groups (p<0.001). PVAS score after treatment showed superior result in NP group but it was not significant (p=0.088). In ASES score, NP group had superior result than BP group and it had significant difference. Similarly in FVAS, NP group showed superior result but the data before treatment was significantly different (p=0.028) Conclusion: Transdermal buprenorphine patch didn't show superior treatment result in the patient with frozen state of frozen shoulder which was applied with oral NSAIDs after single intra-articular glenohumeral steroid injection in short-term follow-up.

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The Selection of the Most Painful Word in the Visual Analogue Scale(VAS) for Pain and the Psychosocial Factors in Association with Pain Assessment in Korean Adult Cancer Patients - for the Development of Korean Cancer Pain Assessment Tool(K-CPAT) by Delphi Method - ("표준형 성인 암성 통증 평가도구" 개발을 위한 시각통증등급의 최고통증강도 어휘 및 심리.사회적 평가 항목의 선정 - 델파이 방법을 이용 -)

  • Kim, Jin-Seo;Chun, Byung-Chul;Choi, Youn-Seon;Song, Chan-Hee;Yeom, Chang-Hwan;Lee, Myung-Aha;Lee, June-Young;Yoon, So-Young;Jang, Se-Kwon;Lee, Young-Hee;Lee, Kyoung-Uk;Lee, Chul;Park, Jean-No
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.11-21
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    • 2003
  • This paper addresses the minor differences in the description of pain in Korean language in order to develop a standarized cancer pain aneument tool for Korean adults, Korean Cancer Pain Assessement Tool. The subtle differences in the meaning of expressions used cannot be translated into English and therefore we omiltted the English abstract.

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Multi-purpose Geophysical Measurements System Using PXI (PXI를 이용한 다목적 물리탐사 측정 시스템)

  • Choi Seong-Jun;Kim Jung-Ho;Sung Nak-Hun;Jeong Ji-Min
    • Geophysics and Geophysical Exploration
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    • v.8 no.3
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    • pp.224-231
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    • 2005
  • In geophysical field surveys, commercial equipments often fail to resolve the subsurface target or even sometimes fail to be applied because they do not fit to the various field situations or the physical properties of the medium or target. We developed a geophysical measurement system, which can be easily adapted for the various field situations and targets. The system based on PXI with A/D converter and some stand alone equipment such as Network Analyzer was applied to borehole radar survey, borehole sonic measurement and electromagnetic noise measurement. The system for borehole radar survey consists of PXI, Network Analyzer, dipole antennas, GPIB interface is used for PXI to control Network Analyzer. The system for borehole sonic measurement consists of PXI, 24 Bit A/D converter, high voltage pulse generator, transmitting and receiving piezoelectric sensors. The electromagnetic noise measurement system consists of PXI, 24 Bit A/D converter, 2 horizontal component electric field sensors and 2 horizontal and 1 vertical component magnetic filed sensors. The borehole radar system has been successfully applied to detect the width of the artificial tunnel through which the borehole pass and to image buried steel pipe, while the commercial borehole radar equipment failed. The borehole sonic system was tested to detect the width of artificial tunnel and showed a reasonable result. The characteristic of electromagnetic noise was grasped at an urban area with the data from the electromagnetic noise measurement system. The system is also applied to characterize the signal distortion by induction between the electric cables in resistivity survey. The system can be applied various geophysical problems with a simple modification of the system and sensors.

Improving the nutrition quotient and dietary self-efficacy through personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s (개인별 목표 설정과 스마트폰 기반 영양상담을 통한 20-30대 성인의 영양지수 및 식이 자아효능감 향상)

  • Dahyeon Kim;Dawon Park;Young-Hee Han;Taisun Hyun
    • Journal of Nutrition and Health
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    • v.56 no.4
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    • pp.419-438
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    • 2023
  • Purpose: This study examines the effectiveness of personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s. Methods: Nutrition counseling was conducted for a total of 30 adults through a 1:1 chat room of a mobile instant messenger, once a week for 8 weeks. The first week of counseling included a preliminary online questionnaire survey and a dietary intake survey. Based on the results of the preliminary survey, 2 dietary goals were set in the second week and the participants were asked to record their achievements on a daily checklist. From the third week onwards, counselors sent feedback messages based on the checklist and provided information on dietary guidelines in a card news format every week. Post-counseling questionnaires and dietary intake surveys were conducted in the seventh week. Changes in dietary habits during the counseling were reviewed in the eighth week, followed by a questionnaire survey on the evaluation of the counseling process. Results: The nutrition quotient (NQ) scores and self-efficacy scores were significantly higher after nutrition counseling. The NQ scores of consumption frequencies of fruits, milk and dairy products, nuts, fast food, Ramyeon, sweet and greasy baked products, sugarsweetened beverages, the number of vegetable dishes at meals, and breakfast frequency were significantly higher after nutrition counseling. The intake of protein, vitamin A, thiamin, riboflavin, folate, calcium, and iron, and the index of nutritional quality of vitamin A, riboflavin, folate, calcium, and iron were higher after nutrition education. The participants were satisfied with the nutrition counseling program and the provided nutrition information. Conclusion: Personalized goal setting and smartphone-based nutrition counseling were found to be effective in improving the quality of diet and self-efficacy in young adults. Similar results were obtained in both the underweight/normal weight and the overweight/obese groups.

Development of Rapid-cycling Brassica rapa Plant Program based on Cognitive Apprenticeship Model and its Application Effects (인지적 도제 모델 기반의 Rapid-cycling Brassica rapa 식물 프로그램의 개발 및 적용 효과)

  • Jae Kwon Kim;Sung-Ha Kim
    • Journal of Science Education
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    • v.47 no.2
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    • pp.192-210
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    • 2023
  • This study was intended to develop the plant molecular biology experimental program using Rapid-cycling Brassica rapa (RcBr) based on the teaching steps and teaching methods of the cognitive apprenticeship model and to determine its application effects. In order to improve a subject's cognitive function and expertise on molecular biology experiments, two themes composed of a total 8 class sessions were selected: 'Identification of DFR gene in purple RcBr and non-purple RcBr' and 'Identification of RcBr's genetic polymorphism site using the DNA profiling method'. Research subjects were 18 pre-service teaching majors in biology education of H University in Chungbuk, Korea. The effectiveness of the developed program was verified by analyzing the enhancement of 'cognitive function' related to the use of molecular biology knowledge and technology, and the enhancement of 'domain-general metacognitive abilities.' The effect of the developed program was also determined by analyzing the task flow diagram provided. The developed program was effective in improving the cognitive functions of the pre-service teachers on the use of knowledge and technology of molecular biology experiments. It was especially effective to improve the higher cognitive function of pre-service teachers who did not have the previous experience. The developed program also showed a significant improvement in the task of metacognitive knowledge and in the planning, checking, and evaluation of metacognitive regulation, which are sub-elements of domain-general metacognitive abilities. It was found that the developed program's self-test activity could help the pre-service teachers to improve their metacognitive regulation. Therefore, this developed program turned out to be helpful for pre-service teachers to develop core competencies needed for molecular biology experimental classes. If the teaching and learning materials of the developed program could be reconstructed and applied to in-service teachers or high school students, it would be expected to improve their metacognitive abilities.

A Preliminary Study on Depressive Symptoms and Glycemic Controls in Diabetic Patients (당뇨병 환자에서의 우울 및 관련증상에 관한 예비적 연구)

  • Ko, Seung-Hyun;Jeong, Jong-Hyun;Hong, Seung-Chul;Han, Jin-Hee;Lee, Seung-Pil;Ahn, Yoo-Bae;Song, Ki-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.165-173
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    • 2004
  • Objectives: Diabetes mellitus is a heterogeneous, chronic, progressive disease characterized by hyperglycemia and abnormality in protein, carbohydrate, fat metabolism. Recent studies have reorted two times prevalence of depression in individuals with diabetes compared to individuals without diabetics. This study was designed to investigate glycemic controls, anxiety, alexithymia, stress responses between depressed diabetic patients and non-depressed diabetic patients. Methods The subjects were 60 diabetic patients(mean age : $50.3{\pm}9.7$ years, 31 men and 29 women) who were confirmed to have diabetes depending on the laboratory findings as welt as clinical symptoms at the St. Vincent Hospital Diabetes Clinic, from Mar. 2004 to Sep. 2004. Laboratory test including, blood chemistry. glycated hemoglobin, urinalysis for proteinuria and Korean version of Beck Depression Inventory(BDI), State and Trait Anxiety Inventory(STAI), Toronto Alexithymia Scale(TAS) and Stress Response Inventory(SRI) were used for assessment. Based on BDI scores, all diabetics were divided into 13 depressed-diabetics group(above 20 point) and 47 non-depressed group(below 20 point). We compared demographic data. glycemic controls, STAI, TAS and SRI scores between two groups by independent t-test. Results : 1) Depressed diabetic groups were 13(mean age : $55.4{\pm}7.2$ years, 7 men and 6 women) and non depressed groups were 47(mean age $48.9{\pm}9.8$ years, 24 men and 23 women). In depressed diabetics, compared with non-depressed group, manifested aged(p=0.031), but other demographic data showed no difference between two groups. 2) No significant differences were noted in FBS, PP2h, Hb A1C, total cholesterol, HDL-cholesterol, SGOT/SGPT, BUN levels between depressed and non-depressed groups. But, blood creatine levels of depressed group were significantly increased than non-depressed group(p=0.026). 3) No significant differences were found in the score of STAI, STAI-S, STAI-T, TAS between depressed and non-depressed groups. 4) The SRI scores of depressed groups were significantly higher than non-depressed groups$(59.7{\pm}24.9\;vs.\;31.5{\pm}22.0)(p=0.000)$. Conclusion : The above results suggest that depressed diabetic patients are have more stress responses and higher blood creatine levels. However, there were no differences in laboratory data related to glycemic controls, and anxiety. alexithymia levels between two groups. We suggest that physicians should consider integrated approaches for psychiatric problems in the management of diabetes.

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A Study on Outplacement Countermeasure and Retention Level Examination Analysis about Outplacement Competency of Special Security Government Official (특정직 경호공무원의 전직역량에 대한 보유수준 분석 및 전직지원방안 연구)

  • Kim, Beom-Seok
    • Korean Security Journal
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    • no.33
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    • pp.51-80
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    • 2012
  • This study is to summarize main contents which was mentioned by Beomseok Kim' doctoral dissertation. The purpose of this study focuses on presenting the outplacement countermeasure and retention level examination analysis about outplacement competency of special security government official through implement of questionnaire method. The questionnaire for retention level examination including four groups of outplacement competency and twenty subcategories was implemented in the object of six hundered persons relevant to outplacement more than forty age and five grade administration official of special security government officials, who have outplacement experiences as outplacement successors, outplacement losers, and outplacement expectants, in order to achieve this research purpose effectively. The questionnaire examination items are four groups of outplacement competency and twenty subcategories which are the group of knowledge competency & four subcategories including expert knowledge, outplacement knowledge, self comprehension, and organization comprehension, the group of skill competency & nine subcategories including job skill competency, job performance skill, problem-solving skill, reforming skill, communication skill, organization management skill, crisis management skill, career development skill, and human network application skill, the group of attitude-emotion competency & seven subcategories including positive attitude, active attitude, responsibility, professionalism, devoting-sacrificing attitude, affinity, and self-controlling ability, and the group of value-ethics competency & two subcategories including ethical consciousness and morality. The respondents highly regard twenty-two outplacement competency and they consider themselves well-qualified for the subcategories valued over 4.0 such as the professional knowledge, active attitude, responsibility, ethics and morality while they mark the other subcategories below average still need to be improved. Thus, the following is suggestions for successful outplacement. First, individual effort is essential to strengthen their capabilities based on accurate self evaluation, for which the awareness and concept need to be redefined to help them face up to the reality by readjusting career goal to a realistic level. Second, active career development plan to improve shortcoming in terms of outplacement competency is required. Third, it is necessary to establish the infrastructure related to outplacement training such as ON-OFF Line training system and facilities for learning to reinforce user-oriented outplacement training as a regular training course before during after the retirement.

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