• Title/Summary/Keyword: Care pathway

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Effects of Children's Peer Initiative on Peer Acceptance: Focusing on Moderating Effects of Teacher-Child Relationships (유아의 또래주도성이 또래수용도에 미치는 영향: 교사-유아 관계의 조절효과를 중심으로)

  • Lee, Yu Mi;Shin, Nary
    • Korean Journal of Childcare and Education
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    • v.15 no.5
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    • pp.69-86
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    • 2019
  • Objective: This study aimed to provide a systematic understanding of children's peer initiative and peer acceptance and to offer specific information to increase young children's social competence. Methods: Participants were 235 5-year-old children from six child care centers in Sejong City. The participants were interviewed to measure the peer acceptance of children attending the same class. Also, a survey was conducted on their teachers to measure children's peer initiative and the relationship with them. The collected data were analyzed by hierarchical regression using the SPSS 21.0 program. Results: The results showed that significant main effects of friendly and unfriendly peer-initiatives on peer acceptance were found. The effects of teacher-child relationships and their moderating effects, however, were partial; only main influences of close relationships and the interaction effects between peer-initiatives and close relationships were significant. That is, the relationships between improper initiatives and low acceptance levels among peers were more intense when children established conflict relationships with their teacher. Conclusion/Implications: We found that close teacher-child relationships play moderating roles on the pathway from peer initiative to peer acceptance as a protective risk factor for children.

Study of the Developmental History on Hospice·Palliative Care and Need for Korean Medicine (호스피스·완화의료 발전사와 한의학 참여의 필요성)

  • Yoon, Hae-chang;Son, Chang-gue;Lee, Nam-heon;Cho, Jung-hyo
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.662-675
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    • 2018
  • Objective: The aim of this study was to establish the developmental history of hospice palliative care (HPC) with Korean medicine (KM). Methods: We compared the developmental history of HPC in Korea with that of Britain, the United States, Taiwan, Japan, and China. The articles in English or Korean published until Feb. 2017 were searched using 'Hospice' or 'Palliative care' with the name of each nation in the PubMed, MEDLINE, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases for foreign articles and OASIS (Oriental Medicine Advanced Searching Integrated System) for domestic articles. Books and gray literature were searched on the same databases and websites of the Ministry of Health and Welfare and related organizations in each country. Results: Modern palliative care began with the hospice movement led by Dr. Cicely Saunders. HPC in Korea started earlier than in other countries but it took considerable time for social consensus, so Korean policies have only been published recently. In this process, KM was excluded from HPC. For this reason, western medicine in Korea does not fully accept the spirit of HPC, the government does not take an aggressive stance with KM, and the institutes of KM do not have any interest in HPC. The World Health Organization recommends the establishment of policies and programs connected with a country's own health care system. In 2015, the Korean government made the third comprehensive plan for the development of KM. It included critical pathway guidelines about cancer-related fatigue and anorexia. More effort is required to set up HPC than other care types because Korea has two medical systems. Conclusions: Each nation has been trying to improve systems of HPC. We need to overcome the problems and bring out the best by making our own model of HPC with KM.

Obesity-Associated Metabolic Signatures Correlate to Clinical and Inflammatory Profiles of Asthma: A Pilot Study

  • Liu, Ying;Zheng, Jing;Zhang, Hong Ping;Zhang, Xin;Wang, Lei;Wood, Lisa;Wang, Gang
    • Allergy, Asthma & Immunology Research
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    • v.10 no.6
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    • pp.628-647
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    • 2018
  • Purpose: Obesity is associated with metabolic dysregulation, but the underlying metabolic signatures involving clinical and inflammatory profiles of obese asthma are largely unexplored. We aimed at identifying the metabolic signatures of obese asthma. Methods: Eligible subjects with obese (n = 11) and lean (n = 22) asthma underwent body composition and clinical assessment, sputum induction, and blood sampling. Sputum supernatant was assessed for interleukin $(IL)-1{\beta}$, -4, -5, -6, -13, and tumor necrosis factor $(TNF)-{\alpha}$, and serum was detected for leptin, adiponectin and C-reactive protein. Untargeted gas chromatography time-of-flight mass spectrometry (GC-TOF-MS)-based metabolic profiles in sputum, serum and peripheral blood monocular cells (PBMCs) were analyzed by orthogonal projections to latent structures-discriminate analysis (OPLS-DA) and pathway topology enrichment analysis. The differential metabolites were further validated by correlation analysis with body composition, and clinical and inflammatory profiles. Results: Body composition, asthma control, and the levels of $IL-1{\beta}$, -4, -13, leptin and adiponectin in obese asthmatics were significantly different from those in lean asthmatics. OPLS-DA analysis revealed 28 differential metabolites that distinguished obese from lean asthmatic subjects. The validation analysis identified 18 potential metabolic signatures (11 in sputum, 4 in serum and 2 in PBMCs) of obese asthmatics. Pathway topology enrichment analysis revealed that cyanoamino acid metabolism, caffeine metabolism, alanine, aspartate and glutamate metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, pentose phosphate pathway in sputum, and glyoxylate and dicarboxylate metabolism, glycerolipid metabolism and pentose phosphate pathway in serum are suggested to be significant pathways related to obese asthma. Conclusions: GC-TOF-MS-based metabolomics indicates obese asthma is characterized by a metabolic profile different from lean asthma. The potential metabolic signatures indicated novel immune-metabolic mechanisms in obese asthma with providing more phenotypic and therapeutic implications, which needs further replication and validation.

Differential Induction of PepTLP Expression via Complex Regulatory System against Fungal Infection, Wound, and Jasmonic Acid Treatment during Pre-and Post-Ripening of Nonclimacteric Pepper Fruit

  • Jeon, Woong-Bae;Kim, Kwang-Sang;Lee, Hyun-Hwa;Cheong, Soo-Jin;Cho, Song-Mi;Kim, Sun-Min;Pyo, Byoung-Sik;Kim, Ynung-Soon;Oh, Boung-Jun
    • The Plant Pathology Journal
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    • v.20 no.4
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    • pp.258-263
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    • 2004
  • Ripe fruit of pepper (Capsicum annuum) showed resistance to Colletotrichum gloeoporioides, but unripe fruit was susceptible. We previously isolated the PepTLP gene that induced in both unripe and ripe fruit by fungal infection and wound, and only in ripe fruit by jasmonic acid (JA) treatment. To examine further regulation of PepTLP, the action of specific agonist and antagonists of known signaling effector on the .PepTLP expression by fungal infection, wound, and JA was investigated. A similar dephosphorylation event negatively activated all the PepTLP expression in the ripe fruit by fungal infection, wound, and JA. The induction of PepTLP expression by wound is differentially regulated via phosphorylation and dephosphorylation step during pre- and post-ripening, respectively. In addition, the induction of PepTLP expression in the ripe fruit by wound and JA is differentially regulated via dephosphorylation and phosphorylation step, respectively. Only both wound and JA treatment has synergistic effect on the PepTLP expression in the unripe fruit. Both SA and JA treatments on the unripe fruit, and both wound or JA and SA on the ripe fruit could not do any effect on the expression of PepTLP. These results suggest that the induction of PepTLP expression is differentially regulated via complex regulatory system against fungal infection, wound, and JA treatment during pre- and post-ripening of pepper fruit.

Critical Pathway for Spinal Stenosis Patients (척추관 협착증 환자 진료 프로세스 개발)

  • Lee, Hwan Mo;Kim, Ho Jung;Kim, Keung Nyun;Ahn, Poong Gi;Chun, Jahae;Shin, Hyun-Ju;Kim, Yang Soo;Shin, Hye Sun;Kim, In Sook;Chung, Hye Kyung;Kim, Young Ah;Chae, Hyung Ki;Park, In Young
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.83-86
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    • 2009
  • 연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

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Long non-coding RNA T-cell leukemia/lymphoma 6 serves as a sponge for miR-21 modulating the cell proliferation of retinoblastoma through PTEN

  • Tao, Sisi;Wang, Weidong;Liu, Pengfei;Wang, Hua;Chen, Weirong
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.6
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    • pp.449-458
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    • 2019
  • Retinoblastoma (Rb) is one of the most common eye malignancies occur in childhood. The crucial roles of non-coding RNAs, particularly long non-coding RNAs (lncRNAs) and microRNAs (miRNAs), have been widely reported in Rb progression. In the present study, we found the expression of lncRNA T-cell leukemia/lymphoma 6 (TCL6) was significantly downregulated in Rb tissues and cell lines. Knockdown of lncRNA TCL6 promoted cell proliferation while reduced cell apoptosis in Rb cells. Moreover, lncRNA TCL6 serves as a sponge for miR-21, a previously-reported oncogenic miRNA in Rb, by direct targeting to negatively regulated miR-21 expression, therefore modulating Rb proliferation through miR-21. TCL6 overexpression inhibited Rb cell proliferation while miR-21 overexpression exerted an opposing effect; the effect of TCL6 overexpression was partially attenuated by miR-21 overexpression. PTEN/PI3K/AKT signaling pathway was involved in lncRNA TCL6/miR-21 axis modulating Rb cell proliferation. Taken together, lncRNA TCL6 serves as a tumor suppressor by acting as a sponge for miR-21 to counteract miR-21-mediated PTEN repression.

Awareness and Impact of COPD in Korea: An Epidemiologic Insight Survey

  • Hwang, Yong-Il;Kwon, O-Jung;Kim, Young-Whan;Kim, Young-Sam;Park, Yong-Bum;Lee, Myung-Goo;Kim, Dong-Gyu;Jang, Seung-Hun;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.400-407
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    • 2011
  • Background: There were a few studies which were conducted to know about the behavior of the chronic obstructive pulmonary diseases (COPD) patients. The aims of this study was to explore the behaviour of COPD patients, such as awareness and impact of disease, the pathway of visiting doctors, and the treatment pattern and preference. Methods: A face-to-face interview of 300 subjects with COPD was conducted. Results: The most concerned symptom which made the respondents to visit the hospital was 'breathlessness' (78%). Only 58% of them knew the exact diagnosis. Seventy-three percent of them visited the hospital 'once a month' or 'once every 2 month'. They have made 12.8 prescheduled visits to the hospital in the past 1 year. Unscheduled visits and hospital stay figured to two in the past year. Only 11% of respondents felt they were currently in good health. 'Severe' and 'very severe' COPD patients perceived their health to be in a worse condition than 'mild' and 'moderate' COPD patients. When conditions worsened, 42% of patients were hospitalized. The most common prescription treatment was a fixed combination of inhaled corticosteroids and long-acting ${\beta}2$ agonists (48%), followed by a long acting anticholinergics (38%). Conclusion: Over forty percent of the patients didn't know exactly about their condition. Most of them had a negative attitude toward their current health status. Doctors need to know more about COPD patients in terms of their attitude toward the disease, impact of the disease, interaction with healthcare professionals and treatment related problems.

Inhibition of PKC Epsilon Attenuates Cigarette Smoke Extract-Induced Apoptosis in Human Lung Fibroblasts (MRC-5 Cells)

  • Kang, Shin-Myung;Yoon, Jin-Young;Kim, Yu-Jin;Lee, Sang-Pyo;Jeong, Sung-Hwan;Park, Jeong-Woong
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.2
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    • pp.88-96
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    • 2011
  • Background: It is known that cigarette smoke (CS) causes cell death. Apoptotic cell death is involved in the pathogenesis of CS-related lung diseases. Some members of the protein kinase C (PKC) family have roles in cigarette smoke extract (CSE)-induced apoptosis. This study was conducted to investigate the role of PKC epsilon in CSE-induced apoptosis in human lung fibroblast cell line, MRC-5. Methods: Lactate dehydrogenase release was measured using a cytotoxicity detection kit. The MTT assay was used to measure cell viability. Western immunoblot, Hoechst 33342 staining and flow cytometry were used to demonstrate the effect of $PKC{\varepsilon}$. Caspase-3 and caspase-8 activities were determined using a colorimetric assay. To examine $PKC{\varepsilon}$ activation, Western blotting was performed using both fractions of membrane and cytosol. Results: We showed that CSE activated $PKC{\varepsilon}$ by demonstrating increased expression of $PKC{\varepsilon}$ in the plasma membrane fraction. Pre-treatment of $PKC{\varepsilon}$ peptide inhibitor attenuated CSE-induced apoptotic cell death, as demonstrated by the MTT assay (13.03% of control, 85.66% of CSE-treatment, and 53.73% of $PKC{\varepsilon}$ peptide inhibitor-pre-treatment, respectively), Hoechst 33342 staining, and flow cytometry (85.64% of CSE-treatment, 53.73% of $PKC{\varepsilon}$ peptide inhibitor-pre-treatment). Pre-treatment of $PKC{\varepsilon}$ peptide inhibitor reduced caspase-3 expression and attenuated caspase-3, caspase-8 activity compared with CSE treatment alone. Conclusion: $PKC{\varepsilon}$ seem to have pro-apoptotic function and exerts its function through the extrinsic apoptotic pathway in CSE-exposed MRC-5 cells. This study suggests that $PKC{\varepsilon}$ inhibition may be a therapeutic strategy in CS-related lung disease such as chronic obstructive pulmonary disease.

Impairment of Mitochondrial ATP Synthesis Induces RIPK3-dependent Necroptosis in Lung Epithelial Cells During Lung Injury by Lung Inflammation

  • Su Hwan Lee;Ju Hye Shin;Min Woo Park;Junhyung Kim;Kyung Soo Chung;Sungwon Na;Ji-Hwan Ryu;Jin Hwa Lee;Moo Suk Park;Young Sam Kim;Jong-Seok Moon
    • IMMUNE NETWORK
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    • v.22 no.2
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    • pp.18.1-18.15
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    • 2022
  • Dysfunction of mitochondrial metabolism is implicated in cellular injury and cell death. While mitochondrial dysfunction is associated with lung injury by lung inflammation, the mechanism by which the impairment of mitochondrial ATP synthesis regulates necroptosis during acute lung injury (ALI) by lung inflammation is unclear. Here, we showed that the impairment of mitochondrial ATP synthesis induces receptor interacting serine/threonine kinase 3 (RIPK3)-dependent necroptosis during lung injury by lung inflammation. We found that the impairment of mitochondrial ATP synthesis by oligomycin, an inhibitor of ATP synthase, resulted in increased lung injury and RIPK3 levels in lung tissues during lung inflammation by LPS in mice. The elevated RIPK3 and RIPK3 phosphorylation levels by oligomycin resulted in high mixed lineage kinase domain-like (MLKL) phosphorylation, the terminal molecule in necroptotic cell death pathway, in lung epithelial cells during lung inflammation. Moreover, the levels of protein in bronchoalveolar lavage fluid (BALF) were increased by the activation of necroptosis via oligomycin during lung inflammation. Furthermore, the levels of ATP5A, a catalytic subunit of the mitochondrial ATP synthase complex for ATP synthesis, were reduced in lung epithelial cells of lung tissues from patients with acute respiratory distress syndrome (ARDS), the most severe form of ALI. The levels of RIPK3, RIPK3 phosphorylation and MLKL phosphorylation were elevated in lung epithelial cells in patients with ARDS. Our results suggest that the impairment of mitochondrial ATP synthesis induces RIPK3-dependent necroptosis in lung epithelial cells during lung injury by lung inflammation.

Decision-tree Model of Treatment-seeking Behaviors after Detecting Symptoms by Korean Stroke Patients

  • Oh Hyo-Sook;Park Hyeoun-Ae
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.662-670
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    • 2006
  • Purpose. This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. Methods. The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Results. Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. Conclusions. The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.