• Title/Summary/Keyword: Clinical Practice Stress

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Coenzyme Q10: a progress towards the treatment of neurodegenerative disease

  • Kumar, Peeyush;Kumar, Pramod;Ram, Alpana;Kuma, Mithilesh;Kumar, Rajeev
    • Advances in Traditional Medicine
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    • v.10 no.4
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    • pp.239-253
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    • 2010
  • Coenzyme $Q_{10}$ ($CoQ_{10}$, or ubiquinone) is an electron carrier of the mitochondrial respiratory chain (electron transport chain) with antioxidant properties. In view of the involvement of $CoQ_{10}$ in oxidative phosphorylation and cellular antioxidant protection a deficiency in this quinone would be expected to contribute to disease pathophysiology by causing a failure in energy metabolism and antioxidant status. Indeed, a deficit in $CoQ_{10}$ status has been determined in a number of neuromuscular and neurodegenerative disorders. Primary disorders of $CoQ_{10}$ biosynthesis are potentially treatable conditions and therefore a high degree of clinical awareness about this condition is essential. A secondary loss of $CoQ_{10}$ status following HMG-CoA reductase inhibitor (statins) treatment has been implicated in the pathophysiology of the myotoxicity associated with this pharmacotherapy. $CoQ_{10}$ and its analogue, idebenone, have been widely used in the treatment of neurodegenerative and neuromuscular disorders. These compounds could potentially play a role in the treatment of mitochondrial disorders, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Friedreich's ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of $CoQ_{10}$, as well as the rationale and the role in clinical practice of $CoQ_{10}$ supplementation in different neurological diseases, from primary $CoQ_{10}$ deficiency to neurodegenerative disorders. These will help in future for treatment of patients suffering from neurodegenerative disease.

Memory of Pain and Preemptive Analgesia (통증의 기억과 선행진통)

  • Song, Sun-Ok
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.12-20
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    • 2000
  • The memory of pain can be more damaging than its initial experience. Several factors arc related the directions of pain memory: current pain intensity, emotion, expectation of pain, and peak intensity of previous pain. The possible mechanisms behind the memory of pain are neuroplastic changes of nervous system via peripheral and central sensitization. Peripheral sensitization is induced by neurohumoral alterations at the site of injury and nearby. Biochemicals such as K+, prostaglandins, bradykinin, substance P, histamine and serotonin, increase transduction and produce continuous nociceptive input. Central sensitization takes place within the dorsal horn of spinal cord and amplifies the nociceptive input from the periphery. The mechanisms of central sensitization involve a variety of transmitters and postsynaptic mechanisms resulting from the activations of NMDA receptors by glutamate. and activation of NK-1 tachykinnin receptors by substance-P and neurokinnin. The clinical result of peripheral and central sensitization is hyperalgesia, allodynia, spontaneous pain, referred pain, or sympathetically maintained pain. These persistent sensory responses to noxious stimuli arc a form of memory. The hypothesis of preemptive analgesia is that analgesia administered before the painful stimulus will prevent or reduce subsequent pain and analgesic requirements in comparison to the identical analgesic intervention administered after the painful stimulus, by preventing or reducing the memory of pain in the nervous system. Conventionally, pain management was initiated following noxious stimuli such as surgery. More recently, however many have endorsed preemptive analgesia initiated before surgery. Treatments to control postsurgical pain are often best started before injury activates peripheral nociceptors and triggers central sensitization. Such preemption is not achieved solely by regional anesthesia and drug therapy but also requires behavioral interventions to decrease anxiety or stress. Although the benefit of preemptive analgesia may not be obvious in every circumstance, and in many cases may not sufficient to abolish central sensitization, it is an appropriate and human goal of clinical practice.

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A literature study on the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer (암환자의 성정(性情)과 심욕(心慾) 조절 방법에 대한 문헌적 고찰)

  • Jeon, Hyeonjin;Oh, Hyun-Joo;Lee, Sookyung
    • Journal of Sasang Constitutional Medicine
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    • v.30 no.4
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    • pp.11-21
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    • 2018
  • Objective The management of psychological distress in patients with cancer is a major concern in clinical practice. In this paper, we discussed how to apply the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine to patients with cancer. Methods We investigated the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) through the literature of " Gyukchigo (格致藁)", "Donguisusebowon-Sasangchobongyun (東醫壽世保元 四象草本卷)", "Donguisusebowon (東醫壽世保元) and "Dongmuyougo (東武遺稿)", and presented the controlling methods of Seong-Jeong (性情) and covetous desire (心慾) for patients with cancer based on the clinical experience. Results We identified the equilibrium and harmony (中節) of sorrow-anger-joy-pleasure (喜怒哀樂) is the basis of treatment and suggested 'understanding of the others (知人)', 'understanding of the diseases (知病)' and 'knowing and acting (知行)' as methods to control of Seong-Jeong (性情) and covetous desire (心慾). The 'understanding of the others (知人)' and 'understanding of the diseases (知病)' could reduce the psychological distress. The 'knowing and acting (知行)' encourages the patients to overcome the covetous desire (心慾) and have a positive attitude to life and disease. Conclusion The controlling method of Seong-Jeong (性情) and covetous desire (心慾) of Sasang constitutional medicine could help cancer treatment controlling the psychological distress of patients with cancer, and could impact positively on the view of life and disease.

Safety and antifatigue effect of Korean Red Ginseng capsule: A randomized, double-blind and placebo-controlled clinical trial

  • Yang, Yi;Wang, Hong;Zhang, Ming;Shi, Mengxue;Yang, Cailing;Ni, Qiang;Wang, Qi;Li, Jing;Wang, Xuemei;Zhang, Chen;Li, Zhi
    • Journal of Ginseng Research
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    • v.46 no.4
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    • pp.543-549
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    • 2022
  • Background: In physical activity or labor, the human body is in a state of high intensity stress, and all parts or physiological functions of the body respond positively to maintain or balance the need for movement. The human body has many physiological changes in the process of movement, and fatigue is the external manifestation of various complex changes inside the human body. Fatigue is also a physiological mechanism of self-protection after the body reaches a certain level of activity, which can prevent the occurrence of life-threatening excessive functional failure. The generation of fatigue is a very complex process, and its mechanism has not been concluded yet. Therefore, it is an important work to search and screen the effective components of natural plants that have anti-fatigue effect and to explore their mechanism. Methods: This was a 8-week, randomized, double-blind, placebo-controlled clinical trial. A total of 110 subjects who passed physical examination were included according to the scheme design, and randomly divided into a test group which was given KRG and a placebo control group. The calculation is carried out according to the standard of sub-high-intensity exercise test. Results: There was no adverse effect on safety index of subjects after taking red ginseng capsule. After KRG treatment, subjective strength grade is significant lower than placebo treatment. Blood lactic acid content is significantly get lower after trial in KRG group, and significant lower than placebo group. Creatine phosphokinase(CK) content is significantly get lower after trial in KRG group, and significant lower than placebo group. Conclusion: According to the criterion in the test scheme, the result shows that KRG is helpful on relieving physical fatigue.

Factors influencing the transition shock of newly-graduated nurses (신규졸업간호사의 전환충격 영향요인)

  • Moon, Kil Je;Cho, Moo Yong
    • The Journal of Korean Academic Society of Nursing Education
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    • v.28 no.2
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    • pp.156-166
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    • 2022
  • Purpose: The purpose of this study was to identify factors that can affect transition shock in newly-graduated nurses. Methods: The first descriptive written survey was conducted on 450 graduate students from five nursing colleges. After their employment, the second survey was conducted on 316 participants who had responded to the first survey. A total of 158 respondents were used for the final analysis. Data were analyzed using an independent t-test, ANOVA, Tukey test, Pearson's correlation coefficient, and hierarchical multiple regression analysis with the SPSS Win 25.0 Program. Results: The average age of the participants was 24.25±4.47. Of the participants, 126 (79.8%) were satisfied that they had majored in nursing. The average score for transition shock was 2.61±0.55 points. Factors influencing the transition shock of newly-graduated nurses were the working department, working period, and working environment. The more positively the newly-graduated nurses perceived the nursing work environment, the less of a transition shock they experienced. Grade point average, clinical competence, confidence in performing core nursing skills, and nursing professionalism did not affect their transition shock. It could be confirmed that there is a gap between college nursing education and the clinical field. Conclusion: In order to reduce the transition shock of newly-graduated nurses, it is necessary to improve the nursing work environment and apply educational and emotional support strategies according to the characteristics of each work department and the period of work.

Review of Indicators and Tools used to Assess Korean Medicine Infertility Treatment (한의 난임 치료에 활용되는 평가지표와 평가도구 사용 현황 조사 및 고찰)

  • Soo-Jin Lee;Dong-Il Kim;Su-Ji Choi
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.3
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    • pp.173-195
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    • 2023
  • Objectives: To investigate and analyze the assessment indicators and tools used in clinical practice to assess Korean medicine (KM) treatment for infertility, and to establish a basis for assessment tools to diagnose and assess infertility. Methods: Relevant studies published until March 2023 were extracted from Pubmed, Research Information Sharing Service, and National Digital Science Library databases. Results: Sixty-four studies comprising 4,105 patients were included. We investigated pregnancy outcomes, and assessed pregnancy- and childbirth-related factors, overall health, reproductive health, and mental health. Pregnancy result was most common primary outcome. Ongoing pregnancy, stillbirth, miscarriage, and ectopic pregnancy rates were suggested as indicators of pregnancy and childbirth-related assessment. Overall health was most commonly assessed with Likert and Visual analogue scale (VAS). Among reproductive health variables, menstrual history was most frequently assessed. Moreover, indicators such as reproductive function, sexual intercourse, and gynecological disease were assessed. The Infertility Stress Scale and the Fertility Quality of Life tool (FertiQoL) were used to assess mental health. Conclusions: Subjective scales and objective assessment tools, such as the Likert scale and blood tests/ultrasonography, respectively, are used to assess KM infertility treatment. Inconsistent assessment tools make quantitative analyses more challenging. The development of a standardized mental and physical function assessment questionnaire with confirmed reliability and validity ensure the effectiveness of KM infertility treatment, and promote future studies on infertility treatment.

A Predictive Model of Health Promotion Behavior in Nursing Students (간호대학생의 건강증진행위 예측모형)

  • Oh, Jae-Woo;Moon, Young-Sook
    • Journal of Digital Convergence
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    • v.12 no.10
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    • pp.391-403
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    • 2014
  • This study seeks to carry out a literary review of preceding studies and the health improvement model of Pender(1987) on university students majoring in nursing to explain the health improvement behaviors and identify the factors that affect their activities to provide a framework for developing a more effective nursing mediation method that promotes health improvement behaviors. The study subjects were 204 university students majoring in nursing who have had clinical practice experience. The period for data collection was from April 1to May 30, 2014 and a total of 204 copies of the questionnaire were used for analysis. For the collected data, frequency analysis, percentage, ANOVA, t-test and correlation analysis were conducted using SPSS, LISREL, and path analyss was done for hypothesis testing. The overall index of hypothesis model showed a good congruence as ${\chi}^2=.06$(p=.812), df=1, ${\chi}^2(df)=.000$, GFI=0.97, AGFI=1.0, SRMR=.002, NFI=0.947, NNFI=0.957, RMSEA=0.016, CN=266. Looking at the verification of the hypothesis presented in the model, the variables that affect health improvement behaviors were perceived disability, perceived self-efficacy, perceived social support, while stress from clinical practice, perceived health status, persistence and perceived benefits did not affect health improvement behaviors.

Validity and Reliability of the Korean Version of the Global Assessment of Recent Stress Scale (전반적인 스트레스평가 척도 한국판의 타당도 및 신뢰도)

  • Koh, Kyung-Bong;Park, Joong-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.8 no.2
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    • pp.201-211
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    • 2000
  • Objectives : The purpose of this study was to determine the validity and reliablity of the Korean version of the Global Assessment of Recent Stress(GARS) Scale developed for assessing the severity of current perceived stressors, and then to use the scale in clinical practice. Methods : The questionnaire was completed by 215 healthy subjects. A comparison was made regarding the perception of stressors among 242 patients(71 with anxiety disorder, 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Factor analysis was done using oblique rotation after maximum-likelihood factor analysis. Results : Factor analysis yielded 1 subscale. Reliability was computed by administering the GARS Scale to 69 healthy subjects during a 2-week interval. Test-retest reliability for 8 items and the total score was significantly high, ranging between 0.85-.95. Internal consistency was significant(Cronbach's a for 7 items : .86). Convergent validity was computed by correlating the 8 items and the total score with the total score of the stress response inventory(SRI), the perceived stress questionnaire(PSQ), and the somatization, anxiety, depression, hostility subscales and general indices of the symptom checklist-90-revised(SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the 8 item scores of the patient and control groups. Significant differences were found in area relevant to sickness or illness and the overill global area. The patients with anxiety disorder were significantly higher in area relevant to sickness or illness than the healthy group, whereas the patients with depressive disorder was significantly higher in the overall global score than healthy group. The depressive disorder group was the highest in overall global score of the GARS scale among 4 patient groups, and showed a significant higher scores in interpersonal relationship and overall global area than the psychosomatic disorder group. Conclusions : These results indicate that the Korean version of the GARS scale is highly reliable and valid, and that it can be utilized as an effective measure of perceived stressors for research in stress-related fields. It is suggested that depressive disorder patients are more likely to perceive recent stressors than psychosomatic disorder patients.

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Neurobiological Factors of Suicide (자살의 신경생물학적 요인)

  • Song, Hoo Rim;Woo, Young Sup;Jun, Tae Youn
    • Mood & Emotion
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    • v.10 no.1
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    • pp.13-21
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    • 2012
  • Suicide is a complex behavior associated with various neurobiological and psychosocial factors. It is considered that genetic polymorphism combined with environmental stress such as child-adolescent trauma make differences in neurobiological systems, which cause psychiatric disorders or pessimistic personality, impulse-aggressive behaviors, lack of judgment, and finally result in suicidal behavior. Much progress in the neurobiology of suicide has been made over the several decades. There seems to be a hereditary disposition to suicide independent of psychiatric disorder. The changes in neurotransmitters, neurohormones, neurotrophic factors, cytokines, lipid metabolisms related with their genetic polymorphism can contribute to disturbance of signal transductions and neuronal circuits vulnerable to suicide. It is likely that the main factors are dysfunctions of serotonin (5-HT) and hypothalamus-pituitary-adrenal (HPA) axis. Our understanding about the neurobiology of suicide is still limited. However, clinical practice could be assisted by neurobiological findings capable of making the detection of risk populations with higher sensitivity and the development of new treatment interventions. The settlement of biological markers in suicidal behaviors and their relationships is required.

Development of the Anger Response Scale and its Application in Clinical Practice (분노반응척도의 개발과 임상적 적용)

  • Koh, Kyung-Bong;Park, Joong-Kyu;Kim, Chan-Hyung;Kim, Do-Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.2
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    • pp.122-134
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    • 2004
  • Objective : The purpose of this study was to develop the Anger Response Scale(ARS), and then to use the scale in clinical practice. Methods First, a preliminary survey was conducted for 123 healthy adults to obtain 16 response items. Second, a preliminary questionnaire was completed by 258 healthy subjects. Third, a comparison was made regarding anger responses among 189 patients(59 with anxiety disorder, 72 with depressive disorder and 58 with somatoform disorder) and 258 healthy subjects. Results : Factor analysis yielded 4 subscales : aggression, irritability, avoidance and anger suppression. Reliability was computed by administering the ARS to 53 healthy subjects during a 2-week interval. Test-retest reliability for 4 subscales and the total score was significantly high, ranging between .53-.71. Cronbach's ${\alpha}$ for 4 subscales ranged between .62-.72, and .76 for the total score. Convergent validity was computed by correlating the 4 subscales and the total score with the total score of Aggression Questionnaire, State-Trait Anger Expression Inventory, anger and aggression subscale of Stress Response Inventory and hostility subscale of Symptom Checklist-90-Revised. The disorder group was significantly higher than normal group in scores of the avoidance and anger suppression subacale. The depressive disorder and somatoform disorder groups scored significantly higher on the avoidance subscale than the normal group. Conclusion : These results indicate that the ARS is highly reliable and valid. In addition, avoidance response is likely to be a characteristic anger response of the depressive disorder and somatoform disorder groups.

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