• Perspectives in Nursing Science
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• v.3 no.1
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• pp.35-45
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• 2006

In Korea, about 8.3% over aged 65 are suffering from Alzheimer's disease or other type of dementia. Among dementia-related behaviors, wandering is the one of strongest factors on burden and stress of caregivers. On Lee and Kwon's report with community living persons with dementia, upto 85% of caregivers reported wandering as a problem. Wandering is a frequently encountered problem in communities and long-term care facilities, but it is among least understood dementia. related behavior. Despite the prevalence of wandering, its significant adverse outcomes, and the increase in persons with dementia in Korea, no systematic research has been conducted in Korea. The purpose of this study is to review on literature related to wandering behavior among persons with dementia. The specific topics related to wandering are included: definition, the prevalence of dementia and wandering behavior, the influencing factor on wandering, outcomes of wandering behavior, and the measurement method. Wandering is defined as "aimless walking" and "Meandering, aimless or repetitive locomotion that exposes one to harm and is incongruent with boundaries, limits, or obstacles". Wandering is viewed as a problematic behavior, however, it has to be understood as need-driven compromised behavior. For example, wandering may be an expression of searching for familiar person and/or place. Recently, in Korea, there is an effort for establishing the therapeutic environment for elders who are wanderers in long-term-care facilities. Cognitive impairment of persons with dementia is found to be a consistent factor on wandering behavior through many national and international studies. The adverse outcomes of wandering are serious problem in persons with dementia as well as their caregivers. The adverse outcomes include falls, fractures, getting lost, use of restraints, or even death. In fact, wandering is one of the major reasons for a patient to be institutionalized. For measurement of wandering behavior, two methods are broadly used: observation using stop watch, and survey form. A revised instrument of the Korean version of Algase wandering scale (K_RAWS) is established the psychometric properties (Son, Song, & Lim, 2006) demonstrating valid and reliable instrument in measuring wandering behavior among persons with dementia who are residing in communities. K_RAWS has a 39 items with six subscales including persistent walking, repetitive walking, spatial disorientation, eloping behavior, negative outcome, and mealtime impulsivity. In conclusion, studies including the prevalence of wandering behavior and predictive factors on wandering should be conducted to understand wandering clearly before developing any types of intervention.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.15-32
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• 1996

The clinical practice program for home care nurses was implemented in June 1994, to help to set up a hospital-based home care system in the Kwangju City area as a collaborative work between the Department of Orthopedic Surgery at Chunnam University Hospital and Chunnam University School of Nursing. Under the developed clinical practice strategy, the eight week training was given to five licensed home care nurses who had completed Part I and II of the home health care nursing practicum from June 1994. The purpose of this descriptive evaluation study was to identify the effectiveness of the clinical practice program for home care nurses specialized in the area of patient care for people with musculoskeletal function impairment. As a method in data analysis, data triangulation was used in the five home care nurse case evaluations. The variety of data analyzed include confidence score by home care nurse self-evaluation, patient and family member satisfaction scores, and competency score by preceptor evaluation. The study findings revealed that an increase rate in nursing performance didrate necessarily coincide with an increase not in competency score and also, not with the patient /family member satisfaction scores. And an order derived from the clinical performance scores of five home care nurses corresponded to those from three measurements-competency score, patient satisfaction score, and family member satisfaction score. However, it differed from the order associated with the confidence score. Consistency derived from the three objective evaluation methods may lead to the possibility that the level of competency measured by educator can be further explained by the levels of patient/family member satisfaction. The salient finding of this study was that, in case of nurse A who have had little clinical experience in the orthopedic patient care, there was a significant increase in the level of confidence and competency in subscale of professional skill with the home care clinical practice. Therefore, the effect of the clinical practice program would be successful for nurses who have had little experience in the area of specialization. The study results suggest that there might be some time difference in the development of cognitive sense (confidence) in performance and actual clinical performance (competency). In future research, relationships between the confidence and competency score, and between the confidence score and the patient satisfaction score should to be measured in different time frame to achieve a better explanation power of the study outcome.

• Journal of Genetic Medicine
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• v.5 no.1
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• pp.41-46
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• 2008

Purpose : Fragile X syndrome (FXS) is the most common heritable cause of cognitive impairment. FXS is caused by hyperexpansion and hypermethylation of a polymorphic CGG trinucleotide repeat in the 5' untranslated region of the fragile X mental retadation-1(FMR1) gene. Combination of Southern blotting and simple polymerase chain reaction(PCR) amplification of the FMR1 repeat region is commonly used for diagnosis in females. To give a definite diagnosis in a female child suspected of having FXS, we carried out the molecular diagnostic test for FXS using the recently developed Abbott Molecular Fragile X PCR Kit. Methods : The PCR amplification of the FMR1 repeat region was performed using the Abbott Mdecular Fragile X PCR Kit. The amplified products were analyzed by size-separate analysis on 1.5% agarose gels and by DNA fragment analysis using Gene scan. Results : Agarose gel and Gene scan analyses of PCR products of the FMR1 repeat region showed that the patient had two heterozygous alleles with a normal 30 repeats and full mutation of >200 repeats whereas her mother had two heterozygous alleles with the normal 30 repeats and premutation of 108 repeats, suggesting that the premutation of 108 repeats in her mother may have led to the full mutation of >200 repeats in the patient. Conclusion : We diagnosed FXS in a female patient using a simplified molecular diagnostic test. This commercially available diagnostic test for FXS, based on PCR, may be a suitable alternative or complement method to Southern blot analysis and PCR analysis and/or methylation specific(MS)-PCR analysis for the molecular diagnosis of FXS in both males and females.

• Therapeutic Science for Rehabilitation
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• v.4 no.2
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• pp.7-15
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• 2015

Objectives : The aim of this study was to assess the clinical effect of exercise program used for treatment of activity of daily living skill in patients with dementia. Methods : We searched foreign studies registered from 2007 to 2014 based on PubMed database, using the following search terms : dementia, alzheimer disease, cognitive impairment, exercise program, physical activity, activity of daily living, ADL. Total 5 studies included from 215 studies after analysis papers. Results : selected paper's average pedro score was 6, Katz index of ADLs, Bathel ADL index, IADL activity of daily living assessment tool were used. there was significant improves of activity of daily living skill in the use of exercise program groups and it prevent decreased of activity of daily living skill. Conclusion : This study provide evidence of exercise program applied in clinical use and demonstrate effective on activity of daily living ability. This results expected to help suggesting basic data for exercise program to improve activity of daily living ability and making effective treatment approach method in the future.

• Journal of the Institute of Electronics and Information Engineers
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• v.50 no.10
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• pp.207-216
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• 2013

The aim of this study is to design a classifier for sleep stage analysis and select important feature set which shows sleep stage well based on physiological signals during sleep. Sleep has a significant effect on the quality of human life. When people undergo lack of sleep or sleep-related disease, they are likely to reduced concentration and cognitive impairment affects, etc. Therefore, there are a lot of research to analyze sleep stage. In this study, after acquisition physiological signals during sleep, we do pre-processing such as filtering for extracting features. The features are used input for the new combination algorithm using genetic algorithm(GA) and neural networks(NN). The algorithm selects features which have high weights to classify sleep stage. As the result of this study, accuracy of the algorithm is up to 90.26% with electroencephalography(EEG) signal and electrocardiography(ECG) signal, and selecting features are alpha and delta frequency band power of EEG signal and standard deviation of all normal RR intervals(SDNN) of ECG signal. We checked the selected features are well shown that they have important information to classify sleep stage as doing repeating the algorithm. This research could use for not only diagnose disease related to sleep but also make a guideline of sleep stage analysis.

• Journal of Ginseng Research
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• v.32 no.4
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• pp.341-346
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• 2008

In the present study, we assessed the effects of white ginseng and red ginseng extract on the learning and memory impairments induced by scopolamine. The cognition-enhancing effect of ginseng extracts was investigated using the Morris water maze and Y-maze test. Drug-induced amnesia was induced by treating animals with scopolamine (2 mg/kg, i.p.), an antagonist of muscarinic acetylcholine (ACh) receptor. Tacrine was used a positive control. Ginseng extract (200 mg/kg, p.o.), tacrine (10 mg/kg, p.o.) administration significantly reduced the escape latency during training in the Morris water maze (p<0.05). At the probe trial session, scopolamine significantly increased the escape latency on day 5 in comparison with control (p<0.01). The effect of ginseng extracts on spontaneous alternation in Y-maze was similar to that of scopolamine treated group. In addition, numbers of arm entries were similar in all experimental groups. Moreover, red ginseng extract significantly inhibited acetylcholinesterase activity in the cortex and serum (p<0.05). Brain ACh contents of ginseng extract treated groups increased more than that of scopolamine group, which did not show statistically significant. These results suggest that ginseng extract may be useful for the treatment of cognitive impairment.

• Journal of Families and Better Life
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• v.25 no.1 s.85
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• pp.127-144
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• 2007

This study was conducted for the purpose of analyzing volunteer workers' perceptions of and attitudes toward the behavior problems of the elderly residents after caring for the residents voluntarily at low-income nursing homes. Eleven male and female volunteers ranging from age 19 to 52 were asked how they felt about the elderly residents' behavior problems and what kind of behavioral problems they had experienced after doing volunteer works in the three chosen facilities. In particular, they were expected to explain what emotional changes they experienced during their volunteer service. In this study, it was observed that most of the elderly subjects experienced three categories of behavior problems: habitual, repetitious and unreasonable activities caused by the elderly residents' life span backgrounds, unexpected and/or abrupt behaviors resulting from gradual cognitive impairments, and physiological, awkward activities caused from gradual senility. The volunteers tend to believe that the elderly residents are naturally expected to act positively, since they have been provided with well- planned, regular care services such as bathing, counseling, activity programs, and religious guidances. On the other hand, some respondents stated that their experiences at the nursing homes caused them to form negative images of the elderly; they feel that the elderly are not helpful for giving advices on critical decisions, guiding and encouraging their daily lives, and offering any positive influences toward their own lives. Rather, they find themselves getting too much stressed as a result of their intimate contacts with demented or senile residents. Overall, in this study, it is proposed that education for confronting sudden abrupt behavior problems should be intensified more for female volunteers, since they tend to be more susceptible to emotional harassment resulting from the problem behaviors. It is also proposed that young volunteers who have not been systematically trained for confronting aggressive behaviors need to be separately assigned their roles in order to minimize the potential of confronting unseemly situations resulting from male residents whose mental health has deteriorated. Furthermore, it is also suggested that the combination of leisure-related activities for healthy residents and stressful intimate services for the frail residents be systematically planned and implanted for the volunteer program so that the volunteers can lessen the chances of suddenly finding themselves confronted with extremely abrupt agitations.

• The Journal of Korean Medicine
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• v.26 no.3 s.63
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• pp.27-42
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• 2005

Objectives : Alzheimer's disease (AD) is a progressive and fatal neurodegenerative disease characterized by amyloid plaques and neurofibrillary tangles. These plaques are associated with degenerating neuronal processes and consist primarily of fibrillary aggregates of beta-amyloid$ protein, generated from amyloid precursor protein (APP). Another amyloidogenic fragment, the carboxyl terminus (CT) of APP, which is composed of 99-105 amino acid residues containing the complete $A{\beta}$ sequence, also appears to be toxic to neurones. Recent evidence suggest that CT105, carboxy terminal 105 amino acids peptide fragment of APP, may be an important factor causing neurotoxicity in AD. Methods : Although a variety of oriental prescriptions including Pinelliae rhizoma have traditionally been utilized for the treatment of AD, their pharmacological effects and action mechanisms have not yet been fully elucidated. In the present study, we investigated effects of the dichloromethane extract of Pinelliae rhizoma (PINR) on neurotoxicity and the formation of reactive oxygen species (ROS) and nitric oxide (NO) in SK-N-SH cells overexpressed with CT105. In addition, we evaluated its radical scavenging activity and effects on acetylcholinesterase (AChE) activity. Furthermore, effects on cognitive deficits induced by scopolamine treatment in rats were evaluated. Results ; We found in this study that PINR significantly inhibited apoptotic neuronal death induced by CT105 overexpression in SK-N-SH cells. Based on morphological examinations by phase-contrast microscopy, PINR reversed apoptotic changes of CT105-expressed cells. It was also found that PINR significantly promoted neurite outgrowth and inhibited formation of ROS nd NO. PINR was shown to scavenge DPPH radicals and noncompetitively inhibit AChE activity. Furthermore, it reduced scopolamine-induced memory impairment in rata, assessed by passive avoidance test. Conclusions : Taken together, these results demonstrate that PINR exhibits neuroprotective, antioxidant, and memory enhancing effects, and therefore may bs beneficial for the treatment of AD.

• KIPS Transactions on Software and Data Engineering
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• v.9 no.4
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• pp.137-144
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• 2020

Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.3
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• pp.185-193
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• 2015

The purpose of this study was to demonstrate clinical effects on cognition, visual perception, depression, anxiety, and activities of daily living by applying the N-BACK program, a brain stimulated training program, which is used for the clinical purpose. To prove this, subjects suspected of cognitive impairment with 18-23 points in a Korean version of mental status examination (MMSE-K) were recruited among the population who had been diagnosed with stroke duration and suffered from it for six months of duration, and 10 of the subjects were selected into the experimental group and the control group, respectively. A total of 20 sessions were carried out for 30 minutes per day 5 times for 4 weeks. As a result, the experimental group who has been applied the N-BACK program showed positive results in the improvement of cognition, visual perception, depression, anxiety, and daily living skills. The results obtained from this study expect us that applying the N-BACK program for the improvement of cognition, visual perception, depression, and anxiety to stroke patients has a positive effect on the rehabilitation of patients and will lead them to improve daily living activities more independently.