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Ethnography of Caring Experience for the Senile Dementia (노인성 치매 환자의 돌봄경험에 대한 문화기술지)

  • 김귀분;이경희
    • Journal of Korean Academy of Nursing
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    • v.28 no.4
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    • pp.1047-1059
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    • 1998
  • Senile Dementia is one of the dispositional mental disorder which has been known to the world since Hippocratic age. It has become a wide-spread social problem all over the world because of chronic disease processes and the demands of dependent care for several years as well as improbability of treatment of it at the causal level. Essentially, life styles of the older generation differ from those of the younger generation. While the fomer is used to the patriarchal system and the spirit of filial piet and respect, the latter is pragmatized and individualized under the effects of the Western material civilization. These differences between the two generations cause conflict between family members. In particular, the pain and conflict of care-givers who take care of a totally dependent dementia patient not only is inciting to the collapse of the family union, but is expanding into a serious social problem. According to this practical difficulty, this study has tried to compare dementia care-givers' experiences inter-culturally and to help set up more proper nursing interventions, describing and explaining them through ethnographies by participant observation and in-depth interviews that enable seeing them in a more close, honest and certain way. It also tries to provide a theoetical model of nusing care for dementia patients which is proper to Korean culture. This study is composed of 12 participants (4 males, 8 females) whose ages range from 37-71 years. The relations of patients are 5 spouses(3 husbands, 2 wives), 4 daughters-in-law, 2 daughters, and 1 son-in-law. The following are the care-givers' meaning of experiences that results of the study shows. The first is "psychological conflict". It contains the minds of getting angry, reproaching, being driven to dispair, blaming oneself, giving up lives, and being afraid, hopeless, and resigned. The second is "physical, social and psychological pressure" . At this stage, care-givers are shown to be under stress of both body and soul for the lack of freedom and tiredness. They also feel constraint because they hardly cope with the care and live through others' eyes. The third is "isolation". It makes the relationship of patient care-giver to be estranged, without understanding each other. They, also, experience indifference such as being upset and left alone. The forth is "acceptance" They gradually have compassion, bear up and then adapt themselves to the circumstances they are in. The fifth is "love". Now they learn to reward the other with love. It is also shown that this stage contains the process of winning others' recognition. The final is "hope". In this stage they really want situations to go smoothly and hope everything will be O.K. These consequences enable us to summarize the principles of cue experience such as, in the early stage, negative response such as physical·psychological confusion, pain and conflict are primary. Then the stage of acceptance emerges. It is an initial positive response phase when care-givers may admit their situations. As time passes by a positive response stage emerges. At last they have love and hope. Three stages we noted above : however, there are never consistent situations. Rather it gradually comes into the stage of acceptance, repeating continuous conflict, pressure and isolation. If any interest and understanding of families or the support of surrounding society lack, it will again be converted to negative responses sooner or later. Otherwise, positive responses like hope and love can be encouraged if the family and the surroundings give active aids and understanding. After all, the principles of dementia care experiences neither stay at any stage, nor develop from negative stages to positive stages steadily. They are cycling systems in which negative responses and positive responses are constantly being converted. I would like to suggest the following based on the above conclusions : First, the systematic and planned education of dementia should be performed in order to enhance public relations. Second, a special medical treatment center which deals with dementia, under government's charge, should be managed. Third, the various studies approaching dementia care experiences result in the development of more reasonable and useful nursing guidelines.

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Effect of Trichostatin A on Anti HepG2 Liver Carcinoma Cells: Inhibition of HDAC Activity and Activation of Wnt/β-Catenin Signaling

  • Shi, Qing-Qiang;Zuo, Guo-Wei;Feng, Zi-Qiang;Zhao, Lv-Cui;Luo, Lian;You, Zhi-Mei;Li, Dang-Yang;Xia, Jing;Li, Jing;Chen, Di-Long
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7849-7855
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    • 2014
  • Purpose: To investigate the effect of deacetylase inhibitory trichostatin A (TSA) on anti HepG2 liver carcinoma cells and explore the underlying mechanisms. Materials and Methods: HepG2 cells exposed to different concentrations of TSA for 24, 48, or 72h were examined for cell growth inhibition using CCK8, changes in cell cycle distribution with flow cytometry, cell apoptosis with annexin V-FTIC/PI double staining, and cell morphology changes under an inverted microscope. Expression of ${\beta}$-catenin, HDAC1, HDAC3, H3K9, CyclinD1 and Bax proteins was tested by Western blotting. Gene expression for ${\beta}$-catenin, HDAC1and HDAC3 was tested by q-PCR. ${\beta}$-catenin and H3K9 proteins were also tested by immunofluorescence. Activity of Renilla luciferase (pTCF/LEF-luc) was assessed using the Luciferase Reporter Assay system reagent. The activity of total HDACs was detected with a HDACs colorimetric kit. Results: Exposure to TSA caused significant dose-and time-dependent inhibition of HepG2 cell proliferation (p<0.05) and resulted in increased cell percentages in G0/G1 and G2/M phases and decrease in the S phase. The apoptotic index in the control group was $6.22{\pm}0.25%$, which increased to $7.17{\pm}0.20%$ and $18.1{\pm}0.42%$ in the treatment group. Exposure to 250 and 500nmol/L TSA also caused cell morphology changes with numerous floating cells. Expression of ${\beta}$-catenin, H3K9and Bax proteins was significantly increased, expression levels of CyclinD1, HDAC1, HDAC3 were decreased. Expression of ${\beta}$-catenin at the genetic level was significantly increased, with no significant difference in HDAC1and HDAC3 genes. In the cytoplasm, expression of ${\beta}$-catenin fluorescence protein was not obvious changed and in the nucleus, small amounts of green fluorescence were observed. H3K9 fluorescence protein were increased. Expression levels of the transcription factor TCF werealso increased in HepG2 cells following induction by TSA, whikle the activity of total HDACs was decreased. Conclusions: TSA inhibits HDAC activity, promotes histone acetylation, and activates Wnt/${\beta}$-catenin signaling to inhibit proliferation of HepG2 cell, arrest cell cycling and induce apoptosis.

Estimation of Fractional Urban Tree Canopy Cover through Machine Learning Using Optical Satellite Images (기계학습을 이용한 광학 위성 영상 기반의 도시 내 수목 피복률 추정)

  • Sejeong Bae ;Bokyung Son ;Taejun Sung ;Yeonsu Lee ;Jungho Im ;Yoojin Kang
    • Korean Journal of Remote Sensing
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    • v.39 no.5_3
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    • pp.1009-1029
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    • 2023
  • Urban trees play a vital role in urban ecosystems,significantly reducing impervious surfaces and impacting carbon cycling within the city. Although previous research has demonstrated the efficacy of employing artificial intelligence in conjunction with airborne light detection and ranging (LiDAR) data to generate urban tree information, the availability and cost constraints associated with LiDAR data pose limitations. Consequently, this study employed freely accessible, high-resolution multispectral satellite imagery (i.e., Sentinel-2 data) to estimate fractional tree canopy cover (FTC) within the urban confines of Suwon, South Korea, employing machine learning techniques. This study leveraged a median composite image derived from a time series of Sentinel-2 images. In order to account for the diverse land cover found in urban areas, the model incorporated three types of input variables: average (mean) and standard deviation (std) values within a 30-meter grid from 10 m resolution of optical indices from Sentinel-2, and fractional coverage for distinct land cover classes within 30 m grids from the existing level 3 land cover map. Four schemes with different combinations of input variables were compared. Notably, when all three factors (i.e., mean, std, and fractional cover) were used to consider the variation of landcover in urban areas(Scheme 4, S4), the machine learning model exhibited improved performance compared to using only the mean of optical indices (Scheme 1). Of the various models proposed, the random forest (RF) model with S4 demonstrated the most remarkable performance, achieving R2 of 0.8196, and mean absolute error (MAE) of 0.0749, and a root mean squared error (RMSE) of 0.1022. The std variable exhibited the highest impact on model outputs within the heterogeneous land covers based on the variable importance analysis. This trained RF model with S4 was then applied to the entire Suwon region, consistently delivering robust results with an R2 of 0.8702, MAE of 0.0873, and RMSE of 0.1335. The FTC estimation method developed in this study is expected to offer advantages for application in various regions, providing fundamental data for a better understanding of carbon dynamics in urban ecosystems in the future.