• Sleep Medicine and Psychophysiology
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• v.25 no.2
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• pp.74-81
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• 2018

Objectives: Insomnia is one of the major concerns in the elderly population. Cognitive behavioral treatment for insomnia is the first line treatment option, but there are some limitations including time and cost burdens and the requirement for sufficient cognitive resources to obtain a proper treatment effect. The Brief intervention for insomnia (BII) is a treatment that focuses on behavioral aspects of insomnia in primary care practices. The purpose of this study was to evaluate the effects of BII in community-dwelling older adults. Methods: A total of 47 older adults with insomnia were enrolled from community centers between May 2016 and January 2018. They participated in the BII program for three weeks. We gathered sleep-related participant information with using the Pittsburgh sleep quality index (PSQI), the Sleep hygiene index, and a sleep diary. Clinical efficacy was evaluated by comparing total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) before and after the treatment. Results: There was significant improvement in sleep-related features after BII. Global score and sleep quality from the PSQI, freshness, and WASO from the sleep diary showed statistically significant improvement. Conclusion: We found BII showed positive clinical efficacy in community dwelling older adults, especially from the perspective of subjective sleep quality and WASO. This finding implies that BII can be effectively applied for the managment of elderly insomnia patients in a community setting.

• Journal of the Korean Institute of Traditional Landscape Architecture
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• v.36 no.4
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• pp.113-123
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• 2018

The purpose of this research is to develop evaluation indicators forperformance improvement of horticultural therapy garden. In order to achieve a therapeutic purpose, the gardening activity held by the trained horticultural therapist. Moreover, horticultural therapy is 'a medical model' for the treatment and basic premise of the research was set, as horticultural therapy garden is characterized area to support activities of patients and horticultural therapist functionally and efficiently. For this study, three times of Delphi and AHP techniques were proceeded to export panels who were recruited by purposive sampling. Through these techniques, it was possible to deduct the evaluation indicator which maximizes the performance of the horticultural therapy garden. The evaluation items were prioritized by typing and stratification of the indicator. The results and discussions were stated as followings. Firstly, a questionnaire of experts was conducted to horticultural therapists and civil servants who were in charge of horticultural therapy. As results(horticultural therapists: 87.8%, civil servants: 75.2%), It is possible to conclude that both positions have the high recognition and agreed on the necessity of horticultural therapy. Secondly, Delphi investigation was conducted three times in order to develop the evaluation indicator for performance evaluation. After Delphi analysis, total 34 of evaluation elements to improve the performance of the horticultural therapy garden by reliability and validity analysis results. Thirdly, AHP analysis of each evaluation indicator was conducted on the relative importance and weighting. Moreover, the results showed 'interaction between nature and human' as the most important element, and in order of 'plan of the program', 'social interaction', 'sustainable environmental', and 'universal design rule', respectively. On the other hand, the exports from the university and research institute evaluated the importance of 'interaction between nature and human', while horticultural therapists chose 'plan of the program' as the most important element. Fourthly, the total weight was used to develop weight applied evaluation indicator for the performance evaluation of the horticultural therapy garden. The weight applying to evaluation index is generally calculated multiply the evaluation scores and the total weight using AHP analysis. Finally, 'the evaluation indicator and evaluation score sheet for performance improvement of the horticultural therapy garden' was finally stated based on the relative order of priority between evaluation indicators and analyzing the weight. If it was deducted the improvement points for the efficiency of already established horticultural therapy garden using the 'weight applied evaluation sheet', it is possible to expand it by judging the importance with the decision of the priority because the item importance decided by experts was reflected. Moreover, in the condition of new garden establishment, it is expected to be helpful in suggesting ways for performance improvement and in setting the guidelines by understanding the major indicators of performance improvement in horticultural therapy activity.

• Korean Journal of Health Psychology
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• v.14 no.3
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• pp.579-596
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• 2009

This study aimed to develop the Korean tool of competency to consent to psychiatric treatment and to analyze the reliability and validity of this tool. Also the developed tool's efficiency in determining whether a patient possesses treatment consent competence was checked using the Receiver Operating Characteristic curve and the relevant indices. A total of 193 patients with mental illness, who were hospitalized in a mental hospital or were in community mental health center, participated in this study. We administered a questionnaire consisting of 14 questions concerning understanding, appreciation, reasoning ability, and expression of a choice to the subjects. To investigate the validity of the tool, we conducted the K-MMSE, insight test, estimated IQ, and BPRS. The tool's reliability and usefulness were examined via Cronbach's alpha, ICC, and ROC analysis, and criterion related validation was performed. This tool showed that internal consistency and agreement between raters was relatively high(ICC .80~.98, Cronbach's alpha .56~.83)and the confirmatory factor analysis for constructive validation showed that the tool was valid. Also, estimated IQ, and MMSE were significantly correlated to understanding, appreciation, expression of a choice, and reasoning ability. However, the BPRS did not show significant correlation with any subcompetences. In ROC analysis, full scale cutoff score 18.5 was suggested. Subscale cutoff scores were understanding 4.5, appreciation 8.5, reasoning ability 3.5, and expression of a choice 0.5. These results suggest that this assessment tool is reliable, valid and efficient diagnostically. Finally, limitations and implications of this study were discussed.

• Journal of Animal Science and Technology
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• v.45 no.6
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• pp.1007-1018
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• 2003

This study was conducted to investigate the effect of feeding of garlic stalk silage on performance and carcass characteristics of Hanwoo steers. Feeding trial was conducted with 27 heads of Hanwoo steers and these animals were divided into two groups of control(rice straw) and garlic stalk silage. Animals consuming rice straw were fed concentrates and rice straw for 22 months from the 5 months of age and animals consuming garlic stalk silage were fed concentrates, rice straw and garlic stalk silage for 22 months from the 5 months of age. Animals fed rice straw and garlic stalk silage were fed 1.34 and 1.47, 1.69 and 1.74, 1.65 and 1.66% concentrates to body weight for the growing period, fattening period and finishing period, respectively. Animals fed rice straw and garlic stalk silage as roughage sources were fed 1.37 and 1.38, 0.65 and 0.63, 0.43 and 0.43% roughages to body weight for the growing period, fattening period and finishing period, respectively. Also, animals fed garlic stalk silage were offered 0.22 and 0.33% garlic stalk silage to body weight for the fattening and finishing period, respectively. Animals fed rice straw and garlic stalk silage as a roughage sources did not differ in average daily gain during the whole feeding periods. Animals of control group consumed less concentrates and roughage than those fed garlic stalk silage during the whole feeding periods. However, feed efficiency was not significantly different between both treatments. Beef yield including backfat thickness, eye muscle area and carcass weight was slightly lower in the animals fed garlic stalk silage than in the animals fed rice straw even though there were no differences between both treatments. However, beef quality including beef color, fat color, texture, maturity and marbling score was slightly higher in the garlic stalk silage-fed animals than in the animals fed rice straw although there were not statistically different between both treatments. Animals consuming garlic stalk silage was significantly(p<0.05) lower in shear value than those fed rice straw. Amino acid composition including essential amino acid and non-essential amino acid was not different between animals fed rice straw and garlic stalk silage. Eye muscle area of animals fed garlic stalk silage contained slightly higher oleic acid, less linoleic acid and arachidonic acid and more linolenic acid than that of animals fed rice straw only as a roughage sources. So eye muscle area of animals fed garlic stalk silage contained more mono-unsaturated fatty acid than that of animals fed rice straw and $\omega$6/$\omega$3 ratio was narrower in the animals fed garlic stalk silage than in the animals fed rice straw. Economic income was higher by 20% in the animals fed garlic stalk silage than in the animals fed rice straw. Therefore, It may be concluded that feeding of garlic stalk silage as a roughage sources to steers during the fattening period seems to improve meat quality, fatty acid composition and economic income.

• Childhood Kidney Diseases
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• v.3 no.2
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• pp.170-179
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• 1999

Purpose: To evaluate whether or not sodium restriction had its own beneficial effect and increased the efficiency of the anti-hypertensive drugs on the progression of renal failure. Methods: We studied using the excision remnant kidney model. Treatment groups were as follows: 5/6 nephrectomy and a 0.49% (normal-high) sodium diet (NN); 5/6 nephrectomy and a 0.25% (normal-low) sodium diet (LN); 5/6 nephrectomy, a 0.49% sodium diet and enalapril (NNE); 5/6 nephrectomy, a 0.49% sodium diet and nicardipine (NNN); 5/6 nephrectomy, a 0.25% sodium diet and enalapril (LNE); 5/6 nephrectomy, a 0.25% sodium diet and nicardipine (LNN). Both diets were isocaloric and had the same content of protein, phosphorus and calcium. Proteinuria, remnant kidney weight, mesangial expansion scores, and glomerular volume were assessed. Results: Blood pressure tended to be lower in LN compared to NN (P<0.05). NN developed progressive hypertension. LNE, LU, NNE, and NNN reduced blood pressure. LNE, LNN, NNE, NNN, and LN had significantly less proteinuria than NN at 16 weeks (P<0.05). At 24 weeks, LN developed proteinuria (82 mg/day), which were lessened in LNE (54 mg/day) and not lessened in LNN (76 mg/day). Mesangial expansion scores were significantly less in LN rats compared to those in NN rats. Glomerular volumes at 24 weeks in LN rats were significantly less compared to those at 16 weeks in NN rats. Mesangial expansion scores and glomerular volumes at 4, weeks, 12 weeks, and 24 weeks were not different among LN, LNE, and LNN groups. Conclusion: Dietary salt restriction lessens renal damage, at least in part, by inhibiting compensatory renal growth and reducing blood pressure. Enalapril was particularly successful in reducing proteinuria and glomerular injury when combined with dietary salt restriction.

• Sleep Medicine and Psychophysiology
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• v.3 no.2
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• pp.32-42
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• 1996

Objectives : Upper airway resistance syndrome(UARS) is a sleep-related breathing disorder characterized by abnormal negative intrathoracic pressure during sleep. Abnormally increased negative intrathoracic pressure results in microarousal and sleep fragmentation which underlay UARS-associated complaints of daytime fatigue and sleepiness. Although daytime dysfunction in patients with UARS is comparable to that of sleep apnea syndrome, UARS has been relatively unnoticed in clinical setting. That is why UARS is apt to be excluded in diagnosing of sleep-related breathing disorders since its respiratory disturbance index and arterial oxygen saturation are within normal limits. The current study presents a summary of clinical and polysomnographic characteristics found in patients with UARS. The present study aims (1) to explore characteristics of patients diagnosed with UARS, (2) to characterize the polysomnographic findings of UARS patients, and (3) to enhance the understanding of UARS through those clinical and laboratory characteristics. Methods : This was a retrospective study of 20 UARS patients (male 15, female 5) and 30 obstructive sleep apnea (OSA) patients (male 21, female 9) at the Stanford Sleep Disorders Clinic. We diagnosed patients as having UARS when they met critenia, RDI < 5 characteristic findings of an elevated esophageal pressure($<-10\;cmH_2O$), frequent arousals secondary to an elevated esophageal pressure, and symptoms of daytime fatigue and sleepiness. We used polysomnographic value, which is standardized by Williams et al(1974), as normal control. Statiotical test were done with student t-tests. Results : (1) Mean age of UARS was $41.0\;{\pm}\;14.8$ years and OSA was $50.9\;{\pm}\;12.0$ years. UARS subject was significantly younger than OSA subject (p<0.05). (2) The total score of Epworth Sleepiness Scale (ESS) was UARS $9.7\;{\pm}\;6.3$ and OSAS $11.2\;{\pm}\;6.3$. There was no significant difference between two groups. (3) The mean body mass index was UARS $28.1\;{\pm}\;5.7\;kg/m^2$ and OSAS $32.9\;{\pm}\;7.0\;kg/m^2$. UARS had significantly lower meen body man index than OSAS subjects (p<0.05). (4) The polysomnographic parameters of UARS were not significantly different from those of OSA except RDI(p<0.001), $SaO_2$ (p<0.001) and slow wave sleep latency (p<0.05). (5) Compared with normal control, Total sleep time in UARS subjects was significantly shorter (p<0.001), sleep efficiency index was significantly lower (p<0.001), total awakening percentage was significantly higher (p<0.001), and sleep stage 1 (p<0.001) were significantly higher. (6) OSA patients showed poor sleep quality and distinct abnormal sleep architectures compared with normal control. Conclusions : Conclusions from the above results are as follows : (1) UARS patients were younger and had lower body mass index when umpared with OSA patients. (2) The quality of sleep and sleep architectures of the UARS and OSA patients are significantly different from those of normal control. (3) ESS scores and awakening frequencies of UARS are similar with those of OSA, suggesting that daytime dysfunction of UARS patients may be comparable to those of OSA patients. (4) The RDI and the $SaO_2$ which are important indicators in diagnosing sleep-related breathing disorders, of UARS subjects are close to normal value. (5) According to the the above results, we unclude that despite the absence of $SaO_2$ drops and the absence of an elevated number of apnea and hypopnea, subjects developed clinical complaints which were associated with laborious breathing, elevated Pes nadir, and frequently snoring. (6) Accordingly, we suggest including LIARS in the differential diagnosis list when sleep related breathing disorder is suspected clinically and overnight polysomnographic findings except snoring and frequent microarousal are within normal limits.