• Korean Circulation Journal
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• v.52 no.9
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• pp.659-679
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• 2022

Efforts to improve end-of-life (EOL) care have generally been focused on cancer patients, but high-quality EOL care is also important for patients with other serious medical illnesses including heart failure (HF). Recent HF guidelines offer more clinical considerations for palliative care including EOL care than ever before. Because HF patients can experience rapid, unexpected clinical deterioration or sudden death throughout the disease trajectory, choosing an appropriate time to discuss issues such as advance directives or hospice can be challenging in real clinical situations. Therefore, EOL issues should be discussed early. Conversations are important for understanding patient and family expectations and developing mutually agreed goals of care. In particular, high-quality communication with patient and family through a multidisciplinary team is necessary to define patient-centered goals of care and establish treatment based on goals. Control of symptoms such as dyspnea, pain, anxiety/depression, fatigue, nausea, anorexia, and altered mental status throughout the dying process is an important issue that is often overlooked. When quality-of-life outweighs expanding quantity-of-life, the transition to EOL care should be considered. Advanced care planning including resuscitation (i.e., do-not resuscitate order), device deactivation, site for last days and bereavement support for the family should focus on ensuring a good death and be reviewed regularly. It is essential to ensure that treatment for all HF patients incorporates discussions about the overall goals of care and individual patient preferences at both the EOL and sudden changes in health status. In this review, we focus on EOL care for end-stage HF patients.

• Journal of Microbiology and Biotechnology
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• v.34 no.9
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• pp.1739-1747
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• 2024

Alzheimer's disease (AD) is a progressive neurological disorder that represents a major cause of dementia worldwide. Its pathogenesis involves multiple pathways, including the amyloid cascade, tau protein, oxidative stress, and metal ion dysregulation. Recent studies have suggested a critical link between changes in gut microbial diversity and the disruption of the gut-brain axis in AD. Previous studies primarily explored the potential benefits of probiotics and prebiotics in managing AD. However, studies have yet to fully describe a novel promising approach involving the use of synbiotics, which include a combination of active probiotics and new-generation prebiotics. Synbiotics show potential for mitigating the onset and progression of AD, thereby offering a holistic approach to address the multifaceted nature of AD. This review article primarily aims to gain further insights into the mechanisms of AD, specifically the intricate interaction between gut bacteria and the brain via the gut-brain axis. By understanding this relationship, we can identify potential targets for intervention and therapeutic strategies to combat AD effectively. This review also discusses substantial evidence supporting the role of synbiotics as a promising AD treatment that surpasses traditional probiotic or prebiotic interventions. We find that synbiotics may be used not only to address cognitive decline but also to reduce AD-related psychological burden, thus enhancing the overall quality of life of patients with AD.

• Journal of Korean society of Dental Hygiene
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• v.14 no.6
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• pp.903-913
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• 2014

Objectives: The purpose of the study was to investigate the content analysis of daily tooth cleaning service records by caregivers in a long-term care facility. Methods: The data were analyzed by qualitative research based on content analysis of the daily records of the processes and results of daily tooth cleaning service. Twenty caregivers provided tooth, gum and denture cleaning service after breakfast, lunch, and dinner to 48 elderly residents. The study lasted about two weeks(from August 4 to August 20, 2014). The researcher reconstructed the language by repeatedly reviewing the caregivers statements in the records. The content categories were derived from the records through a reiterative manual comparative analysis. Using constant comparison method, reconstructed meanings were incorporated into various meanings and reanalyzed by final categories called as analytic coding. In order to validate the reliability, 6 times of discussion made the common meanings through a master's degree student and a dental hygiene professor. Results: The caregivers identified lack of understanding and ability to recognize the functional physical and mental changes in the elderly. The elderly had difficulty in recognizing silent communication and daily tooth cleaning. The caregivers were so strenuous in taking care of the daily tooth cleaning service for the elderly. At last, they gave up the daily tooth cleaning service and took on it to the guardians. They found that there was no social supporting network for oral health of the elderly residents. Conclusions: Caregivers had insufficient understanding of the functional physical and mental changes in the elderly residents, and they had difficulty providing daily tooth cleaning service to the elderly due to poor skill and abilities.

• The Journal of the Convergence on Culture Technology
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• v.9 no.6
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• pp.1127-1134
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• 2023

This study is a qualitative study to uncover the meaning and structure of nursing students' online psychiatric nursing practice experience by applying Parse's research method. The subjects of the study were 9 fourth-year nursing students at K University who took psychiatric nursing practice online in the COVID-19 situation. Data collection was conducted from March 7, 2022 to May 27, 2022. As a result of the study, the core concepts of nursing students' online practice experience in psychiatric nursing in the COVID-19 situation were: 'Recognizing the importance of understanding oneself and others', 'Preparing for communication to build therapeutic relationships', and 'A perspective on the future through exploration of the meaning of nursing'. Structural transposition was presented as 'Empathy for self and others', 'Mindset for interpersonal human relationship', 'Exploring the essence of nursing and self-realization'. Conceptual integration appeared as 'Valuing', 'Revealing-Concealing', 'Revealing-Concealing'. In conclusion, nursing students' online practice experience in mental health nursing in the COVID-19 situation was an experience of growing and transcending as future nurses by recognizing the importance of human understanding and communication for the therapeutic relationship that is the purpose of mental nursing. This study will serve as basic data for efficient clinical practice operations in various unpredictable situations, such as future pandemics.

• Perspectives in Nursing Science
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• v.7 no.1
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• pp.10-22
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• 2010

Purpose: Through a thorough examination of the CCSC (Community Comprehensive Support Center) system in Japan, this study suggests a scheme to provide community-based preventive health care services for the elderly in Korea. Methods: The study inquired into the applicability of the Japanese model by reviewing the data related to the CCSC project, aided by both in-depth interviews with staff in the field and consultations with specialists. Results: Rearrangement of the Visiting Health Management Project system is needed to manage the collective or individual visiting care management for frailty prevention of the elderly in communities. The delegated service system for preventive care in the community, including direct management by one of the public health centers, also needs to be reviewed and the application of stricter standards for the selection of the agency or corporation to run the delegated service is necessary. Long-Term Care Insurance, along with national and local grants, is to be considered as a financial resource for the community-based preventive health care model for the elderly. By making active use of education rooms at district offices, senior citizen centers in neighborhoods for the elderly with easy access can be created. The project needs to raise active supports from communities, develop programs which can be absorbed into particular local cultures, and promote the understanding of the preventive project in local communities. The preventive program should focus on first solving the problems of depression, seclusion, and lack of mobility of the elderly. Second, the program should instruct physical self-management for exercise-nutrition-dental maintenance, and third, the program should strengthen the cognitive abilities of the elderly. In addition, it is necessary to systematize and implement counter-plans of the family and community to protect the elderly who has mental and cognitive problems. Finally, by establishing a network of public health welfare resources based upon research on a community level, assessment and planning for the health of the elderly should be one with their family, and comprehensive consultation and recommendations should be provided to the family. Conclusion: Taking into consideration the experience Japan has had with respect to a similar project, it is appropriate to develop and implement a service system which would combine the Visiting Health Management Project system which has already been established and a preventive health care model for the elderly on a community level.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.29-41
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• 2004

Objectives: This study was to identify socioeconomic factors and health-related behaviors influencing on HRQOL(health-related quality of life) for the older adults in rural area. Methods: 483 subjects aged over 65 years responded a direct interview, which covered HRQOL, BMI, socioeconomic characteristics, and health-related behaviors including smoking, drinking, and exercise. Results: Overall, the mean number of healthy days were 15.1 days and not significantly different by sex. Men didn't show a significant difference in HRQOL by age group. But women reported lower levels of healthy days and higher levels of activity limitation and physical unhealthy days with increasing age. Results from ANCOVA showed HRQOL to be significantly associated with education, job, and family type. Men presented no significant difference in HRQOL by health-related behaviors, but women who have been drinking, or have less number of chronic diseases reported higher mean healthy days and lower activity limitation days, physical unhealthy days, and mental unhealthy days. Older adults who reported good to excellent self-rated health were higher healthy days and lower activity limitation, physical unhealthy days, and mental unhealthy days than those who reported fair to poor health status. Conclusions: The HRQOL for the older adults in rural area was related to socioeconomic characteristics, health-related behaviors and self-rated health status. A better understanding of factors related to HRQOL would help to improve the older adults' quality of life.

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.659-671
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• 2020

Severe congenital heart disease (CHD) is a chronic disease requiring continuous and holistic health management to improve patients' quality of life. This study explored the health management experiences of adolescents with severe CHDs in Korea. On the basis of in-depth interviews with nine youths, four categories and 12 subcategories were identified. The participants lacked a full understanding of their health status and the need for appropriate health management for their health status. Nonetheless, they practiced health management to some extent, in ways that were affected by heart function, self-identity, and social support. Although adolescents with severe CHDs were affected by physical limitations and the discriminatory gaze around them, they tried to achieve normalcy through managing information, seeking homogeneity with peers, and fostering positive acceptance about their disease. Regarding demands for health management programs, disease knowledge and mental health content were preferred, and the preferred delivery methods were self-help group camps and smartphone applications. Based on the results of this study, we suggest a health management intervention to promote a healthy transition to adulthood for adolescents with severe CHDs, and that policy-makers should consider measures that would enable a successful transition to adulthood in the future of youth with severe CHDs.

• Journal of Nutrition and Health
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• v.48 no.3
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• pp.221-227
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• 2015

Purpose: Confronting the growing burden of dementia requires understanding the causes and predictors of dementia in order to develop preventive strategies. In Korea a large proportion (71%) of dementia is Alzheimer's disease, and the risk factors have not yet been elucidated. Dietary factors may be possible risk factors, however research on the relationship between Alzheimer's disease and dietary behaviors has been insufficient. The purpose of this study was to investigate the association between compliance with the "Dietary Guidelines for Elderly (The Ministry of Health and Welfare, 2011)" and Alzheimer's disease among Korean elderly. Methods: Elderly persons who visited a University hospital or a dementia center of Seoul and agreed to participate in the examinations were selected. Among 277 subjects, 89 Alzheimer patients were selected with diagnosis and 118 subjects were assigned to the control group. Diagnosis of Alzheimer's disease was based on Alzheimer's disease criteria of Diagnostic and Statistical manual of Mental Disorders, 4th edition (DSM-IV) and criteria of National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and related Disorders Association (NINCDS-ADRDA). Information on the general characteristics, health related behaviors and compliance with the dietary guidelines for Korean elderly was collected by face to face interview using a structured questionnaire. Anthropometric variables were measured during the survey. Results: Total compliance score of dietary guidelines was significantly lower in the Alzheimer's disease group than in the control group (p = 0.0001). The odds ratio of Alzheimer's disease was significantly decreased in the group with the highest dietary guideline compliance score (OR = 0.47, 95 % CI = 0.18~1.09) compared to the group with the lowest compliance score. Conclusion: The results indicate that increasing compliance with the dietary guidelines could be an effective strategy to decrease the risk of Alzheimer's disease among Korean elderly.

• Journal of Technologic Dentistry
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• v.31 no.3
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• pp.67-85
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• 2009

This study aims to provide the research for dental technician's stress prevention and management with basic materials by understanding dental technician's psychosocial stress level and examining relevant factors. The subject of this study is 255 dental technologists who work mainly in Seoul Gyeonggi district for a month of April of 2009 and I conducted cross-sectional study through self administered survey. The contents of survey include general feature, occupational feature, health behavior feature. I used Karasek's Job Content Questionnaire, JCQ and Psychosocial well-being index, PWI-SF as means of measurement. To compare the level of dental technician's psychosocial stress, I conducted t-test and ANOVA and I measured the factors that are related with psychosocial stress symptom with step by step multiple regressive analysis. According to the result of Cronbach's a value which is yielded to verify the reliability of means of measurement, the reliability of concept is sufficient. The detailed result of this study is as follows. 1. According to the result of analyzing the stress symptom in accordance with general feature and occupational feature, those dental technologists who are older and not married, graduate from junior college, have lower position, work at university hospital or general hospital show lower stress(p<0.05). There is no difference in the level of psychosocial stress with regard to duty related feature, period of service, daily average working hours, monthly average pay. 2. With regard to health behavior feature, those dental technologists who control weight better and have meal more regularly show lower stress(p<0.05). Those dental technicians who smoke, drink liquid and take a suitable sleep show low stress but the difference does not have significance statistically. 3. With regard to the factors of stress in the workplace, those dental technicians who have lower duty related requirement, have higher duty related control ability, have higher social support, have less instability of employment and have less workload and physical burden show lower stress(p<0.05). 4. According to the result of analyzing the factors that influence dental technologist's stress symptom, social support has the most enormous influence on stress symptom. Unstable employment, regular exercise, regular eating, daily average sleeping hours and technological capacity are also important in this order. According to the result of this study, those dental technicians who have higher social support, less instability of employment, do exercise more regularly, take enough sleep more soundly and have higher technological capacity show lower psychosocial stress symptom. Therefore, to adjust appropriately the dental technician's stress and properly maintain and improve the dental technician's mental health, effective management plan that enables dental technicians to maintain smooth human relationships for dental technicians should be sought. In addition, heath education and health management for dental technicians should be given more thoroughly so that they can establish desirable health behavior in daily life.

• Korean Journal of Social Welfare
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• v.65 no.4
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• pp.367-393
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• 2013

Quality of life(QoL) of older cancer patients have not gained enough attention from researchers even when cancer is the number one cause of death of Korean elderly. Therefore, this study aims at understanding the QoL of older cancer patients and factors related to it, applying Taylor(2012)'s Stress-Coping Process model, and by comparing with older chronic disease patients and middle-aged cancer patients. Results indicated that physical health QoL of older cancer patients was the worst and their mental health QoL was similar with middle aged cancer patients. Multi-group analysis of Structural Equation Modeling indicated that the relation between QoL and the stress coping resources was not statistically different from older cancer patients and older chronic disease group, as well older cancer patients and middle-aged cancer patients. Implications of results to improve the QoL of older cancer patients are discussed.