• Title/Summary/Keyword: cancer communication

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The Current State and Implementation of Music Therapy for Adults With Intellectual Disabilities (국내 성인지적장애인 음악치료 중재 현황)

  • Oh, Ji Eun
    • Journal of Music and Human Behavior
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    • v.13 no.2
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    • pp.17-30
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    • 2016
  • This study aimed to examine the current state of music therapy for adults with intellectual disabilities (ID) by conducting a survey of music therapists. Completed surveys from 32 certified music therapists were included for analysis. The questionnaire was composed of 38 items that asked about the participants' background, work environment and music therapy implementation experience (including assessment, goal establishment, intervention strategy and difficulties). The results of the study showed that music therapy for adults with ID was practiced in diverse facilities. Enhancing social interaction was the most frequently set goal by music therapists, whereas facilities mostly required the music therapy services for emotional stability. Also, instrument playing was used most among music activities, and musical structure was considered most when choosing music for therapy. Among the influential institutional factors, characteristics of the facility were considered most frequently, and the level of functioning was the most considered in terms of client-related factors. To advance the effective use of music therapy interventions with adults with ID, development of music therapy assessment tools and more active communication with facility staff were also suggested when working with this population.

Hospice and Palliative Care in Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 호스피스 완화의료)

  • Shin, Jinyoung;Park, Hye Yun;Lee, Jungkwon
    • Journal of Hospice and Palliative Care
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    • v.20 no.2
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    • pp.81-92
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation that is usually progressive. It is a major cause of morbidity and mortality worldwide, leading to substantial and increasing economic and social burden. Palliative care for COPD patients aims to reduce symptoms and exacerbations and improve exercise tolerance and quality of life. It is difficult to make a prognosis for COPD patients due to the variable illness trajectory and advanced care of patients. However, severity of breathlessness, assessment of lung function impairment, and frequency of exacerbations can help to identify palliative care needs and determine effective methods to mitigate symptoms, which is discussed in this paper. In these patients, it is recommended to provide individualized palliative care along with curative/restorative care at the onset of COPD symptoms. Before launching a palliative care system in Korea, it is necessary to prepare pulmonary rehabilitation resources, patient-centered communication, timely palliative responsiveness, and a program for effective advanced care planning. A multidisciplinary approach involving collaboration with not only the respiratory and palliative care teams but also primary care offers a new model of care for these patients and should be considered with a priority.

Sensing the Stress: the Role of the Stress-activated p38/Hog1 MAPK Signalling Pathway in Human Pathogenic Fungus Cryptococcus neoformans

  • Bahn, Yong-Sun;Heitman, Joseph
    • Proceedings of the Microbiological Society of Korea Conference
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    • 2007.05a
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    • pp.120-122
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    • 2007
  • All living organisms use numerous signal-transduction pathways to sense and respond to their environments and thereby survive and proliferate in a range of biological niches. Molecular dissection of these signalling networks has increased our understanding of these communication processes and provides a platform for therapeutic intervention when these pathways malfunction in disease states, including infection. Owing to the expanding availability of sequenced genomes, a wealth of genetic and molecular tools and the conservation of signalling networks, members of the fungal kingdom serve as excellent model systems for more complex, multicellular organisms. Here, we employed Cryptococcus neoformans as a model system to understand how fungal-signalling circuits operate at the molecular level to sense and respond to a plethora of environmental stresses, including osmoticshock, UV, high temperature, oxidative stress and toxic drugs/metabolites. The stress-activated p38/Hog1 MAPK pathway is structurally conserved in many organisms as diverse as yeast and mammals, but its regulation is uniquely specialized in a majority of clinical Cryptococcus neoformans serotype A and D strains to control differentiation and virulence factor regulation. C. neoformans Hog1 MAPK is controlled by Pbs2 MAPK kinase (MAPKK). The Pbs2-Hog1 MAPK cascade is controlled by the fungal "two-component" system that is composed of a response regulator, Ssk1, and multiple sensor kinases, including two-component.like (Tco) 1 and Tco2. Tco1 and Tco2 play shared and distinct roles in stress responses and drug sensitivity through the Hog1 MAPK system. Furthermore, each sensor kinase mediates unique cellular functions for virulence and morphological differentiation. We also identified and characterized the Ssk2 MAPKKK upstream of the MAPKK Pbs2 and the MAPK Hog1 in C. neoformans. The SSK2 gene was identified as a potential component responsible for differential Hog1 regulation between the serotype D sibling f1 strains B3501 and B3502 through comparative analysis of their meiotic map with the meiotic segregation of Hog1-dependent sensitivity to the fungicide fludioxonil. Ssk2 is the only polymorphic component in the Hog1 MAPK module, including two coding sequence changes between the SSK2 alleles in B3501 and B3502 strains. To further support this finding, the SSK2 allele exchange completely swapped Hog1-related phenotypes between B3501 and B3502 strains. In the serotype A strain H99, disruption of the SSK2 gene dramatically enhanced capsule biosynthesis and mating efficiency, similar to pbs2 and hog1 mutations. Furthermore, ssk2, pbs2, and hog1 mutants are all hypersensitive to a variety of stresses and completely resistant to fludioxonil. Taken together, these findings indicate that Ssk2 is the critical interface protein connecting the two-component system and the Pbs2-Hog1 pathway in C. neoformans.

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Bioactive Molecules Produced by Probiotics to Control Enteric Pathogens (프로바이오틱스가 생산하는 생리활성 물질의 장내 유해균 억제 효과)

  • Lim, Kwang-Sei;Griffiths, Mansel W.;Park, Dong June;Oh, Sejong
    • Journal of Dairy Science and Biotechnology
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    • v.32 no.2
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    • pp.141-145
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    • 2014
  • There is a burgeoning number of products on the market that contain probiotics, but do they do you any good? What exactly are probiotics? They have been defined as living organisms that, when ingested in sufficient quantities, provide health benefits beyond basic nutrition. They are often referred to as "friendly bacteria" or "good bacteria." Probiotics have been claimed, amongst other things, to (i) reduce the incidence of colon cancer and other diseases of the colon, such as IBS, (ii) stimulate the immune system, (iii) have anti-hypertensive and anti-cholesterolemic properties, (iv) mitigate against the effect of antibiotics on the intestinal microbiota, and (v) protect against gastrointestinal infections. However, the scientific basis for many of these claims is not well-established. Indeed, the European Food Safety Authority has denied the use of several health claims associated with probiotics, particularly those related to mitigation of diarrhea following consumption of antibiotics. Thus, there is a need for research on the mechanisms of action of probiotics. We have been mainly interested in the use of probiotics to control enteric infections. There are several possible modes of action to explain how probiotics may protect the host from enteric pathogens, including competitive exclusion and immunomodulation. We have shown that probiotics produce bioactive molecules that interfere with bacterial cell-cell communication (also called quorum sensing), and this results in a down-regulation of virulence genes that are responsible for attachment of the pathogen to the gastrointestinal epithelium. These bioactive molecules act on a variety of bacteria, including enterohemorrhagic and enterotoxigenic Escherichia coli, Salmonella, Clostridium difficile and Clostridium perfringens, and there is evidence that they can inhibit the formation of biofilms by Listeria monocytogenes. These bioactive molecules, which are peptidic in nature, can exert their effects not only in vitro but also in vivo, and we have shown that they mitigate against E. coli O157:H7 and Salmonella in mice and Salmonella and E. coli K88 infections in pigs. They can be delivered in foods such as yoghurt and maintain their activity.

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Mesenchymal Stem Cell-derived Exosomes: Applications in Cell-free Therapy (중간엽줄기세포유래 엑소좀: 비세포치료제로서의 활용)

  • Heo, June Seok;Kim, Jinkwan
    • Korean Journal of Clinical Laboratory Science
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    • v.50 no.4
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    • pp.391-398
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    • 2018
  • Mesenchymal stem cells (MSCs) are an attractive resource for refractory patients because of their anti-inflammatory/immunomodulatory capability and multi-lineage differentiation potential. The transplantation of MSCs has led to positive results in preclinical and clinical application to various diseases, including autoimmune disease, cardiovascular disease, cancer, liver cirrhosis, and ischemic stroke. On the other hand, studies have shown that paracrine factors, not direct cell replacement for damaged cells or tissue, are the main contributors in MSC-based therapy. More recently, evidence has indicated that MSC-derived exosomes play crucial roles in regulating the paracrine factors that can mediate tissue regeneration via transferring nucleic acids, proteins, and lipids to the local microenvironment and cell-to-cell communication. The use of these exosomes is likely to be beneficial for the therapeutic application of MSCs because their use can avoid harmful effects, such as tumor formation involved in cell transplantation. Therefore, therapeutic applications using MSC-derived exosomes might be safe and efficient strategies for regenerative medicine and tissue engineering. This review summarizes the recent advances and provides a comprehensive understanding of the role of MSC-derived exosomes as a therapeutic agent.

Awareness of Doctors' Shared Decision-Making in Life-Sustaining Care Decisions

  • Kim, Dalyong;Lee, Hyun Jung;Yu, Soo-Young;Kwon, Jung Hye;Ahn, Hee Kyung;Kim, Jee Hyun;Seo, Seyoung;Maeng, Chi Hoon;Lim, Seungtaek;Kim, Do Yeun;Shin, Sung Joon
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.204-213
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    • 2021
  • Purpose: At the end of life, communication is a key factor for good care. However, in clinical practice, it is difficult to adequately discuss end-of-life care. In order to understand and analyze how decision-making related to life-sustaining treatment (LST) is performed, the shared decision-making (SDM) behaviors of physicians were investigated. Methods: A questionnaire was designed after reviewing the literature on attitudes toward SDM or decision-making related to LST. A final item was added after consulting experts. The survey was completed by internal medicine residents and hematologists/medical oncologists who treat terminal cancer patients. Results: In total, 202 respondents completed the questionnaire, and 88.6% said that the decision to continue or end LST is usually a result of SDM since they believed that sufficient explanation is provided to patients and caregivers, patients and caregivers make their own decisions according to their values, and there is sufficient time for patients and caregivers to make a decision. Expected satisfaction with the decision-making process was the highest for caregivers (57.4%), followed by physicians (49.5%) and patients (41.1%). In total, 38.1% of respondents said that SDM was adequately practiced when making decisions related to LST. The most common reason for inadequate SDM was time pressure (89.6%). Conclusion: Although most physicians answered that they practiced SDM when making decisions regarding LST, satisfactory SDM is rarely practiced in the clinical field. A model for the proper implementation of SDM is needed, and additional studies must be conducted to develop an SDM model in collaboration with other academic organizations.

Differences in Patients' and Family Caregivers' Ratings of Cancer Pain (암환자와 그 가족간호자가 지각하는 환자의 통증강도 차이)

  • Kim, Hyun-Sook;Yu, Su-Jeong;Kwon, Shin-Young;Park, Yeon-Hee
    • Journal of Hospice and Palliative Care
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    • v.11 no.1
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    • pp.42-50
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    • 2008
  • Purpose: Undertreatment of canter pain, especially due to the differences in the perception of pain between the patients and caregivers, is a well recognized problem. The purpose of this study were to determine if there exist differences in communication about pain intensity scores between patients and their family caregivers in Korea. Methods: A total of 127 patient-family caregiver dyads who have experienced canter pain participated in this study at a hospital in Seoul for six months. The data were obtained by fare to face interview with a structured questionnaire based on Brief Pain Inventory-Korean version and other previous researches. The clinical information for all patients was compiled by reviewing their medical records. Results: Patients' 'worst-pain for 24-hour' and 'right-now-pain' scores estimated by family caregivers were significantly higher than those by patient themselves. The degree of agreement between patients and family caregivers in the estimate of patients' 'worst-pain for 24-hour' intensity categories was 78.7% for 'severe pain', 40% for 'no pain', 27.5% for 'mild pain' and 22.9% for 'moderate pain'. In case of 'right-now-pain' intensity categories, the agreement was 50% for 'severe pain', 47.2% for mild pain, 46.3% for 'no pain', and 26.3% for 'moderate pain'. Conclusion: This study demonstrates that the degree of agreement between patients and family caregivers in the estimate of patients 'pain intensity categories was less than 50% except for 'severe pain'. The results indicate that Korean family caregivers tend to overestimate the canter pain intensity of their caring patients, especially, when a lancer patient has 'moderate' or 'mild pain'. Health Providers are advised to educate patient-family caregiver dyads to use a pain measurement scale to promote their agreement in pain Intensity stores. Further analyses and studies are needed to identify the factors and differences that influence their communication about pain intensity scores between patients and their family caregivers.

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The Relationship between Internet Search Volumes and Stock Price Changes: An Empirical Study on KOSDAQ Market (개별 기업에 대한 인터넷 검색량과 주가변동성의 관계: 국내 코스닥시장에서의 산업별 실증분석)

  • Jeon, Saemi;Chung, Yeojin;Lee, Dongyoup
    • Journal of Intelligence and Information Systems
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    • v.22 no.2
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    • pp.81-96
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    • 2016
  • As the internet has become widespread and easy to access everywhere, it is common for people to search information via online search engines such as Google and Naver in everyday life. Recent studies have used online search volume of specific keyword as a measure of the internet users' attention in order to predict disease outbreaks such as flu and cancer, an unemployment rate, and an index of a nation's economic condition, and etc. For stock traders, web search is also one of major information resources to obtain data about individual stock items. Therefore, search volume of a stock item can reflect the amount of investors' attention on it. The investor attention has been regarded as a crucial factor influencing on stock price but it has been measured by indirect proxies such as market capitalization, trading volume, advertising expense, and etc. It has been theoretically and empirically proved that an increase of investors' attention on a stock item brings temporary increase of the stock price and the price recovers in the long run. Recent development of internet environment enables to measure the investor attention directly by the internet search volume of individual stock item, which has been used to show the attention-induced price pressure. Previous studies focus mainly on Dow Jones and NASDAQ market in the United States. In this paper, we investigate the relationship between the individual investors' attention measured by the internet search volumes and stock price changes of individual stock items in the KOSDAQ market in Korea, where the proportion of the trades by individual investors are about 90% of the total. In addition, we examine the difference between industries in the influence of investors' attention on stock return. The internet search volume of stocks were gathered from "Naver Trend" service weekly between January 2007 and June 2015. The regression model with the error term with AR(1) covariance structure is used to analyze the data since the weekly prices in a stock item are systematically correlated. The market capitalization, trading volume, the increment of trading volume, and the month in which each trade occurs are included in the model as control variables. The fitted model shows that an abnormal increase of search volume of a stock item has a positive influence on the stock return and the amount of the influence varies among the industry. The stock items in IT software, construction, and distribution industries have shown to be more influenced by the abnormally large internet search volume than the average across the industries. On the other hand, the stock items in IT hardware, manufacturing, entertainment, finance, and communication industries are less influenced by the abnormal search volume than the average. In order to verify price pressure caused by investors' attention in KOSDAQ, the stock return of the current week is modelled using the abnormal search volume observed one to four weeks ahead. On average, the abnormally large increment of the search volume increased the stock return of the current week and one week later, and it decreased the stock return in two and three weeks later. There is no significant relationship with the stock return after 4 weeks. This relationship differs among the industries. An abnormal search volume brings particularly severe price reversal on the stocks in the IT software industry, which are often to be targets of irrational investments by individual investors. An abnormal search volume caused less severe price reversal on the stocks in the manufacturing and IT hardware industries than on average across the industries. The price reversal was not observed in the communication, finance, entertainment, and transportation industries, which are known to be influenced largely by macro-economic factors such as oil price and currency exchange rate. The result of this study can be utilized to construct an intelligent trading system based on the big data gathered from web search engines, social network services, and internet communities. Particularly, the difference of price reversal effect between industries may provide useful information to make a portfolio and build an investment strategy.

Curriculum Development for Hospice and Palliative Care Nurses (간호사를 위한 호스피스 완화의료 교육과정 개발)

  • Choi, Eun-Sook;Kim, Hyun-Sook;Lee, So-Woo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.77-85
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    • 2006
  • Purpose: The purpose of this study is to develop the basic curriculum for the nurses who work at hospice and palliative care settings. Methods: Seven curricula of hospice and palliative care for the nurses in Korea and other countries were reviewed, and Education Need for hospice and palliative care was surveyed from 162 nurses by mailing the questionnaires to hospice palliative care settings. Results: 1. The curricula of hospice and palliative care for the nurses in Korea and other countries in common include 'understanding of hospice and palliative care', 'understanding of lift and death', 'pain and symptom management for person with terminal disease', 'on-the-spot study and practical training', 'management of hospice and palliative ward', 'hospice and palliative care at home', 'physical assessment', 'therapeutic communication skills', 'children's hospice', 'administration and management of hospice and palliative care', 'interdisciplinary team of hospice and palliative care', 'ethics and laws in hospice and palliative care', 'psychological, social and spiritual care', 'care of the dying', 'bereavement care', etc. 2. The scores above 3.3 were marked for 34 items in education Need Survey. The highest scores were given in the order for the items 'understanding of death and dying', 'attitude and response to death and dying', 'understanding and assessment of pain' etc. respondents marked that they have been trained for 'pain and symptom management', 'ethics and laws in hospice and palliative care', 'building the system for cooperation and publicity activities in hospice' etc. 3. The basic curriculum of hospice and palliative care for the nurses requires 78 studying hours for 17 subjects, comprising 48 hours of theory education and 30 hours of practical training. The education methods are lectures, discussions, and case studies. Conclusion: The efforts of developed basic curriculum should be evaluated after educating nurses. It is necessary to develop the standard curriculum and regularly update it based on the result of education Need Survey for actively working nurses in hospice and palliative care settings.

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Novel Gap Junction Molecules, Connexin 37, Enhances the Bystander Effect in HSVtk/GCV Gene Therapy (Herpes Simplex Virus thymidine Kinase/Ganciclovir 유전자 치료에서 새로운 간격결합분자 Connexin 37에 의한 방관자 효과의 증가)

  • Kim, Sun Young;Yi, Ho Keun;Lee, Jung Chang;Hwang, Dong Jin;Hwang, Pyoung Han;Lee, Dae Yeol;Cho, Soo Chul
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.541-547
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    • 2003
  • Purpose : Gap junction intercellular communication(GJIC) is an important mechanism of the bystander effect in herpes simplex thymidine kinase/ganciclovir(HSVtk/GCV) gene therapy Therefore, we attempted to enhance the bystander effect in vitro by exogenous overexpressing connexin 37(Cx37) in cells to increase GJIC. Methods : NIH3T3 cells were transfected with the Cx37 and HSVtk gene or the HSVtk gene alone by the calcium phosphate method, and we detected their expression from these cells by RT-PCR. GCV-mediated cytotoxicity and the bystander effect of each transfectant was then assessed and compared. Results : Cells transfected with HSVtk became sensitive to low concentration of GCV. We found significantly increased cytotoxicity in HSVtk/GCV gene therapy after introduction of the HSVtk and Cx37 genes together compared with the cytotoxicity seen after introduction of the HSVtk gene in vitro. Co-expression of the HSVtk and Cx37 genes potentiates HSVtk/GCV gene therapy through the bystander effect. Conclusion : These results indicated that the increase of GJIC using Cx37 have potentiated the bystander effect of HSVtk/GCV therapy, and may be a new approach to improve response in suicidal cancer gene therapy.