• Title/Summary/Keyword: cognitive assessment

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Association between Characteristics of Brain Magnetic Resonance Imaging and Atypical Antipsychotics Use in Dementia Patients (치매 환자에서 뇌 자기공명영상의 특징과 비정형 항정신병 약제 사용여부의 상관 관계)

  • Choi, Jongtaek;Kim, Jiwon;Roh, Yangho;Rhu, Sukhwan;Woo, Sungil;Hahn, Sangwoo;Hwang, Jaeuk
    • Korean Journal of Biological Psychiatry
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    • v.20 no.3
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    • pp.97-103
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    • 2013
  • Objectives We aimed to identify the neuroimaging marker for prediction of the use of atypical antipsychotics (AAP) in dementia patients. Methods From April 2010 to March 2013, 31 patients who were diagnosed as dementia at the psychiatric department of Soonchunhyang University Hospital, completed the brain magnetic resonance imaging scan and cognitive test for dementia. Ten patients were treated with AAP for the improvement of behavioral and psychological symptoms of dementia (BPSD) and the other 21patients were not. Using T1 weighted and Fluid Attenuated Inversion Recovery (FLAIR) images of brain, areas of white matter (WM), gray matter (GM), cerebrospinal fluid (CSF) and white matter hyperintensities (WMH) have been segmented and measured. Multivariate logistic regression models were applied for assessment of association between AAP use and the GM/WM ratio, the WMH/whole brain (GM + WM + CSF) ratio. Results There was a significant association between AAP use and the GM/WM ratio (odds ratio, OR = 1.18, 95% confidence interval, CI 1.01-1.38, p = 0.037), while there was no association between AAP use and the WMH/whole brain ratio (OR = 0.82, 95% CI 0.27-2.48, p = 0.73). Conclusions The GM/WM ratio could be a biological marker for the prediction of AAP use and BPSD in patients with dementia. It was more likely to increase as dementia progress since atrophy of WM was more prominent than that of GM over aging.

Risk Factors related to Delirium Development in Patients in Surgical Intensive Care Unit (외과계 중환자실의 섬망 발생 위험요인 조사연구)

  • Lee, Eun-Joon;Shim, Mi-Young;Song, Suk-Hee;Lee, Mi-Mi;Kim, Hye-Mi;Kang, Bong-Sun;Yang, Eun-Jeen;Lim, Ji-Young;Kim, Jin-A;Lee, Mi-Na
    • Journal of Korean Critical Care Nursing
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    • v.3 no.2
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    • pp.37-48
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    • 2010
  • Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.

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A Case of Headache and Memory Disorder after Traumatic Brain Injury Treated with Modified Seogakjihwang-tang (외상성 뇌손상 후두통과 기억장애가 발생한 환자에 서각지황탕가감방(犀角地黃湯加減方)을 투여한 1례 보고)

  • Lee, Sang-Ah;Kwon, Tae-Wook;Kim, Myung-Ho;Son, Han-Beom;Ahn, Lib;Jang, Myung-Woong;Choi, Dong-Jun
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.438-446
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    • 2013
  • The purpose of this study is to report the clinical effects of modified Seogakjihwang-tang on a patient who had headache and memory disorder after traumatic brain injury, which were considered as the result of blood stasis. The patient had headache and memory disorder after traumatic brain injury and treated with modified Seogakjihwang-tang three times a day for 60days. As a result, the numerical rating scale and pain rating score of headache decreased and the scores of mini-mental state examination-Korea, the Korean version of Montreal cognitive assessment and the mini-memory test increased during treatment with modified Seogakjihwang-tang. Therefore, this case supports a possibility that modified Seogakjihwang-tang might be an effective treatment to patients with headache and memory disorder after traumatic brain injury.

Student apprentices' and mentors' perceptions on a science research apprenticeship program (과학 분야 사사 프로그램에 대한 학생 및 교수들의 인식 조사)

  • 임희준
    • Journal of Gifted/Talented Education
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    • v.14 no.1
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    • pp.29-46
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    • 2004
  • This study investigated a 7-week summer science research apprenticeship program for gifted high school students in U.S. The purpose of the study was to examine the reasons why the high school student participated in the program, the students' perceptions on the benefits of the apprenticeship program, and to investigate mentors' perceptions on assessment and mentorship of the students' projects. For this study, laboratory works and group meetings were observed, students' journal and research products were analyzed, and interviews were administrated with student apprentices and some mentors. The result revealed that the main reasons of students' participation were to perform research with university professionals, to understand the scientific research, and to explore their college/career decisions. Students' participation was strongly associated with their internal motivation and interests. The students perceived the benefits of the apprenticeship program as providing them with the experience of the nature of real scientific research, of learning of scientific knowledge on the focus area, and wiser college/career decisions. Students' projects were assessed and guided through on-going interactions and cognitive apprenticeship between mentors and student apprentices.

Implementation of a Learning Space Navigator for WBI (WBI를 위한 학습공간 네비게이터 구현)

  • Hong, Hyeun-Sool;Han, Sung-Kook
    • The Journal of Korean Association of Computer Education
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    • v.4 no.1
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    • pp.175-181
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    • 2001
  • WBI provides new opportunities to realize the flexible learning environment based on hypermedia and to support distance learning with a diverse interaction. The instructors or learners in WBI claim to be able to resolve reluctant fluctuations such as disorientation and cognitive overload. To overcome these phenomena, a supplementary tool able to manage a learning space organized by the instructor's or learner's own way and offer effective navigation techniques is presented in this paper. A learning space management and navigation tool called HyperMap dynamically represents the learning space in the form of a two-dimensional labeled graph. This HyperMap also can be used for an instruction design tool, learners portfolio for the exchange of learning experiences, and the assessment of WBI.

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Study on Fatality Risk of Senior Driver with Aging Classification (초기·중기·후기 고령운전자의 사망자 발생위험도 분석과 시사점)

  • Choi, Jaesung
    • Journal of the Korean Society of Safety
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    • v.33 no.1
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    • pp.148-161
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    • 2018
  • A traffic fatality by young people marked average annual decrease of 4.5% since 2011. Meanwhile, a traffic fatality by senior over 65 years old marked average annual increase of 7.9% for the last five years which means that the annual increase of traffic fatality by senior will be a serious problem. This study started questioning that senior drivers over 65 years old did not retain the same causal factor of fatal traffic accidents and thus extensively analyzed a risk of it by age group quantitatively, dividing the senior driver group into the early, middle and latter stages. Depending on the aging level, the risk of traffic fatality showed a wide difference in seven different types of traffic accidents generally, and happened to increase with latter and middle parts of the senior driver more than the early part. Therefore, this study proposes four policy suggestions: 1) The senior driver need to be offered customized driving educations and the improvement of road environment is also recommended. 2) Political assistance is needed to support and guide a safety related technology installation for the new or existing car. 3) Renewal of driving license and an aptitude test(physical examination, cognitive test) for drivers over 75 years old should take in a less than 3 years and an additional road test is needed as occasion demands. 4) Like the United States and Europe, development and extension of customized treatment guidebook for medical teams who examine senior drivers is needed and establishment of education and administration system that a supervisor of driving license renewal can impose safety restriction and American anonymity reporting system is considered to institutionalize in the medium to longer term.

A Critical Evaluation of the Concept and Writing of Learning Outcomes (학습성과의 개념과 작성에 대한 탐구)

  • Lee, Dong Yub;Yang, Eunbae B.
    • Korean Medical Education Review
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    • v.18 no.3
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    • pp.125-131
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    • 2016
  • Recent changes in educational paradigms that emphasize the performance or outcomes of education are redefining how learning objectives are being described as 'learning outcomes' in various academic disciplines. Medical education is not an exception to this trend. However, it has come to our attention that the key concepts and appropriate descriptions of learning outcomes have not been well understood among educators and that this lack of understanding has hindered our efforts to implement the practice in the field. This study aims to provide a direction to establish and describe learning outcomes by examining previous studies that have focused on setting learning objectives as well as learning outcomes. Setting and describing learning outcomes starts from reflection on the approach of behavioral learning objectives, which overemphasizes learner's acquired knowledge, skills, and attitude in each classroom rather than actual performance. On the other hand, the learning outcome approach focuses on what the learner is able to do as a result of a learning experience. This approach is more learner-friendly and encourages students to lead and be responsible for their learning process. Learning outcomes can best be described when the relevance of actual contexts and the hierarchy of learning objectives are considered. In addition, they should be in the form of context, task, performance, and level, as well as be planned with proper assessment and feedback procedures. When these conditions are met, the learning outcome approach is beneficial to students as it presents a curriculum that is more open to learners. Despite these advantages of the learning outcome approach, there is a possible concern that setting the learning outcomes and describing them can restrict evaluation to lower cognitive skills if the concept of learning outcome is narrowly interpreted or is set too low. To avoid such narrow applications, it is important for educators to understand the comprehensiveness of the learning outcome setting and to consider long-term outcomes embedded in an organizational vision rather than only short-term behavioral outcomes.

Effects of Non-pharmacological Interventions on Primary Insomnia in Adults Aged 55 and Above: A Meta-analysis (수면장애가 있는 중장년 환자에게 적용한 비약물적 중재의 효과: 메타분석)

  • Kim, Ji Hyun;Oh, Pok Ja
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.13-29
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    • 2016
  • Purpose: This study was performed to evaluate the effects of non-pharmacological interventions on sleep disturbance amongst adults aged 55 and above. Methods: PubMed, Cochrane Library, EMBASE, CINAHL and several Korean databases were searched. The main search strategy combined terms including non-pharmacological interventions and presence of insomnia. Non-pharmacological interventions included cognitive behavioral therapy, auricular acupuncture, aromatherapy, and emotional freedom techniques. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non randomized studies. Data were analyzed by the RevMan 5.3 program of Cochrane Library. Results: Sixteen clinical trials met the inclusion criteria with a total of 962 participants. Non-pharmacological interventions was conducted for a mean of 5.5 weeks, 7.7 sessions, and an average of 70 minutes per session. The effects of non-pharmacological interventions on sleep quality (ES=-1.18), sleep efficiency (ES=-1.14), sleep onset latency (ES=-0.88), awakening time after sleep onset (ES=-0.87), and sleep belief (ES=-0.71) were significant, and their effect sizes were ranged from moderate to large. However, the effects on total sleep time and insomnia severity were not significant. Conclusion: The findings of the current study suggest that non-pharmacological interventions have a positive impact on attitudes and beliefs about sleep, sleep quality, sleep duration, and sleep efficiency. Therefore, the findings of the study provide an evidence to incorporate various non-pharmacological interventions into nursing practice to improve both sleep quality and quantity in patients with insomnia.

Quality of Life in Malaysian Colorectal Cancer Patients : A Preliminary Result

  • Natrah, M.S.;Ezat, Sharifa W.P.;Syed, M.A.;Rizal, A.M. Mohd;Saperi, S.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.957-962
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    • 2012
  • Objective: Rapidly increasing colorectal cancer (CRC) incidence in Malaysia and the introduction of cutting edge new treatments, which prolong survival, mean that treatment outcome measures meed to be evaluated, including consideration of patient's quality of life (QoL) assessment. There are limited data on QoL in CRC patients, especially in Malaysia. Therefore, this study was performed focusing on cancer stages and age groups. Methods: The cross sectional study was conducted from June to September 2011 at three public tertiary hospitals with the EORTC QLQ C-30 questionnaire in addition to face to face interview and review of medical records of 100 respondents. Results: The mean age was 57.3 (SD 11.9) years with 56.0% are males and 44.0% females, 62% of Malay ethnicity, 30% Chinese, 7% Indian and 1% Sikh. Majority were educated up to secondary level (42%) and 90% respondents had CRC stages III and IV. Mean global health status (GHS) score was 79.1 (SD 21.4). Mean scores for functional status (physical, emotional, role, cognitive, social) rangeds between 79.5 (SD 26.6) to 92.2 (SD 13.7). Mean symptom scores (fatigue, pain, nausea/vomiting, constipation, diarrhea, insomnia, dyspnoea, loss of appetite) ranged between 4.00 (SD 8.58) to 20.7 (SD 30.6). Respondents role function significantly deteriorates with increasing stage of the disease (p=0.044). Females had worse symptoms of pain (p=0.022), fatigue (p=0.031) and dyspnoea (p=0.031). Mean insomnia (p=0.006) and diarrhea (p=0.024) demonstrated significant differences between age groups. Conclusion: QOL in CRC patients in this study was comparable to that in other studies done in developed countries. Pain, fatigue and dyspnoea are worse among female CRC patients. Given that functions deteriorates with advanced stage of the disease at diagnosis, a systematic screening programme to detect cases as early as possible is essential nationwide.

A Study on the User Experience according to the Existence of Explanation Facilities and Individuals Privacy Concern Level (대화형 에이전트의 설명 기능과 프라이버시 염려 수준에 따른 사용자 경험 차이에 관한 연구)

  • Kang, Chan-Young;Choi, Kee-Eun;Kang, Hyun-Min
    • The Journal of the Korea Contents Association
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    • v.20 no.2
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    • pp.203-214
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    • 2020
  • Nowadays, smart speakers are increasingly personalized and serve as recommendation agents for user. The aim of this study is find out effects of 'Explanation facilities' on transparency, perceived trust, user satisfaction, behavioral intentions of users to reuse, privacy risk, and quality of recommendation in the context of an interact with smart speaker's conversational agents. And we also use measurement for level of privacy concerns to see individuals's level of privacy concerns affected the assessment. The result of this study as follow; First, all measurement variable are significantly related to 'Explanation facilities' Second, perceived trust, privacy risk are significantly related to individual's level of privacy concern. This study found that 'Explanation facilities' could be applied in context of smart speaker and possibility of cognitive dissonance according to the level of privacy concerns.