Factors Influencing Physical Activity in Adolescents with Complex Congenital Heart Disease

PURPOSE: We aimed to identify factors influencing physical activity in adolescents with complex congenital heart disease. METHODS: We recruited 92 adolescents with complex congenital heart disease from a tertiary medical center in Seoul, measured their levels of physical activity, and identified factors that influenced their physical activity levels using the Global Physical Activity Questionnaire, the New York Heart Association classification, congenital heart disease complexity, the Self-Efficacy Scale, and the Parental Bonding Instrument scale. Stepwise multiple linear regression was used to determine factors influencing physical activity. RESULTS: Total physical activity was higher in males than in females (t=4.46, p<.001). Adolescents who participated in school physical education classes engaged in more physical activity than those who did not (t=6.77, p<.001). Higher self-efficacy (β=.41, p<.001), male gender (β=.37, p<.001) and participation in school physical education classes (β=.19, p=.042) were associated with a higher likelihood of engagement in physical activity. CONCLUSION: It is necessary to develop nursing interventions that enhance self-efficacy in order to promote physical activity in adolescents with complex congenital heart disease. Physical activity should also be promoted in an individualized manner, taking into account gender, disease severity, and parental attitude.

Attitude toward Suicide and Personal Experiences of Suicide among Doctors and Health Care Workers in Korea / 신경정신의학

OBJECTIVES: The aim of this study was to investigate attitudes toward suicide and personal experiences with suicide among doctors and health care workers in Korea. METHODS: A total of 622 participants were included in this study and 617 participants completed a self-report questionnaire that included 31 items; 184 doctors and 433 health care workers. A questionnaire was used for assessment of demographic characteristics, attitude toward suicide, and personal experiences with suicide in doctors and health care workers. The collected data were evaluated using chi-square and binary logistic regression analyses. A probability level of p<0.05 was considered statistically significant. RESULTS: More permissive attitudes toward suicide showed an association with doctor group and non-religious group (p<0.05). Religious group and older age showed an association with a more negative attitude (p<0.05). The lifetime and one-year prevalence rates of suicidal ideation were 31.4% and 9.8%, respectively, in all participants. The lifetime prevalence of suicidal ideation was higher in the religious group (33.9%, p<0.05). Among all participants, 32.1% reported loss of a patient by suicide, and 29.9% reported contact with a patient at risk of suicide or with depression. In addition, 72.5% reported contact with a depressed patient. CONCLUSION: Attitudes toward suicide among doctors and health care workers were shown to differ significantly between age, gender, doctor group and health care worker group, religious group and non-religious group. The reported level of suicidal ideation among doctors and health care workers is worthy of concern. Research is needed for establishment of effective prevention strategies on the basis of our findings.

Genistein Supplementation Inhibits Atherosclerosis with Stabilization of the Lesions in Hypercholesterolemic Rabbits

The effect of genistein on aortic atherosclerosis was studied by immunohistochemistry with RAM-11 and HHF-35 antibodies and western blotting for matrix metalloproteinase-3 (MMP-3) in New Zealand White rabbits. After provocation of atherosclerosis with hyperlipidemic diet, the rabbits were divided as hyperlipidemic diet group (HD), normal diet group (ND) and hyperlipidemic plus genistein diet group (HD+genistein) for 4 and half months. The average cross sectional area of atherosclerotic lesion was 0.269 mm2 after provocation. The lesion was progressed by continuous hyperlipidemic diet (10.06 mm2) but was increased mildly by genistein (0.997 mm2), and decreased by normal diet (0.228 mm2). The ratio of macrophages to smooth muscle cells in the lesion was not changed by genistein supplementation. The western blotting showed reduction of MMP-3 expression in HD+genistein and ND groups than HD group. The inhibition of atherogenesis by genistein was might be due to improve the endothelial dysfunction rather than direct action on macrophages and/or smooth muscle cells in the lesion, since endothelial dysfunction by lipid peroxidation was the main atherogenic factor in the hypercholesterolemicrabbits. The genistein supplementation also suggests that it helps the stabilization of the atherosclerotic lesion by inhibition of MMP-3 expression.

Usefulness of IMI and HPC of Sysmex SE-9000, and IRF and HFR of Sysmex R-3000 to Refine Apheresis Timing of Peripheral Blood Stem Cell Harvest / 대한혈액학회지

BACKGROUND: The Sysmex SE-9000 and R- 3000 automated cell counters provide estimates of immature cells referred to as immature myeloid information (IMI), hematopoietic progenitor cells (HPC), immature reticulocyte fraction (IRF) as high and medium fluorescent reticulocytes, and high fluorescence ratio (HFR) as high fluorescent reticulocytes. The aim of this study was to evaluate whether these parameters were useful to refine apheresis timing of peripheral blood stem cell (PBSC) harvest. METHOD: For 140 peripheral blood harvest procedures of 26 patients, pre-harvest peripheral blood (PB) WBC, mononuclear cells (MNC), IMI, HPC, CD34-positive cells, reticulocyte (%, number), IRF and HFR were tested and compared with harvested CD34-positive cell content. RESULTS: Correlation coefficients between pre-harvest WBC, MNC, IMI, HPC, CD34-positive cells, reticulocyte %, reticulocyte number, IRF and HFR of PB and harvested CD34-positive cell content were 0.15, 0.06, 0.60, 0.78, 0.77, 0.004, 0.06, 0.28 and 0.40. Applying the criteria IMI 300X10degrees/L, HPC 5X10degrees/L and CD34-positive cells 5X10derees/L of PB on the first day of 30 cycles of harvests, positive predictive value to predict the mean CD34+ cell count over 0.5X106/kg per one leukapheresis and negative predictive value to predict the mean CD34+ cell count less than 0.5X10derees/kg per one leukapheresis were 73.3%/93.3%, 57.8%/90.9% and 78.6%/ 93.7% respectively. CONCLUSION: Pre-harvest PB IMI and HPC of Sysmex SE-9000 are comparable with PB CD34- positive cells in terms of correlation with harvested CD34-positive cell content. For PB IMI and HPC are simple, inexpensive and rapid to get results, PB IMI and HPC are useful to refine apheresis timing of PBSC harvests and to screen poor-mobilizers.