Cognitive Reaction Time Performance And Subjective Drowsiness: A Critical Evaluation Of The Effect Of Whole-Body Vibrations

@#It is believed that exposure to whole-body vibration (WBV) may increase seated occupant drowsiness, and seated occupant drowsiness may contribute to vehicular accidents. Previous studies on driver comfort have indicated that long-term exposure to WBV may have an adverse effect on musculoskeletal disorders. However, the effects of WBV on seated occupants’ drowsiness have been less rigorously studied. Thus, this study aims to investigate the association between exposure to WBV and drowsiness level. Laboratory experiments were designed and involved eighteen healthy male volunteers. Volunteers were exposed to random gaussian vibration for 20-minutes with the frequency between 1-15Hz. The transmitted vibration magnitude was adjusted for each volunteer to become 0.2ms-2 for low vibration magnitude and 0.4ms2 for medium vibration magnitude. Volunteers’ vigilance was measured by the Psychomotor Vigilance Task (PVT) before and after the vibration exposure. The analyses revealed a substantial drop in volunteers’ vigilance level after exposure to vibration and the effect was more pronounced in high vibration amplitude 0.4 ms-2. These findings suggested that exposure to vibration even as low as 20-minutes may attribute to the reduction of alertness level.

Factores asociados a somnolencia diurna en conductores de transporte público de Lima Metropolitana / Factors associated with daytime sleepiness in public transportation drivers in Lima Metropolitan area

RESUMEN Objetivos . Determinar la frecuencia de somnolencia y sus factores asociados en conductores de transporte público de Lima Metropolitana. Materiales y métodos . Estudio analítico transversal realizado en conductores de entre 18 y 65 años, que laboren en alguna empresa de transporte público registrada en la Municipalidad de Lima. La somnolencia se evaluó mediante una versión de la Escala de Somnolencia de Epworth validada en Perú. Las variables que se pudieron comportar como factores asociados se obtuvieron mediante una ficha de recolección de datos. Se utilizó la regresión logística para estimar la magnitud de la asociación entre la somnolencia y las variables consideradas como factores asociados. Resultados . Se incluyeron a 440 conductores, cuya mediana de edad fue 38,0 años y la mayoría (99,3%) fueron varones. Del total de conductores el 17,7% (78) presentaron somnolencia diurna. Se encontró una asociación significativa entre la somnolencia y el sistema de rotación 2 x 1 (p=0,038) y entre la somnolencia y las horas de sueño menores a siete (p=0,011). El análisis de regresión logística demostró que aquellos conductores con seis o menos horas de sueño tienen mayor probabilidad de somnolencia diurna (OR 1,83; IC95%: 1,03-3,25). Conclusiones . Aproximadamente, uno de cada cinco conductores presentó somnolencia diurna, la cual estuvo asociada con tener seis o menos horas de sueño al día.

ABSTRACT Objective . To determine the frequency of sleepiness and its associated factors in public transportation drivers in Lima metropolitan area. Materials and Methods . Transversal analytical study carried out on drivers between 18 and 65 years old who work in a public transportation company registered in the Municipality of Lima. Sleepiness was assessed using a version of the Epworth Sleepiness Scale validated in Peru. The variables that could behave as associated factors were obtained by a data collection sheet. Logistic regression was used to estimate the magnitude of the association between sleepiness and variables considered as associated factors. Results . Four hundred forty (440) drivers were included, median age was 38.0 years and the majority (99.3%) were males. From the total number of drivers, 17.7% (78) experienced daytime sleepiness. A significant association was found between sleepiness and the 2 x 1 rotation system (p=0.038), and between sleepiness and hours of sleep under seven (p=0.011). Logistic regression analysis showed that drivers with six or fewer hours of sleep were more likely to have daytime sleepiness (OR 1.83, 95% CI: 1.03-3.25). Conclusions . Approximately one out of five drivers experienced daytime sleepiness, which was associated with having six or fewer hours of sleep per day.

Medical and Law Graduates and their sleep disorders: Daytime oversleep and Risk Factors

Backgroud: The exogenous factors such as family dynamics, psychosocial stress, academic hours and lifestyle can alter the quality of sleep and affect the people's physical, occupational, cognitive and social functioning. Objectives: evaluate the epidemiological profile, excessive daytime sleepiness, risk factors and the quality of sleep among university students. Method: Cross-sectional study with 701 Medical and Law students from a private Brazilian Northeastern College. The Sociodemographic profile, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale questionnaires have been applied. The data were submitted to simple and percentage frequency as well as bivariate and multivariate analysis. Significance level: 5%. Results: The sample was with 659 students, 243(37%) of Medicine and 416(63%) of Law. Age group 18-24 years, predominance of females, age group 18-24 years, female 393 (60%); they self-declared being white 282 (42.7%) and brown 303 (45.9%), said they were single 604(92%) and alcohol consumers more than 60%. Poor sleep quality and sleep disturbance were found in 169(70%) medical students and 221(54%) in law ones, being statistically significant (p <0.001) for the medical students. In this comparison, The Law students presented a higher risk (RR 1.34 (1.15-1.56), p <0.001) for disturbance and poor sleep quality. The risk of excessive daytime sleepiness versus drug use represented 71% (RR 1.71, 95% CI 1.18-2.49) for law students. General concerns, studies, anxiety and insomnia were the most frequent risk factors. Conclusion: Risk factors which are part of Medical and Law students' daily routine affect their sleep quality and increase the risks of excessive daytime sleepiness.(AU)

Introdução: Fatores exógenos como dinâmica familiar, estresse psicossocial, horário acadêmico e estilo de vida podem alterar a qualidade do sono e repercutir no funcionamento físico, ocupacional, cognitivo e social do indivíduo. Objetivos: avaliar o perfil epidemiológico, a taxa de sonolência excessiva diurna, fatores de risco e a qualidade de sono entre estudantes universitários. Método: Estudo transversal com 659 universitários dos cursos de Medicina e Direito, de uma universidade privada do Nordeste do Brasil. Questionários sociodemográfico, Índice de Qualidade do Sono de Pittsburgh e Escala de Sonolência de Epworth foram aplicados nesse estudo. Dados submetidos à frequência simples e percentuais, análise bivariada e multivariada. Testes utilizados: Qui-quadrado de Pearson, Mann-Whitney, Mantel-Haenszel e Breslow-Day. Nível de significância 5%. Resultados: os 659 alunos foram inseridos na pesquisa, sendo 243(37%) de Medicina e 416 (63%) de Direito. Faixa etária 18-24 anos; predomínio do sexo feminino. Apresentaram qualidade de sono ruim e distúrbio do sono 169 (70%) estudantes de Medicina e 221(54%) de Direito, sendo estatisticamente significativo (p<0,001) para os de Medicina. Quando comparados aos alunos de Direto, esses apresentaram maior risco (RR 1,34 (1,15-1,56), p<0,001) para distúrbio e qualidade ruim do sono. O risco de sonolência diurna excessiva versus uso de drogas representou 71% (RR 1,71; IC95% 1,18-2,49) para os alunos de Direito. Preocupações, estudos, ansiedade e insônia foram fatores de risco mais frequentes. Conclusão: Fatores de risco que fazem parte do cotidiano de alunos do curso de Medicina e Direito afetam a qualidade de sono e aumentam o risco de sonolência diurna excessiva.(AU)

Research status of sleep disorders in children / 中华实用儿科临床杂志

Good sleep plays a key role in children's physical growth,mental development and personality matu-rity.Sleep disorders are common and most easily neglected problems in children.Early sleep problems of children can sustain from childhood to adulthood,not only have relevance to the children's physical,cognitive and behavioral development,but also to be the high risk factors of the adult obesity,hypertension,depression,anxiety and other chronic diseases.A deep study of sleep disorders in children is very important for the protection of children's physical and men-tal health.This article reviews the etiology,classification,diagnosis and treatment of sleep disorders in children.

Hipersomnias / Hypersomnia

Las hipersomnias son un grupo de trastornos caracterizados por una somnolencia excesiva durante al menos 1 mes, evidenciada tanto por episodios prolongados de sueño como por episodios de sueño diurno que se producen prácticamente cada día. Se dividen en primarios o centrales, (Hipersomnia idiopática, Narcolepsia y Síndrome de Klein-Levin) y secundarios (Privación del sueño crónica en niños). La somnolencia excesiva debe ser de su ciente gravedad como para provocar alteraciones clínicas significativas o deterioro social, escolar, laboral o de otras áreas importantes de la actividad del individuo; no aparece en el transcurso de otro trastorno del sueño o de otro trastorno mental ni se debe a los efectos fisiológicos directos de una sustancia o de una enfermedad médica. La somnolencia excesiva diurna (SDE) es una manifestación común, se presenta con una frecuencia variable; del 11% en niños hasta el 52,8% en adolescentes. La predominancia es igual en la narcolepsia con o sin cataplejía y en el Síndrome de Kleine-Levin. Su diagnóstico adecuado se basa en la historia clínica y estudios de polisomnografía. Y el tratamiento, ayudará al paciente a mejorar en sus actividades y a elevar su autoestima. La fisiopatología no es clara y su tratamiento va enfocado a disminuir el sueño diurno con fármacos como el Modafinil, Claritromicina o simpaticomiméticos y terapias de apoyo.

Abstract Hypersomnias are a group of disorders characterized by excessive drowsiness for at least 1 month, evidenced by both prolonged episodes of sleep and episodes of daytime sleep that occur almost every day. They are divided into primary or central, (idiopathic hypersomnia, Narcolepsy and Klein-Levin Syndrome) and secondary (Deprivation of chronic sleep in children). Excessive drowsiness should be of sufficient severity to cause significant cant clinical alterations or social, school, work or other important areas of the individual's activity; which does not appear in the course of another sleep disorder or other mental disorder, nor is it due to the direct physiological effects of substances or medical illness. Excessive daytime sleepiness (EDS) is a common manifestation; it occurs with a variable frequency; From 11% in children to 52.8% in adolescents. The predominance is the same in Narcolepsy with or without cataplexy and in Kleine-Levin Syndrome. The adequate diagnosis is based on clinical history and studies of polysomnography. The treatment will help the patient to improve their activities and raise their self-esteem. The pathophysiology is not clear and the treatment is focused on decreasing daytime sleep with drugs such as Modafinil, Clarithromycin or sympathomimetics and supportive therapies.

Pharmaceutical Care for A Patient with Delirium and Drowsiness Induced by Oxycodone Hydrochloride Prolonged-release Tablet During the Cancer Pain Treatment / 医药导报

Objective To discuss the pharmaceutical care protocol and methods for clinical pharmacists taking part in cancer pain management. Methods A patient developed delirium and drowsiness after using oxycodone hydrochloride prolonged-release tablet ( OXYCONTIN) and morphine hydrochloride tablet for pain titration treatment. The clinical pharmacist analyzed the reasons of delirium and drowsiness,and suggested a dose reduction of OXYCONTIN or converting OXYCONTIN to another opioid analgesic. Results The suggestion of the clinical pharmacist was partly accepted. After adjusting the treatment, the delirium and drowsiness disappeared gradually, and the pain was well controlled. Conclusion In clinical practice, especially when faced with a rare adverse drug reaction, clinical pharmacists are helpful for ensuring the safety and effectiveness in pain management, as well as improving the level of the treatment, by the implementation of individualized drug therapy.

Vida cotidiana del adulto mayor y la necesidad de sueño-descanso / Daily life of the elderly and the need for sleep-rest

La necesidad de sueño-descanso en el adulto mayor se encuentra seriamente comprometida debido a la presencia de trastornos del sueño, específicamente insomnio y somnolencia excesiva diurna, que en la actualidad representan un problema de salud pública. La etiología de dichos trastornos es multifactorial, ya que además del factor biológico existen otros componentes en su vida cotidiana que los agravan, tales como factores psicológicos, ambientales y económicos. En este sentido, la vida cotidiana del adulto mayor se visualiza como objeto de estudio de esta investigación en relación a la necesidad de sueño-descanso. OBJETIVO: Describir, analizar e interpretar las vivencias de la vida cotidiana del adulto mayor en relación con la necesidad de sueño-descanso. MÉTODO: Se realizó un estudio usando la técnica de investigación cualitativa, fenomenológica, exploratoria y descriptiva. Se eligieron a cinco adultos mayores que presentaran insomnio o somnolencia excesiva diurna y se les aplicó la entrevista en profundidad. El análisis de los datos fue de contenido tipo temático. RESULTADOS: Se encontraron dos categorías y tres subcategorías. 1. Prácticas del adulto mayor: a) Prácticas repetitivas, las cuales realiza de forma involuntaria el adulto mayor en su vida cotidiana, tales como establecer un horario autoimpuesto para dormir y despertar, el cual reduce la cantidad de horas recomendadas de sueño y por consecuencia la eficacia del mismo. b) Tareas agobiantes: Son actividades que realiza el adulto mayor como parte de su cotidianeidad y que responden a necesidades de terceras personas y que le generan una sensación de estrés durante el día, el cual, modifica el ciclo de sueño, presentando insomnio y cansancio emocional y mental, así como una disminución del tiempo que dedican a sí mismos. c) Actividades recreativas, que son regeneradoras de energía, ayudan a liberar el estrés y fomentan un descanso integral en el adulto mayor, sin embargo no hay una consciencia de la importancia que tiene el tiempo de ocio en la vejez, y los adultos mayores no le dan prioridad en su vida cotidiana. 2 Ansiedad nocturna, se refiere a un estado de agitación e inquietud que dificulta la conciliación y mantenimiento del sueño, propiciando la aparición de pensamientos y sentimientos negativos por problemas familiares y económicos principalmente, los cuales provocan síntomas de insomnio, afecto deprimido y somatización de enfermedades. CONCLUSIÓN: Los resultados obtenidos sugieren que el adulto mayor cae en un círculo vicioso que afecta la necesidad de sueño-descanso, pues no distribuye de manera adecuada el tiempo en su vida cotidiana, ya que realiza actividades que son generadoras de estrés que provocan un cambio en el ciclo de sueño-vigilia con la presencia de insomnio, el cual conlleva a un agotamiento y un deterioro en la realización de actividades cotidianas.

The elderly necessity of sleeping is compromised due to sleep disorders, specifically insomnia and excessive daytime sleepiness (EDS), which are currently an issue in public health. The etiology of said disorders is multifactorial because, besides the biological factor, there are other components in the everyday- life that aggravate them; such as psychological factors, environmental factors and economic factors. Considering this, the elderly everyday-life will be this research object of study in relation to the necessity of sleeping. OBJECTIVE: Describe, analyze and interpret the elderly everday-life experiences in relation to the necessity of sleeping. METHOD: The study was made using a qualitative, phenomenological, exploratory and descriptive research method. Five elderlies suffering from insomnia or EDS were chosen and interviewed. The data was analyzed using thematic analysis. RESULTS: There are two categories and three subcategories. 1. Elderly customs: a) Repetitive customs, which are done unintentionally by the elderly in their everyday-life, such as having a self-imposed schedule to sleep and wake, which, reduces the recommended amount of sleep and therefore the efficacy of it. b) Overwhelming activities, which are activities that the elderly do in their everyday-life in order to fulfil other's needs, which cause them a feeling of stress during the day that affects the sleep cycle, causing insomnia, emotional exhaustion and mental fatigue, as well as a decrease in the amount of time they spend on themselves. c) Recreational activities, which give energy, help to relieve stress and promote complete rest in the elderly. However, there is not awareness of how important this leisure time is at old age, so the elderly do not give it priority in their everyday-life. 2. Sleep anxiety, which refers to a state of turmoil and restlessness that causes problems to fall asleep and stay asleep, leading to negative thoughts and feelings, caused mainly by family and economic problems, which results in insomnia, depression and somatization. CONCLUSION: The results suggest that the elderly falls into a vicious circle that affects the necessity of sleeping. As a result of they not being able to organize their everyday-life time properly; due to the fact that they do activities that cause stress and a change in the sleep-wake cycle in conjunction with the presence of insomnia, which leads to exhaustion and deterioration in the performance of daily activities.

Estudo comparativo sobre qualidade do sono entre universitários de uma instituição de ensino do sul catarinense / Comparative study about sleep quality in students of a South brazilian university

O sono tem função biológica fundamental na consolidação da memória, na termorregulação, na conservação e restauração da energia e, na restauração do metabolismo energético cerebral. Suas alterações interferem no funcionamento físico, ocupacional, cognitivo e social do indivíduo, comprometendo a qualidade de vida. Logo, este estudo objetivou estudar a qualidade do sono de 309 acadêmicos dos cursos de Medicina, Engenharia Civil e Direito, das primeiras, segundas, sétimas e oitavas fases, da Universidade do Sul de Santa Catarina, através do questionário de Pittsburgh-PSQI. Este estudo respeita a norma 466/2012 do Conselho Nacional de Saúde e, foi aprovado pelo CEP da Universidade. Dos estudantes entrevistados, 51,7% são do sexo feminino. As idades variaram de 18 a 56 anos, com média de 23 anos. 45% dos estudantes eram do curso de Medicina, 25,8% eram do curso de Engenharia Civil e 25,2% eram do curso de Direito. Por meio do questionário PSQI verificou-se que os estudantes demoravam, em média, 25 minutos para iniciar o sono. A duração média do sono na amostra foi de 6h50min. A associação entre qualidade do sono e os diferentes cursos se mostrou estatisticamente significante (p=0,009). Verificou-se que a Medicina apresentou 64,7% dos alunos com qualidade do sono ruim, no Direito, 60,3% e, no curso de Engenharia Civil 44,6% dos estudantes. Logo, concluiu-se que a qualidade do sono ruim foi mais prevalente entre os estudantes de Medicina, se comparada ao Direito e à Engenharia Civil e, a pior qualidade do sono foi encontrada nos estudantes da oitava fase.

Sleep has a fundamental biological role in memory consolidation, thermoregulation, conservation and restoration of energy. Your changes interfere with physical, occupational, cognitive and social functioning of the person, affecting the quality of life. Therefore, this study aimed to study the sleep quality of 309 academics of Medicine, Civil Engineering and Law, on the first, second, seventh and eighth semesters of the University (UNISUL), through the Pittsburgh-PSQI questionnaire. This study regards the norm 466/2012 of the National Health Council (CNS) and was approved by the Concil of Ethic Research of the University. Of the students surveyed, 51.7% are female. The ages ranged from 18 to 56 years, averaging 23 years. 45% of students were Medicine students, 25.8% were Civil Engineering students and 25.2% were Law students. The PSQI questionnaire found that students lingered on average 25 minutes to fall asleep. The average sleep duration in the sample was 6h50min. The association between quality of sleep and the different courses was statistically significant (p=0.009). It was found that Medicine has 64.7% of students with poor sleep quality, in Law 60.3% has poor quality of sleep and, in the Civil Engineering 44.6% of the students. Therefore, it was concluded that poor sleep quality was more prevalent among medical students, compared to Law and Civil Engineering and the worst sleep quality was found in the students of the eighth semester.

Caracterización clínica, bioquímica e imagenológica en una cohorte de pacientes diagnosticados con hiperglicinemia no cetósica clásica: estudio ambispectivo 2000-2014, Medellín, Colombia / Clinical, biochemical and imaging characterization in a cohort of patients diagnosed with classical nonketotic hyperglycinemia: ambispective study 2000-2014, Medellin-Colombia

Introducción: La hiperglicinemia no cetósica (HGNC) es un error innato del metabolismo del grupo de las aminoacidopatías, de carácter autosómico recesivo, causado por un defecto en el sistema de clivaje de la glicina. Es una entidad rara y no se conoce su incidencia en Colombia. Objetivo: Describir características clínicas, bioquímica e imagenológicas en una cohorte de pacientes diagnosticados con hiperglicinemia no cetósica clásica Materiales y métodos: Estudio de tipo descriptivo, ambispectivo, en el periodo enero 2000-2014, en varios centros de Medellín. Resultados: Se incluyeron 20 pacientes que cumplían criterios de inclusión, de los 35 pacientes que cumplían con el criterio de búsqueda, en su mayoría de sexo femenino y con un Apgar adecuado al nacer. El promedio de inicio de los síntomas fue de 2,6 días; somnolencia, hipoactividad, apnea, convulsiones y singulto fueron los principales síntomas, y las convulsiones de tipo focal las más frecuentes. La relación glicina LCR/plasma en promedio fue 0,42. El patrón estallido-supresión en el electroencefalograma y la ausencia o retraso en la mielinización de la sustancia blanca supratentorial en la resonancia magnética fueron hallazgos comunes. Conclusión: La HGNC es frecuente en nuestro medio, por lo cual es necesario que se disponga de pruebas bioquímicas y moleculares necesarias para diagnóstico oportuno, manejo integral y asesoría genética.

Introduction: Nonketotic Hyperglycinemia is an inborn error of metabolism in a group of aminoacidopathies, autosomal recessive, caused by a defect in the system of the glycine cleavage. It is rare, and the incidence is unknown in Colombia. Objective:To describe clinical, biochemical and imaging characteristics in a cohort of patients diagnosed with classical nonketotic hyperglycinemia. Materials and methods: This is a descriptive-ambispective study during the period January 2000 - 2014 in some centers of Medellin. Results: There were 35 patients who met the search criteria and finally 20 patients who met inclusion criteria. We found in this cohort more girls than boys, and most of them with a good APGAR. The average onset of symptoms was 2.6 days, with drowsiness, hypoactivity, apnea, seizures and singultus the main symptoms. The focal seizures were the most frequent type. The average value of CSF glycine to plasma glycine ratio was 0.42. The burst suppression pattern in the EEG and the absence or delayed myelination in the supratentorial white matter on MRI were common findings. All patients received dextromethorphan as part of their treatment and the vast majority of sodium benzoate. Conclusion: HGNC is common in our environment. It´s necessary to have available biochemical and molecular evidence for timely diagnosis, comprehensive management and genetic counseling.

Drowsiness detection for single channel EEG by DWT best m-term approximation

Introduction In this paper we propose a promising new technique for drowsiness detection. It consists of applying the best m-term approximation on a single-channel electroencephalography (EEG) signal preprocessed through a discrete wavelet transform. Methods In order to classify EEG epochs as awake or drowsy states, the most significant m terms from the wavelet expansion of an EEG signal are selected according to the magnitude of their coefficients related to the alpha and beta rhythms. Results By using a simple thresholding strategy it provides hit rates comparable to those using more complex techniques. It was tested on a set of 6 hours and 50 minutes EEG drowsiness signals from PhysioNet Sleep Database yielding an overall sensitivity (TPR) of 84.98% and 98.65% of precision (PPV). Conclusion The method has proved itself efficient at separating data from different brain rhythms, thus alleviating the requirement for complex post-processing classification algorithms.

The study on opioid switching for the purpose of the quality of life improvement in the gynecologic cancer

Oxycodone controlled-release (CR) tablets are used as a first-line opioid analgesic for cancer pain. However, use of oxycodone CR tablets is associated with toxicities such as drowsiness and constipation, leading to deterioration of the quality of life (QOL), especially in patients with gynecologic cancer. In contrast, fentanyl has a superior toxicity profile while still showing a strong analgesic effect. Although fentanyl has been approved for switching from opioid, there have been no Japanese studies of patients with gynecologic cancer who were switched to transdermal fentanyl after experiencing toxicity during therapy with oxycodone CR. More importantly early introduction of palliative therapy for pain has not been adopted routinely in the management of gynecologic cancer. Thus, it appears that treatment for patients with gynecologic cancer remains unsatisfactory at present. We conducted research into improvement of the toxicity profile and pain control with the aim of improving QOL for patients with gynecologic cancer. We showed that pain, drowsiness, and constipation could be significantly improved in gynecologic cancer patients as a result of switching to transdermal fentanyl therapy at an early stage.

Effects of Posture and Acute Sleep Deprivation on Heart Rate Variability

PURPOSE: In our previous study to investigate autonomic nervous system (ANS) activity due to radio frequency (RF) radiation using heart rate variability (HRV), drowsiness was observed in approximately half of all subjects. Therefore, the usage of HRV with unwanted drowsiness could falsely indicate the effects of RF radiation by mobile phones on the ANS. The objective of this study was to determine which posture is appropriate for accurate HRV analysis for provocation study. MATERIALS AND METHODS: A total of 52 healthy subjects (25 males and 27 females) participated in this experiment. We measured the number of times a subject showed drowsiness or sleep deprivation due to awakening, and analyzed HRV six times over 30 minutes in sitting and recumbent postures, using power spectrum. RESULTS: We employed the ratio of low frequency power to high frequency power (LFP/HFP) to analyze the changes in the ANS. The number of sleep deprivation occurrences in the sitting posture was significantly less than that in the recumbent posture (p<0.01), resulting in smaller increase of LFP/HFP. Although LFP/HFP of the two postures varied with time without any provocation, it was more stable in sitting than in recumbent postures. CONCLUSION: A sitting posture is preferable to a recumbent posture for analyzing HRV, because of decreased drowsiness and sleep deprivation, thereby decreasing variation of LFP/HFP during experiment. Considering the drowsiness, it is also recommended that any experiment should be completed within 15 minutes, if possible.

Factors Related to Substantial Pain in Terminally Ill Cancer Patients / 한국호스피스완화의료학회지

PURPOSE: Pain is the most common and influential symptom in cancer patients. Few studies concerning pain intensity in the terminally ill cancer patients have been done. This study aimed to identify factors related with more than moderate pain. METHODS: This study used secondary data of 162 terminal cancer inpatients at the palliative ward of six training hospitals in Korea. Physician-assessed pain assessment was by 10 point numeric rating scale. Substantial pain was defined more than moderate intensity by the Korean National Guideline for cancer pain. The Korean version of the MD Anderson Symptom Inventory was self-administered to assess symptoms. Survival prediction was estimated by the attending physicians at the time of admission. RESULTS: Less than six weeks of predicted survival and more than numeric rating of six for worst drowsiness in the previous 24 h were significantly related to substantial pain (P=0.012 and P=0.046, respectively). The dose of opioid analgesics was positively related to substantial pain (P=0.004). CONCLUSION: Factors positively related to substantial pain were less than six weeks of predicted survival and considerable drowsiness. Careful monitoring and active preparation for pain are required in terminal cancer patients having those factors.